In 1978, Deng Xiaoping began the economic reforms now referred to as "Gaige Kaifang," through which China ushered in an era of unprecedented receptivity to foreign influence. The shift to liberalized trade policy led to reduced poverty levels and set China on the path to economic strength. But the reforms also catalyzed massive change within the formerly centralized medical system. Medicine is now the domain of the private sector and provincial and local governments, rather than the national government. While market reforms in the economy have been a boon for the Chinese, similar reforms in the healthcare system have improved quality but also created unequal access to healthcare due to rising costs. While healthcare prices have risen over the past two decades, the number of hospitals in China has actually grown. In 1980, there were approximately 9,900 hospitals in China. As of 2005, there were about 18,700. A boom in the number of hospitals in such a short span speaks to the changing medical landscape in China. However, it also obscures the added costs that have come along with this seemingly positive change. Chinese hospitals, especially in urban centers, increasingly rely on advanced medical technology. The increased importation of such technology, from MRIs to CT Scans and surgical equipment, along with the inevitable diffusion of such technology throughout Chinese hospitals, has certainly increased the efficiency and quality of medical practice. But rather than increasing competition and driving down costs, the introduction of free market reforms and improvements in the level of medical technology have had the reverse effect; they have actually driven costs, and prices for patients, up. As the Chinese government continues to privatize healthcare, it is vital to understand the cause behind the seemingly paradoxical rise in medical costs. Economic reforms, if focused solely on economic policy and not tailored to specific sectors such as healthcare, can undermine a country's medical system by creating increased disparity in medical services for the wealthy and the poor. There is no better example of this pitfall than today's China. More importantly, and there is no real solution in sight. As medical costs for patients rise, expensive medical technologies continue to enter hospitals all over the country and push up costs even further. William Hsiao of the Harvard School of Public Health attributes this phenomenon to new profit incentives that are reordering priorities for Chinese hospitals and medical practitioners. Profit incentives decrease physicians' concern for providing affordable, accessible treatment and increase the pressure to use high-cost technology catered towards those who can pay for it. The contradictory coexistence of an economic boom and a healthcare gap presents a tradeoff for China's policy makers. The government can either allow an American-style high-quality but expensive medical care system, or pursue a more egalitarian, but more regulated and inflexible system. Chinese policy towards the market for advanced medical devices reflects the government's attempts to address this dilemma. [ILLUSTRATION OMITTED] Laissez-Faire Healthcare Under Mao Tse-tung's government, Chinese healthcare was based on communal principles, wherein the state owned and operated aspects of the healthcare system. China's Cooperative Medical System during the Cold War era ensured that even rural farmers had some access to healthcare, even if it came from barefoot doctors who were community experts in Western and traditional forms of medicine. Some of the accomplishments under the old system included a decline in infant mortality and a modest increase in life expectancy. The barefoot doctor system would not survive the turbulent years of economic reform. The power struggle between economic liberals and hard-line communists created political turmoil in the early 1980s that shook the foundation of the government's healthcare program. …


Abstract Background: Emotional Freedom Techniques (EFT) is proposed as an effective therapy for the treatment of common mental health problems. It has, however, been met with criticism and is not presently considered a mainstream treatment option for conditions such as anxiety or trauma. Conversely, both cognitive behavior therapy (CBT) and Eye Movement desensitization and Reprocessing (EMDR) have achieved recognition in advancing into mainstream status, yet EFT is still perceived as an alternative treatment option despite evidence of effectiveness, in more than 100 clinical trials and 40 research reviews and meta-analyses. Aims: By examining the views of trained practitioners, this project aimed to explore the barriers and the facilitators to EFT becoming a mainstream treatment option in the UK's National Health Service (NHS) for common mental health problems. Method: Semi-structured interviews were conducted (N=12) exploring views of EFT practitioners. Transcripts were then subjected to thematic analysis. Results: Analysis of participants' views resulted in three themes: (1) research as an asset and a challenge, (2) public perceptions of EFT as a therapeutic modality, and (3) EFT training standards. These themes are perceived as interlinked in the process of EFT becoming mainstream. Findings from this study indicate the requirement of further research evidence that is more widely disseminated to enable increased awareness to the public and those within the medical profession of EFT as a potentially beneficial adjunct intervention. Importantly, training for EFT therapists needs to be improved and standardized. Implications: Based on the results, a series of recommendations are discussed that aim to address the barriers identified.


Objective Describe normative baseline SCAT 2 and 3 (SCAT) performance in elite athletes. Design Retrospective cohort. Setting United States Olympic Committee Sports Medicine Clinics. Participants Six hundred and forty-one SCAT baseline evaluations were performed on a population of 565 elite athletes (291 women and 350 men, mean age 24.9±5.2 years) representing 23 Summer and Winter Olympic sports as part of a multimodal concussion management program. Intervention No intervention was applied. The SCAT evaluations were administered as a component of baseline testing on healthy athletes. Main Outcome Measurements Baseline SCAT performance on major components is described. T-tests were used to compare differences in baseline performance by sex. Results During baseline evaluation elite athletes reported a mean of 2.1 (1.8–2.4) symptoms with average symptom severity scores of 3.4 (3.0–3.9). Mean scores on SCAT 3 components in this population were; orientation 4.9 (4.8–4.9), immediate memory 14.5 (14.4–14.5), concentration 3.9 (3.8–4.0), tandem gait 11.7 (11.4–12.0), delayed recall 3.7 (3.6–3.8), balance 2.83 (2.2–3.4), SAC total 26.9 (26.8–27.1). This population reported historys of 1.19 (1.0–1.4) previous concussions. Females reported significantly more symptoms (3.9 vs 3.0, P=0.04), and scored significantly higher on the orientation (4.9 vs. 4.8, P=0.004), immediate memory (14.6 vs. 14.4, P=0.003), concentration (4.1 vs 3.8, P=0.0013) SAC total score (27.3 vs. 26.6, P<0.01) Conclusions Population specific normative values for baseline SCAT performance in a population of elite athletes are presented in this case series. Clinical relevance Clinicians are encouraged to reference population specific normative values when interpreting SCAT performance. Acknowledgements None. Competing interests None.


Rational engineering of amylosucrase required detailed investigations of the molecular basis of catalysis. Biochemical characterization of the enzyme coupled to structural analyses enabled the polymerization mechanism to be elucidated. This provided key information for successfully changing amylosucrase to a hydrolase or an improved polymerase using site-directed mutagenesis. In parallel, a combinatorial approach was developed to further improve the catalyst. The method, based on random mutagenesis and recombination of parent sequences, has generated libraries of variants. These were searched for improved polymer formation using a first step of selection followed by a screening test including a double detection method. Several mutants with desired properties have been isolated, their sequences revealed that they could not have been designed following a rational approach.


Objective To determine the impact of different protective and nonprotective mechanical ventilation strategies on the degree of pulmonary inflammation, oxidative damage, and hemodynamic stability in a saline lavage model of acute lung injury. Design A prospective, randomized, controlled, in vivo animal laboratory study. Setting Animal research facility of a health sciences university. Subjects Forty-six New Zealand White rabbits. Interventions Mature rabbits were instrumented with a tracheostomy and vascular catheters. Lavage-injured rabbits were randomized to receive conventional ventilation with either a) low peak end-expiratory pressure (PEEP; tidal volume of 10 mL/kg, PEEP of 2 cm H2O); b) high PEEP (tidal volume of 10 mL/kg, PEEP of 10 cm H2O); c) low tidal volume with PEEP above Pflex (open lung strategy, tidal volume of 6 mL/kg, PEEP set 2 cm H2O > Pflex); or d) high-frequency oscillatory ventilation. Animals were ventilated for 4 hrs. Lung lavage fluid and tissue samples were obtained immediately after animals were killed. Lung lavage fluid was assayed for measurements of total protein, elastase activity, tumor necrosis factor-&agr;, and malondialdehyde. Lung tissue homogenates were assayed for measurements of myeloperoxidase activity and malondialdehyde. The need for inotropic support was recorded. Measurements and Main Results Animals that received a lung protective strategy (open lung or high-frequency oscillatory ventilation) exhibited more favorable oxygenation and lung mechanics compared with the low PEEP and high PEEP groups. Animals ventilated by a lung protective strategy also showed attenuation of inflammation (reduced tracheal fluid protein, tracheal fluid elastase, tracheal fluid tumor necrosis factor-&agr;, and pulmonary leukostasis). Animals treated with high-frequency oscillatory ventilation had attenuated oxidative injury to the lung and greater hemodynamic stability compared with the other experimental groups. Conclusions Both lung protective strategies were associated with improved oxygenation, attenuated inflammation, and decreased lung damage. However, in this small-animal model of acute lung injury, an open lung strategy with deliberate hypercapnia was associated with significant hemodynamic instability.


Objective: Suicide rate is unfortunately increasing in recent years and its assessment is a must. Most studies have evaluated different factors like personality, depression, or environment in suicide attempters but cognitive functions have been overlooked in suicide attempters. The current research aimed to evaluate a kind of cognitive function, namely attention in survivors of suicide. Methods: This case-control study was conducted in Tehran, Iran in 2015. Two groups of patients one with recent suicide attempts and the other one with no suicide attempt were compared in domains of focus of attention and attention bias. A total of 18 patients participated in each group. Instruments used for this research included questionnaire of focus of attention and simple stroop test software. Correlation of these 2 instruments was compared between groups. Data were analyzed by the independent t-test, ANOVA, and the Pearson correlation. Results: Mean age of suicide attempters was 29.5 years which was significantly lower than that in the control group and most of them were women. They spent more time in recognizing incongruent stimulus, congruent, and incongruent response. The time that was spent on experiment of incongruent stimulus, congruent, and incongruent response was significantly higher in suicide attempters. In suicide attempters, there was a significant correlation between number of congruent and incongruent errors with focus of attention. Conclusion: Our results showed that attention as a cognitive function may be impaired in suicide attempters. Thus, it is necessary to recognize cognitive functions of suicide attempters along with other comorbid psychological factors for preventing future suicide attempts and eventually losing precious lives.


An excellent transportation system is integral for Shanghai as it aims for sustainable development. Decision-making has a far-reaching impact on transportation, which should be improved and supplied with assistance. This thesis aims to design a tool based on a Decision Support System (DSS) named the Transportation Sustainability Decision Support System (TSDSS). The Framework for Strategic Sustainable Development (FSSD) is a key element that was integrated in the TSDSS which will guide the users to backcast from sustainability principles to be strategic in moving transportation in Shanghai towards sustainability. The TSDSS has 3 modules based on the ABCD method and 4 base systems including a Database System, a Model Base System, a Method Base System and a Knowledge Base System, which are designed to help Shanghai's transportation system move in the right direction towards sustainability.


Abstract. LIDAR (Light Detection and Ranging) is a laser altimeter system that determines the distance by measuring pulse travel time. The data from the LIDAR systems provide unique information on the vertical structure of land covers. Compared to ground-based and airborne LIDARs providing a high-resolution digital surface model, space-borne LIDARs can provide important information about the vertical profile of the atmosphere in a global scale. The overall objective of these satellites is to study the elevation changes and the vertical distribution of clouds and aerosols. In this paper an overview on the space-borne laser scanner satellites are accomplished and their applications are introduced. The first space-borne LIDAR is the ICESat (Ice, Cloud and land Elevation Satellite) satellite carrying the GLAS instrument which was launched in January 2003. The CALIPSO (the Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observations, 2006), CATS-ISS (the Cloud-Aerosol Transport System, 2015), ADM-Aeolus (Atmospheric Dynamics Mission, 2018), and ICESat-2 (Ice, Cloud and land Elevation Satellite-2, 2018) satellites were respectively lunched and began to receive information about the vertical structure of the atmosphere and land cover. In addition, two ACE (The Aerosol-Cloud-Ecosystems, 2022) and EarthCARE (Earth Clouds, Aerosols and Radiation Explorer, 2021) space-borne satellites were planned for future. The data of the satellites are increasingly utilized to improve the numerical weather predictions (NWP) and climate modeling.


Issue management, a central part of software maintenance, requires much effort for complex software systems. The continuous inflow of issue reports makes it hard for developers to stay on top of the situation, and the threatening information overload makes activities such as duplicate management, Issue Assignment (IA), and Change Impact Analysis (CIA) tedious and error-prone. Still, most practitioners work with tools that act as little more than issue containers. Machine Learning encompasses approaches that identify patterns or make predictions based on empirical data. While humans have limited ability to work with big data, ML instead tends to improve the more training data that is available. Consequently, we argue that the challenge of information overload in issue management appears to be particularly suitable for ML-based tool support. While others have initially explored the area, we develop two ML-based tools, and evaluate them in proprietary software engineering contexts. We replicated [1] for five projects in two companies, and our automated IA obtains an accuracy matching the current manual processes. Thus, as our solution delivers instantaneous IA, an organization can potentially save considerable analysis effort. Moreover, for the most comprehensive of the five projects, we implemented automated CIA in the tool ImpRec [3]. We evaluated the tool in a longitudinal in situ study, i.e., deployment in two development teams in industry. Based on log analysis and complementary interviews using the QUPER model [2] for utility assessment, we conclude that ImpRec offered helpful support in the CIA task. (Less)


This paper presents a novel Loss of Mains (LoM) protection method based on IEC 61850 General Object Oriented Substation Event (GOOSE) protocol. With the increased penetration of distributed generation (DG), the requirements for LoM or anti-islanding protection has become common in the electric utilities. The development of Smart Grids including extensive communication capabilities enables also communication based LoM approaches. Since IEC 61850 standard based systems are the mainstream in the substation communication, expanding this technology deeper in the distribution network provides interesting solution for communication based LoM protection. The standard IEC 61850-7-420 defines logical nodes (LNs) suitable for this purpose but there are not yet available devices applying this part of the standard. Therefore in this research, a light-weight 61850 GOOSE based LoM solution has been developed and demonstrated applying a microcontroller and available open source software. This paper introduces object modeling according to IEC 61850-7-420 defined LNs and an implementation applying GOOSE messages and microcontroller. The validity of the light-weight implementation is demonstrated with a simple laboratory setup that has been used for measuring the message latencies.


Research attributes much of the rise in obesity to technological progress reducing the cost of food consumption. We examine this hypothesis in the context of Walmart Supercenters, whose advancements in retail logistics have translated to substantial reductions in food prices. Using data from the Behavioral Risk Factor Surveillance System matched with Walmart Supercenter entry dates and locations, we examine the effects of Supercenters on body mass index (BMI) and obesity. We account for the endogeneity of Walmart Supercenter locations with an instrumental variables approach that exploits the unique geographical pattern of Supercenter expansion around Walmart's headquarters in Bentonville, Arkansas. An additional Supercenter per 100,000 residents increases average BMI by 0.25 units and the obesity rate by 2.4 percentage points. These results imply that the proliferation of Walmart Supercenters explains 11% of the rise in obesity since the late 1980s, but the resulting increase in medical expenditures offsets only a small portion of consumers' savings from shopping at Supercenters.


Today's high-yielding soybean varieties respond favorably to early planting. Multi-year results from statewide university research farms suggest that mid-April to early May planting dates produce top yields in most comparisons. Research farm and on-farm strip trials also suggest that elite varieties yield similarly over a wide range of seeding rates and resulting harvest populations. Based on these results, producers are advised to plant soybeans as soon as spring field conditions allow, with a seeding rate of 150,000 to 175,000 seeds per acre. The yield response of modern varieties to early planting raises questions about expanding the soybean planting season (very early planting of some soybean acres in late March or early April) when weather conditions allow. In 2000 a soybean "planting date x seed treatment" study was initiated to evaluate yield response of two adapted, high-yield varieties to very early planting. Research objectives are to determine whether planting soybeans earlier than corn could be a viable management option for Iowa producers, and if fungicide seed treatments are needed to make this practice profitable. Establishment of similar studies at four other university research farms statewide afforded yield response comparisons of adapted varieties from five unique soil associations and environments. Soils at the Armstrong Research Farm are typical of the Marshall-Exira soil association.


1. Introduction On 30 January 2008, the Court of Arbitration for Sport ("CAS") ruled that player Andrew Webster was entitled to unilaterally terminate his employment contract with Heart of Midlothian after the so-called protected period of his contract. The CAS decided that as result of the unilateral termination, player Webster only had to pay the remaining value of his contract as compensation to his former club Heart of Midlothian. This was the first case in which the CAS had to decide with regards to the amount of compensation in case of a unilateral termination of a player after the protected period. On the one hand, the international football world was pleasantly surprised after the decision (the players), but on the other also seriously shocked (the clubs). The question now was whether the Webster-case was another land mark judgment in the international football world, such as the famous Bosman-case. (1) After Webster, the main issue was, is every player free to unilaterally terminate his employment contract after the protected period by only paying the remaining value of his contract as compensation? In an earlier edition of the International Sports Law Journal, I wrote an article regarding the Webster-case and its consequences for the future. In that article I analyzed whether the clubs would indeed face more difficulties after the decision, given that the players might be entitled to terminate their contracts unilaterally after the protected period. In that article it was concluded that it should not be presumed beyond doubt after the Webster-case that the remaining value in future cases had to considered as the only criterion in order to establish the amount of compensation. After Webster we were left with many unanswered questions that gave rise to the suspicion that the remaining value should not be the only decisive criterion in determining the amount of compensation. For example, in future cases aggravating circumstances, more specifically the status and behavior of the parties, could play an important role and could have effect on the amount of compensation to be paid. And, more importantly, does not each request for compensation has to be assessed on a case-by-case basis? (2) Many questions were still unanswered. On 19 May 2009, the CAS came with a follow up. In the so-called Matuzalem-case, the CAS decided that the remaining value was not the only criterion in order to establish the amount of compensation after a unilateral termination of a player outside the protected period. In this case, the CAS ruled that the award of damages had to be based upon the principle of "positive interest", i.e. putting the injured party in the position it would have been in, had there been no breach of contract. The Matuzalem-case provided clubs and players with judicial handholds to claim extra damages on the party breaching the contract. The CAS was not willing to follow the CAS panel in the Webster-case since it was of the opinion that extra damages could be claimed. Now the CAS panel in the Matuzalem-case ruled differently, it was interesting to see what CAS panels would decide in future with regards to the amount of compensation in case of a unilateral termination after the protected period. It was interesting to see what the future would bring and how this jurisprudence was going to develop. Would the Webster-doctrine be followed or was Matuzalem leading? In the recent De Sanctis-case, the CAS now seems to clarify things up. In this case, in which was also adjudicated with regards to a termination after the protected period, the Italian player Morgan de Sanctis played with the Italian club Udinese and terminated his contract after the protected period, such as Webster and Matuzalem did previously. Udinese claimed that the player and his new club Sevilla were not entitled to (only) pay the remaining value of the contract and claimed that the award of damages had to be based upon the principle of "positive interest", such as the CAS did in Matuzalem. …


Background. We aimed to determine whether a 6-day course of intravenous methylprednisolone (MP) improves outcome in patients with SARS CoV-2 infection at risk of developing Acute Respiratory Distress Syndrome (ARDS). Methods. Multicentric, partially randomized, preference, open-label trial, including adults with COVID-19 pneumonia, impaired gas exchange and biochemical evidence of hyper-inflammation. Patients were assigned to standard of care (SOC), or SOC plus intravenous MP [40mg/12h 3 days, then 20mg/12h 3 days]. The primary endpoint was a composite of death, admission to the intensive care unit (ICU) or requirement of non-invasive ventilation (NIV). Results. We analyzed 85 patients (34, randomized to MP; 22, assigned to MP by clinician preference; 29, control group). Patient age (mean 68{+/-}yr) was related to outcome. The use of MP was associated with a reduced risk of the composite endpoint in the intention-to-treat, age-stratified analysis (combined risk ratio -RR- 0.55 [95% CI 0.33-0.91]; p=0.024). In the per-protocol analysis, RR was 0.11 (0.01-0.83) in patients aged 72 yr or less, 0.61 (0.32-1.17) in those over 72 yr, and 0.37 (0.19-0.74, p=0.0037) in the whole group after age-adjustment by stratification. The decrease in C-reactive protein levels was more pronounced in the MP group (p=0.0003). Hyperglycemia was more frequent in the MP group. Conclusions A short course of MP had a beneficial effect on the clinical outcome of severe COVID-19 pneumonia, decreasing the risk of the composite end point of admission to ICU, NIV or death.


Based on the temperature change in an embankment, a seepage flow simulator and monitoring system based on distributed optical fiber sensing are proposed. A simulator is designed that consists of scale model of embankment with definite length, seepage flow control cell and monitoring cell. Conventional hygrothermograph and flowmeter are employed in system dispersedly. The results from those conventional instruments were used to compare with the data from a distributed fibre sensing DiTeSt analyzer. The simulator equipment can monitor various embankments with different boundary conditions, such as temperature, distributions of soakage line and scales. The process of producing seepage pathway and configuration of sensing cable are presented, as well as test results with a field-installed fiber optic sensing cable. The simulator and results are helpful to build reasonable configurations for field real-time monitoring of abnormal seepage flow, which also offer an effective approach to study problems related to a secured embankment.


Vandetanib is a novel multitarget tyrosine kinase inhibitor (TKI) that inhibits vascular endothelial growth factor receptor-2 (VEGFR-2), with additional inhibition of epidermal growth factor receptor (EGFR) and rearranged during transfection receptor signaling, which has shown promising results in clinical trials for advanced non-small cell lung cancer. However, the mechanisms of acquired resistance to vandetanib remain unclear. Therefore, we established in vitro vandetanib-resistant PC-9/VanR cells from PC-9, a vandetanib-sensitive lung adenocarcinoma cell line, by chronic exposure to this agent. PC-9/VanR cells were 50-fold more resistant to vandetanib than PC-9 cells in vitro. Compared with PC-9 cells, PC-9/VanR cells showed emergence of an EGFR T790M mutation, moderately elevated MET amplification, and similar VEGFR-2 inhibition by vandetanib. Note that phospho-MET in PC-9/VanR was suppressed following EGFR inhibition by an irreversible EGFR-TKI, indicating that MET signaling of PC-9/VanR was dependent on EGFR signaling and that MET amplification was not the primary mechanism of resistance to vandetanib. In contrast to the in vitro experiment, vandetanib effectively inhibited the growth of PC-9/VanR tumors in an in vivo xenograft model through the antiangiogenesis effects of VEGFR-2 inhibition. In conclusion, the multitarget TKI vandetanib induced or selected for the EGFR T790M mutation as observed previously with highly selective EGFR-TKIs. However, vandetanib retained significant efficacy in vivo against xenografts harboring the T790M mutation, providing a strong scientific rationale for investigating vandetanib in clinical settings where acquired resistance through emergence of EGFR T790M mutations limits the effectiveness of highly selective EGFR-TKIs.


Accepted: 05.09.2013 Foreign language teachers need to motivate their students to learn English. Literature can be a good means to achieve motivation in ELT classes. There has recently been a revival of interest in literature as a practical, motivating and an effective resource available for language learning. Therefore, we can assume that literature and authentic literary materials, especially short stories can enhance motivation of ELT students. Keeping this in mind, this study was carried out in an ELT classroom by using two homogeneous groups: an experimental group and a control group. First, for one semester, Experimental Group was provided with unabridged, authentic short stories, whereas Control Group was exposed to abridged and simplified texts and reading passages. The findings showed that the Experimental Group's overall results of final exams and outcomes were better than that of the Control Group. Second, an attitude survey was used to understand the level of motivation of literature and to determine whether literature has a positive effect on reading and writing. The results suggested that use of short stories enhances learning and may be good motivational means in second and/or foreign language teaching settings through developing integrated reading, speaking, writing and listening skills. The results of this study may be beneficial to language practitioners in their classroom teaching.


Objectives To evaluate the utilisation of oxycodone in a tertiary care centre based in the North of England serving a population of 330 000. Methods A prospective study which gathered data from October 2011 to March 2012. Medical notes were screened to determine the prevalence of oxycodone use during the study period. The medication histories were determined; once the reason for oxycodone initiation was established, it was interpreted and classified as either appropriate or inappropriate. Results During the study period, a total of 51 patients were taking oxycodone; one patient was lost to follow-up. General practitioners were found to be the most common group responsible for initiating oxycodone (22 patients, 44%), followed by specialist palliative care nurses (11 patients, 22%). Other prescribers included palliative care consultants (nine patients, 18%); hospital doctors (seven patients, 14%) and a site-specific specialist nurse (one patient, 2%). Of the 50 patients, 17 (34%) were considered to be using oxycodone inappropriately. The most frequent reason for inappropriate use was initiating oxycodone without initially trying morphine. Conclusions Oxycodone is initiated inappropriately in a significant number of palliative care patients and should only be used as a second-line strong opioid or if morphine is not suitable or cannot be tolerated. The specialist palliative care team should be consulted for advice in cases of complex pain management.


In the mid North Atlantic Chauliodus sloani is caught mainly between 55° and 29° N, while the majority is caught north of 35° N. The greatest density is found around 40° N. Chauliodus danae has the northern limit of its distribution at about 45° N. C. danae, in particular the smaller specimens, shows clear vertical migration and has food preference, while C. sloani does not show such migration and is most probably a random feeder. In both species there is a significant increase in length from south to north. From the analysis of growth features in the otoliths it is demonstrated that C. danae grows relatively faster than C. sloani, though it reaches a smaller maximum length. C. sloani attains a greater maximum length and a higher age. Together with some anatomical differences, these are indications that the relation between both species is less close than usually supposed.


The thesis presents a new perspective on Giovanni Girolamo Kapsperger (ca.1580-1651), who is nowadays only famous for his works for theorbo and lute, his remarkable output of vocal music of all genres being still mostly neglected from musicologists and performers. The thesis aims to change the perception of the composer via three different angles: A reconstruction of his life and career with a substantial amount of new biographical information builds one pillar of the book, whereas in the second part his vocal works are approached and contextualized as prototypes of radical "stile novo" in Roman characteristic. The last third is dedicated to questions about basso continuo and Roman performance practice in Kapsperger's lifetime, dealing also with the composers' own material on continuo as fount of inspiration for continuo players of all instruments.


The Chinese automobile sector has experienced rapid growth over the past decade, with China recently becoming the world's largest producer of automobiles. Given the steel-intensive nature of automobile production, the expansion of China's automobile sector has seen it become an important end-user of steel. With the number of cars in China still very low relative to its large population, car sales are likely to remain at a high level for the foreseeable future; accordingly, Chinese car makers should remain a significant (and growing) source of demand for steel.


During the nineteenth century, 'Batswana' became used as label for a large number of people inhabiting the interior of southern Africa, and European missionaries played an important role in the evolution of the term's meaning and the adoption of that meaning by both Europeans and Batswana. Through their long years of residence among Batswana and development ofwrillenforms of Sets wan a, missionaries became acknowledged by other Europeans as experts on Tswana culture, and their notions of Tswana ethnicity became incorporated into European understandings of Africans and, eventually, into Batswana understandings of themselves. The development of Tswana identity passed through several stages and involved different layers of construction, depending on the level of European knowledge of Tswana societies, the purposes served by that knowledge, and the changing circumstances of Tswana peoples' relations with Europeans and others. Although Tswana identity has, in a sense, been invented, that identity has not existed in one set form nor has it simply been imposed upon Africans by Europeans. Parallel to European allempts to define Tswananess, Batswana developed their own understandings of Tswana identity, and although missionaries contributed much to the formation of 'Tswana' identity, it was not purely a European invention but resulted instead from interaction between Europeans and Africans and their mutual classification of the other in reference to themselves.


Transmission through a single subwavelength slit surrounded by nonperiodic or approximately periodic grooves in perfect conductive film has been analyzed numerically by the finite-difference time-domain method. Results show that the periodicity of the grooves is not the necessary condition to enhance the transmission, but is sufficient to obtain high enhancement. A spectrum with low enhancement and multiple peaks is obtained through a slit with nonperiodic grooves that is due to the resonances at different wavelengths caused by nonperiodicity. The spectrum of a slit with approximately periodic grooves is almost similar to that of a slit with absolutely periodic grooves regardless of whether the grooves are symmetric with respect to the slit, especially when the deflection of the grooves is very small compared to the grooves' period.


Longevity risk is a major issue for the developed world. As both mortality rates and birth rates fall, the increasing burden of providing for retirees falls on a smaller working population. Under such circumstances, the accurate modelling and measurement of longevity risk becomes particularly important. Longevity risk is present in the annuity portfolios of insurance companies, and increasingly of reinsurers as well. However, the biggest concentration of longevity risk in the private sector in the United Kingdom is most often in the shape of definedbenefit pension promises by employers. This makes longevity risk of crucial interest to managers and investors, even if they think that their business has nothing to do with insurance. Actuaries handle longevity risk by breaking it into two components: the current (or period) rates of mortality, and the projection of future rates. In both areas actuaries have made significant advances in their modelling and understanding of longevity risk. This critical review outlines how methods have developed, and how the papers in the accompanying thesis have contributed to these advances.


Large seaport hubs in Northwestern Europe are aiming to develop as circular hotspots and are striving to become first movers in the circular economy (CE) transition. In order to facilitate their transition, it is therefore relevant to unravel potential patterns of the circular transition that ports are currently undertaking. In this paper, we explore the CE patterns of five Belgian seaports. Based on recent (strategy) documents from port authorities and on in-depth interviews with local port executives, the circular initiatives of these ports are mapped, based on their spatial characteristics and transition focus. The set of initiatives per port indicates its maturity level in terms of transition towards a circular approach. For most studied seaports, an energy recovery focus based on industrial symbiosis initiatives seems to dominate the first stages in the transition process. Most initiatives are not (yet) financially sustainable, and there is a lack of information on potential new business models that ports can adopt in view of a sustainable transition. The analysis of CE patterns in this paper contributes to how ports lift themselves out of the linear lock-in, as it demonstrates that ports may walk a different path and at a diverging speed in their CE transition, but also that the Belgian ports so far have focused too little on their cargo orchestrating role in that change process. Moreover, it offers a first insight into how integrated and sustainable the ports' CE initiatives currently are.


Solar energy is an abundant resource, especially in Australia. While increasing numbers of households, businesses and utility companies are installing photovoltaics to combat climate change and ever increasing power bills, network operators are having to deal with the problems this can cause such as voltage rise and other power quality issues. Monitoring of PV systems is becoming increasingly more important in addressing such issues, as is localised environmental monitoring. Utilising different sensors to measure solar radiation, ambient temperature and wind speed, network operators are better able to predict and react to environmental changes which can affect the output of PV systems.

This report focuses on the installation of an environmental and PV inverter monitoring system for the Photovoltaic Training Facility on the Engineering and Energy Building at Murdoch University. This work follows on from that of Stuart Kempin who designed and managed the installation of the PV Training Facility and Mael Riou who designed much of the environmental monitoring system.

The environmental monitoring system consists of two anemometers, a wind vane, an ambient temperature sensor, two pyranometers (one mounted horizontally and one mounted on the plane of the PV array) and RTD temperature sensors for PV module temperature measurement. The communication interface for these sensors incorporates I/O modules from Avantech's ADAM 4000 series and communicates via RS485 with a computer running the LabView programming software for monitoring and logging purposes. Design work for the environmental monitoring system is now complete, including specifications and drawings for the mounting brackets.

For monitoring the PV inverters, serial communication is also utilised. Where required, each inverter is fitted with a serial communication card which is wired to the same computer used for environmental monitoring via an RS485 to USB adapter. Again, the LabView programming software is used to monitor the inverters. All physical aspects of the inverter monitoring system have been completed. This includes the selection and acquisition of a suitable computer interface along with enclosure design and construction to suit. Installation of serial communication cards in the inverters and wiring and connection of the inverters has also been completed.

Several smaller assignments were also undertaken over the course of the project such as the review of technical diagrams provided by the installer of the PV Training Facility and testing of the SMA Backup system to ensure correct functionality. Some background information on the functional earthing of PV arrays is given and discussed in relation to the PV Training Facility. Unfortunately, 3 final schematic diagrams of the system have not yet been obtained however sections of the actual system configuration including the functional earthing arrangement have been confirmed.

The eventual goal of the system is to provide a solid, safe and informative teaching platform which can be used in the future to educate students on the role such monitoring systems may have in real-world scenarios. It is also planned to utilise the system to compare PV technologies and inverter topologies and their reactions under different environmental conditions.


OBJECTIVE
The aim of this study was to present the evolution of four patients presenting pulmonary alveolar proteinosis and treated at the State University of Londrina School of Medicine. We focus on the importance of whole-lung lavage as the treatment of choice.

METHODS
A retrospective study of four patients, three females and one male, 22 to 34 years old, presenting similar histories of progressive dyspnea and dry cough. The final diagnosis was established through open-lung biopsy. Three of the patients underwent whole-lung lavage in the Department of Surgery. The procedures were performed under general anesthesia and using a double-lumen endotracheal tube.

RESULTS
One patient presented spontaneous regression of the pulmonary alveolar proteinosis without the need for whole-lung lavage. In the other three cases, the number of lavages varied: in one patient, a single unilateral lavage resulted in complete remission of the bilateral process; in another patient, three lavages yielded no significant improvement; in the remaining patient, four lavages provided intervening periods of transient improvement.

CONCLUSION
In the cases evaluated, whole-lung lavage proved an efficient treatment for pulmonary alveolar proteinosis. Although some patients presented a certain resistance to the procedure, it might lead to complete remission of the disease in others.


A "collusion puzzle†exists by which, even though increasing the number of firms reduces the ability to tacitly collude, and leads to a collapse in collusion in experimental markets with three or more firms, in natural markets there are such numbers of firms colluding successfully. We present an experiment showing that, if managers are deferential toward an authority, firms can induce more collusion by delegating production decisions to middle managers and providing suitable informal nudges. This holds not only with two but also with four firms. We are also able to distinguish compliance effects from coordination effects.


Fuzzy systems are currently finding practical applications, ranging from "soft" regulatory control in consumer products to accurate modelling of non-linear systems. This paper presents the design of a classification system for vehicle acoustic signal classification. Traffic management and information systems rely on a suite of sensors for estimating traffic parameters. Currently inductive loop detectors and video-based systems are often used to count and detect vehicles. Loop detectors are expensive to maintain and video-based systems are sensitive to environmental conditions and do not perform well in vehicle classification. Vehicle classification is important in the computation of the percentages of vehicle classes that use streets and motorways. The use of an automated system can lead to adequate road surface maintenance with obvious results in cost and quality. However the sound of a working vehicle could provide an important clue to the vehicle type. A novel approach, based on adaptive fuzzy logic systems, has been discussed in this paper. Its performance is evaluated through a simulation study, using metered data collected from a roadside microphone-array sensor at the Valle d'Aosta highway in north-western Italy. The results indicate that the fuzzy classifier based on the proposed defuzzification method, namely area of balance (AOB), provide more accurate classifications compared to other classifiers.


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PR value is not in the column centimeters alone says Simone Appleton.
A standard dictionary definition of value usually refers to an amount of goods, services or money that is a fair equivalent for something else. But when it comes to quantifying the value, or investment return for public relations (PR) activities, some traditional methods hardly start to justify the means, and sometimes not even the end.
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This study describes the planning, teaching, and challenges of one classroom teacher during writing time in two second grade classrooms. The study looks at how this teacher planned for and implemented a writing curriculum in which computers played a role and what this teacher did in an attempt to influence children's development as writers. Data collected included four formal interviews with the teacher and observations over a period of two semesters of the teacher as she worked in the classroom and computer lab during writing time. The constant comparative method as described by Maykut and Morehouse (1994) was used to analyze the data. Analysis revealed that this teacher's approach was influenced by state standards and policy guidelines, as well as her early experiences with literacy. In the lab, she focused on helping students develop keyboarding skills through keyboarding exercises, a computer game, and occasional word-proceeding of writing pieces done in the classroom. In the classroom she used a routine that consisted of three pre-writing activities. These involved students in reading materials related to the topic, brainstorming ideas they recalled, mapping relationships among brainstormed ideas, and writing group and individual accounts of their reading. Her approach to teaching in the city was quite similar to the approach she used in the county school. It differed insofar as in the county school she introduced the students to using the computer to conduct information searches about topics in the official state curriculum. Among the challenges she identified in her teaching were time and management problems. Based on these findings, the study identified four foci that might contribute to more effective use of computers in writing instruction. These include the teacher conceptions of literacy, effective planning, effective implementation and classroom management.


Background The management of human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC) has changed dramatically with the introduction and widespread use of HER2-targeted therapies. However, there is relatively limited real-world information on patterns of use, effectiveness and safety in whole of population cohorts. The research programme detailed in this protocol will generate evidence on the prescribing patterns, safety monitoring and outcomes of patients with BC treated with HER2-targeted therapies in Australia. Methods/design Our ongoing research programme will involve a series of retrospective cohort studies that include every patient accessing Commonwealth-funded HER2-targeted therapies for the treatment of early BC and advanced BC in Australia. At the time of writing, our cohorts consist of 11 406 patients with early BC and 5631 with advanced BC who accessed trastuzumab and lapatinib between 2001 and 2014. Pertuzumab and trastuzumab emtansine were publicly funded for metastatic BC in 2015, and future data updates will include patients accessing these medicines. We will use dispensing claims for cancer and other medicines, medical service claims and demographics data for each patient accessing HER2-targeted therapies to undertake this research. Ethics and dissemination Ethics approval has been granted by the Population Health Service Research Ethics Committee and data access approval has been granted by the Australian Department of Human Services (DHS) External Review Evaluation Committee. Our findings will be reported in peer-reviewed publications, conference presentations and policy forums. By providing detailed information on the use and outcomes associated with HER2-targeted therapies in a national cohort treated in routine clinical care, our research programme will better inform clinicians and patients about the real-world use of these treatments and will assist third-party payers to better understand the use and economic costs of these treatments.


A prevalent type of protein misfolding causes the formation of β-sheet-rich structures known as amyloid fibrils. Research into the mechanisms of fibril formation has implications for both disease prevention and nanoscale templating technologies. This investigation into the aggregation of insulin utilises ion mobility mass spectrometry coupled with molecular modelling to identify and characterise oligomers formed during the 'lag' phase that precedes fibril growth. High resolution mass spectrometry and collision induced dissociation is used to unequivocally assign species as m/z coincident multimers or confomers, providing a robust analytical approach that supports the use of molecular dynamics to atomistically resolve the observed oligomers. We show that insulin oligomerises to form species In where 2 ≤ n ≤ 12 and within this set of oligomers we delineate over 60 distinct conformations, the most dominant of which are compact species. Modelling trained with experimental data suggests that the dominant compact dimers are enriched in β-sheet secondary structure and dominated by hydrophobic interactions, and provides a linear relationship between Rg and collision cross section. This approach provides detailed insight to the early stages of assembly of this much studied amyloidogenic protein, and can be used to inform models of nucleation and growth.


Primary Healthcare Staffing Needs Assessment— A Discrete Event Simulation Study Tolulope Abe Chair of the Supervisory Committee: Associate Professor Kenneth Sherr Global Health Background: Mozambique has a shortage of primary healthcare workers, effecting the quality of primary healthcare delivery. The specific aim of the proposed research is utilizing Industrial & Systems Engineering methods, specifically discrete event simulation, to identify strategies to improve primary healthcare delivery system performance in the Sofala Province of Mozambique. To improve primary healthcare delivery and assist facility-level management with decisionmaking, the research team decided to study staffing level effects on patient waiting time and develop a decision support tool that determines staffing level needs to maintain an average total wait time of less than 60minutes. Methods: A discrete event simulation study was performed to model primary healthcare facility delivery systems using Arena Simulation software. What-if scenario experiments testing the impact health worker staffing level and patient demand fluctuations have on patient waiting time were designed using Statistical Analysis Software, and the experimental runs were performed using Arena Simulation Process Analyzer application. Minitab was used to perform a regression analysis to find mathematical models of wait time as a function of patient demand and staffing levels. Results: The mathematical relationship of health worker staffing and patient demand levels with average patient wait time was estimated using regression analysis. The number of staff required to provide services was the aggregate of staffing needed for all patient types of a given facility. This approach produced staffing and wait time results that could not be validated and used to create a spreadsheet-based decision support tool. Conclusion: The spreadsheet-based decision support tool aimed to bridge the gap between industrial and systems engineering methods and healthcare stakeholder knowledge of these methods while promoting implementation by allowing decision makers to perform simulations through a user-friendly tool. Although the proposed approach described in this study could not be validated, this method is beneficial when attempting to evaluate performance improvement strategy impacts on measures of performance. To create the spreadsheet-based decision support tool, it is recommended that an alternative approach be used to determine the relationship between wait time, patient demand, and staffing levels, such as queuing analysis.


We study a generalization of the treatment effect model in which an observed discrete classifier indicates in which one of a set of counterfactual processes a decision maker is observed. The other observed outcomes are delivered by the particular counterfactual process in which the decision maker is found. Models of the counterfactual processes can be incomplete in the sense that even with knowledge of the values of observed exogenous and unobserved variables they may not deliver a unique value of the endogenous outcomes. We study the identifying power of models of this sort that incorporate (i) conditional independence restrictions under which unobserved variables and the classifier variable are stochastically independent conditional on some of the observed exogenous variables and (ii) marginal independence restrictions under which unobservable variables and a subset of the exogenous variables are independently distributed. Building on results in Chesher and Rosen (2014a), we characterize the identifying power of these models for fundamental structural relationships and probability distributions and for interesting functionals of these objects, some of which may be point identified. In one example of an application, we observe the entry decisions of firms that can choose which of a number of markets to enter and we observe various endogenous outcomes delivered in the markets they choose to enter.


The association between traffic–related air pollution and long–term respiratory health problems has been extensively studied. In this work we evaluated the effect of traffic–related air pollution on respiratory symptoms in children living in Florence, Italy. Children were selected from different schools part of the Italian Studies on Respiratory Disorders in Children and the Environment 2. Exposure to traffic air pollution was assessed through a dispersion model and weighted by distance using four different criteria. A Bayesian hierarchical logistic regression model was specified to assess the impact of traffic air pollution on cough or phlegm and asthma. Potential confounders were included in the analysis. Familiarity of asthma and exposure to second–hand smoking showed the strongest positive association with respiratory symptoms. No evidence of increasing risk of asthma with urban air pollution was found, while some evidence of an association was observed for carbon dioxide and cough or phlegm.


Abstract Microseismic monitoring provides good spatial and temporal information about hydraulic-fracture development in unconventional reservoirs, but it is insufficient by itself to define all the important characteristics of the created fracture system. Other diagnostics can aid in interpretation of fracturing, particularly with respect to volumetric distribution (using microdeformation) and near-wellbore conditions (using fiber optics). The ultimate goal is a better understanding of the effectively producing system through a combination of diagnostics and modeling.


Positron emission tomography (PET) is a powerful in vivo imaging technique capable of providing dynamic information on biochemical processes in the living human subject. Applications of PET in oncology, neurology, psychiatry, cardiology and other medical specialties continue to grow. The use of PET relies on the characteristics and availability of appropriately labeled radiopharmaceuticals. Carbon-11 is one of the most useful radionuclides for PET chemistry, since its introduction into a biologically active molecule dose not modify the biochemical properties of the compound. [11C]Carbon dioxide (CO2), produced by cyclotron, is the most common and versatile primary labeling precursor in the production of 11C–labeled radiopharmaceuticals.


BACKGROUND
During primary percutaneous coronary intervention (PCI), manual thrombectomy may reduce distal embolization and thus improve microvascular perfusion. Small trials have suggested that thrombectomy improves surrogate and clinical outcomes, but a larger trial has reported conflicting results.

METHODS
We randomly assigned 10,732 patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary PCI to a strategy of routine upfront manual thrombectomy versus PCI alone. The primary outcome was a composite of death from cardiovascular causes, recurrent myocardial infarction, cardiogenic shock, or New York Heart Association (NYHA) class IV heart failure within 180 days. The key safety outcome was stroke within 30 days.

RESULTS
The primary outcome occurred in 347 of 5033 patients (6.9%) in the thrombectomy group versus 351 of 5030 patients (7.0%) in the PCI-alone group (hazard ratio in the thrombectomy group, 0.99; 95% confidence interval [CI], 0.85 to 1.15; P=0.86). The rates of cardiovascular death (3.1% with thrombectomy vs. 3.5% with PCI alone; hazard ratio, 0.90; 95% CI, 0.73 to 1.12; P=0.34) and the primary outcome plus stent thrombosis or target-vessel revascularization (9.9% vs. 9.8%; hazard ratio, 1.00; 95% CI, 0.89 to 1.14; P=0.95) were also similar. Stroke within 30 days occurred in 33 patients (0.7%) in the thrombectomy group versus 16 patients (0.3%) in the PCI-alone group (hazard ratio, 2.06; 95% CI, 1.13 to 3.75; P=0.02).

CONCLUSIONS
In patients with STEMI who were undergoing primary PCI, routine manual thrombectomy, as compared with PCI alone, did not reduce the risk of cardiovascular death, recurrent myocardial infarction, cardiogenic shock, or NYHA class IV heart failure within 180 days but was associated with an increased rate of stroke within 30 days. (Funded by Medtronic and the Canadian Institutes of Health Research; TOTAL ClinicalTrials.gov number, NCT01149044.).


The U.S. Department of Housing and Urban Development (HUD) recently announced the creation of a pilot loan program for home energy improvements. The PowerSaver loan program is a new, energy-focused variant of the Title I Property Improvement Loan Insurance Program (Title I Program) and is planned for introduction in early 2011. The PowerSaver pilot will provide lender insurance for secured and unsecured loans up to $25,000 to single family homeowners. These loans will specifically target residential energy efficiency and renewable energy improvements. HUD estimates the two-year pilot will fund approximately 24,000 loans worth up to $300 million; the program is not capped. The Federal Housing Administration (FHA), HUD's mortgage insurance unit, will provide up to $25 million in grants as incentives to participating lenders. FHA is seeking lenders in communities with existing programs for promoting residential energy upgrades.


ABSTRACT The lower Georgia Coastal Plain consists of six Pleistocene barrier island coastlines. Each barrier sequence can be sub-divided into lagoon-salt marsh and barrier island facies. The former include estuary and tidal channel sediments, whereas the barrier island facies include dune, littoral and offshore channel deposits. Thus, each barrier sequence constitutes a formation. The Georgia Sea Islands bordering the mainland are, for the most part, Holocene in age. The Pleistocene deposits are deeply podsolized in marked contrast to the poorly developed soil profiles in the Holocene sediments. Analysis of the heavy mineral fraction of samples from the Pleistocene Formations shows that, despite pedogenesis and diagenesis, there is no apparent relationship between depth of weathering and occurrence of minerals. Distinctive constituents of the Pleistocene barrier island deposits in order of percentage occurrence are sillimanite, staurolite, kyanite, epidote, hornblende, garnet, andalusite and zoisite--a medium to high grade metamorphic suite. Two heavy mineral provinces can be distinguished, based primarily on the epidote and green hornblende content of the Pleistocene and Holocene sediments. These are a Holocene beach province, fairly high in both epidote and green hornblende, and a Pleistocene province low in both minerals. These two provinces are also distinctive with regard to the amount of sillimanite which is far more abundant in Pleistocene, than in Holocene sands. Corroborative evidence has been found in respect of a number of conclusions reached by previous workers. The principal conclusion is that the heavy minerals of the Georgia Coastal Plain appear to have been derived originally from the Georgia Piedmont.


Integrins are cell adhesion receptors that are evolutionary old and that play important roles during developmental and pathological processes. The integrin family is composed of 24 αβ heterodimeric members that mediate the attachment of cells to the extracellular matrix (ECM) but that also take part in specialized cell-cell interactions. Only a subset of integrins (8 out of 24) recognizes the RGD sequence in the native ligands. In some ECM molecules, such as collagen and certain laminin isoforms, the RGD sequences are exposed upon denaturation or proteolytic cleavage, allowing cells to bind these ligands by using RGD-binding receptors. Proteolytic cleavage of ECM proteins might also generate fragments with novel biological activity such as endostatin, tumstatin, and endorepellin. Nine integrin chains contain an αI domain, including the collagen-binding integrins α1β1, α2β1, α10β1, and α11β1. The collagen-binding integrins recognize the triple-helical GFOGER sequence in the major collagens, but their ability to recognize these sequences in vivo is dependent on the fibrillar status and accessibility of the interactive domains in the fibrillar collagens. The current review summarizes some basic facts about the integrin family including a historical perspective, their structure, and their ligand-binding properties.


The financial crisis has brought the problems of regulatory failure and unbridled counterparty risk to the forefront in financial discussions. In the last decade, central counterparties have been created in order to face those insidious problems. In Mexico, both the stock and the derivatives markets have central counterparties, but the money market has not. This paper addresses the issue of creating a central counterparty for the Mexican money market. Recommendations that must be followed in the design and the management of risk of a central counterparty, given by international regulatory institutions, are presented in this study. Also, two different conceptual designs for a central counterparty, appropriate for the Mexican market, are proposed. Final conclusions support the creation of a new central counterparty for the Mexican money market.


Immunotropic aspect of the Bacillus coagulans probiotic action Objective Currently, probiotics are increasingly used as the alternative to antibiotics as well as the preventive measures in humans. In particular, probiotics occupy a key position in the treatment of antibiotics-associated intestinal dysbiosis. A spore-forming microorganism lactobacillus Bacillus coagulans is one of the most promising probiotics. However, some of its pharmacological effects remain poorly understood. Aim. This study is aimed at investigation of the effect of Bacillus coagulans (Laktovit Forte) on the intestinal dysbiosis syndrome in mice caused by streptomycin against the background of cyclophosphamide-induced cellular immunodeficiency. Methods. Pharmacological method: mouse model in vivo with immunodeficiency caused by cyclophosphamide. Key findings. In mice with colitis caused by streptomycin treatment, the administration of Bacillus coagulans (Laktovit Forte medicinal product) resulted in an antidiarrheal effect, normalization of gastrointestinal motility, and prevention of the animals' weight loss. Given the cyclophosphamide-induced immunosuppression and streptomycin-associated diarrhoea, the immunity was completely restored only under the action of Bacillus coagulans. Conclusions. According to all parameters, Bacillus coagulans has been proved to be more effective as compared to the Linex Forte reference product containing lacto‐ and bifidobacteria.


Objectives: Hearing impairment in children is considered as an important public health problem. Auditory function in these children is poor and depends on their hearing aids efficacy and also their ears' status. Hearing aids are very expensive and ear disease deteriorates its performance. Therefore detecting the ear disease and offering proper treatment is necessary. The aim of this study is to highlight the prevalence of ear disease in children with SNHL to justify the efforts made to insure diagnosis and adequate treatment. Method: Eighty children with bilateral sensorineural hearing loss were selected in our study from deaf Welfare Clinic affiliated to Welfare Organization. Otological examination and tympanometry were performed for all these children. Results: The most pathologic finding was ear wax and observed in 37 children (48.7%). Ear discharge was seen in 7 (8.7%) children. Normal TM in 63 (81.8%), abnormal TM in 14 (18.2%) and perforated TM in 3 cases were detected. Conclusion: The most common disorder was wax which deteriorates hearing aids performance by clogged ear molds. Middle ear disease which aggravates the degree of hearing loss in one forth of children was observed. The high prevalence of external and middle ear disease highlights the need of regular otological examination in hearing impaired children.


Elimination of redundant synapses and formation of functional circuits in developing brain involves axon guidance molecules. As the brain develops, early synapse formation is exuberant and haphazard. But as development progresses, connections are refined into functional networks. In that process, many synapses get eliminated. Uesaka et al. now show that molecules already known for axon guidance are functional later on when they regulate the synaptic pruning needed to refine the circuits connected during axon guidance. N. Uesaka, M. Uchigashima, T. Mikuni, T. Nakazawa, H. Nakao, H. Hirai, A. Aiba, M. Watanabe, M. Kano, Retrograde semaphorin signaling regulates synapse elimination in the developing mouse brain. Science 344, 1020–1023 (2014). [Abstract] [Full Text]


Background The use of biological drugs such as tocilizumab for rheumatoid arthritis (RA) is very expensive. However, some observational studies and recommendations from guidelines (BBF) suggest the possibility of reducing the dose of biologicals to the minimum effective dose in patients with good control of the disease. Purpose To assess the financial impact, measured as direct costs, of the use of reduced doses of tocilizumab for the treatment of RA in a tertiary hospital. Material and methods Observational, descriptive and retrospective study with patients diagnosed with RA. We included patients who received low doses of tocilizumab, because they had achieved remission or low disease activity with standard doses of tocilizumab (8 mg/kg every 28 days). Results 7 patients were included, all of them treated with tocilizumab 6 mg/kg every 28 days. The average weight was 75 kg (55–100). The average annual cost per patient with a dose of 6 mg/kg every 28 days was €9,394 (6,647–13,899). The average annual cost for the same patient in the previous year, with doses of 8 mg/kg every 28 days, had been €12,178 (8,863–16,115). The average saving per patient/year was €2,784 (2,215–3,939). The use of reduced doses of tocilizumab for these 7 patients resulted in annual savings for the hospital of €19,490. Conclusion Reducing the dose of tocilizumab in patients who have achieved remission or low disease activity having previously been treated with standard doses of tocilizumab provided direct savings for the hospital. Therefore, we are aware of the need to implement optimisation strategies in relation to the treatment of RA with tocilizumab in selected patients. However, more studies should be performed in order to determine the effectiveness of these dose reduction strategies and their financial impact on both direct and indirect costs. References and/or Acknowledgements No conflict of interest.


The urge to be seen to be 'doing something' is leading Europe's policy-makers to rely on the few instruments with which the EU can claim to foster growth. But, as Daniel Gros points out in this Commentary, they should recognise that today's growth crisis is quite different than it has been in the past. In his view, the real bargain should not be austerity plus a Marshall Plan for the south, but rather continued austerity plus labour-market reforms in the south, combined with more infrastructure investment in Germany and other AAA-rated countries like the Netherlands.


The development of mediation in Hong Kong is no longer in its infancy. Four decades after incorporating the process into the labour dispute resolution system, it is applicable in other specific fields and considered suitable for most types of contentious cases. This article examines the implementation and institutionalisation of mediation into the administrative and judicial systems. In so doing, it gauges the effectiveness and identifies major weaknesses of each stage of development. It concludes by proposing to expand the scope of application to consumer disputes and elder care issues, adopt an opt-out rather than opt-in triggering mechanism when time is ripe, and fine-tune certain provisions of the Mediation Ordinance so as to impose quality control over mediators, remove legal uncertainty concerning applicability of the Ordinance, and clarify the extent of statutory protection of mediation confidentiality.


As one of the most recommended strategies in decision making of contemporary medicine, evidence-based medicine (EBM) is attracting more and more attention. For EBM, the scientific evidences are obtained mainly from the randomized controlled trials (RCTs), systematic review and meta-analysis. In particular, meta-analysis can help researchers statistically combine several independent studies for a same clinical problem. In meta-analysis, Cohen's d and Hedges' g are among the most commonly used effect size measurements for continuous data. To compute these mean difference criteria, the sample mean and standard deviation are two conventional statistics reported in the literature. However, some other clinical studies may instead report the median, minimum and maximum values, and/or sample quartiles. Such a situation requires researchers to estimate the sample mean and standard deviation from these reported summary statistics. We note, however, that most existing estimators in the literature have some serious limitations. For this, we propose to improve the existing methods and extend them to three frequently encountered scenarios. In this thesis, we developed the optimal sample mean estimators, the normality test statistics and the updated Cohen's d mean difference criterion for three commonly encountered scenarios in meta-analysis. In Chapter 1, we gave a brief introduction on evidence-based medicine, meta-analysis and the summary data. In Chapter 2, we introduced our optimal estimators of the sample mean under the three scenarios, respectively. In Chapter 3, we proposed several methods for testing the normality of the underlying data. And in Chapter 4, we proposed to improve the famous Cohen's d and its relevant parameters. To assess the practical performance of our newly proposed methods, we also chose a few real data at the end of each chapter as illustrating examples. Numerical results of those studies indicated that our proposed methods have satisfactory performance both in theory and in practice. Following our new methodology, we also recommended an improved procedure for medical researchers to conduct meta-analysis. For illustration, we chose a meta-analysis in Chapter 5 on the effect of phytosterols to plasma CRP level (Rocha et al., 2016) to compare the results obtained from our recommended procedure and from the original methods.


Canadian universities' sharpened focus on international students starting in the early 2000s coincided with the growing interest by students from China to study abroad. Various actors, including states, have shaped and benefited from this increase in student migration. I examine how student migrants deal with the feeling rules transmitted to them, as an under-explored site where the migration experience is shaped and justified. In light of the work of Sara Ahmed and Arlie Russell Hochschild, I explore how students feel and are asked to feel about their studies abroad, and how emotions work in framing and maintaining the migration narrative. Through Ahmed's concept of skin of the collective, I argue that Chinese student migrants are affected by and contribute to an affective atmosphere regarding their years of study in Canada as specific feeling rules help them make sense of similar experiences of confusion, frustration, self-reliance, and responsibility. Based on interviews with students and university staffers, I discuss the links between this type of migration, the actors involved, and the emotional landscapes students navigate in order to highlight how they interpret their own experiences and how these interpretations contribute to maintaining a general narrative about being Chinese international students in Canada.


A self-consistent method for calculating electron transport through a molecular device is developed. It is based on density functional theory electronic structure calculations under periodic boundary conditions and implemented in the framework of the nonequilibrium Green function approach. To avoid the substantial computational cost in finding theI-V characteristic of large systems, we also develop an approximate but much more efficient non-self-consistent method. Here the change in effective potential in the device region caused by a bias is approximated by the main features of the voltage drop. As applications, the I-V curves of a carbon chain and an aluminum chain sandwiched between two aluminum electrodes are calculated—two systems in which the voltage drops very differently. By comparing to the self-consistent results, we show that this non-self-consistent approach works well and can give quantitatively good results.


When the availability of a vital resource varies between times of overabundance and extreme scarcity, management regimes must manifest flexibility and authority to adapt while maintaining legitimacy. Unfortunately, the need for adaptability often conflicts with the desire for certainty in legal and regulatory regimes, and laws that fail to account for variability often result in conflict when the inevitable disturbance occurs. Additional keys to resilience are collaboration among physical scientists, political actors, local leaders, and other stakeholders, and, when the commons is shared among sovereign states, collaboration between and among institutions with authority to act at different scales or with respect to different aspects of an ecological system. At the scale of transboundary river basins, where treaties govern water utilization, particular treaty mechanisms can reduce conflict potential by fostering collaboration and accounting for change. One necessary element is a mechanism for coordination and collaboration at the scale of the basin. This could be satisfied by mechanisms ranging from informal networks to the establishment of an international commission to jointly manage water, but a mechanism for collaboration at the basin scale alone does not ensure sound water management. To better guide resource management, study of applied resilience theory has revealed a number of management practices that are integral for adaptive governance. Here, we describe key resilience principles for treaty design and adaptive governance and then apply the principles to a case study of one transboundary basin where the need and willingness to manage collaboratively and iteratively is high—the Okavango River Basin of southwest Africa. This descriptive and applied approach should be particularly instructive for treaty negotiators, transboundary resource managers, and should aid program developers.


Intestinal lymhangiectasia (IL) is a rare cause of intractable, but potential curable ascites. It is characterised by a dilation of the lymphatics of the mucosa, submucosa, or subserosa in the small intestine and subsequent loss of lymph fluid. The symptoms are edema, diarrhea, and chylous ascites. It has been considered a rare disease in children with congenital malformations, but has recently been diagnosed more frequently in adults. The latter is more often caused by a local obstruction of the lymph vessels. We report a case of primary IL in a 62-year-old man, who presented with chylous ascites, diarrhea, and edema. The symptoms dramatically improved with the recommended low-fat, protein-rich diet, supplemented with medium-chain triglycerides (MCT) and parenteral nutrition. After cessation of the parenteral nutrition the chylous ascites relapsed and the parenteral nutrition, MCTs and diet were reinitiated, but he did not need paracentesis anymore. IL is now more frequently diagnosed, including asymptomatic cases being examined for other diseases. Therefore, it is important to be aware of this condition even in middle-aged patients since it can be treated and occationally cured.


For years, E. faecium only sporadically caused opportunistic infections in humans and was considered a relatively harmless commensal. In the last two decades, however, a specific polyclonal E. faecium subpopulation has rapidly become a prominent cause of nosocomial infections, which are often difficult to treat due to acquisition of resistance traits against multiple antimicrobials. These so-called hospital-derived E. faecium clones, that are characterized by ampicillin resistance, are responsible for the vast majority of hospital outbreaks and infections worldwide and are enriched with over a hundred specific genes, including (putative) virulence genes. The studies described in this thesis focus on the different forces that drive the epidemic rise of hospital-derived E. faecium. These studies demonstrated that on hospital wards where ampicillin-resistant E. faecium (ARE) colonization is endemic, ARE epidemiology is characterized by high admission, high patient-to-patient transmission and high environmental contamination rates and, as a consequence, by high infection attack rates. In particular patients of whom the intestinal flora is disrupted by the use of antibiotics are at high risk of acquiring colonization when they are exposed to ARE, either via a (re)admitted carrier or via the contaminated environment. ARE acquisition typically leads to high density intestinal colonization with E. faecium, which is probably one of the factors that contribute to successful transmission of ARE to other patients, by facilitating colonization of the skin and the inanimate environment. Colonization with ARE is only sporadically present in healthy humans in the community. Among healthy dogs and cats, however, ARE colonization was found to be prevalent. Part of the canine and feline strains were genetically indistinguishable from ARE clones that are frequently observed in nosocomial infections and outbreaks. This suggests that transfer of ARE between the animal and hospital reservoir has occurred in the past and that dogs and cats may still form an occasional source for nosocomial spread of ARE. To prevent infections it is important to control the spread of ARE. Mathematical modelling provided theoretical evidence that screening and pre-emptive isolation of patients at high risk of colonization on admission can be an effective measure to reduce endemic levels of nosocomial ARE carriage, in various different situations. It is important, though, to aim at a high sensitivity of the screening strategy, since this will yield the best efficacy at the lowest costs in the long term. In an intervention study in hospitalized patients, daily intake of probiotics, defined as representatives of the normal intestinal flora, to increase colonization resistance, unfortunately failed to prevent acquisition of ARE. The results of this thesis may form an important contribution to the development and design of infection control measures for ARE and similar nosocomial pathogens


This article presents two case studies of transmedial entertainment, one of the pulp franchise The Shadow and one of the contemporary franchise Transformers. The article argues that previous studies of transmedia entertainment have focused too much on narrative in a strict sense (plot/story), ignoring the interplay between the contexts of production and reception as well as narrative elements other than plot, notably those that create the greater narrative 'world'. The article therefore focuses on an integrated analysis of the production/reception of the two transmedia properties, and the narrative disjunctions created by extending a transmedia world across different media platforms. The study finds that transmedia narratives cannot be understood without taking media industry objectives into account, and that previous studies have overemphasized the narrative integration of transmedial properties.


We argue that the estimation of mutual information between high dimensional continuous random variables can be achieved by gradient descent over neural networks. We present a Mutual Information Neural Estimator (MINE) that is linearly scalable in dimensionality as well as in sample size, trainable through back-prop, and strongly consistent. We present a handful of applications on which MINE can be used to minimize or maximize mutual information. We apply MINE to improve adversarially trained generative models. We also use MINE to implement Information Bottleneck, applying it to supervised classification; our results demonstrate substantial improvement in flexibility and performance in these settings.


Background: The birth of a premature infant and admission to the NICU is often unexpected and traumatic for families, leading to increased distress and can negatively impact parental-infant attachment. Appropriate interventions can help to lessen the negative impact of a NICU admission on families, improving parental mental health, reducing distress, enhancing parent- infant relationships, and improving the long-term physical, cognitive, emotional, and social development of the infant.
Aims: The purpose of this study is to examine and evaluate research evidence on the effectiveness of current interventions for improving parental distress in the NICU. Methods: A rapid review was conducted utilizing a protocol based on the Virginia Commonwealth University guidance. Keyword searches were conducted on CINAHL, MEDLINE, and PsychINFO, and studies were selected according to pre-defined eligibility criteria, published between January 2015 and January 2020. The literature search included primary studies of interventions with parental stress and/or anxiety reduction as outcomes.
Results: A total of 14 articles were included, evaluating the effectiveness of 13 different interventions, including narrative writing, art therapy, structured nursing interventions, anxiety counselling, spiritual care, organizational change, music therapy, relaxation, and mindfulness techniques. With the Pexception of three, all the studies found significant results in the reduction of stress and/or anxiety levels of the subjects, with mothers having overall higher levels of stress indicated by higher stress scores on standardized measurement tools.
Conclusion:  There is a need for ongoing assessment of parental distress and integration of appropriate interventions within the NICU settings. In this review, both individualized and group interventions including narrative writing, art therapy, music therapy, spiritual care, activity-based group therapy, music therapy, audio-assisted relaxation techniques, mindfulness based neurodevelopmental care, cognitive behavioral based counselling, family nurture intervention and a structured nursing intervention were shown to be effective in reducing parental stress and/or anxiety in the NICU.  The small scale of the studies included in this review impact generalizability to a broader audience and emphasizes the need for larger scope, multi-center studies at an international level to build on and broaden our level of knowledge on how to better support families and reduce parental distress in the NICU.


In More Than a Movie, producer and entertainment attorney F. Miguel Valenti presents a compelling argument for the creative community to consider the consequences of its products, from movies to TV to the Internet. Valenti refrains from attacking the industries in which he himself works, but argues for reflection on the part of those who create media. More Than a Movie takes a pioneering first step toward outlining the issues in an insider fashion, and provides the tools to make ethical decisions about creating for the big and small screens. Edited by veteran media writer Les Brown and media consultant Laurie Trotta, More Than a Movie is written to stimulate debate in professional and academic arenas, and for the enjoyment of everyone who loves entertainment. The book contains a foreword by noted author and director Peter Bogdanovich, and commentary from producers Christine Vachon and David Brown. Mediascope, a Studio City, California-based media policy organization, commissioned the book upon discovering that ethical discussions seldom occur in film and television schools, although they are staples for studying law, medicine, business and journalism. Issues range from ethnic and gender stereotyping to excessive and gratuitous violence."It's not about censorship -- it's about having a responsibility for what we do," says author Valenti (no relation to MPAA's Jack Valenti). "The book outlines how we are helping to shape societal values and individual behavior with the artistic choices we make." A team of writers from across the nation offer essays: Neil Hickey, editor, Columbia Journalism Review; Annette Insdorf, Columbia University; Ted Pease, professor and columnist; Jack Pitman, Variety; Martin Koughan, Emmy Award-winning documentarian. The essays in More Than a Movie are interspersed with stories of actual ethical dilemmas told by noted screenwriters, directors and other practitioners in interviews by Manhattan writer Laura Blum.


Despite decades of research, the consistent estimation of structural forward-looking macroeconomic equations remains a formidable empirical challenge because of pervasive endogeneity issues. Prominent cases—the estimation of Phillips curves, Euler equations, or monetary policy rules—have typically relied on using predetermined variables as instruments, with mixed success. In this work, we propose a new approach that consists in using sequences of independently identified structural shocks as instrumental variables. Our approach is robust to weak instruments and is valid regardless of the shocks' variance contribution. We estimate a Phillips curve using monetary shocks as instruments and find that conventional methods substantially underestimate the slope of the Phillips curve.


Joint acceleration and velocity feedbacks are incorporated into a classical internal force control of a robot in contact with the environment. This is intended to achieve a robust contact transition and force tracking performance for varying unknown environments, without any need of adjusting the controller parameters. A unified control structure is proposed for free motion, contact transition, and constrained motion in view of the consumption of the initial kinetic energy generated by a nonzero impact velocity. The influence of the velocity and acceleration feedbacks, which are introduced especially for suppressing the transition oscillation, on the postcontact tracking performance is discussed. Extensive experiments are conducted on the third joint of a three-link direct-drive robot to verify the proposed scheme for environments of various stiffnesses, including elastic (sponge), less elastic (cardboard), and hard (steel plate) surfaces. Results are compared with those obtained by the transition control scheme without the acceleration feedback. The ability of the proposed control scheme in resisting the force disturbance during the postcontact period is also experimentally investigated.


Background: There are few studies on the patterns of clustering of health-related behaviours among adolescents. Most of the studies have not adequately explored the clustering of a wide range of health-related behaviours. The very few studies examining the determinants and variations in the clustering of health-related behaviours among adolescents merely assessed the variations in the clustering of health-related behaviours by socio-demographic factors. Moreover, they did not use rigorous statistical methods. Objectives: To assess the distribution of six health-related behaviours, namely, intake of fruits, intake of sweets, toothbrushing, physical activity, smoking, and physical fighting, in Saudi Arabian male adolescents. To identify the patterns of clustering of the six health-related behaviours in Saudi Arabian male adolescents. To assess the variations of the clustering count of the six health-related behaviours by demographic and socioeconomic status factors. To identify the role of psychosocial determinants of the clustering count of the six health-related behaviours. The psychosocial determinants assessed were self-confidence, future orientation, life satisfaction, and peer relationships. Methods: A representative stratified cluster random sample of 1335 Saudi Arabian male adolescents living in Riyadh city took part in this study. A modified WHO questionnaire was used to assess health-related behaviours. Hierarchical Agglomerative Cluster Analysis (HACA) was used as a first step to identify broad clusters of the six health-compromising behaviours (HCBs). Then clustering was assessed using an observed to expected ratio (O/E) method for possible combinations of the six HCBs. Poisson regression models were constructed to assess variations between selected explanatory variables and clustering count of the six HCBs. Results: About 85% of adolescents had low fruit consumption, 74% brushed their teeth less frequently, 64% had low physical activity, 51% had been involved in physical fighting, 43% ate more sweets, and 23% smoked tobacco. Hierarchical Agglomerative Cluster Analysis suggested two broad and stable clusters of the six health-compromising behaviours among Saudi male adolescents; 1. The first cluster included low fruit consumption, less frequent toothbrushing and low physical activity. 2. The second cluster included high sweets consumption, smoking and physical fighting. There were more than sixty patterns of health-compromising behaviours among both younger and older adolescent boys. Most patterns with the highest O/E ratio included smoking behaviour. Older adolescents (17-19 years) were more likely to have a greater clustering count of HCBs (RR: 1.06; 95% CI: 1.01-1.13) compared to younger adolescents (13-14 years). Adolescents whose fathers' education was up to secondary school or lower had a greater rate for clustering count of HCBs (RR: 1.07; 95% CI: 1.01-1.16) compared to those whose fathers completed higher education. There were no significant differences in clustering count of HCBs in relation to adolescents' perceived self-confidence (RR: 1.05; 95% CI: 0.99-1.12) and future orientation (RR: 1.05; 95% CI: 0.98-1.13). Adolescents who had low levels of life satisfaction (RR: 1.20; 95%CI: 1.10-1.31) and those who had middle levels of life satisfaction (RR: 1.07; 95% CI: 1.00-1.16) had a greater rate of clustering of HCBs compared to those with a high level of life satisfaction. The clustering rate of HCBs was higher for each extra evening meeting with friends (RR: 1.03; 95%CI: 1.01-1.04). Conclusions: The six health-compromising behaviours clustered into two broad clusters. Most of the clustering patterns with the highest O/E ratio included smoking behaviour. Adolescents' father's education level and life satisfaction were significantly negatively associated with clustering of health-compromising behaviours. Age of adolescents and evening meetings with friends were significantly positively associated with clustering of health-compromising behaviours. There were no significant variations in the clustering of health-compromising behaviours with adolescents' self-confidence and future orientation, after adjusting for age and father's education level.


We report the presence of two previously unrecognized features in the dorsal ribs of mosasaurs: first, the presence of extremely dense, pervasive extrinsic fibres (anchoring soft tissue to bone, sometimes called Sharpey's fibres); and second, high intraspecific variation in costal bone compactness. Extensive extrinsic fibres are developed in the dorsal ribs of the mosasaurs Tylosaurus proriger and Eonatator sternbergi. The dorsal ribs of these mosasaurs are also characterized by a longitudinally ridged texture that almost completely covers the bone. Pervasive extrinsic fibres and ridged textures are absent in the mosasaur Selmasaurus russelli as well as the dorsal ribs of extant semi‐aquatic reptiles (e.g. crocodyliforms) and mosasaurs' close extant relatives and analogues (e.g. snakes and varanids). Similar ridged textures characterize the dorsal ribs of several other mosasaur taxa but are developed to a lesser extent (e.g. Mosasaurus, Clidastes, Platecarpus and Ectenosaurus), but in no other taxa have pervasive extrinsic fibres been reported. We interpret these osteohistological features in T. proriger and E. sternbergi as evidence of tendinous attachment of extensive and highly differentiated axial musculature capable of producing great stresses, most likely related to stabilization of the trunk relative to contralateral movements of the tail during carangiform locomotion. We also report the compactness indices (percentage of space occupied by bone rather than cavities) for these large mosasaur ribs, which are much higher than previously reported. This suggests high intraspecific variation in bone compactness that complicates its use in reconstructing mosasaur palaeoecology.


Conventional capital budgeting techniques such as the discounted cash flow analysis fail to recognize managerial flexibility that may have a huge option value. Such managerial flexibility may include abandonment option, option to defer development, option to expand, option to contract, and switching options. Though the extension of option pricing theory to valuation of other assets is not a novel concept, it has become increasingly popular with the new economy frenzy. Unable to justify the strikingly high market valuations of technology stocks with orthodox techniques, academics and market professionals have started to exploit option pricing technologies that presage relatively much higher valuations, which are indeed justifiable for highly flexible and high-growth companies. Nevertheless, these valuations are also highly sensitive to initial conditions and exact specification of parameters, which can be a viable explanation for the relatively much higher volatility of returns for Internet stocks. Regardless of the discussion whether it makes sense to use real options in order to justify high market valuations, the real option methodology is indispensable in recognizing the managerial flexibility, which may be inherently embedded in any capital budgeting project. * Istanbul Commerce University, Faculty of Commercial Science.