Introduction I'm here because my parents don't have legal status.... All of us have to fight for the rights of immigrants ... [and] all of us have to do our part--Patricia, eighth-grade student, quoted by Soto in the San Diego Union-Tribune, March 30, 2006. IT SHOULD NOT HAVE BEEN SURPRISING THAT YOUTH WERE CENTER STAGE AS POLITICAL actors responding to the recent attacks against human and civil rights in the United States. Like generations of youth activists before, participants in this movement challenged anti-immigrant sentiment and used powerful methods to ensure that their voice would be heard. Whether they walked out of school, organized sit-ins, conducted educational forums, or contributed to voter registration initiatives, Latina/o youth (1) activists flexed their capacity to politically participate in the ongoing immigration debate. At that time, their concern focused on House Resolution (H.R.) 4437. (2) Combined with deaths at the border, (3) abuse at the hands of smugglers and unscrupulous employers, and the division of immigrant families, this bill was another attack against Latina/o immigrants. It became the rallying cry for many, who mobilized in the spring of 2006. In their own way, Latina/o youth responded to these attacks, concerned about their own futures and those of their friends and family. For Latina/o youth who chose to mobilize, many of whom are children of immigrants or are immigrants themselves, their actions were deeply personal. As one high school student commented to a Washington Post reporter, "this is the beginning of a new life. We're going to fight. If our mom or dad gets deported, we feel that pain too" (Shapira, 2006). Beyond the legislative debates and mass marches, another central story line emerged during this coverage: Latina/o youth are causing serious unrest and disturbances in communities throughout the country. In one San Antonio newspaper, it was reported that "for many people, the sight of a nationwide phenomenon of students taking the streets is disrespectful, aggravating, and insulting" (Clack, 2006). Adding to this negative portrayal, media depicted youth as "uninformed" about the issue and "acting out" simply to cause trouble and skip school. Research has noted that negative images such as these have strong influential power, often becoming so imbedded in the minds of audiences that they become difficult to contradict (Gilliam and Bales, 2001). Indeed, the media's portrayal of Latina/o youth as "truants" and "troublemakers" recast an exercise of their constitutionally granted freedom of expression into undesirable and even criminal behavior. By associating these negative images and characterizations with the face of Latina/o youth, media outlets essentially racialized (Omi and Winant, 1989) their portrayals and opinions of them. Consequently, any analysis of these manifestations of youth activism must center on race. A race-based analysis affords us a lens to better understand the racialized images of Latina/o youth activism that dominated mainstream media and enables us to better understand the activism itself as an effort to dismantle the type of racist nativism (4) directed at Latina/o immigrants. This study utilizes a Latina/o Critical Race Theory (LatCrit) framework to understand the central role of race and racism in this Latina/o youth activism. Our objectives are twofold: to give this activism the merit and complexity it deserves and to challenge the negative portrayals of Latina/o youth activists by the mainstream media. Using content analysis of newspaper articles, we argue that the efforts by Latina/o youth activists in the spring of 2006 were multifaceted, conscientious expressions of concern for social justice and human rights. (5) Their actions did not stem from a "desire to skip class," as many media outlets alleged. The activism was oriented toward a more inclusive notion of social justice, (6) defined as the desire and struggle to dismantle the structures of inequality that perpetuate racist nativism and other forms of subordination. …


This paper looks at the history of WBAP while examining how programming has changed from 1922-2014 and how WBAPs audience helped shape programming at the station. This paper reveals four formatting changes throughout the stations history and provides in-depth statistical analysis of how WBAPs audience changed during the stations 90 plus years of existence.


"Great themes run through this book: local differentiation and societal integration, reform and revolution, innovation and renewal, conservatism and radicalism, tradition and modernity. All relate to the fascinating dialectic of Chinese history." This comment by G. William Skinner aptly describes this pioneering volume in which twelve specialists in Chinese history discuss the great questions of history in the dramatic context of the "New China" of the early twentieth century. The work of young scholars from seven countries who have had access to Chinese, British, and French archives opened only in recent years, the book provides new findings that presage not only a reinterpretation of the Revolution of 1911 itself but also of the dynamic links between Imperial China and both the communist revolution of 1927-49 and the Great Proletarian Cultural Revolution of today. "An outstanding example of historians' inquiries is this collection of essays by 12 authorities, brilliantly edited by Mary Wright of Yale. Brilliant because unlike most such cooperative endeavors, the studies in this volume focus on a single major topic, China in the years around the revolution of 1911. The papers vary in scope, from a general interpretation of the origins of the warlord armies, which were to dominate Chinese political life until the mid-twenties, to a fascinating reconstruction of events hour-by-hour during the first week of the revolution in the city where it began, Wuchang...This important work is bound to have a great impact on our understanding of modern China, and will surely stimulate further research in the period."-New York Times Book Review "Will set a style for ten to twenty years hence by all scholars of the subject."-John K. Fairbank.


Background The purpose of this study was to investigate the occurrence and duration of extended blinks ≥ 70 msec and their associated interblink intervals in normal subjects and in subjects with mild to moderate dry eye. Methods This single-center, prospective, double-blind study included 11 subjects with dry eye and eight subjects with normal eyes. Extended blinks were defined as lid closure in at least two successive video frames (≥70 msec). Digital video imaging of each subject's eyes was recorded while the subject viewed a 10-minute documentary. The subjects did not know that blink was the outcome being measured. Following capture, the videos were manually analyzed in a masked fashion for the occurrence of extended blinks. The length of the interblink interval (ie, time between blinks) before and after these extended blinks (the interblink interval ratio) was calculated, as well as differences in lid contact times. Results The dry eye group had a median extended blink duration which was 2.53 times longer than that of the normal group. For subjects with dry eye, interblink intervals post-extended blink were significantly longer than interblink intervals pre-extended blink (P < 0.001). Interblink intervals did not lengthen significantly in normal subjects. In both groups, the duration of the extended blink was significantly (P = 0.001) and positively correlated with interblink interval ratio (post-extended to pre-extended blink interblink interval), such that for each doubling of extended blink duration, the interblink interval ratio increased by 10%. Blinks longer than one second in duration occurred almost exclusively in subjects with dry eye. Conclusion This study reports three central findings: blink duration tended to be longer in subjects with dry eye; a lengthening of the interblink interval after an extended blink occurred in subjects with dry eye but not in those without dry eye; and a longer blink duration was associated with a significantly increased interblink interval ratio in all subjects.


For the people of early modern England, the dividing line between the natural and supernatural worlds was both negotiable and porous - particularly when it came to issues of authority. Without a precise separation between 'science' and 'magic' the realm of the supernatural was a contested one, that could be used both to bolster and challenge various forms of authority and the exercise of power in early modern England. In order to better understand these issues, this volume addresses a range of questions regarding the ways in which ideas, beliefs and constructions of the supernatural threatened and conflicted with authority, as well as how the power of the supernatural could be used by authorities (monarchical, religious, legal or familial) to reinforce established social norms. Drawing upon a range of historical, literary and dramatic texts the collection reveals intersecting early modern anxieties in relation to the supernatural, issues of control and the exercise of power at different levels of society, from the upper echelons of power at court to local and domestic spaces, and in a range of publication contexts - manuscript sources, printed prose texts and the early modern stage.
Divided into three sections - 'Magic at Court', 'Performance, Text and Language' and 'Witchcraft' the 'Devil and the Body' - the volume offers a broad cultural approach to the subject that reflects current research by a range of early modern scholars from the disciplines of history and literature. By bringing scholars into an interdisciplinary dialogue, the case studies presented here generate fresh insights within and between disciplines and different methodologies and approaches, which are mutually illuminating.


Background: The availability and use of medical imaging equipment is undoubtedly on the increase which means wear and tear is expected by the users. Objective: To outline the challenges of medical imaging equipment operational policies for efficient radiodiagnosis in nine northern Nigeria hospitals. Materials and methods: Sixty five (65) questionnaires were administered to radiographers and equipment engineers; interviews were conducted; and data obtained from log books. Results: Result showed that only two out of the nine hospitals had a full typical radiology department. The chief executive officers/hospital administrators carry out all radiological equipment procurement and are oblivious to the need of professional input. Out of the 61 imaging equipment installed in the area 51 (84%) were functional at the time of survey while 10 (16%) had broken down. In terms of downtime 81% of minor faults lasted for between 48 to 72 hours; 9% lasted for 24 hours. Major faults lasted for up to two months. Only one of the nine hospitals (11%) implements planned patterns of inventory documentation, including clinical risk assessment. Conclusion: Reduction in the downtime of imaging equipment; utilization of a medical equipment maintenance plan; use of high caliber professionals for quality assurance in establishing prompt service delivery as well as enhanced efficiency and effectiveness in all radiological processes should significantly improve equipment lifespan.


Despite much talk of a culture war, scholars continue to argue over whether the American public is divided on cultural and social issues. Some of the most prominent work in this area, such as Fiorina's Culture War?, has rejected the idea. However, this work has in turn been criticized for focussing only on the distribution of attitudes within the American public and ignoring the possibility that the culture war may also be driven by the increasing strength with which sections of the population hold their opinions. This paper tests the strength, or saliency, hypothesis using individual-level over-time data and nonlinear regression. It finds (1) that there was a steady and significant increase in concern about traditional moral issues between the early 1980s and 2000, but (2) that the over-time increase was driven by an upward and equal shift in the importance attached to traditional moral issues by Republicans and Democrats, conservatives and liberals, evangelicals and non-evangelicals, and frequent and infrequent worshippers alike. While the first finding offers support for the saliency hypothesis and the culture war thesis, the second challenges the idea that Americans are engaged in a war over culture. Both findings enhance but also complicate our theoretical understanding of the culture war, and have important real-world consequences for American politics.


We studied spawning ecology of cutthroat trout ( Oncorhynchus clarki ) in streams that originate as springs along the Salt River, a Snake River tributary in western Wyoming. We assessed (1) relative numbers of upstream-migrant and resident adults present during the spawning period in spring streams, (2) influence of habitat modification on use of spring streams for spawning, and (3) habitat features used for spawning in spring streams. Four spring streams were studied, 2 with substantial modification to enhance trout habitat and 2 with little or no modification. Modifications consisted primarily of constructing alternating pools and gravel-cobble riffles. Only a small portion of adult fish in spring streams during the spawning period had migrated upstream from the Salt River between March and the middle of June. Larger numbers of adult fish and more redds were observed in the 2 modified streams compared with the 2 streams with little or no modification. Most spawning occurred on constructed riffles with small gravel and over a narrow range of depths and velocities. Cutthroat trout, rainbow trout ( Oncorhynchus mykiss ), and their hybrids were observed in 1 stream with habitat modifications, indicating that measures to halt invasion by rainbow trout, as well as habitat improvement, are needed to preserve this native trout within the Salt River valley.


Reversible protein phosphorylation plays a key role in cell signalling during neural
development and thus controls cell proliferation, survival, differentiation and function.
Kinases and their counter-partners the phosphatases tightly regulate protein
phosphorylation. In the developing nervous system the neurotrophin receptor family of
protein tyrosine kinases (TrkA, B and C) are major players in this signalling network
during normal neuron development and also in several diseases such as neuropathies,
degenerative disorders and cancers. Recently, receptor-type protein tyrosine
phosphatases (RPTPs) were suggested to be possible regulators of Trks. Thus
understanding the relationships between RPTPs and Trks may help to develop new
therapeutics to control aberrant neurotrophin signalling in disease. In this study I
investigated the relationship between RPTPs and Trks in murine embryonic sensory
neurons from dorsal root ganglia (DRGs), a primary cell model. The expression and
coexpression of RPTPs and Trks was extensively studied during critical stages of DRG
maturation using qPCR arrays at Merck-Serono, Geneva, and fluorescent in-situ
hybridization and immunohistochemical techniques. This revealed a relatively high
expression of several candidate RPTPs, which were expressed in particular TrkA+,
TrkB+ and/or TrkC+ subpopulations of sensory neurons, indicating a potential
relationship in their signalling functions. To further analyze a potential direct interaction
between candidate RPTPs with Trk proteins, a bimolecular-fluorescent
complementation assay (BiFc) was tested. However, this particular assay, when used
with type I transmembrane proteins, suffered from high, unspecific protein interactions.
In the main experimental approach, a lentiviral-mediated shRNAi-induced knockdown
system in primary cell cultures was set-up and the effects of the knockdowns of Ptprf,
Ptprs and Ptpro on endogenous Trk gene expression and Trk phosphorylation and
activation were analysed. These results suggest a potential role of the encoded proteins
LAR and RPTPσ in Trk function and of RPTP-BK in the differentiation and
specification of Trk+ neurons.


Year by year, performance of the power system distribution lines is one of the
important subject that need to be considered. This paper presents a review on the effects of
contamination on distribution overhead lines. Apart from the physical configuration of the lines
such as lower in height and simple build-up structure, the location of the lines and the withstand
capability of the systems are among another factors that determine the performance of the line.
Insulator, which is used in between the cross-arm and phase conductor for instance, is very much
sensitive to the surrounding environment such as humidity (wet and dry) and contamination such
as salt, cement, dust, smog and etc. In the event of the direct or indirect effects of the lightning for
instance, this contamination will affect the breakdown strength of the insulator which will result in
the flashover across the insulator or coordination gap. This paper will consider in details the
effect from different contaminants and different types of testing in evaluating the performance of
the insulator. At the end of the paper, some mitigations approaches will be suggested with respect
to the issue being discussed.


To protect complex power-grid control networks, power operators need efficient security assessment techniques that take into account both cyber side and the power side of the cyber-physical critical infrastructures. In this paper, we present CPINDEX, a security-oriented stochastic risk management technique that calculates cyber-physical security indices to measure the security level of the underlying cyber-physical setting. CPINDEX installs appropriate cyber-side instrumentation probes on individual host systems to dynamically capture and profile low-level system activities such as interprocess communications among operating system assets. CPINDEX uses the generated logs along with the topological information about the power network configuration to build stochastic Bayesian network models of the whole cyber-physical infrastructure and update them dynamically based on the current state of the underlying power system. Finally, CPINDEX implements belief propagation algorithms on the created stochastic models combined with a novel graph-theoretic power system indexing algorithm to calculate the cyber-physical index, i.e., to measure the security-level of the system's current cyber-physical state. The results of our experiments with actual attacks against a real-world power control network shows that CPINDEX, within few seconds, can efficiently compute the numerical indices during the attack that indicate the progressing malicious attack correctly.


In the 21st century, public policy actors are increasingly confronted with environmental questions that, as for now, have been solved through actions of state-control. This paper studies the theories and practicality of free market environmentalism and its fundamental difference with current regulatory systems. The research focuses on the conceptualisation of property rights by different economists and philosophers and seeks to illustrate how policies relying on a consistent defence of property rights or the absence of state actors altogether could indeed be beneficial.


In recent years the bestselling Awakenings and The Man Who Mistook His Wife for a Hat have received great critical acclaim, but Oliver Sacks's readers may remember that he began his medical career working with migraine patients. In this, the latest edition of "Migraine," he returns to his first book and enriches it with additional case histories, new findings, and practical information on treatment. To define "migraine, " suggests Oliver Sacks, one must embrace the dizzying variety of experiences of its sufferers. For some, the affliction features of a headache of monumental proportions. For others, there is no pain at all. Some attacks are triggered by weather, some intense light. Still others consist of intense light -- hallucinatory displays of dazzling loops, stars, and geometrics. "Migraine" is Sacks's brilliant examination of a debilitating ailment and the profound implications of neurological illness. Synthesizing his patients' case histories with 2,000 years of human research into the problem, he casts the migraine as exemplar of our psychological transparency, a complex biological response to external factors. Here is a classic meditation on the nature of health and malady, on the unity of mind and body. Here, too, is Sacks's discovery of how the migraine shows us, through hallucinatory displays, the elemental activity of the cerebral cortex -- and potentially, the self-organizing patterns of Nature itself. Enormously compelling, compassionate, and profound, Migraine offers comfort for sufferers -- and insight to all.


3737 Background: The improved safety profile of the oral fluoropyrimidine X (Xeloda) versus bolus 5-FU/LV has been demonstrated in over 3000 pts in 3 large randomized trials in 1st line metastatic and adjuvant colon cancer (Twelves EJC 2002, Scheithauer Ann Oncol 2003). In addition, the safety advantage over 5-FU/LV in the adjuvant setting was maintained in older pts (≥65 years) and also in terms of less early severe toxicity with X. The median age of pts at diagnosis of colon cancer is increasing in developed countries. Therefore we examined whether there is enough evidence to support the safe use of X in an elderly population, i.e. pts 70 years and older.

METHODS
We performed retrospective analyses on the safety database of the X-ACT adjuvant colon cancer trial, which compared X (993 pts) to 5-FU/LV Mayo Clinic Regimen (974 pts) in Dukes' C colon cancer pts. Adverse events (AEs) in the two arms were analyzed by age: <40, 41-69 and ≥70 years. P-values are not calculated due to the retrospective nature of analysis.

RESULTS
Sufficient patient numbers enable comparisons between X and 5-FU/LV for the 41-69 age group (763 vs 738, not shown) and ≥70 group (186 vs 205, table), whereas there were few pts aged <40 (44 vs 31, not shown). [Figure: see text] Hyperbilirubinemia was minimal in both arms when graded by NCI CTCAE.

CONCLUSIONS
The improved safety profile of X vs 5-FU/LV is not only maintained in pts over 65, but also in the elderly over 70 years of age. It would be of interest to compare this dataset to that of the INT 0089 trial (Mayo Clinic regimen vs Roswell Park weekly bolus regimen). Pending the final results of the X-ACT study, capecitabine could provide a convenient and effective new option for an aging population. Study sponsored by F. Hoffmann-La Roche Ltd, Basel, Switzerland. No significant financial relationships to disclose.


The authors were commissioned to work as part of a design team in the production of a new supermarket checkout. The primary goals at the onset of the project were to reduce build costs and enhance customer interaction without compromising health and safety. The ergonomics issues identified through the initial literature search highlighted two key checkout operator considerations: the need to minimise the risk of musculoskeletal injury; and the importance of factors other than equipment design, such as task design and training, in minimising risk and optimising performance. This paper discusses how these two considerations were maintained and developed throughout the design process as the original project goals changed. Its purpose is not to discuss the ergonomics of checkout design; rather, it uses the checkout design case history to highlight where the ergonomics practitioner can successfully contribute to project success.


The article analyses the diplomatic negotiations that London and Peking started in the early 1980s to discuss the future of Hong Kong and the conditions for its return to the motherland. In particular, it highlights the initial diverging positions of the two parties and how the main protagonists (the British Prime Minister Margaret Thatcher and the Chinese paramount leader Deng Xiaoping) played a crucial role in reaching an agreement. The first of the article's three parts focuses on the adjustments imposed on Chinese foreign policy by Deng Xiaoping's new leadership in the late 1970s. The second part is specifically devoted to the negotiations, started and closed by Margaret Thatcher's visits to Peking in September 1982 and December 1984, respectively. The third part sheds light on the personality of both protagonists, who played a fundamental role in determining the outcome of the negotiations.


The Hoffman Family Library provides support for nursing students completing course assignments and research projects. Using library services and resources will help you successfully achieve your learning objectives and prepare you to use information reso


Patients absconding from psychiatric settings are a phenomenon that has increasingly caught the attention of nursing researchers in Western countries. This phenomenon also occurs in psychiatric hospitals in Indonesia. However, this is not a topic that has received a great deal of attention in terms of research in Indonesia.

The aim of the study is to provide a profile of absconding events over a one-year period in one psychiatric setting. The objectives of the study are to:

• identify demographic patterns associated with all patients who abscond from one psychiatric hospital during a one-year period;

• describe the experience of patients and nurses related to incidents of absconding;

• identify the contextual factors that promote and obstruct absconding behaviour; and

• discuss the ways in which absconding events in this case differ or are similar to reports of absconding in the West.

A case study using mixed methods and concurrent triangulation has been undertaken in order to provide a profile of absconding events over a period of one year in a psychiatric hospital in Indonesia. Data included a one-year audit of absconding events, a period of observation, and interviews with patients and nurses.

Over a one-year period of data collection 133 absconding events were recorded that involved 106 patients. The predominant pattern of people who abscond is that they are young male patients with a history of previous admission. 70% of patients return to the hospital on the day of absconding. On the face of it, this information is consistent with findings in the West, however qualitative data reveals significant differences.

Sixteen patients who absconded during a seven-month period of data collection were interviewed. Three themes were identified: 'The call to home', 'Hopes and realities' and 'Us and them'. All these themes link to the process of recovery. 'The call to home' and hopes for happier life are considered as the first step in the process of recovery. 'The call to home' reflected the patients' eagerness to have connection with their family and to feel safe. Patients hope to experience a happier life, however most of their hopes are dashed as they fail to reach home or their family sent them back to hospital. The last theme is 'Us and them' in which the patients describe the differences between them and others, and the consequence of the differences which create negative feelings and forms a barrier to developing and growing towards recovery.

Observations and interviews with 24 nurses reveal a style of nursing that is custodial rather than therapeutic. The days are filled with routine duties, and opportunities to prepare patients for discharge as an important part of the recovery process, are missed. The nursing staff is disappointed with the attitude of the family and community towards people with mental health problems and believes that families are responsible for patients once they are ready for discharge.

The majority of patients who absconded from the hospital in this study were ready for discharge and awaiting collection by their family. They were considered to be in the process of recovery, but it appears that there is little adequate support for patients who are ready to be discharged from hospital. It is not unusual for patients who have absconded to be brought back to hospital again by their family if they are not well received in the community.

Short term recommendations centre on the rehabilitation focus and activities in the hospital. Nurses should become more involved with interventions that are appropriate in rehabilitation processes and see it as an integral part of discharge planning included in management plans. In the longer term, nurses require resources to support their education and the implementation and evaluation of person-centered models of care. Strategic plans should be implemented to change public and professional attitudes towards people with a mental health problem. Further research on this topic is required to understand family and community attitudes, recovery from a range of perspectives and test alternative models of nursing care.


Relying on critical feminist understandings of power, this study explores how the gendered expectations and intersectional identity of women teachers impacts their negotiation of power in the practice of teacher leadership and social justice advocacy. This study takes a critical stance towards the existing body of literature and challenges the current feminized and patriarchal understanding of teacher leadership. Using a collaborative autoethnographic approach, a group of practicing teacher leaders examined their lived experiences as teacher leaders. The participants reported experiencing gendered expectations in their teaching contexts of support/nurturing, passivity, collaboration, normative gender expression, and all-encompassing teacher identity. Practicing teacher leadership in this gendered environment was a balancing act that required the ability to be a "chameleon." The complexity of teaching and intricate nature of connections and networks allowed teachers to pick and choose a variety of strategies and resources with which to negotiate power. The study finds that much of the work of teacher leadership involved negotiating the interpersonal and cultural domains of power in order to develop coalitions of diverse stakeholders to resist the oppressive forces found in the structural and disciplinary domains. The teachers reported often having to "play against" negative assumptions of their ability to be leaders based on race and gender. The study concludes that the scholarly understanding of the practice of teacher leadership must be redefined to include the social justice focus of much of its practice, the intricacy of teachers' networks, an understanding of power as multidirectional and multidimensional, the nuance of gendered norms found in teaching, and the unresolved paradoxes that teacher leaders face every day.


Abstract: This paper draws on interviews with 81 Canadian football players and administrators across junior, university, and professional football, as well as 20 published autobiographies of football players, to examine the development and consequences of sporting masculinity. In this paper, the concept of sporting masculinity is further developed and contrasted with other masculinities, particularly hegemonic masculinity. Various aspects of sporting masculinity in Canadian football are examined such as: the development of a male space, sentiments of superiority both on and off the field, body image issues, playing through pain and injury, analogies of war, and football as a total institution. This paper concludes with a discussion of the dangerous and harmful consequences of sporting masculinity to football players, as well the larger social issues that arise from this identity and the characteristics it can entail. Key words: Sport; Masculinity; Violence; Qualitative Research Resume: Cet article s'appuie sur des entretiens avec 81 joueurs et administrateurs de football canathens, dans le foot junior, universitaire et professionnel, ainsi que 20 autobiographies publiees par des joueurs de football, pour examiner l'evolution et les consequences de la masculinite sportive. Dans cet article, le concept de masculinite sportive est developpee par contraste avec d'autres formes de masculinite, en particulier la masculinite hegemonique. De divers aspects de la masculinite sportive dans le football canathen sont examines, tels que le developpement d'un espace masculin, les sentiments de superiorite a la fois sur et hors du terrain, les problemes d'image corporelle, l'epreuve de douleur et de blessures, les analogies de la guerre, et le football comme une institution totale. Cet article se termine par une discussion sur les consequences dangereuses et nefastes de la masculinite sportive vis-a-vis des joueurs de football, ainsi que de grandes questions sociales qui decoulent de cette identite et les caracteristiques qu'elle peut comporter. Mots cles: Sport; Masculinite; La violence; La recherche qualitative "We have surrendered our identities to some stereotyped stallion gone mad. And the more this horse seems to be disappearing from our culture, the more fervidly we cling to the saddle. The new institutional representation and spokesman for this horse has become sport, especially football." (Gary Shaw, 1972, p. 221) 1. INTRODUCTION Numerous researchers have explored the central role of sport in creating and maintaining dominant forms of masculinity (Hall, 1985; Messner, 1992; Pronger, 1990; Sabo, 1985; Woodward, 2006). These researchers have argued that in sport, a particular form of masculine identity is developed through the legitimation of violence, various myths of heroism, and the exclusion of women. Sport allows men to display physical dominance and superiority; to run faster, jump higher, and hit harder than others on the field. The vast majority of literature pertaining to masculinity in sport examines sport in general, rather than the intricacies of masculine identity formation within specific sporting contexts. The aim of this paper is to explore various aspects of sporting masculinity in Canadian gridiron football including how it is constructed, what it is characterized by, and its often harmful consequences. This study draws on 81 semi-directed qualitative interviews with junior, university, and professional football players and administrators across Canada, as well as the published autobiographies of 20 football players. The study began as an exploration of the legal issue of consent but the centrality of masculinity to the rules of interaction and behaviour in Canadian football became immediately clear during the research. This paper opens with a brief discussion of the descriptive concept of sporting masculinity, as it is used in this study. Several aspects of sporting masculinity are then explored including: the separating out of men, sentiments of superiority both on and off the field, body image, playing with pain, paying the price for glory, analogies of war, and football as a total institution. …


We marry two powerful ideas: deep representation learning for visual recognition and language understanding, and symbolic program execution for reasoning. Our neural-symbolic visual question answering (NS-VQA) system first recovers a structural scene representation from the image and a program trace from the question. It then executes the program on the scene representation to obtain an answer. Incorporating symbolic structure as prior knowledge offers three unique advantages. First, executing programs on a symbolic space is more robust to long program traces; our model can solve complex reasoning tasks better, achieving an accuracy of 99.8% on the CLEVR dataset. Second, the model is more data- and memory-efficient: it performs well after learning on a small number of training data; it can also encode an image into a compact representation, requiring less storage than existing methods for offline question answering. Third, symbolic program execution offers full transparency to the reasoning process; we are thus able to interpret and diagnose each execution step.


Purpose . To assess and rank the performance of different methods of predicting the probability of death following a specified surgical procedure. Method . Actuarial estimates of the probability of early mortality for 40 patients were derived from 2 sources: a large published surgical series and a smaller series from the center where surgery was performed. Surgeons and cardiologists also provided probability estimates for these patients. Results . Estimates derived from the published literature were too optimistic and did not differentiate between patients more, or less, likely to die (i.e., failed to discriminate). Doctors' judgments were unbiased but failed to discriminate. Local actuarial estimates (influenced by only 1 or 2 variables) were unbiased, did discriminate, but exhibited more random variation. Conclusions . The preferred source of estimates depends upon which aspect of accuracy is of greatest importance. Differences in patient selection and error in the identification of risk factors mean that published results will not always appropriately predict surgical risk at other institutions. Risk stratification may be more robust when based on a small set of cross-validated predictors rather than a larger set of predictors that includes some whose reliability has not been confirmed.


Synthetic lipid bilayers in a giant unilamellar vesicle (GUV) format were used to study potentially harmful interactions between nanoparticles and biomembranes. Confocal fluorescence microscopy shows that 20 nm polystyrene nanoparticles with cationic surfaces adhere strongly to these lipid bilayer membranes. This adhesion is sensitive to the ionic strength of the surrounding medium and is independent of the lipid composition of the membrane, indicating that it is driven by nonspecific electrostatic interactions. Nanoparticles bound to the GUV membrane form extended protrusions that incorporate the membrane lipids. As the membrane material is pulled into these protrusions, the diameter of the GUV shrinks. This process is accompanied by the formation of transient pores in the membrane, as indicated by the leakage of high-molecular weight polymers from the GUV interior. There is an upper limit to the molecular weight of polymer that will leak through these pores; based on this size limit, the pore diameter can be estimated as 18–27 nm. These results suggest that nanoparticle adhesion imposes surface tension on biomembranes via a steric crowding mechanism, leading to poration. The phenomenon is potentially a physiologically relevant mode of interaction between nanoparticles and biomembranes, and may help explain observed plasma membrane permeabilization in the presence of broad classes of nanoparticles.


There is wide recognition that promoting healthcare value involves decreasing 'low-value' services—care without clinical benefit, little benefit compared with cost or disproportionate potential harm.1 While low-value care has been presumed to be a problem predominantly in the USA in the context of an expensive, fragmented, multipayer, fee-for-service system, recent evidence suggests low-value services are pervasive even in government-funded healthcare systems with universal coverage and interoperability.2 Accordingly, low-value care is garnering attention across the globe.3

In response, policymakers, insurers and individual healthcare systems must work together to create and track measures of low-value care. In the USA, a number of states have begun to use such measures to characterise low-value care delivered by healthcare provider organisations.4–6 Many of the existing measures have been derived from the national Choosing Wisely campaign7 with examples such as cervical cancer screening in women >65 years, preoperative testing in asymptomatic patients undergoing low-risk surgical procedures and diagnostic imaging for uncomplicated headache.8 More measures are likely to emerge amid the proliferation of value-based payment and care delivery reforms.

While measuring low-value care is laudable and necessary, it is also challenging. Widely available data sources, such as claims, imperfectly capture clinical appropriateness of specific services. Measures should be valid and clearly define which facet(s) of value are being captured, and for which stakeholders. Engagement and collaboration between insurers and clinicians are needed to meaningfully implement these measures. Measures could create unintended consequences by prompting clinicians to focus disproportionately on measured services to the detriment of other aspects of care or select diagnostic coding aligned with a desired outcome. For example, a low-value care measure dissuading antibiotic prescribing in patients with acute bronchitis could drive clinicians to code more diagnoses as 'upper respiratory tract infection' …


Essential to the notion of the Web is the idea of an open community: anyone can contribute their ideas to the whole. This openness, the size and dynamism of the community impose challenges on the development of resource discovery applications for educational or research activities. On the other hand, there have been many efforts to organize and structure the mass of data. Scholarly repositories have adopted the Open Archives Initiative – the Protocol for Metadata Harvesting (OAI-PMH) and the Dublin Core metadata for displaying information. Thus, it is relevant to develop technologies in order to improve the discovering of resources taking into account the user information needs and the user context. This paper describes an approach which considers structured information resources with OAI-PMH, an ontological representation, and user context as inputs to a framework for building information retrieval applications.


With European natural gas consumption having declined since the beginning of this decade it may seem strange to focus on transmission system bottlenecks in a regional market which, having seen dramatic expansion since its inception in the late 1960s, has at best only modest growth potential. Work by Beatrice Petrovich examining the price correlation of European gas trading hubs suggests that the capacity and contractual relationships of Europe's transmission system lagged behind changing supply flow patterns and the responsiveness required to allow gas to flow freely in response to hub price supply signals in a liberalising market. Projecting forward to 2030 this paper, using the EWI TIGER model, looks at how bottlenecks may change under two scenarios based on high and low cases for LNG and Russian pipeline gas imports respectively, in the context of modest European gas demand growth. Bottlenecks are examined both in terms of LNG and pipeline import capacity at the European border and at critical interconnector points within Europe. This paper should be of interest at a strategic level for commercial participants in the gas market and also for regulators and system operators charged with ensuring that future infrastructure is in place to facilitate pan-European traded markets against a background of changing supply patterns. This paper is the product of excellent co-operation between OIES and ewi Energy Research and Scenarios.


Background— Vascular inflammation and lipid deposition are prominent features of atherosclerotic lesion formation. We have shown previously that the dithiol compound α-lipoic acid (LA) exerts antiinflammatory effects by inhibiting tumor necrosis factor-α– and lipopolysaccharide-induced endothelial and monocyte activation in vitro and lipopolysaccharide-induced acute inflammatory responses in vivo. Here, we investigated whether LA inhibits atherosclerosis in apolipoprotein E–deficient (apoE−/−) and apoE/low-density lipoprotein receptor–deficient mice, 2 well-established animal models of human atherosclerosis. Methods and Results— Four-week–old female apoE−/− mice (n=20 per group) or apoE/low-density lipoprotein receptor–deficient mice (n=21 per group) were fed for 10 weeks a Western-type chow diet containing 15% fat and 0.125% cholesterol without or with 0.2% (wt/wt) R,S-LA or a normal chow diet containing 4% fat without or with 0.2% (wt/wt) R-LA, respectively. Supplementation with LA significantly reduced atherosclerotic lesion formation in the aortic sinus of both mouse models by ≈20% and in the aortic arch and thoracic aorta of apoE−/− and apoE/low-density lipoprotein receptor–deficient mice by ≈55% and 40%, respectively. This strong antiatherogenic effect of LA was associated with almost 40% less body weight gain and lower serum and very low-density lipoprotein levels of triglycerides but not cholesterol. In addition, LA supplementation reduced aortic expression of adhesion molecules and proinflammatory cytokines and aortic macrophage accumulation. These antiinflammatory effects of LA were more pronounced in the aortic arch and the thoracic aorta than in the aortic sinus, reflecting the corresponding reductions in atherosclerosis. Conclusions— Our study shows that dietary LA supplementation inhibits atherosclerotic lesion formation in 2 mouse models of human atherosclerosis, an inhibition that appears to be due to the "antiobesity," antihypertriglyceridemic, and antiinflammatory effects of LA. LA may be a useful adjunct in the prevention and treatment of atherosclerotic vascular diseases.


Background Nucleotide sequence and taxonomy reference databases are critical resources for widespread applications including marker-gene and metagenome sequencing for microbiome analysis, diet metabarcoding, and environmental DNA (eDNA) surveys. Reproducibly generating, managing, using, and evaluating nucleotide sequence and taxonomy reference databases creates a significant bottleneck for researchers aiming to generate custom sequence databases. Furthermore, database composition drastically influences results, and lack of standardizations limits cross-study comparisons. To address these challenges, we developed RESCRIPt, a software package for reproducible generation and management of reference sequence taxonomy databases, including dedicated functions that streamline creating databases from popular sources, and functions for evaluating, comparing, and interactively exploring qualitative and quantitative characteristics across reference databases. Results To highlight the breadth and capabilities of RESCRIPt, we provide several examples for working with popular databases for microbiome profiling (SILVA, Greengenes, NCBI-RefSeq, GTDB), eDNA, and diet metabarcoding surveys (BOLD, GenBank), as well as for genome comparison. We show that bigger is not always better, and reference databases with standardized taxonomies and those that focus on type strains have quantitative advantages, though may not be appropriate for all use cases. Most databases appear to benefit from some curation (quality filtering), though sequence clustering appears detrimental to database quality. Finally, we demonstrate the breadth and extensibility of RESCRIPt for reproducible workflows with a comparison of global hepatitis genomes. Conclusions RESCRIPt provides tools to democratize the process of reference database acquisition and management, enabling researchers to reproducibly and transparently create reference materials for diverse research applications. RESCRIPt is released under a permissive BSD-3 license at https://github.com/bokulich-lab/RESCRIPt.


Concerns about intensive, chemically-based agriculture have precipitated a call for ecologically-based practices. We investigated the ramifications of two such practices. First, we investigated targeted sheep grazing for cover-crop termination. Second, we compared the community dynamics of carabid beetles (Coleoptera:Carabidae), a group of beneficial insects in agroecosystems, among three vegetation systems in alfalfa (Medicago sativa L.) production. Cover-crops are grown to improve soil quality and reduce erosion. While covercrops do not provide a direct source of revenue, integrating livestock grazing to terminate them could provide alternative revenue. We conducted a two year study of the impacts terminating cover-crops with sheep grazing on soil quality, weed and carabid communities, and crop yield in a diversified vegetable market garden. In 2012 and 2013, we seeded a four species cover-crop that was terminated by either tractor mowing or sheep grazing following a completely randomized design. In 2013, we planted spinach, kohlrabi, and lettuce into previously grazed or mowed plots following a split-plot design. The cover-crop provided forage worth $24.00 $44.00 ha as a grazing lease. There were no differences in soil chemistry, compaction, temperature or moisture between grazed and mowed plots. Despite temporal shifts in weed and carabid community structure, we found no differences in those communities between termination methods. Finally, cash crop yields did not differ between strategies. Our results suggest that this practice can provide an economic benefit for producers without detrimental agronomic or ecological consequences. Alfalfa is the third biggest crop in Montana by gross revenue. As a perennial crop, it can allow for high populations of pest and beneficial insects. Practices that favor predatory insects could enhance biological control of pests. We conducted a two year study investigating carabid community dynamics and habitat preferences of common carabid species under three habitat management strategies: monoculture alfalfa, barely nurse-cropped alfalfa and uncultivated refugia. Our results indicate that carabid communities vary among the three systems. Barley nurse-crop systems had greater total carabid activity-density than either of the other two system, which suggests that nursecropping may be an effective habitat management strategy to enhance carabid populations.


Wide acceptance of silvopasture as an alternative sustainable agricultural system in the southeastern United States will depend on an improved understanding of the tree-forage interactions and recognition of its environmental benefits. The objective of this study was to evaluate differences in soil nitrate leaching in different land-use systems, in north Florida. An 18-yr-old loblolly pine (Pinus taeda L.) plantation was thinned in the summer of 2002 to create a fifth-row thinned, nontraditional intensive pine plantation (FO), silvopastures (HE = fourth-row conventionally thinned with random tree distribution and DO = double-row sets of trees with 15-m wide alleys), and an open pasture (PA). 'Argentine' bahiagrass (Paspalum notatum Flügge.) was established as understory vegetation in HE, DO, and PA. From 2004 to 2005 soil nitrate leaching was sampled and compared in the DO, HE, PA, and FO systems at 0.3 and 1.2 m depths after fertilizer application. Significant nitrate peaks were observed at 0.3 m depth after N fertilizer application in all systems. At the 1.2 m depth, the maximum nitrate concentrations were 67, 18, and 8 mg L(-1), in the forest plantation, open pasture, and both silvopastures, respectively. In general, reduced nitrate leaching at 1.2 m depth was observed in silvopastures compared with other land-used systems. These results are not intended to have a direct bearing on traditional pine plantation management, but rather support the potential role of silvopasture systems in reducing nitrate losses from the soil.


This report describes the effects of the antiepileptic agent gabapentin on anxiety and memory. Male Wistar rats received ( ) ( ) intraperitoneal administrations of gabapentin 10, 30 and 100 mgrkg , diazepam 1 mgrkg , saline or diazepam vehicle ( ) ( 30 minutes prior to experimental procedures. Animals were: 1 tested on step-down inhibitory avoidance footshock ) ( ) 0.3 mA and habituation to an open-field for memory assessment; and 2 submitted to the elevated plus-maze to evaluate the potential anxiolytic effects of gabapentin. Animals treated with gabapentin showed a reduction in anxiety similar to that observed in animals treated with diazepam. Memory was not affected by gabapentin in any of the tests, but was impaired by diazepam. The lack of effects of gabapentin on memory suggest a potential advantage of this drug over compounds with previously known anxiolytic property, which have amnesic effects at doses used for the treatment of anxiety disorders. Q 2000 Lippincott Williams & Wilkins.


Adult patients awaiting dental treatment were screened for self-reported anxiety using an 11-point Likert scale. Those in the higher half of the range (n = 30) received a 10-min intervention consisting of a 4-min Emotional Freedom Techniques (EFT) explanation and 6-min treatment. All patients reported a decrease in subjective anxiety, with a mean pretreatment score of 8.03 and a posttreatment score of 3.03. Paired t tests revealed a statistically signifi cant decrease (p < .001). These results are consistent with other published reports of EFTs effi cacy for anxiety. They suggest that even a very brief EFT intervention can reduce anxiety and that an additional controlled trial with both observerand participant-rated measures should be undertaken.


The overall aim of this study is to reveal the most frequently used psychological constructs in global empirical research on consumer acceptance. Next to the relative popularity, this study evaluates the significance of applied psychological constructs for explaining individual acceptance behaviour. Out of the multitude of available studies, ranging from health innovations to pre-school education methods, 49 studies with a focus on technological product innovations were selected based on a set of inclusion criteria. The review revealed that most research in this particular field is based on either the theory of planned behaviour (TPB) model or the technology acceptance model (TAM). Yet, these fundamental models were only rarely applied in their original composition. Additional context-specific predictors are widely common in order to adapt these models to a variety of further motives.


The water cycle is an integral part of Earth surface dynamics, and water's oxygen-isotope composition retains information about the forcing and response of Earth's local and global climate. Water isotope signals of the recent geological past can be directly obtained from archives such as ice cores, groundwater, or pore fluid. For the more distant past, mineral proxies have to be used. Multiple episodes of global glaciation may have occurred in the Neoproterozoic Era, of which the record of oxygen-isotope composition of glacial meltwater is sparse; the few records that are derived from carbonate minerals are prone to late-burial and metamorphic alteration, and therefore subject to alternative explanations. Here we present a case in which meltwater δ 18 O is retrieved from barite (BaSO 4 ) and malachite (Cu 2 CO 3 (OH) 2 )–associated sulfate (MAS) in a diamictite in Kaiyang, Guizhou, South China. The core of our argument is based on the lowest-ever-published sulfate δ 18 O values found in the barite and MAS, reaching as low as –20.3‰ (Vienna standard mean ocean water, VSMOW). These data suggest that the water involved in the oxidative weathering of these chalcocite clasts had a δ 18 O value of –34‰ ± 10‰, similar to that of polar glaciers today. Excluding the possibility of glacier meltwater alteration during the past 600 m.y. after the deposition of the diamictite, the sulfate mineral assemblage reported here provides an important constraint on the nature of the Neoproterozoic glaciation that the Kaiyang diamictite represents.


To the Editor:

Smith-Magenis syndrome (SMS; OMIM 182290) is a genomic disorder characterized by multiple congenital anomalies, developmental delay, intellectual disability, and a distinct behavioral phenotype including aggressiveness, self-injury, and sleep disturbances [Edelman et al., 2007; Greenberg et al., 1996; Smith et al., 1986]. Most patients with SMS (~75%) harbor a recurrent 3.7 megabase (Mb) microdeletion of 17p11.2, mediated by flanking low copy repeats (LCRs) [Bi et al., 2003; Chen et al., 1997; Potocki et al., 2003; Shaw et al., 2002]. . The retinoic acid-induced gene 1 (RAI1) is one of approximately 25 genes within the SMS critical region [Bi et al., 2002; Vlangos et al., 2003], and heterozygous RAI1 mutations have been reported in individuals who resemble SMS patients clinically, but who lack a 17p11.2 deletion; thus, haploinsufficiency of RAI1 is considered the cause of most of the manifestations of SMS [Bi et al., 2004, 2006; Girirajan et al., 2005, 2006; Slager et al., 2003]. Nonetheless, the prevalence of some phenotypes, for example cardiovascular malformations and hearing loss, differ between SMS deletion patients and those with RAI1 point mutations [Edelman et al., 2007; Girirajan et al., 2006], suggesting that other loci within 17p11.2 and/or genomic rearrangement itself [Ricard et al., 2010] may contribute to or modify the SMS phenotype.

Subjective sleep disturbances are well documented in SMS [Smith et al., 1998]. Additionally, objective sleep disturbances, including multiple awakenings, decreased or increased percentage of REM sleep, and decreased total sleep time have been detected by polysomnography [Greenberg et al., 1996; Potocki et al., 2000] and actigraphy [De Leersnyder et al., 2001a; Gropman et al., 2006]. Inverted circadian rhythmicity of melatonin in SMS deletion patients has also been reported [De Leersnyder et al., 2001a; Potocki et al., 2000].

Persons with RAI1 mutations also have a high rate of subjective sleep disturbance (14 of 14 subjects described in [Bi et al., 2004, 2006; Girirajan et al., 2005, 2006; Slager et al., 2003]), statistically equivalent to that of individuals with the common (3.7 Mb) SMS deletion (39/39 in [Potocki et al., 2003]). It is unknown if RAI1 mutations lead to an alteration of melatonin rhythmicity. Given melatonin's role in sleep-wake patterning [Brzezinski 1997], we hypothesized that haploinsufficiency of RAI1 alone may lead to inversion of melatonin rhythmicity, potentially explaining disordered sleep in individuals with this genotype. In this report we document an inverted circadian rhythm of melatonin in a child and an adult who each harbor a RAI1 mutation.

Individuals with clinical suspicion for SMS were enrolled in a multidisciplinary clinical study, approved by the Institutional Review Board of Baylor College of Medicine, at Texas Children's Hospital in Houston, USA; informed consent was provided in each case. This comprehensive clinical protocol included physical examination, polysomnography, and urine collection to measure 6-sulfatoxymelatonin (6-hydroxymelatonin sulfate, aMT6s), the major excreted metabolite of melatonin [Reiter, 1991; Potocki et al., 2000]. Molecular characterization and some phenotypic details of these subjects have been described previously [Bi et al., 2004, 2006; Chen et al., 1997; Liburd et al., 2001; Potocki et al., 2000, 2003; Slager et al., 2003]. Briefly, individuals with clinical suspicion for SMS were screened by FISH for deletions on chromosome 17p11.2. Subjects who did not have a del(17)(p11.2p11.2) by FISH underwent sequencing of the RAI1 gene, which identified a heterozygous nonsense mutation in subject 1106, an 11-year-old girl [Bi et al., 2004], and a heterozygous frameshift mutation in subject 526 (listed as SMS156 in Slager et al., [2003]), a 27-year-old woman. Both of these subjects experienced subjective sleep disturbances by parental report. Subject 1106 took melatonin (6 mg at bedtime), which was discontinued 3 weeks prior to the study. Subject 526 took no medications.

Subjects were evaluated in the sleep laboratory at Texas Children's Hospital [Potocki et al., 2000]. Briefly, the subjects underwent continuous 21-channel polysomnographic monitoring as well as in-person and video behavioral monitoring for one night. Sleep staging was determined using standard criteria. A multiple sleep latency test (MSLT) was performed the following day. The subjects' spontaneously voided urine was collected at several time points and analyzed for aMT6s concentration [Potocki et al., 2000]. Urine from a healthy girl and a healthy man, analyzed similarly, served as controls [Reiter et al., 1996].

Both subjects with RAI1 mutations demonstrated sleep disturbances by polysomnography similar to those of subjects with the SMS common deletion (Table I). MSLT findings were normal (data not shown). The rhythm of urinary aMT6s concentration, a surrogate for serum melatonin concentration [Reiter, 1991], was found to be altered in both subjects with RAI1 mutations (Fig. 1). A normal circadian rhythm of urinary aMT6s concentration peaks in the early morning (Fig. 1a), resulting from a nocturnal maximum of melatonin production. In contrast, the urinary aMT6s concentration in both child (1106) and adult (526) with RAI1 point mutations (Fig. 1b) displayed an inverted pattern with a daytime maximum, similar to age-matched subjects with the SMS common deletion (1206 and 1123, respectively [Potocki et al., 2000]) shown for comparison (Fig. 1c). As subjects 1106 and 1206 and the younger control individual are children, their overall levels of aMT6s are expectedly higher than those of the adult control individual or of subjects 526 and 1123 [Waldhauser et al., 1984].

Figure 1

Melatonin rhythmicity is altered in RAI1 mutation patients

Table I

Sleep abnormalities in four subjects.

Subjective sleep disturbance is common in SMS, corroborated by objective abnormalities on polysomnography [Greenberg et al., 1991, 1996]. SMS deletion patients have been reported to have an inverted circadian rhythm of melatonin [De Leersnyder et al., 2001a; Potocki et al., 2000]. Our results indicate that SMS patients with mutations in RAI1, a gene mapping within the SMS critical region, have similarly altered melatonin rhythmicity.

It is unknown whether RAI1 is the only gene within the SMS critical region for which reduced dosage leads to altered melatonin rhythmicity. For example, RASD1, also located within the SMS critical region, is a modulator of the responsiveness of the core (suprachiasmatic nucleus) circadian clock to photic and nonphotic inputs [Cheng et al., 2004]. It is also unknown 1) whether alteration of melatonin rhythmicity is solely responsible for the sleep disturbances in SMS, 2) whether this alteration accompanies or causes similar disturbance of the core circadian clock, peripheral clocks, or other clock outputs, and 3) most basically, whether it constitutes a true inversion of rhythmicity or simply a phase advance or delay of approximately half of a day.

Properly-timed exogenous administration of melatonin can shift human circadian rhythms [Lewy et al., 1992] and promote and quantitatively improve sleep in adults with sleep disorders and in children with neurodevelopmental difficulties [Brzezinski 1997; Jan et al., 2000; Zhdanova and Wurtman 1997]. Thus, exogenous melatonin has been given nocturnally to SMS patients to induce and improve sleep, in some cases in combination with diurnal β1-adrenergic antagonist administration to inhibit daytime melatonin production and resultant daytime sleepiness [Carpizo et al., 2006; De Leersnyder et al., 2001b, 2003, 2006]. The success of this regimen in a small number of patients is promising, and our results indicate that, in addition to SMS deletion patients, it is rational that RAI1 mutation patients may also benefit from such treatments.


Coastal defences are proliferating in response to anticipated climate change and there is increasing need for ecologically sensitive design in their construction. Typically, these structures support lower biodiversity than natural rocky shores. Although several studies have tested habitat enhancement interventions that incorporate novel water-retaining features into coastal defences, there remains a need for additional long-term, fully replicated trials to identify alternative cost-effective designs. We created artificial rock pools of two depths (12 cm, 5 cm) by drill-coring into a shore-parallel intertidal granite breakwater, to investigate their potential as an intervention for delivering ecological enhancement. After 18 months the artificial rock pools supported greater species richness than adjacent granite rock surfaces on the breakwater, and similar species richness to natural rock pools on nearby rocky shores. Community composition was, however, different between artificial and natural pools. The depth of artificial rock pools did not affect richness or community structure. Although the novel habitats did not support the same communities as natural rock pools, they clearly provided important habitat for several species that were otherwise absent at mid-shore height on the breakwater. These findings reveal the potential of drill-cored rock pools as an affordable and easily replicated means of enhancing biodiversity on a variety of coastal defence structures, both at the design stage and retrospectively.


Positive feedback is a ubiquitous signal transduction motif that allows systems to convert graded inputs into decisive, all-or-none outputs. Here we investigate why the positive feedback switches that regulate polarization of budding yeast, calcium signaling, Xenopus oocyte maturation, and various other processes use multiple interlinked loops rather than single positive feedback loops. Mathematical simulations revealed that linking fast and slow positive feedback loops creates a "dual-time" switch that is both rapidly inducible and resistant to noise in the upstream signaling system.


Glucose Control Goes Out on a Limb Roux-en-Y gastric bypass, a surgical procedure used to induce weight loss in morbidly obese patients, often leads to permanent remission of diabetes, even when patients regain weight. Studying a rat model, Saeidi et al. (p. 406; see Perspective by Berthoud) found that the surgically reconfigured intestinal segment (the Roux limb) underwent an adaptive response characterized by increased glucose uptake and utilization, apparently triggered by exposure to undigested nutrients. As a result of this change, the intestine provided a major tissue for whole-body glucose control. Whether the same adaptive response occurs in the human intestine remains to be examined. The intestine can adopt a role in glucose control after surgery, possibly explaining why the surgery cures diabetes. [Also see Perspective by Berthoud] The resolution of type 2 diabetes after Roux-en-Y gastric bypass (RYGB) attests to the important role of the gastrointestinal tract in glucose homeostasis. Previous studies in RYGB-treated rats have shown that the Roux limb displays hyperplasia and hypertrophy. Here, we report that the Roux limb of RYGB-treated rats exhibits reprogramming of intestinal glucose metabolism to meet its increased bioenergetic demands; glucose transporter-1 is up-regulated, basolateral glucose uptake is enhanced, aerobic glycolysis is augmented, and glucose is directed toward metabolic pathways that support tissue growth. We show that reprogramming of intestinal glucose metabolism is triggered by the exposure of the Roux limb to undigested nutrients. We demonstrate by positron emission tomography–computed tomography scanning and biodistribution analysis using 2-deoxy-2-[18F]fluoro-d-glucose that reprogramming of intestinal glucose metabolism renders the intestine a major tissue for glucose disposal, contributing to the improvement in glycemic control after RYGB.


The expenditure of resources to modify the probabilities of suffering losses is called "self-protection."(1) As noted by Briys and Schlesinger (1990), expenditures on self-protection do not merely trade income in one state of the world for income in another as market insurance contracts do. Rather, self-protection reduces income in all states, shifting the support of the wealth distribution to the left. Hence, increases in self-protection spending do not in general lead to less risky income prospects in the sense of stochastic dominance.(2) Consequently, the willingness of agents to engage in self-protection fails to parallel agents' willingness to buy market insurance in several important respects. Both risk-loving and risk-averse agents may buy self-protection, and more risk-averse agents will not generally spend more on self-protection than less risk-averse agents.(3) This characteristic of self-protection makes its analysis considerably more difficult than that of insurance. In addition, analysis of self-protection choice must account for the fact that any agent's optimal level of self-protection spending depends on an exogenous, technical" relationship between spending and loss probability. This relationship summarizes the agent's opportunities to reduce loss probabilities and is a critical component in determining optimal self-protection choice. The purpose of this article is to present a set of comparative static results for the simplest and most widely-used model of self-protection choice. Interest focuses on the effects of changes in initial wealth and potential losses on optimal self-protection expenditures.(4) The goal is to seek results of a general character which do not depend on the particular form of the technical relationship between spending and loss probability, nor on restrictive characterizations of agents' von Neumann - Morgenstern utility functions for wealth. Further, the main findings will be stated in terms of the characteristics of agents' attitudes towards risk in a relatively straight-forward fashion, and a set of results useful for evaluating economic problems that involve self-protection will be derived. Optimal Self-Protection Choice Consider the simplest model of self-protection choice in which an agent faces the potential of losing a fixed sum of money L. Letting [y.sub.o] be the agent's initial wealth, s her spending on self-protection, p(s) the probability of suffering the loss L given self-protection expenditure s > 0, and u(.), the agent's von-Neumann Morgenstern utility function for money, write the agent's expected utility given self-protection spending level s as v(s,L,yo), where v(s,L,[y.sup.o]) = p(s)u([y.sup.o]-s-L) + [1 - p(s)]u([y.sub.o]-s). (1) Letting y = [y.sub.o] - s, and assuming the required differentiability of p(-) and u(-), the optimal level of self-protection spending s* is given by the firstorder condition -p'(s*)[u(y) - u(y-L)l - [1 - p(s*)]u'(y) - p(s*)u'(y-L) [less than or equal to] 0, (2) with equality holding if s* > 0. The second-order necessary condition for an interior solution requires -p"(s*)[u(y) - u(y-L)] + 2p'(s*)[u'(y) - u'(y - L)] + [1 - p(s*)]u"(y) + p(s*)u"(y-L) The first-order condition given by (2) has an immediate conventional interpretation in terms of costs and benefits: the (expected) marginal benefit of self-protection spending (-p'(s*)[u(y) - u(y-L)]) should be equal to the (expected) marginal "cost" of such spending ([1-p(s*)]u'(y) + p(s*)u'(y-L)) at the optimal choice s*. Comparative Static Results for Changes in Initial Wealth The initial goal is evaluating the effect of changes in the agent's initial wealth [y.sub.o] on optimal self-protection spending s*. If the purchase of selfprotection is identified with the purchase of an economic good such as a burglar alarm, security guard service, or smoke detector, then the issue of how changes in (initial) wealth [y. …


The objective of this paper is to apply field data, without modification, for a number of case studies in different numerical models to find the best non-calibrated approach. The purpose of the comparison is to identify which of a number of well-known and frequently used approaches to failure prediction, that gives the best agreement with the observed fallouts with respect to location, depth, shape, and extent. Four case studies are presented which all are situated in hard rock masses that are massive or sparsely fractured, at depths of 630-965 m below surface. The observed fallouts are compared with the results from five numerical models in Examine2D and Phase2D by studying (i) strength factors (SF) and yielded elements and (ii) volumetric and (iii) maximum shear strains. This study demonstrates that when the rock mass strength parameters are defined by either the Hoek-Brown or the Mohr-Coulomb criterion the predicted fallout depth by the SF and yielded elements resulted in a reasonable agreement with the observed fallout depth. Still the extent on the boundary and shape is incorrect. As a preliminary result, the volumetric strain is not found to be a good indicator of fallouts of hard (high strength) rock masses. Also, due to the high rock mass strength, no shear bands were formed when evaluating the maximum shear strain, except when using instantaneous softening of friction and/or cohesion. However the instantaneous softening approaches significantly overestimated the predicted fallouts. Despite the fact that none of the approaches in this study showed perfect agreement with the actual fallouts, a 2D stress analysis program can be used for guidance of where, on the boundary, the actual compressive fallout will occur.


The article presents the evaluation of the effectiveness of two groins located at Gonzaguinha and Milionários Beaches, situated on the southeast coast of Brazil. The effectiveness of these coastal defense structures is evaluated in terms of sedimentary dynamics, which is one of the most important environmental processes to be assessed in coastal engineering studies. The applied method is based on the implementation of the Delft3D numerical model system tools. Delft3D-WAVE module was used for waves modelling, Delft3D-FLOW for hydrodynamic modelling and Delft3D-SED for sediment transport modelling. The calibration of the models was carried out in a way that the simulations adequately represent the region studied, evaluating improvements in the model elements with the use of statistical comparisons of similarity between the results and waves, currents and tides data recorded in the study area. Analysis of the maximum wave heights was carried to select the months with higher accumulated energy to implement these conditions in the engineering scenarios. The engineering studies were performed for two scenarios: 1) numerical simulation of the area considering only the two existing groins; 2) conception of breakwaters coupled at the ends of the existing groins, resulting in two "T" shaped structures. The sediment model showed that, for the simulated period, the area is affected by erosive processes and that the existing groins have little effectiveness in defending the coast in question. The implemented T structures showed some effectiveness in protecting the beaches against erosion and provided the recovery of the portion directly covered by it on the Milionários Beach. In order to complement this study, it is suggested the conception of further engineering scenarios that might recover other areas of the studied region. Keywords—Coastal engineering, coastal erosion, Sao Vicente Bay, Delft3D, coastal engineering works.


This article conducts a close listening of the Australian podcast series Breathless: The Death of David Dungay Jr ., which reports on the death in custody of Aboriginal man David Dungay and his family's struggle for justice in its wake. Bringing an orientation toward sound and listening into conversation with Christina Sharpe's concept of "archives of breathlessness," it argues that Breathless can be heard as part of a larger sonic archive where Black and Indigenous breath is taken, stopped, let go, and held on to, and where the sounds of settler-colonial violence—and resistance to that violence—repeat across time and space. Drawing on notions of repetition, protraction, reckoning and recuperation, I explore the multiple ways "just hearings" in relation to Indigenous struggles for justice in the wake of colonization are stalled, protracted, and refused, while also listening for the sounds of Indigenous resistance, survival and moments of collective breath.


Many techniques for the visualization of data structures and algorithms have been proposed and shown to be pedagogically effective. Yet, they are not widely adopted because they lack suitable methods for automatically generating the visualizations, lack integration among visualizations, and lack integration with basic integrated development environment (IDE) support. In this work, additionally it was identified that the lack of adoption was because these tools do not focus on one of the main problems students in an introductory level data structures and algorithms class face; that is, the transition from abstract and static concepts to dynamic implementation. To effectively use visualizations when developing code, it is useful to automatically generate multiple synchronized views without leaving the IDE. The jGRASP IDE has been extended to provide object viewers that automatically generate dynamic, state-based visualizations of data structures in Java. Such seamless integration of a lightweight IDE with a set of pedagogically effective software visualizations is unique and is currently unavailable in any other environment.
Formal and repeatable controlled experiments were conducted to investigate the effect of these viewers on the performance of students. These studies indicated a statistically significant improvement over traditional methods of visual debugging that use breakpoints. Six controlled experiments were conducted to test various hypotheses. The goal of Experiments I and III was to determine if students would be able to code more accurately and in less time using the jGRASP data structure viewers for a relatively easy (singly linked list) and a relatively hard (linked binary tree) to understand data structure. The goals of Experiment II and IV was to determine if students would be able to find and correct more logical errors accurately and faster using jGRASP viewers for a relatively easy (singly linked list) and a relatively hard (linked binary tree) to understand data structure. Experiment V was conducted using min-max heap to test if students would be able to transition from concept to implementation faster and more accurately using jGRASP viewers for data structures that are covered only conceptually in lectures. Experiment VI was conducted using linked priority queue to test if students would be able to apply concepts for data structures that were not covered in lectures faster and more accurately using jGRASP viewers. In all six experiments, the group using jGRASP viewers performed significantly better than the other group.
Thus, this research has shown that automatic generation of visualizations for data structures tightly integrated within an IDE helps students not only learn concepts but also aids in transitioning from static concept to dynamic implementation for both relatively easy and hard to learn data structures.


Cytomegalovirus (CMV) in patients with moderate-to-severe UC can worsen colitis and be associated with corticosteroid refractoriness.1,2,3,4 Early diagnosis and proper intervention is therefore very important. However, the clinical diagnosis of CMV colitis is very difficult.

The diagnosis of CMV colitis in UC patients can be confirmed by histology, which comprises either PCR or immunohistochemistry (IHC).5 However, tissue PCR for CMV is controversial because of the possibility for false positives.6 Although IHC staining may be the best method to confirm CMV colitis,7,8,9 it takes several days for this test to yield results, and could be associated with hemorrhage or perforation.10,11,12 Many clinicians have tried to identify the best method of diagnosing CMV colitis. With this in mind, I read the study of Chun et al.13 with great interest. They assessed the clinical utility of the CMV antigenemia assay for the diagnosis of CMV colitis and predicting the outcomes of patients with UC. According to their results, CMV colitis was more common in patients with positive CMV antigenemia (eight patients, 66.7%), and this association was statistically significant (P=0.001). The results were consistent with other similar studies, which showed low sensitivity and high specificity.12,14 They suggested 2 pp65-positive cells per 2×105 polymorphonuclear leukocytes as a cut-off value, and this is very meaningful.

However, among patients with positive antigenemia assay results, three did not have CMV colitis and four with negative results had CMV colitis. In addition, ganciclovir was considered only in tissue-confirmed cases with steroid refractoriness. I am therefore curious as to whether these results have any clinical significance in the diagnosis of CMV colitis. Can the antigenemia assay substitute histologic evaluation? I believe that Chun et al. did not clearly demonstrate the significance of the CMV antigenemia assay without histology in the diagnosis of CMV colitis. Even in cases where the antigenemia assay was negative, they considered antiviral therapy if tissues showed CMV colitis. Therefore, I think we eventually need endoscopy and tissue confirmation in steroid refractory UC patients to decide upon antiviral therapy. One study suggested that the CMV antigenemia assay has a diagnostic role only in conjunction with endoscopic findings.14 I agree with this opinion; however, considering the high rate of false positive results of PCR for CMV, it could be helpful for diagnosis only when tissue PCR is positive and IHC staining is negative.

The role of CMV in the exacerbation of UC is still under debate.6 Several studies have reported that CMV reactivation could be improved without antiviral treatment,15,16 and others have suggested that in patients who are resistant to corticosteroids, antiviral therapy should be considered if they are positive for CMV in tissue studies.17 Chun et al. also demonstrated a significant association of CMV antigenemia with steroid refractoriness, and suggested early rescue therapy.13

CMV antigenemia could be a good predictor of clinical outcomes such as steroid refractoriness. However, it is limited in the diagnosis of CMV colitis. Despite these limitations, I think it could be very helpful in some cases. Therefore, we need to define the proper indication of the CMV antigenemia assay in the diagnosis of CMV colitis.


The problems of distressed urban areas are getting worse year after year. Due to limited resources and Amenities of municipal organizations for solving every problem concerning urban distressed textures, it is essential to determine the priorities of each area based on identified factors and criteria. In distressed areas, there are different circumstances and distinctive citizens with their needs and special expectations, so in this article we face many criteria with fuzziness. This study aimed to apply the fuzzy analytic hierarchy process (FAHP) to prioritize the most important issues for each urban distressed area in Karaj. For this purpose a hierarchical model with 4 main factors (social, physical, environmental and economic) and 17 sub factors were suggested. Four zones of the city (central Karaj, Hesarak, Mehrshahr and Fardis) were analyzed. The findings of the paper suggest that social factors with a weights of about 30% are the most significant problems cause in these areas and physical factors with 27% weight we're in second place. Among the areas, Fardis and Hesarak areas were most affected by social factors and Central Karaj and Mehrshar had the most priority for physical factors.


PURPOSE/OBJECTIVES
To evaluate a resiliency program designed to educate oncology nurses about compassion fatigue.

DESIGN
Descriptive pilot study.

SETTING
A National Cancer Institute-designated comprehensive cancer center in the midwestern United States.

SAMPLE
13 oncology nurses employed in an outpatient infusion center.

METHODS
Nurses attended a five-week program involving five 90-minute sessions on compassion fatigue resiliency. A pre- and post-test design, using repeated measures, was conducted over six months.

MAIN RESEARCH VARIABLES
Scores on the Professional Quality of Life (ProQOL) IV, Maslach Burnout Inventory-Human Services Survey, Impact of Event Scale-Revised (IES-R), and the Nursing Job Satisfaction Scale.

FINDINGS
Long-term benefits were realized from the program. Secondary traumatization scores on the ProQOL IV declined immediately after the program, remained down at three months, and then dropped again at six months, with a statistically significant mean difference compared with baseline. The average IES-R total scores improved significantly overall and for each of the three postintervention time points. Participants evaluated the program positively with respect to their ability to apply and benefit from resiliency techniques.

CONCLUSIONS
This is the first reported study to show benefits gained from a compassion fatigue intervention program. Participants received useful strategies for managing stress at work and home.

IMPLICATIONS FOR NURSING
Compassion fatigue is a prevalent condition among healthcare providers. Development of resiliency to compassion fatigue may improve decision making, clarity of communication, and patient and nurse satisfaction.

KNOWLEDGE TRANSLATION
Self-regulation offers an approach to reduce stress during a perceived threat. Working by intention reduces reactivity in the workplace and makes communication more intentional and, therefore, effective.


Policy-makers and scientists have raised concerns about the functioning of the Clean Development Mechanism (CDM), in particular regarding its low contribution to sustainable development, unbalanced regional and sectoral distribution of projects, and its limited contribution to global emission reductions. Differentiation between countries or project types has been proposed as a possible way forward to address these problems. An overview is provided of the different ways in which CDM differentiation could be implemented. The implications for the actors involved in the CDM are analysed, along with a quantitative assessment of the impacts on the carbon market, using bottom-up marginal abatement cost curves. The discounting of CDM credits, quota systems, or differentiated eligibility of countries could help to address several of the concerns raised. Preferential treatment may also make a limited contribution to achieving the aims of CDM differentiation by increasing opportunities for under-represented host countries. The impact on the carbon market appears to be limited for most options.


This thesis concerns the continuing development of a classification system for the interpretation of images. The approach involves segmenting the image into a number of regions, then describing each region in terms of a set of features, and finally passing the feature-description on to a neural network which has been trained to label the region with an object-type. The work begins with a detailed investigation of the feature-set. A psychophysical study, aimed at revealing which visual cues a human subject might use, is presented. The neural network is then subjected to a similar analysis, the results permitting a number of comparisons to be made between the machine vision system and its biological counterpart. Drawing on the psychophysical observations, the existing feature-set undergoes a series of refinements, with the properties of texture, colour, and shape coming under scrutiny. Significant improvements in classification accuracy are found when incorporating the revised feature-set. Directing attention towards the analysis of time-varying imagery, a number of temporal constraints are developed in order to promote continuity over the sequence. It is shown how the concept of temporal coherence can be exploited to improve both computational efficiency and classification accuracy. A method, employing a mesh of active contour primitives, is developed which allows an initial segmentation to be evolved over the sequence. Mechanisms are incorporated to ease the transition between frames and to accommodate the topological discontinuities that can arise during the sequence. A set of features, based on complex spatio-temporal Gabor filters, is developed to encode both texture and motion variations in the image data. The work shows not only how the classification system can be applied to the analysis of image sequences, but also how the temporal dimension can actually be exploited to improve overall performance.


Vaccines save between 2 million and 3 million lives each year and protect the entire population from more than a dozen life-threatening diseases. Thanks to vaccination, smallpox was eradicated in 1980, and we are on track to eradicate polio. However, despite great strides in the control of measles, one of the most contagious diseases known, the last few years have unfortunately seen an increase in cases. This is why high vaccination coverage—95% or more—is needed, posing a major technical and communication challenge for health workers. Studies show that telling people about the quality, safety, effectiveness and availability of vaccines is not enough to influence behavior change related to immunization, and in general, doesn´t increase coverage. For this reason, it´s necessary to understand the reasons why people choose not to get vaccinated or not get their children vaccinated, in order to begin a two-way respectful dialogue using the best, most effective messages. Given this context, the main objective of these guidelines is to provide tools for staff working in the field of immunization to support effective communication between health personnel and the general population, with the aim of strengthening, maintaining or recovering trust in vaccines and the immunization programs in the Region of the Americas.


Six thousand years of sediment accumulation and autocompaction in a transgressive valley-fill deposit are simulated numerically. Rates of accumulation of freshwater organic-rich mud, subtidal mud, and organic-rich mud of the modern salt marsh are specified by using existing sedimentologic, paleontologic, and geochronologic data. Processes of pore-water explusion and autocompaction are determined from finite-strain consolidation theory. Model parameters for subtidal mud facies are determined from laboratory consolidation tests. Model parameters for organic-rich deposits are determined by sampling equivalent modern sedimentary environments and by model calibration. Model calibration involves (1) reproducing the present distribution of void ratios measured in a 7.6 m Vibracore, (2) correctly calculating the preserved thickness of lithologic units, and (3) determining a history of elevation changes of the sediment surface that is consistent with the Delaware sea-level curve and the known sequence of paleoenvironments of Wolfe Glade, Delaware. The results indicate that preserved horizons in the 10 m Holocene section of Wolfe Glade have been lowered a maximum of 2.3 m. The rate of lowering due to autocompaction alone has been one-half to one-third of the rate of sea-level rise during most of the past 6000 yr. Numerical experiments suggest that organic-rich freshwater wetland deposits are primarily responsible for the extensive autocompaction at Wolfe Glade. Our approach may be used to correct Holocene coastal stratigraphic data for autocompaction, but careful model calibration (based in part on the stratigraphy) will usually be required.


Fossil discoveries from South Africa have greatly expanded knowledge of the development of life on Earth. In particular, the enormous palaeontological wealth of the Karoo, covering a period of almost 100 million years from the Permian to the Jurassic, has enhanced understanding of the evolution of important tetrapod lineages, including mammals and dinosaurs. These fossils provide the best record of continental Permian to Jurassic faunal biodiversity, and have been crucial to studies of the global Permo-Triassic mass extinction in the continental realm, as well as giving insight into other extinction events. Recent collaborative interdisciplinary studies of stratigraphic and geographic distribution patterns of Karoo fossils have enhanced biostratigraphic resolution and global correlation of vertebrate faunas from the Permian to the Jurassic. This in turn has led to a better understanding of the biodiversity across Pangaea, and the places of origin and initial diversity of early tetrapod evolutionary lineages. Many of these originated in the southern African portion of the Gondwanan super-continent. The combination of palaeontological and sedimentological studies has led to new basin development models and solved problems which each discipline in isolation could not have achieved.


Hybrid wired-wireless Network-on-Chip (WiNoC) has emerged as an alternative solution to the poor scalability and performance issues of conventional wireline NoC design for future System-on-Chip (SoC). Existing feasible wireless solution for WiNoCs in the form of millimeter wave (mm-Wave) relies on free space signal radiation which has high power dissipation with high degradation rate in the signal strength per transmission distance. Moreover, over the lossy wireless medium, combining wireless and wireline channels drastically reduces the total reliability of the communication fabric. Surface wave has been proposed as an alternative wireless technology for low power on-chip communication. With the right design considerations, the reliability and performance benefits of the surface wave channel could be extended. In this paper, we propose a surface wave communication fabric for emerging WiNoCs that is able to match the reliability of traditional wireline NoCs. First, we propose a realistic channel model which demonstrates that existing mm-Wave WiNoCs suffers from not only free-space spreading loss (FSSL) but also molecular absorption attenuation (MAA), especially at high frequency band, which reduces the reliability of the system. Consequently, we employ a carefully designed transducer and commercially available thin metal conductor coated with a low cost dielectric material to generate surface wave signals with improved transmission gain. Our experimental results demonstrate that the proposed communication fabric can achieve a 5dB operational bandwidth of about 60GHz around the center frequency (60GHz). By improving the transmission reliability of wireless layer, the proposed communication fabric can improve maximum sustainable load of NoCs by an average of 20.9% and 133.3% compared to existing WiNoCs and wireline NoCs, respectively.


Emerging scale-out workloads need extensive amounts of computational resources. However, data centers using modern server hardware face physical constraints in space and power, limiting further expansion and requiring improvements in the computational density per server and in the per-operation energy. Continuing to improve the computational resources of the cloud while staying within physical constraints mandates optimizing server efficiency. In this work, we demonstrate that modern server processors are highly inefficient for running cloud workloads. To address this problem, we investigate the microarchitectural behavior of scale-out workloads and present opportunities to enable specialized processor designs that closely match the needs of the cloud.


Editor's Note The journal is delighted to continue a collaboration with the International Association for Hospice and Palliative Care (IAHPC) in publication of book reviews relevant to symptom control in advanced disease. These reviews are adapted from the work of Roger Woodruff, MD, FRACP, FAChPM, an internationally recognized oncologist and palliative care specialist physician from Australia. Dr. Woodruff's reviews appear concurrently or did so previously in the IAHPC Newsletter, which is accessible through the IAHPC Web site: http://hospicecare.com.


The small diameter of the hepatic artery is one of the complexities of living donor liver transplantation (LDLT). We analyzed whether the direct suture technique using surgical loupes can simplify the operative process for LDLT compared with fixed microscopic reconstruction. We applied the direct technique to rationalize the operative process and abolished routine microsurgery from 2004. Two hundred and nine LDLT with a postoperative period over 34 months were carried out from 1996 to 2008. The patients were divided into two groups: the micro group (children: 20, adults: 72) and the non‐micro group (children: 12, adults: 97). Running anastomosis was undertaken in the non‐micro group. The anastomotic size of the children was significantly smaller than that of the adults, but larger than 2 mm (2.38 ± 0.4 vs. 2.7 ± 0.47 mm, p = 0.0005). By appropriate choice of the proximal artery, direct anastomosis is possible even in children. Early complications occurred in seven cases in the micro group, but none occurred in the non‐micro group (p < 0.05). Significant reductions were observed in operation time (p < 0.0001), blood loss (p < 0.05), and hospital stay (p < 0.01) in the non‐micro group. Non‐microscopic anastomosis is useful for the rationalization of LDLT.