Background: Non-Hodgkin's lymphoma is an aggressive malignant
disease in children and adolescents. Although it is the fourth most common
malignancy in Saudi children as reported in Saudi cancer registry, less
information is available about pediatric Non-Hodgkin lymphoma and its outcome
in Saudi Arabia. Study Objectives: To provide demographic data, disease
characteristics, treatment protocol, toxicity and outcome of treatment in
children & adolescents with Non-Hodgkin's lymphoma treated at KFMC. This
study will form base line for future studies about pediatric Non-Hodgkin's lymphoma
in KFMC, which may help to improve outcome for children with cancer in Saudi
Arabia. Study Patients and Method: We retrospectively analyzed 28 children and
adolescents diagnosed to have Non-Hodgkin's lymphoma at KFMC between December
2006 and December 2013, followed-up through June 2014. Results: Of the 28
patients, 10 (35.7%) girls and 18 (64.3%) boys, the male-to-female ratio was
1.8; 1. The median age at time of diagnosis was 6.4 years old (range 2.0 to
13.0 years old). The majority of patients (64.3%) were aged between 5 and 12
years old. Burkitt's lymphoma BL/BLL was the most common pathological subtype
(60.7%), and DLBCL was the second most common subtype (21.4%). Abdominal and
Retroperitoneal involvement was the most common primary site (78.6%) including
the ileocaecal region. Most of the children presented with advanced Stage III
and IV (75%), Cytogenetic study which screens specifically for the t (8; 14)
(q24; q32) a characteristic genetic feature of Burkitt's Lymphoma was obtained
from 21 patients, variant rearrangement was observed in 3/21 samples and
complex chromosomes karyotype in addition to IGH/MYC rearrangement was observed
in 2/21 samples. Those patients presented with very aggressive lymphoma and
combined BM and CNS involvement. We use the French-American-British Mature
B-Cell Lymphoma 96 Protocol (FAB LMB 96) for treatment fornewly diagnosed
Mature B-Cell type NHL and high risk ALL CCG 1961 Protocol for lymphoblastic
lymphoma and international Anaplastic Large Cell Lymphoma 99 Study Protocol for
ALCL. The median follow-up in patients not experiencing an adverse event was
53.1 months. The estimated 3-year EFE and OS rates in the entire cohort of
patients with newly diagnosed NHL treated in the KFMC were 85.2% and 89.2%
respectively; Overall survival (OS) rate of patients with mature B-cell-NHL was
88.9%. Conclusion: The outcomes and survival in our small series appeared to be
excellent compared with those reported in other international trials even
though most of our patients presented in advanced stage of the disease. We feel
that the importance of the current study is to document the relative
distribution of various types of pediatric non-Hodgkin's lymphomas and
age-specific distribution in different Histological subtypes.


This paper discusses a pilot reading-literacy development initiative in a class of Grade 6 township learners. The purpose of the study was to pilot a model of literacy development that could be implemented across a wider platform of schools. The pilot study, using classroom observation and focus group interviews, was designed within a psycholinguistic perspective. Criteria for effective reading-literacy development - access to text and the desire to engage, knowing what to do with text, and opportunities to understand and reflect on text - were used to design the study, and as a lens for analysis. The paper focuses on case studies as illustrative examples of the ways in which the initiative supported access to texts, reading-literacy confidence, and the development of interpretive and reflective reading skills. The study suggests that a conducive literacy environment, including access to texts, knowing what to do with texts, and opportunities to understand and reflect on text - as well as the support of teachers who know how to facilitate literacy - has the potential to achieve literacy gains for even seriously compromised learners.


A collaboration between California Polytechnic Corporation with Georgia Tech Research Institute (GTRI) and DHC Engineering worked on a NASA NRA to develop predictive capabilities for the design and performance of Cruise Efficient, Short Take-Off and Landing (CESTOL) subsonic aircraft. The focus of this work presented in this paper gives details of a large scale wind tunnel effort to validate predictive capabilities for this NRA for aerodynamic and acoustic performance during takeoff and landing. The model, Advanced Model for Extreme Lift and Improved Aeroacoustics (AMELIA), was designed as a 100 passenger, N+2 generation, regional, cruise efficient short takeoff and land (CESTOL) airliner with hybrid blended wing-body with circulation control. AMELIA is a 1/11 scale with a corresponding 10 ft wing span. The National Full-Scale Aerodynamic Complex (NFAC) 40 ft by 80 ft wind tunnel was chosen to perform the large-scale wind tunnel test in the scheduled to start summer of 2011. The NFAC was chosen because both aerodynamic and acoustic measurements will be obtained simultaneously, the tunnel is large enough that the downwash created by the powered lift will not impinge on the tunnel walls, and the schedule and cost fit into Cal Poly's time frame and budget. Several experimental measurement techniques will be used to obtain the necessary data to validate predictive codes being developed as apart of this effort: stationary microphones will be used to obtain far-field acoustic measurements including a 48 element phased array, the Fringe-Image Skin Friction (FISF) technique will be used to measure the global skin friction on the wing, and the a micro flow measurement device will measure the velocity profiles in the in the boundary and shear layers is still in development and presented in this paper.


This paper describes the results of the evaluation of the development of transmigration areas using index numbers. The index describes changes that occur in the economic, socio-cultural, infrastructure, environmental, and institutional dimensions in the Pamulutan Transmigration area, Ogan Ilir, South Sumatra. This study uses a quantitative methods. Quantitative method for determining index numbers. The research was conducted in May 2020. In collecting data using a questionnaire, respondents consisted of elements of the government, private sector, and the community. Respondents gave scores on the questionnaire which was guided directly by the researcher. 50 respondents were divided into 5 groups according to the number of evaluation dimensions. Determination of the index following the technique of multidimensional scaling (MDS). The index results show that the Pamulutan Transmigration Area is included in the category of autonomy. After receiving intervention in several dimensions as a strengthening program for the next 5 years, the area has become a competitive transmigration area. The results showed that the Parit Rambutan area met the autonomous and competitive criteria. Meanwhile, Indralaya and West Pamulutan are still in the undeveloped category. The results of this evaluation become a recommendation for the Ministry of Transmigration to make regulations and intervention actions in the development of transmigration areas for the next 5 years.


Neuroanatomy in Clinical Context, Ninth Edition provides everything the student needs to master the anatomy of the central nervous system, all in a clinical setting. Clear explanations; abundant MRI, CT, MRA, and MRV images; full-color photographs and illustrations; hundreds of review questions; and supplemental online resources combine to provide a sound anatomical base for integrating neurobiological and clinical concepts. In thus applying neuroanatomy clinically, the atlas ensures student preparedness for exams and for rotations. This authoritative approach-combined with such salutary features as full-color stained sections, extensive cranial nerve cross-referencing, and systems neurobiology coverage-sustains the legacy of this revolutionary teaching and learning tool as the neuroanatomy atlas. New and hallmark features elucidate neuroanatomy and systems neurobiology for course success! Features: new! Chapter on Herniation Syndromes decodes the elegant relationship between brain injury and resulting deficit; new! Clinical information integrated throughout the text is screened in blue for quick identification on the page; and new! Enhanced clinical images emphasize clarity and detail like never before, including full-color images replacing many in black and white, higher-resolution brain scans, and reprocessed spinal cord and brainstem images. MRIs complement full-color anatomical illustrations, allowing for visualization of structures both as they appear to the unaided eye and on imaging studies. Unique, full-color illustrations integrate clinical images of representative lesions with the corresponding deficits highlighted. Full-color stained sections facilitate the easy identification of anatomical features. Dozens of pathway drawings superimposed over MRIs connect structure with function of neural pathways. Located on the Point, this atlas' companion website offers a variety of supplemental learning resources to maximize study and review time! Question bank featuring over 280 USMLE-style and chapter-review style questions Bonus dissection photographs and brain slice series.


This paper addresses the practical implementation of means of tolerating residual software faults in complex software systems, especially concurrent and distributed ones. There are several inherent difficulties in implementing such fault-tolerant software systems, including the controlled use of extra redundancy and the mixture of different design concerns. In an attempt to minimize these difficulties, we present a generic implementation approach, composed of a multilayered reference architecture, a configuration method and an architectural pattern. We evaluate our implementation approach using an industrial control application whose control software we equip with the ability to tolerate a variety of software faults. The preliminary evidence from this case study shows that our approach can simplify the implementation process, reduce repetitive development effort and provide high flexibility through a generic interface for a wide range of fault tolerance schemes.


This study expands the general applicability of the Technology Acceptance Model (TAM) across cultures by incorporating cultural influence into its theoretical framework. Elements of Hofstede's cultural theory are incorporated into the TAM framework to examine the moderation effect of Power Distance on the relationship between Subjective Norms on the Perceived Usefulness of email in the context of the People's Republic of China. Moderated structural equation models (MSEMs) are used in the study to explore the moderating effect of Power Distance. The findings show that, contrary to some beliefs, the influence of Subjective Norms on Perceived Usefulness is stronger among individuals with lower Power Distance than among those with higher Power Distance. The individual level analysis of cultural factors used in the study attempts to avoid the over generalizations of cultural typology and remedy the inadequacy of post hoc explanation in conventional IS cultural studies. Findings will help organizations understand the influence of core societal values on email acceptance and so to better utilize social and cultural practices in organizational technological diffusion.


In this paper, we introduce another modification in the technique for making rainbow holograms based upon synthesization of a modulation equivalent to a slit in the objective wave. It has been demonstrated that the plane of localization of the synthesized aperture can be positioned anywhere with respect to the object by using a properly shaped illuminating wave. Thus the object itself rather than its real image is directly responsible for the rainbow hologram formation making the imaging lens unnecessary. A converging or a diverging spherical wave is required to illuminate the object transparency backed by a ground glass. The image reconstruction takes place in accordance with the conventional rainbow holographic process, with the synthesized aperture occupying the plane of convergence or divergence of the object wave as the case may be.


Personal Epistemology and Teacher Education, edited by Joanne Brownlee, Gregg Schraw and Donna Berthelsen, provides an international perspective on teachers' personal epistemology, or beliefs about the nature of knowledge and knowing. Research from The Netherlands, Cyprus, Australia, United States, Canada, Norway, and Taiwan is presented to provide diverse viewpoints on personal epistemology for early childhood, primary, secondary and tertiary teaching contexts. The text provides a platform for cutting-edge theory and research about how personal epistemology can be applied to the context of teacher education, thereby making explicit the connection between personal epistemology and teaching and students' learning outcomes. Topics include: •Cultural differences in teacher epistemology and the impact on students' learning. •Teachers' epistemological beliefs and inclusion. •Teachers' epistemology and reading lessons, citizenship education, and teaching science. •Epistemology in a social context. •Teachers' epistemological beliefs and student autonomy. •Teacher education and analysis of preservice and practicing teachers. •Implications of teachers' epistemological beliefs. •Connections to future practice. Teacher education and teacher behaviours are fore-grounded across the topics, with an emphasis on the origin and composition of teachers' epistemological beliefs and how universities motivate change through formal teacher education. Teaching behaviours are discussed in relation to how teachers' beliefs are related to the curricular and pedagogical choices that they make in their classrooms, assessment of learning outcomes, and classroom management practices.


This paper presents the development of supersonic free jet PVD as a new coating method for structural material to overcome technical problems contained in other coating methods. This PVD method consists of evaporation in gas atmosphere and deposition in vacuum, i.e., ultrafine particles are formed, carried and deposited to form film in a space of connected chambers, where ultrafine particles formed by the evaporation of material in an evaporation chamber with helium gas atmosphere are carried to a substrate with gas flow generated by the pressure difference between the evaporation chamber and a vacuumed deposition chamber and deposited with high velocity to form film. This study aims to form the metallic films of titanium and aluminum with the method and to elucidate the effects of control parameters for the development of the method. The velocity of ultrafine particles should be an important parameter for the film formation. In order to increase carrier gas velocity to increase particle velocity, we designed a nozzle on the assumption of one dimensional isentropic flow to attain the gas velocity of Mach 3.6 at the outlet of the nozzle. The results obtained are as follows: (1) Reduction of coarse particles by suppressing the stagnancy and secondary agglomeration of particles is necessary for producing metallic films of titanium and aluminum. (2) Growth rate of film increases in proportion to electric power to evaporate source metal. (3) To heat a nozzle is effective for the formation of film without voids. (4) No cracks were formed by indenting the diamond indenter of micro Vickers hardness tester at the interface between substrate and coated film with the force of 4.9 N, which indicates strong adhesion between them.


State systems that integrate data by linking police crash reports to medical records provide important information that can be used to better understand motor vehicle crash injuries. The objective of this study was to better understand the facilitators and barriers to successful data linkage systems. Data were collected by questionnaire, focus group, and a literature search. Twenty-five States completed the survey and 19 participated in focus groups. Facilitators of these systems included a community context that supports linkage, one lead agency to oversee the system, coalition of data owners, memorandums of understanding to obtain data, high quality data, staff with the right mix of technical and non-technical skills, technical assistance and training, and stable funding. Barriers included lack of funding, staff turnover, lack of documented procedures, lags in obtaining data, statutory requirements for data use, complex linkage techniques, and failure to adequately market information available from linked databases.


During the last two decades, while disk capacity, disk bandwidth and CPU performance have been improving at a rate of about 60% per year following Moore's law, disk access latency has only been improving at a rate of about 10% per year. The performance gap between disk access latency and the rest of the computer system has been increasing exponentially. Moreover, Redundant Array of Independent Disks (RAID) has become a standard approach to improving the bandwidth and capacity of disk subsystems after over a decade of research and development. As a result, disk access latency becomes a performance bottleneck of many I/O intensive applications. Although several techniques, such as striping, mirroring and data replication within a disk track, have been proposed to reduce disk access latency by sacrificing disk capacity, it is not clear how to systematically configure disk arrays to reduce disk access latency and improve disk throughput for a variety of workloads and disk characteristics.
This dissertation proposes a novel way of designing disk arrays that can flexibly and systematically reduce disk access latency while improving disk throughput. We call this new disk array configuration family "SR-Array" because it considers reducing both seek time and rotational delay in a balanced manner. The dissertation shows, via theoretical and experimental studies, that the SR-Array approach can indeed improve disk access latency significantly compared with existing disk array configuration techniques.
The dissertation makes several contributions. First, we have developed analytical models for disk array configurations, and we show how to use the models to guide disk array designs towards optimal configurations by considering both disk and workload characteristics. Second, we have proposed a robust disk head position prediction mechanism without any hardware support and a new algorithm to reduce both seek time and rotational delay for the SR-Array disk configurations. Third, we have implemented a prototype disk array system together with an accurate simulator in a layered approach that incorporates the configuration models. Finally, we have demonstrated that the SR-Array approach can indeed improve disk I/O performance significantly for several I/O intensive workloads over existing disk array configuration techniques.


This study analyzes the unsteady Rivlin-Ericksen fluid and irreversibility of exponentially temperature dependent variable viscosity of hydromagnetic two-step exothermic chemical reactive flow along the channel axis with walls convective cooling. The non-Newtonian Hele-Shaw flow of Rivlin-Erickson fluid is driven by bimolecular chemical kinetic and unvarying pressure gradient. The reactive fluid is induced by periodic changes in magnetic field and time. The Newtons law of cooling is satisfied by the constant heat coolant convection exchange at the wall surfaces with the neighboring regime. The dimensionless non-Newtonian reactive fluid equations are numerically solved using a convergent and consistence semi-implicit finite difference technique which are confirmed stable. The response of the reactive fluid flow to variational increase in the values of some entrenched fluid parameters in the momentum and energy balance equations are obtained. A satisfying equations for the ratio of irreversibility, entropy generation and Bejan number are solved with the results presented graphically and discussed quantitatively. From the study, it was obtained that the thermal criticality conditions with the right combination of thermo-fluid parameters, the thermal runaway can be prevented. Also, the entropy generation can minimize at low dissipation rate and viscosity.


The Genevan and Cattell-Horn theories of intelligence are compared. The theories are found to be similar in the following respects: Intelligence (operative intelligence and fluid ability) is conceptualized as adaptational in function; the products of everyday learning and crystallized skills reflect the impress of experience; one category of intelligence (operative intelligence, fluid ability) is conceptualized as prior or more fundamental than the other (learned products, crystallized skills). Important differences were also found: Whereas fluid ability is characterized as formless and fixed, operative intelligence is viewed as highly structured and evolving; a compensatory relation between noegenetic crystallized skills and fluid ability is hypothesized where such a relation is not conceived to exist between operative intelligence and learning. The relation of Piagetian operative level to the child's capacity to use crystallized solution procedures (aids) in making elementary numerical comparisons was investigated. Performance on quantitative comparison tasks reflecting the child's understanding of correspondence relations was highly related to operative level. It was also found that the child's capacity to implement solution aids in making quantitative comparisons was, to some extent, moderated by his or her level of operative development.


This thesis aims to provide a strong foundation for successful adoption of electronic textbooks (e-Textbooks) in school education. E-Textbooks are digitized forms of textbooks which have been envisioned to replace existing paper-based textbooks due to its educational advantages. In the context of this research they are textbooks adapted to the national school curriculum. Therefore, it is of paramount importance for the relevant parties (i.e. national and state governments, or school districts) to address their educational policy and identify the challenges they might face, as well as to identify decisions and projects they need to launch in order to provide educational advantages for students that can be applied nation-wide. This thesis starts by providing a brief overview of e-Textbooks, and subsequently an extensive discussion on challenges associated with e-Textbooks in the pursuit of replacing traditional textbooks with e-Textbooks. Additionally, this thesis further provides an extensive review on how the challenges have been approached using existing e-Textbook technologies, such as multi-touch technology, e-Paper, Web 2.0 and cloud computing. The main focus of this thesis is to develop and validate "the E-Textbook in Education Policy: ETiP", focusing on Eight domains (Policy, Infrastructure, Curriculum, Educational content, Standardisation, Human resource, Education Information System and Social study). The ETiP has been developed using the following set of three stages: 1) The Developing Stage in which computers are supplied to schools and computer networks are built at the basic level. Basic curriculum studies of e-Textbooks are conducted by the relevant national authority; 2) The Take-off Stage is reached when the construction of infrastructure required for the usage of electronic textbooks in schools is completed. At this stage, prototypes of e-Textbooks are developed; pilot testing is conducted at schools; and, 3) The Expansion Stage, where new educational content is further developed and revised with the enhancement of infrastructure as time goes by. The distribution of the e-Textbook is also conducted nationwide.


We introduce this thematic issue by exploring the role of leadership in social and political change. In current times, the importance of leadership and choice has proved as important as ever. Leadership is often the critical variable separating success or failure, legitimacy and sustainability or collapse. This thematic issue explores a range of in-depth case studies across the Asia-Pacific region that help illustrate the critical elements of leadership. Collectively they demonstrate that leadership is best understood as a collective process involving motivated agents overcoming barriers to cooperation to form coalitions that have enough power, legitimacy and influence to transform institutions. Five themes emerge from the thematic issue as a whole: leadership is political; the centrality of gender relations; the need for a more critical localism; scalar politics; and the importance of understanding informal processes of leadership and social change.


Data assimilation in Numerical Weather Prediction (NWP) optimally blends observations with atmospheric model data in order to obtain the best possible initial state for an atmospheric model prediction. Specification of error characteristics is an important part of data assimilation. This thesis is concerned with representation of background error standard deviations, with handling of observations, and with observation error characteristics. The research includes both the study of basic assimilation problems within the framework of an idealised quasi-geostrophic model and the development of assimilation algorithms for a full scale limited area high resolution forecasting system.It is shown in this thesis that an accurate representation of background error standard deviations is important for the quality of NWP forecasts. In particular the effect of introducing a time-dependency is investigated and a novel approach to relate the flow-dependency of background error standard deviations to an Eady baroclinic instability measure is developed. The Eady based flow-dependent background error representation is demonstrated to have a positive impact on NWP, as compared to horizontally and temporally independent background error statistics. An alternative method, based on on-line error estimation and maximum likelihood theory, is proven to be able to represent the flow-dependency of background error standard deviations and encouraging results are obtained within the quasi-geostrophic model framework. Furthermore, it is shown that a proper observation handling is an important part of data assimilation. The treatment of error characteristics is specifically shown to be of major importance when exploiting the potential benefit of radar radial wind observations within data assimilation.


This technical note describes the development of Laser Ablation of a Sample In Liquid (LASIL), a technique where the ablation occurs at a solid sample surface submerged in a liquid. LASIL can be performed in a 25 µl isolated, freestanding droplet that acts as a micro-laser cavity, to produce a suspended particulate that can be analysed either directly, or following in-droplet chemistry, by calibration against aqueous standards. The technique is robust and easy to implement being carried out in air, offline to the detection apparatus. The analytical characteristics of LASIL are its ease of quantification, containment of particles, the ease of generating suspended solids in solution from insoluble materials and the control over dissolution and dilution to generate measurable concentrations. NIST 611 (trace elements in glass) was employed as a test sample as it is a commonly used reference material in conventional Laser Ablation (LA) studies. Droplet LASIL allowed the quantification of trace elements in NIST 611 and also investigation of the particle sizes and shapes generated by the ablation process. Particle sizes were found to vary with laser fluence, with higher fluences producing a wider particle size distribution with greater variation in shape. The types of particles found were: jagged particles of 1–2 µm in diameter most probably created by micro-jet impingement, spherical nanometre sized particles from vapour condensation and melt ejection, and thin, string-like particles from particle agglomeration or liquid jet fragmentation. At lower fluences the particle morphology tended towards spherical shapes and formed agglomerates. At this small particle size (below 250 nm), Brownian motion ensures a very slow settling rate in the liquid medium yielding solutions that are stable for analysis over several days. Alternatively, as demonstrated here, post-ablation chemistry can be carried out in the droplet, e.g. acid dissolution, or clean up using micro-extraction techniques. The liquid droplet was analysed by inductively coupled plasma-mass spectrometry (ICP-MS) with calibration against aqueous standards. The ablation yield from the sample was normalised using the found versus known concentration of uranium in the sample and ratioing measured elemental concentrations to this factor. LASIL on a sample immersed in liquid facilitated the study of the effect of the solution composition on the LASIL process.


Though information technology (IT) is increasingly touted as an effective tool through which governments may enhance their development efforts, to date, many IT-related deploy ments have remained in a pilot stage, which does little to aid governments in understanding macrolevel IT policy approaches to confronting development challenges. To address this shortcoming, this article presents a unique nationwide initiative: Macedonia Connects, a multipartner, scaled IT-for education project wherein every school in the country was equipped with both computers and wireless Internet connections and through which the Internet was made available to citizens across the entire country. A number of policy-related aspects of the project are identified and discussed, including the predeployment training of teachers in IT adoption, the equality of technology and training provision across the entire country, the long-term focus on the part of all stakeholders in terms of outcomes, and the business model employed in the public–private partnership. Although it is too early to discuss long-term outcomes, there are many aspects of this case that will be applicable to governments and practitioners alike in future IT-for-development endeavors. Some of Macedonia's neighboring states have already indicated interest in following this model.


A series of hydraulic model test were carried out to investigate the mechanism by which naturally armoring breakwaters, that is breakwaters in which the initial profile is adjusted into a more stable profile as a result of wave action, gain their stability. The breakwater models were instrumented with pressure transducers placed along the outer face of the structure and at the core/filter interface. Specially designed capacitance gages were installed throughout the core to monitor the motion of the phreatic surface within the breakwater. A substantial reduction in the magnitude of the internal and external pressure field was found for a natural armoring breakwater compared with a conventional structure. In addition, this paper provides a detailed summary of research on naturally armoring breakwaters which has occurred during the past 150 years.


[1] The Integrated Microphysics and Aerosol Chemistry on Trajectories (IMPACT) model is used to study polar stratospheric cloud (PSC) formation and evolution in the Antarctic vortex. The model is applied to individual air parcel trajectories driven by UK Met Office (UKMO) wind and temperature fields. The IMPACT model calculates the parcel microphysics, including the formation and sedimentation of ice, nitric acid trihydrate (NAT), sulfuric acid tetrahydrate (SAT), and supercooled ternary solution (STS) aerosols. Model results are validated by comparison with data obtained by the Polar Ozone and Aerosol Measurement (POAM) III solar occultation instrument and are examined for 6 years of POAM data (1998–2003). Comparisons of POAM water vapor and aerosol extinction measurements to the model results help to constrain three microphysical parameters influencing the formation and growth of both type I and type II PSCs. Principally, measurements of aerosol extinction prove to be valuable in differentiating model runs; the relationship of aerosol extinction to temperature is determined by the various particle types as they form and grow. Comparison of IMPACT calculations of this relationship to POAM measurements suggests that the initial fraction of nuclei available for heterogeneous NAT freezing is approximately 0.02% of all aerosols. Constraints are also placed on the accommodation coefficient of ice and the NAT-ice lattice compatibility. However, these two parameters have similar effects on the extinction-temperature relationship, and thus a range of values are permissible for each.


By means of a rat aortic smooth muscle (RASM) cell culture model, the effects of angiotensin II (AII) on early proto-oncogene gene expression, DNA synthesis, and cell proliferation were measured and compared to known mitogens. In 24-h [3H]-thymidine incorporation assays, AII was found to be a weak mitogen when compared to potent mitogens such as fetal bovine serum and platelet-derived growth factor (PDGF). In contrast, when assays were carried out for 48 h, AII induced a significant dose-dependent stimulation of DNA synthesis, which more than doubled at 3 nM AII, and was maximal (five- to eightfold above control) at 100 nM AII. Treatment of cells with the AII type 1 receptor antagonist losartan inhibited the mitogenic effects of AII. AII also stimulated smooth muscle cell proliferation, as indicated by an absolute increase in cell number after AII stimulation of RASM cells for 5 d. AII stimulation of RASM cell growth correlated with the increased expression of specific endogenous growth factors, including transforming growth factor beta 1 (TGF-beta 1) and PDGF A-chain. However, addition of either PDGF- or TGF-beta 1-neutralizing antibodies failed to significantly reduce the delayed mitogenic effects induced by AII. In contrast, we found that AII-stimulated mitogenesis could be inhibited in a dose-dependent manner by the growth factor inhibitor drug suramin. Taken together, our results indicate that enhanced endogenous growth factor expression may represent the direct mechanism by which AII promotes smooth muscle cell growth in some vascular hyperproliferative diseases.


This paper describes a gamified teaching and learning application for tablets: the 3D Class. The 3D Class acts as an interface between Moodle and Apple's Game Center, bringing users to play games while learning, and to learn while gaming. For the students enrolled in courses that are available in a Moodle server, the 3D Class can be used to access them from iOS enabled devices. The integration with the Game Center allows users to compete among other apps users. Even for the users that are not enrolled in any course, they can play the open quizzes, and score in the Gaming Center.


Gentrification is reshaping cities worldwide, resulting in seductive spaces and exclusive communities that aspire to innovation, creativity, sustainability, and technological sophistication. Gentrification is also contributing to growing social-spatial division and urban inequality and precarity. In a time of escalating housing crisis, unaffordable cities, and racial tension, scholars speak of eco-gentrification, techno-gentrification, super-gentrification, and planetary gentrification to describe the different forms and scales of involuntary displacement occurring in vulnerable communities in response to current patterns of development and the hype-driven discourses of the creative city, smart city, millennial city, and sustainable city.
 In this context, how do contemporary creative practices in art, architecture, and related fields help to produce or resist gentrification? What does gentrification look and feel like in specific sites and communities around the globe, and how is that appearance or feeling implicated in promoting stylized renewal to a privileged public? In what ways do the aesthetics of gentrification express contested conditions of migration and mobility? Addressing these questions, this book examines the relationship between aesthetics and gentrification in contemporary cities from multiple, comparative, global, and transnational perspectives.


This paper introduces a range of methods used for data gathering and the results of their analysis in the evaluation of Joint Forest Management initiatives undertaken in India. There were 200 evaluation reports collected from different states in India, of which only 99 had reported on methods used, and issues addressed, in relation to socio-economic, institutional, ecological and gender and training aspects. At the national level 17 reports are available. Many studies were conducted in states where there was support from donor agencies. There were 33 reports addressing the socio-economic issues related to JFM, while only 15 reports addressed ecological issues. There were only 4 reports that addressed training needs of different stakeholders of JFM, while 12 related to gender issues. Based on the data collected so far, it was found that there were no reports that have focused on the monitoring of JFM, and all are evaluation reports. Monitoring is needed to understand the change over time with respect to vegetation, awareness amongst the community members, participation in various JFM activities, enhanced representation of women, incentives accrued and other matters. It is also important to document how the changes have taken place over time, the factors that determine change and its impact. Many projects have conducted mid-term evaluation, in order to enhance their performance through proper corrective measures. A significant finding in this paper is that, it is not clear at this stage, how many took the mid-term evaluation reports seriously and what review process was adopted to improve their future implementation process.


Dilemma is a lexicography component in a tool kit for translation. Dilemma
presents on the request of a text writer relevant lexical information
extracted from previously translated parallel texts by statistical
processing. Dilemma is currently used in the ongoing translation of EC
legislation into the languages of candidate member countries.


Articular cartilage plays an essential role in health and mobility, but is frequently damaged or lost in millions of people that develop arthritis. The molecular mechanisms that create and maintain this thin layer of cartilage that covers the surface of bones in joint regions are poorly understood, in part because tools to manipulate gene expression specifically in this tissue have not been available. Here we use regulatory information from the mouse Gdf5 gene (a bone morphogenetic protein [BMP] family member) to develop new mouse lines that can be used to either activate or inactivate genes specifically in developing joints. Expression of Cre recombinase from Gdf5 bacterial artificial chromosome clones leads to specific activation or inactivation of floxed target genes in developing joints, including early joint interzones, adult articular cartilage, and the joint capsule. We have used this system to test the role of BMP receptor signaling in joint development. Mice with null mutations in Bmpr1a are known to die early in embryogenesis with multiple defects. However, combining a floxed Bmpr1a allele with the Gdf5-Cre driver bypasses this embryonic lethality, and leads to birth and postnatal development of mice missing the Bmpr1a gene in articular regions. Most joints in the body form normally in the absence of Bmpr1a receptor function. However, articular cartilage within the joints gradually wears away in receptor-deficient mice after birth in a process resembling human osteoarthritis. Gdf5-Cre mice provide a general system that can be used to test the role of genes in articular regions. BMP receptor signaling is required not only for early development and creation of multiple tissues, but also for ongoing maintenance of articular cartilage after birth. Genetic variation in the strength of BMP receptor signaling may be an important risk factor in human osteoarthritis, and treatments that mimic or augment BMP receptor signaling should be investigated as a possible therapeutic strategy for maintaining the health of joint linings.


Superoxide dismutase (SOD) activity is closely associated with stress tolerance of creeping bentgrass ( Agrostis stoloniferous L. var. palustris (Huds.) Farw (syn. A. palustris Huds.)). This study was conducted to investigate the influence of two plant growth regulators (PGRs) on the endogenous antioxidant SOD level and photochemical activity in 'Penncross' creeping bentgrass grown under two fertilizer regimes. Mature 'Penncross' was treated monthly with TE at 0.44 g a.i./100 m 2 and PPC at 3.37 g a.i./100 m 2 from May through November at the Virginia Tech Turfgrass Research Center, Blacksburg, Va. Foliar application of TE and PPC increased SOD activity, photochemical activity, and Fm730/Fm690 ratio of creeping bentgrass under the two fertilization regimes as well as when the grass was exposed to a low soil moisture environment. TE reduced clipping weight consistently regardless of the fertilization regime. In contrast, PPC increased clipping weight slightly. Both TE and PPC significantly reduced Dollar spot disease ( Sclerotinia homoeocarpa Bennett) under both high and low fertilization regimes. No significant fertilization × PGR interactions for SOD, photochemical activity of PS II, and Fm730/ Fm690 were observed in well-watered or drought stressed bentgrass. Improvement in stress tolerance of creeping bentgrass by the PGRs appears to be associated partially with an increase of endogenous SOD activity. Chemical names used: trinexapac-ethyl (TE); propiconazole (PPC).


This thesis investigated the relationship between the three-dimensional kinematics of the human back and spinal pathology. This required the development of a system capable of the in vivo measurement of spinal movement non-invasively and in three-dimensions. The opto-electronic CODA-3 Scanner proved unsatisfactory in this respect. The electro-magnetic 3SPACE Isotrak, however, was found to be an accurate and reliable system during a study of twisting in flexed postures. Available axial rotation was significantly increased in some degree of sagittal flexion suggesting that this may be a mechanism for intervertebral disc injury. At high degrees of sagittal flexion a reduction in available axial rotation was noted. In vitro tests on isolated lumbar motion segments confirmed the increase in axial rotation available in flexed postures shown in vivo, this was presumed to be due to an opening of the lumbar zygapophysial joints. Mechanical testing of lumbar interspinous and supraspinous ligaments showed them to be active only in the extremes of sagittal flexion and hence that they could be responsible for the reduction in axial rotation seen in vivo. The 3SPACE Isotrak was used in a clinical study of 80 normal and 43 pathologic subjects. In the normals ranges of motion were, in general, reduced with increasing age in both males and females although a significant increase in sagittal flexion occurred with increasing age in females. Male mobility significantly exceeded female in sagittal flexion but female tended to exceed male in extension, lateral bend and axial rotation. Opposite axial rotation occurred consistently upon lateral bend and vice versa, flexion also occurred on lateral bend but not axial rotation. There was widespread disruption to the primary and coupled movements of the back pain patients when compared to normal movement patterns but there was no clear distinction between the kinematic movement patterns of discrete patient groups. The small numbers in these patient groups warrant a further, more detailed, clinical study.


BACKGROUND/OBJECTIVE
We examine whether midlife vascular risk factors (VRFs) are associated with increased risk of incident Alzheimer's disease (AD) in a systematic review and meta-analysis of published cohort studies.

METHODS
Original cohort studies were included if they reported adjusted combined odds ratio (COR) and corresponding 95% confidence intervals (CIs) or enough information to quantify the association between risk for AD in late-life and baseline VRFs of midlife.

RESULTS
There were positive and significant associations between high blood pressure (COR 1.31; 95% CI: 1.01-1.70), hypercholesterolemia (COR 1.72; 95% CI: 1.32-2.24), obesity (COR 1.88; 95% CI: 1.32-2.69), and diabetes mellitus in midlife (COR 1.4; 95% CI: 1.25-1.57). Smoking and hyperhomocysteinemia (although only one high-quality paper) were also associated with an increased risk of AD generally.

CONCLUSIONS
These results strengthen the epidemiological evidence that VRFs of midlife significantly increase risk for AD.


This research paper explores the in-depth application of Data Mining in the Fourth Industrial Revolution (4IR) in South Africa. The Industrial Revolution concept has fundamentally changed our society and economy. In South Africa, data mining phenomena has not been fully realized in the age of the 4IR. In the age of information and 4IR data is viewed as a strategic assert that companies should invest in. Results in this study shows that the concept of data mining in South African business landscape is not fully executed and applied to business development and management as a practice. Statistical observations also indicate that baselines, historical data and intelligence if used properly can benefit businesses to grow and develop. This study attempted to discover hidden valuable knowledge by analyzing data using statistical data mining techniques during which a new data mining technique to analyze data, interpret it and present it was discovered. This research tested the new approach referred to as Alex Malapane Data Mining Technique (AMDMT) using test questions which were explored as per the objective of this study.


When Andrew Mawson arrived in Bromley-by-Bow in the east end of London, in the 1980s, it was in a state of social, economic and material disrepair. Living there, getting to know the residents and institutions, he soon realized that by unlocking its untapped potential, the community could begin to turn itself around. The result: the Bromley-by-Bow Centre has encouraged literacy, housing, business, health, welfare and enterprise in the area to flourish. Time and again using the same approach, Mawson has succeeded where the government and others have failed. His inspiring and timely book will demonstrate, through his own experience how, by seeking creative, dynamic, entrepreneurial ways of tackling seemingly intractable social problems, we can all make real changes in our communities.


The labor force participation rate of prime-age individuals (age 25 to 54) in the United States declined dramatically during and after the Great Recession. Although the prime-age labor force participation rate has been increasing since mid-2015, it remains below its pre-recession level. Understanding the reasons for this decline requires detailed analysis; aggregate statistics on labor force participation may mask potential differences in labor market outcomes by sex or educational attainment. Didem Tzemen and Thao Tran identify these differences, finding that prime-age men and women without a college degree experienced larger declines in their labor force participation rates during the recession than their college-educated counterparts. The disappearance of routine jobs over the last few decades may explain these declines. In addition, they find that only prime-age women with a college degree have seen their labor force participation rate fully recover to its pre-recession level, although their participation rate remains well below that of both college-educated and non-college-educated men.


Abstract. Sea surface height (SSH) altimetry observations for 1992 to 2009 off California are used to show that observed quasi-zonal jets were likely driven by near-resonance interactions between different scales of the flow. Quartet (modulational) instability dominated and caused non-local transfer of energy from waves and eddies to biannual oscillations and quasi-zonal jets. Two types of quartets were identified: those composed of scales corresponding to (a) quasi-zonal jets, annual and semiannual Rossby waves and mesoscale eddies, and (b) biannual oscillations, semiannual Rossby waves and mesoscale eddies. The spectral centroid regularly shifted into the domain of low-order modes. However, the spectrum of SSHs does not demonstrate a power behavior. This says that the classical inverse cascade is absent. For a case with bottom friction, quartet instability required the existence of a certain level of dissipativity in the flow.


Sign Language Research Contributes to a Better Understanding of Language Acquisition, A Review of Directions in Sign Language Acquisition Directions in Sign Language Acquisition, edited by Gary Morgan and Bencie Woll (Philadelphia: John Benjamins, 2002. 339 pp. Hardcover $60.00. ISBN 9-027234-72-8 [Europe], 1-58811-235-7 [United States]) Directions in Sign Language Acquisition is a collection of current research studies that emphasizes the ways in which knowledge about sign language acquisition can contribute to a better understanding of language and the way in which children acquire it. Inspired by presentations and workshops at the 1999 Congress of the International Association for the Study of Child Language, the book is published as part of this organization's "Trends in Language Acquisition Research" series. The introduction, by editors Morgan and WoIl, provides an excellent framework for the studies included in the book. The background information and terminology they discuss are also very helpful for readers who are not familiar with sign languages. Morgan and WoIl emphasize that these studies support diversity in theoretical and methodological approaches, in languages studied, and in the geographical and academic backgrounds of the contributors. This diversity generally contributes to broadening the scope of the text, but it also restricts connections between some of the chapters. Although the editors claim that the emphasis of the reported studies is both theoretical and practical, the primary focus is on theory, and readers must extract the applications. The first chapter, by Marschark, is a review of research on early language development. It is very thorough and provides an excellent conceptual framework for the book but does not introduce any new research. Marschark clearly introduces the role of gesture as a theme that later chapters also address. Another key point he makes is that researchers need to view language as more than a linguistic system and consider it as a social-communicative system. Analysis must go beyond the grammatical structures and features of a language and include the context and interactions in which they occur. In the second chapter Kamopp provides a description of phonological development in Brazilian Sign Language. Unfortunately, the theoretical background is not written in enough detail for nonphonologists or non-sign-language researchers to follow. he concludes that location and movement features are acquired earlier and more accurately in children's production of signs, whereas the process of acquiring handshapes is slower and involves more errors. These findings are similar to what Marentette (199$) discovered in studying phonological acquisition in American Sign Language. In the third chapter Hoiting and Slobin introduce the use of the Berkeley Transcription System (BTS) as a tool for sign language research. They imply that using the same standards as the rest of the language acquisition ReId adds credibility to research in sign language acquisition. This also acknowledges transcription as a necessary tool. Hoiting and Slobin state that a transcription system should be designed to answer the questions we have. For example, it is not necessary to focus on detailed phonology when this is not the major interest of the research. Since the point of this chapter is to describe the new tool, they only briefly mention studies in which the BTS was used. In chapter four Pizzuto discusses research regarding the development of Italian Sign Language in preschool children. She presents a broad spectrum of findings and information, but because of disorganization in her writing some ofhcr points are difficult to follow. Her primary emphasis is on the variability that occurs in children's use of grammatical structures. She accounts for this unevenness in several ways. First, inflectional morphology in signed languages is highly variable because it is often optional, which makes acquisition slow and irregular. …


The construction of knowledge cannot be examined without the influences of power relations and its ideological instrument; discourse. However, interpretation of given information despite of discourses by the recipients also play an important role at knowledge/identity construction. During the study the indictment of the idea that "missing information about the 'Other' and the words for identifying the 'Other' may cause biased national discourses" is assumed. The study is focused on Cyprus Island, which is divided into two parts and shelters two communities. These communities share certain periods of the past but expressed by different discourses in the history textbooks. The purpose is to figure out whether the history textbooks were influential on the construction of the \'self\' and the \'Other\'. To illustrate whether citizens of both republics are active recipients or passive one; a questionnaire has been delivered to 100 Turkish and 100 Greek Cypriots who live in the island.


ABSTRACT Introduction: Standardization is important across the life cycle of medicinal products, supporting the diagnosis, treatment, and prevention of a wide range of diseases. For rare diseases, standardization is even more important, as patient groups are small, presenting significant challenges in the design, conduct, analysis, and interpretation of clinical studies. It is here that standardization institutions, including the UK's National Institute for Biological Standards and Control (NIBSC), can have a key role. Areas covered: A considerable proportion of NIBSC's work supports the better understanding, diagnosis, treatment, and prevention of rare diseases. NIBSC is also part of the UK's Medicines and Healthcare products Regulatory Agency (MHRA), creating an agency that is uniquely placed to combine scientific and regulatory expertize for the benefit of public health. This review provides an overview of NIBSC's work in rare diseases and highlights the positive impact of the work of standardization institutions in this field. Expert opinion: Standardization in product development is key for patients with rare diseases. The work of standardization institutions is increasingly being recognized as crucial for supporting scientific and clinical advancements, and early and collaborative interactions can provide drug developers with the necessary expertize, when standards matter most.


A comparative study of the carbohydrate metabolism of roots of pea (Pisum sativum var. meteor) and maize (Zea mays var kelvedon glory) seedlings was undertaken at low temperatures (2-14°C) with the aim of demonstrating differences between these species which may be associated with the differing growth capacities of their roots mot this temperature range. Pea roots displayed linear growth rates at all temperatures tested whereas maize roots ceased growth over five days at temperatures below 6°C At the respective temperatures which were minimal for root growth of the two species, roots behaved similarly with regards to soluble sugar content; firstly, total content was maintained in the roots at the initial level, and secondly, sucrose content was at its highest value and glucose content at its lowest. With rise in temperature sucrose content declined while glucose content increased. In maize roots kept at those temperatures where growth was not sustained this relationship broke down. Total sugar content of the roots was not maintained, glucose content was abnormally high and sucrose content very low. Similarly, respiration rate of maize roots at 2°C was abnormally low. When seedings were grown with roots bathed in an external solution of glucose at 2°C (or of glucose or of sucrose at 6°C the disturbances to sugar metabolism and respiration rate of maize roots were partially alleviated and this was associated with a greater amount of growth made by the roots. Examination of the activity and Km of acid invertase extracted from the roots and partially purified, showed that the sucrose levels in roots of both species were inversely related to invertase activity. However in pea, but not in maize roots, Km values for invertase showed a lowering in value after growth of seedlings at 2°C compared with 20°C. Furthermore, in pea, after growth of seedlings at 14 or 2°C Km determined at 2°C was significantly lower than when determined at 14°C. These properties are of adaptive significance at low temperatures since they will act to maintain an appreciable reaction rate. Shifts in Km of a homeostatic nature with respect to temperature were not recorded for invertase from maize roots and in this species the failure to control invertase activity at low temperatures with consequent depletion of sucrose may be associated with the inability of this species to show sustained growth at 2°C. Examination of the Km of MDH likewise revealed a shift in Km value tending to buffer the effect of temperature on reaction rate for MDH from pea but not from maize roots.


The quality of the professional-patient relationship in the treatment of mental illness predicts patient outcome. Hence, we conducted a review of recorded professional-patient communication to identify existing research, methods, and findings. Sixteen studies focused on (i) how psychiatric symptoms are manifested in patient communication; (ii) the role of therapist communication in patient improvement; (iii) the influence of sociodemographic characteristics on doctor-patient communication; and (iv) how patients and professionals jointly construct therapeutic interactions. The findings were disparate and included (a) patient nonverbal communication is impaired in depression and schizophrenia; (b) the use of specific therapeutic skills led to improvement in depression; high expressed emotion (criticism and emotional over-involvement) in treating schizophrenia was a state rather than trait characteristic of therapists; (c) patient gender, income, and education influenced communication about depression, anxiety, and medication; and (d) psychiatrists' varying institutional agendas, which sometimes competed with patients' agendas, strongly shaped their consultations. Few studies investigated two-way professional-patient communication, with most focusing on either patient or therapist communication in isolation from the other. Finally, methodological advances in linking communication processes with treatment outcomes in large-scale observational studies and trials are a challenge for research on medical communication.


Mathematical models and simulation are becoming increasingly used tools in the optimization of wastewater treatment plants. In this paper, the use of these tools is presented for wastewater treatment plant upgrading. Two case studies are presented, which will be upgraded for tertiary treatment to achieve effluent total nitrogen and total phosphorous concentrations below 10 mg/l and 1 mg/l, respectively. The plant performance after upgrading was assessed by first designing the process model, before upgrading the model for future operation under dynamic influent conditions. Long-term simulations revealed some bottlenecks in the upgraded plant performance and thus helped to improve the plant designs. In one case the total volume of the reactors was increased subsequently, while in the other case tighter denitrification control or additional reject water treatment was proposed. These results indicate that mathematical models can be considered as valuable tools to complement the established wastewater treatment plant design procedures. Advantages are gained by simulating the operation under dynamic operating conditions, precise wastewater characterization, as well as adjustment of stoichiometric and kinetic parameters to a particular wastewater treatment plant operation.


Noise is essential for the existence of a liquid market, and if noise traders are not present in the market, the trade volume will drop severely and an important aspect of the market philosophy will be lost. However, these noise traders bring noise to the market, and the existence of noise in prices indicates a temporary deviation in prices from their fundamental values. In particular, high-frequency prices carry a significant amount of noise that is not eliminated by averaging. If the level of noise in stock prices remains high for a period of time, it can be identified as a risk factor because it indicates that the deviation from fundamental values has been sustained. In this paper, after estimating the microstructure noise in high-frequency prices through a modified parametric approach, using a portfolio switching method, we compared the performance of portfolios having a high level of noise with the performance of portfolios having a lower level of noise and concluded that the risk of the high noise level presents itself as a risk premium in the future return and that asset pricing models which capture the systematic risks cannot capture the noise risk in prices.


Nontariff barriers (NTBs) refer to the wide range of policy interventions other than border tariffs that affect trade of goods, services, and factors of production. Most taxonomies of NTBs include market-specific trade and domestic policies affecting trade in that market. Extended taxonomies include macro-economic policies affecting trade. NTBs have gained importance as tariff levels have been reduced worldwide. Common measures of NTBs include tariff-equivalents of the NTB policy or policies and count and frequency measures of NTBs. These NTB measures are subsequently used in various trade models, including gravity equations, to assess trade and/or welfare effects of the measured NTBs.


Since 2008 scientists have conducted experiments in a hyperenergized, 17-mile supercollider beneath the border of France and Switzerland. The Large Hadron Collider (or what scientists call "the LHC") is one of the wonders of the modern world-a highly sophisticated scientific instrument designed to recreate in miniature the conditions of the universe as they existed in the microseconds following the big bang. Among many notable LHC discoveries, one led to the 2013 Nobel Prize in Physics for revealing evidence of the existence of the Higgs boson, the so-called God particle. Picking up where he left off in The Quantum Frontier, physicist Don Lincoln shares an insider's account of the LHC's operational history and gives readers everything they need to become well informed on this marvel of technology. Writing about the LHC's early days, Lincoln offers keen insight into an accident that derailed the operation nine days after the collider's 2008 debut. A faulty solder joint started a chain reaction that caused a massive explosion, damaged 50 superconducting magnets, and vaporized large sections of the conductor. The crippled LHC lay dormant for over a year, while technical teams repaired the damage. Lincoln devotes an entire chapter to the Higgs boson and Higgs field, using several extended analogies to help explain the importance of these concepts to particle physics. In the final chapter, he describes what the discovery of the Higgs boson tells us about our current understanding of basic physics and how the discovery now keeps scientists awake over a nagging inconsistency in their favorite theory. As accessible as it is fascinating, The Large Hadron Collider reveals the inner workings of this masterful achievement of technology, along with the mind-blowing discoveries that will keep it at the center of the scientific frontier for the foreseeable future.


This article investigates the values and latent policies in the area of the availability of specific performance (SP) as a contractual remedy, which have shaped the development of Chinese law. The National People's Congress (Legislature) and Supreme People's Court in China have addressed the remedial structure of Chinese contract law, namely, the availability of the remedy of SP as opposed to the awarding of damages only. The law is clear that the remedies of SP and damages are ordinary remedies that a claimant is free to choose between. The question that this article confronts is whether in practice the equality of SP and damages as remedies are applied in a neutral, unbiased way by the Chinese courts. Simply put, how often do Chinese courts use SP as a remedy for contract breaches? If SP is seldom awarded, the question then becomes: what are the underlying reasons or rationales given for its underutilization? This article employs an empirical study based on data collected by surveys and follow-up interviews with hundreds of Mainland Chinese judges at various levels of the Chinese court system (related to civil and commercial disputes). Based on the statistical findings of the empirical study, a theoretical inquiry is offered to better understand the relative use or non-use of specific performance as a contractual remedy. The findings show that damages are often favored over SP; additionally, judges in the Mainland Chinese court system take a far more proactive role in the preliminary stages of trials and will actively persuade parties to claim damages over specific performance where expedient. The study also shows that, despite popular belief, the higher supervision costs associated with specific performance are not a determinative factor in the decision not to award SP. * Associate Professor, School of Law, City University of Hong Kong. This study has been financially supported by a general research fund from the Research Grants Council of the Hong Kong Special Administrative Region (project no. City U 11600315). He will become Chair in Chinese Law, Law School, Durham University since July, 2020. ** Huber Hurst Professor of Contract Law, University of Florida, Warrington College of Business and Levin College of Law. Northwestern Journal of International Law & Business 40:275 (2020) 276 TABLE OF CONTENTS


The requirement that inventors disclose their inventions in return for a patent is one of the primary justifications for the patent system. Yet that justification has been subject to substantial criticism. Conventional disclosure scholarship focuses on an inventor's disclosure within the patent itself, a document that arguably fails to provide meaningful information to the public and future inventors. As a result, conventional disclosure theory has largely been relegated to the category of a straw man that scholars address perfunctorily when criticizing the patent system. This article rejects the idea that patents serve little to no disclosure function, not by demonstrating that patents themselves convey useful information, but by pointing to the disclosure of information that would not occur in the absence of a patent system, a concept I call "peripheral disclosure." Examples of such disclosures are all around us: the inventor-employee who is only allowed to publish about ongoing research after patent protection has been secured; the marketing materials describing technical information that could not be shared in the absence of a patent; the mere existence of self-disclosing inventions–inventions whose technological underpinnings can be easily perceived or reverse engineered once those inventions are placed in the stream of commerce–that act as the seeds of future innovation, to name but a few. This theory of peripheral disclosure offers a powerful justification for the patent system – one with profound implications for the perpetual discussion over whether the benefits of the patent system outweigh its costs in terms of promoting invention, and offers an important consideration when debating the potential effects of new legislation, such as the recently enacted Leahy-Smith America Invents Act.


With support of the Council of Independent Colleges' Implementing Urban Missions program, Lesley University's School of Management (SOM) has developed relationships with corporations that are committed to making a difference in the communities where they have a presence. Our experience has shown that corporations that wish to support their local community are not limited to philanthropic initiatives as their primary instrument for community outreach; rather, greater benefits can be achieved through collaborative partnerships bringing together businesses, city government, human services agencies and community residents. This article describes the partnerships that Lesley's SOM, the local business community, and community-based organizations have developed in support of the Area 4 neighborhood in Cambridge, Massachusetts.


In the first study to connect the Acadian experience with the heritage of ideas the migrants brought with them from Europe, Naomi Griffiths explores the creation and endurance of the Acadian community and the ways in which the Acadians differed from the people of New England and New France. One result of the war between England and France for the domination of much of North America was the deportation of the Acadians from their homeland in 1755. Griffiths examines the implications of this deportation for the survival of the Acadian community.

In 1600 there were no such people as the Acadians; by 1700 the Acadians, who numbered almost 2,000, lived in an area now covered by northern Maine, New Brunswick, Nova Scotia, Prince Edward Island, and the southern Gaspe region of Quebec. While most of their ancestors had come to live there from France, a number had arrived from Scotland and England. Their relations with the original inhabitants of the region, the Micmac and Malecite peoples, were generally peaceful. In 1713 the Treaty of Utrecht recognized the Acadian community and gave their territory -- on the frontier between New England and New France -- to Great Britain. During the next forty years the Acadians continued to prosper and to develop their political life and distinctive culture. The deportation of 1755, however, exiled the majority of Acadians to other British colonies in North America. Some went on from their original destination to England, France, or Santo Domingo; many of those who arrived in France continued on to Louisiana; some Acadians eventually returned to Nova Scotia, but not to the lands they once held.

The deportation, however, did not destroy the Acadian community. In spite of a horrific death toll, nine years of proscription, and the forfeiture of property and political rights, the Acadians continued to be part of Nova Scotia. The communal existence they were able to sustain, Griffiths shows, formed the basis for the recovery of Acadian society when, in 1764, they were again permitted to own land in the colony. Instead of destroying the Acadian community, the deportation proved to be a source of power for the formation of Acadian identity in the nineteenth century.

By placing Acadian history in the context of North American and European realities, Griffiths removes it from the realms of folklore and partisan political interpretation. She brings into play the current historiographical concerns about the development of the trans-Atlantic world of the seventeenth and eighteenth centuries, considerably sharpening our focus on this period of North American history. (Publisher summary)


New political parties and peoples' movements have been on the rise in Europe and worldwide for over a decade. In order to examine the changes in the political landscape, particularly the rise of populist sentiment across Europe, Intereconomics and the Centre for European Policy Studies (CEPS), invited renowned academics, policy advisors and regional experts to present their ideas at the 9th annual joint conference in November 2019 in Brussels. In this Forum, conference participants look at the common economic determinants and consequences of the current political climate and question the role that the EU may have played against the backdrop of country cases and regional studies. Their contributions analyse issues including the Great Recession, austerity measures, inequality, migration and cultural backlashes and examine the roles they have played in the creation of the current climate as well as the impact that this, in turn, has had on the economy. The struggle to categorise the political sentiment of this period is also carefully considered as the defi nition of the term populism varies widely and often does not refl ect the nuances and complexity of political developments.


Among the old plant collections in book-form, in the Leyden National Herbarium, there are two large volumes, containing a number of well preserved Ceylon plants. These plants are said to have been collected by PAUL HERMANN in the latter half of the 17th century. PAUL HERMANN¹), afterwards Professor of Botany at the University of Leyden, resided in Ceylon as an "Ordinary and First Physician" of the Dutch East Indian Company during the years 1672—1679. Several particularities on his life and on the collections made by him, are to be found in LINNAEUS'S Flora Zeylanica (6), in TRIMEN'S paper entitled "Hermann's Ceylon Herbarium and Linnaeus's Flora Zeylanica" (8), in BOULGER'S study on the history of Ceylon botany (2) and in ARDAGH'S note on HERMANN'S herbarium (1). During his residence in Ceylon HERMANN collected the herbarium, which is now in the possession of the Department of Botany of the British Museum of Natural History, London. The history of this herbarium has been described in TRIMEN'S paper (8). This was not the only collection he made, for on page 131 of TRIMEN'S paper we find that "Besides the herbarium under consideration, Hermann formed another whilst in Ceylon, which he sent to "J. Commelin at Amsterdam. It was from this collection (combined with "that made by J. Hartog, which was sent from Ceylon to Voss, Curator "of the Amsterdam Gardens) that J. Burman, Commelin's successor, com"piled his 'Thesaurus Zeylanicus'." On page 132 TRIMEN mentions still other collections: "Hermann also sent specimens to other botanists of "the time, especially to Gronovius" (the latter fact must be incorrect, for as BOULGER (2) rightly states GRONOVIUS was only five years old at HERMANN'S death in 1695). These "other botanists" may have been BREYNE and PLUKENET (see ARDAGH'S note [1]). It is possible that one of the "sets" came in some way into the possession of the Leyden University and is now in the Leyden Herbarium. However, there is a possibility that, after HERMANN'S death in 1695, a part of his plants, were left at Leyden.


Cancer, a disease people avoid talking about, is the second leading cause of death in Bahrain. The Bahrain Cancer Society established a support group in 1993 with the goals of helping patients and their families cope with this disease and increasing public awareness concerning early detection. Services provided by the group include a weekly 2-hour session to encourage patients to express their feelings and concerns, distribution of informational booklets and visits to people at home and in hospital. Furthermore, the group organizes recreational activities for children with cancer. Patients or their families can also page the group to discuss their problems. The main goal of this paper is to share the Bahrain experience of supporting cancer patients, their families and friends.


This Article uses empirical analysis to provide a new understanding of transnational itigation in US. courts. According to conventional wisdom, the United States has a forum shopping system with two features that encourage plaintzffs to file claims in U.S. courts, even when those claims involve foreign parties or foreign activity: a permissive approach to personal jurisdiction, giving plaintiffs broad court access, and a strong tendency of U.S. judges to apply plaintzfffavoring domestic law. This forum shopping system purportedly contributes to a rising tide of transnational litigation in the United States. Scholars and interest groups have therefore proposed new anti-forum shopping measures aimed at curtailing transnational litigation in U.S. courts. This Article shows that the forum shopping system has evolved and that it no longer encourages plaintzffs to pursue transnational claims in U.S. courts to the extent it supposedly once did. It also presents empirical evidence that transnational litigation in the United States may have actually decreased, not increased, over the last two decades. The analysis suggests that new anti-forum shopping measures may not be as urgent or necessary as their advocates claim. If adopted, such measures could unduly limit access to justice for both American and foreign citizens who, in our era of globalization, are increasingly affected by transnational activity.


Pest outbreaks often give to insect pathogens the opportunity to infect their host species eventually leading them to death. Recent Nidularia outbreaks off urban Quercus ilex L. showed some cases of entomopathogenic fungi virulence, apparently sustained by species of Fusarium and other fungi. Infection is apparent on the Nidularia population because fungi provoke the scale color shifting to orange or dull-green in medium in large patches. After the isolation in an axenic culture of the Kermesid-associate Mycota, ITS genomic regions amplified by PCR using the universal ITS5/ITS4 primers were sequenced by external service (Macrogen, Seoul, South Korea) for molecular identification. Blast analysis (http://blast. ncbi. nlm. nih. gov/Blast. cgi) of the ITS sequence showed a high homology with Quambalaria cyanescens (de Hoog & G. A. de Vries) Z. W. de Beer, Begerow & R. Bauer 2006 (Fungi: Basidiomycota), (identity: 97-96%; e-value 0. 0; coverage 82-75%), Fusarium acuminatum Ellis & Everh. 1895 (Fungi: Ascomycota) and Fusarium avenaceum (Fr. ) Sacc. 1886 (Fungi: Ascomycota) (identity: 99%; e-value 0. 0; coverage 82-80%), and Penicillium sumatraense Svilv. 1936 (Fungi: Ascomycota) (identity: 100%; e-value . 0; coverage 95-91%). We investigate the biological and ecological role of the above-recorded fungi by correlating the age of infected scale and their age. Mass culturing of the most promising pathogen will lead to semi-field trials to demonstrate the isolate entomopathogenic ability. Finally, we discuss the case of homonymy between the fungal Taxon named Nidularia pulvinata (Schwein.) (Gasteromycetes) and the scale Nidularia pulvinata (Planchon) that can lead to some confusion.


Science communication has traditionally been seen as a means of crossing the boundary of science: moving scientific knowledge into the public. This paper presents an alternative understanding. Drawing upon a particular case of social science communication in the form of an interactive installation about the social responsibility of science, it develops the concept of boundary space where phenomena can simultaneously belong to science and nonscience. In addition, the paper describes how the installation functions as a space for interaction between knowledge communication and knowledge production. The paper argues that we should understand science communication as a social practice, which allows scientists and nonscientists to cooperate in performing science as an important part of society. The aim is to add a new kind of analysis to traditional criticisms of deficit-thinking and popularization by asking what can we say more about science communication if we understand it as part of (rather than separated in time and space from) science as a social activity.


Current SOTA adversarially robust models are mostly based on adversarial training (AT) and differ only by some regularizers either at inner maximization or outer minimization steps. Being repetitive in nature during the inner maximization step, they take a huge time to train. We propose a non-iterative method that enforces the following ideas during training. Attribution maps are more aligned to the actual object in the image for adversarially robust models compared to naturally trained models. Also, the allowed set of pixels to perturb an image (that changes model decision) should be restricted to the object pixels only, which reduces the attack strength by limiting the attack space. Our method achieves significant performance gains with a little extra effort (10-20%) over existing AT models and outperforms all other methods in terms of adversarial as well as natural accuracy. We have performed extensive experimentation with CIFAR-10, CIFAR-100, and TinyImageNet datasets and reported results against many popular strong adversarial attacks to prove the effectiveness of our method.


The decline of Moore's law has catalyzed a significant effort to identify beyond-CMOS devices and architectures for the coming decades. A multitude of classical and quantum systems have been proposed to address this challenge, and spintronics has emerged as a promising approach for these post-Moore systems. Many of these architectures are tailored specifically for applications in combinatorial optimization and machine learning. Here we propose the use of spintronics for such applications by exploring two distinct but related computing paradigms. First, the use of spin-currents to manipulate and control quantum information is investigated with demonstrated high-fidelity gate operation. This control is accomplished through repeated entanglement and measurement of a stationary qubit with a flying-spin through spin-torque like effects. Secondly, by transitioning from single-spin quantum bits to larger spin ensembles, we then explore the use of stochastic nanomagnets to realize a probabilistic system that is intrinsically governed by Boltzmann statistics. The nanomagnets explore the search space at rapid speeds and can be used in a wide-range of applications including optimization and quantum emulation by encoding the solution to a given problem as the ground state of the equivalent Boltzmann machine. These applications are demonstrated through hardware emulation using an all-digital autonomous probabilistic circuit.


Palm oil waste (by product)can be used as a potential feed for livestock. Nevertheless, the study research of the effect of Palm oil waste (by product) as a feed to the bull performance was limited. The purpose of this research is to get technology to improve semen quality through improving protein of  feed based on palm oil waste (byproducts). This research was conducted in PTPN 6 Jambi and  used 30 bulls that separated into 3 treatments, treatment I (feed protein 12% and suplementation), treatment II (feed protein 12%) and treatment III (existing feed, feed protein 10%). Parameter were measured i.e feed consumption, libido, sperm motility, mass movement, sperm concentration, sperm abnormality, volume, pH, consistency, colour, body condition score and average daily gain. Design of this research was completely randomized design. Data was analyzed use ANOVA. The result showed that there is no significantly different on semen quality between treatmens. Semen quality of three treatments were appropriate to standart of quality semen of bull (sperm abnormality <20%, sperm motility >50% and sperm concentration >500 million/ml). Based on this consideration, feed with protein level 10% more efficient because it needs less cost but results a good semen quality. The conclusion of this research is protein level 10% can supporting performance reproduction of bull.


THBS2 and CA19-9 markers in human blood improve detection of pancreatic ductal adenocarcinoma. Getting a head start on pancreatic cancer Pancreatic ductal adenocarcinoma (PDAC) has a dismal prognosis due to a lack of diagnostics for detecting early-stage disease. Kim et al. genetically reprogrammed late-stage human PDAC cells to a stem cell–like state, enabling the reprogrammed cells to recapitulate human PDAC progression and revealing secreted candidate markers of early-stage disease. The protein thrombospondin-2 (THBS2) was screened against 746 cancer and control human plasma samples in a multiphase study. The authors report that, THBS2, in combination with the marker CA19-9, boosts detection of the early stages of PDAC in high-risk human populations. Markers are needed to facilitate early detection of pancreatic ductal adenocarcinoma (PDAC), which is often diagnosed too late for effective therapy. Starting with a PDAC cell reprogramming model that recapitulated the progression of human PDAC, we identified secreted proteins and tested a subset as potential markers of PDAC. We optimized an enzyme-linked immunosorbent assay (ELISA) using plasma samples from patients with various stages of PDAC, from individuals with benign pancreatic disease, and from healthy controls. A phase 1 discovery study (n = 20), a phase 2a validation study (n = 189), and a second phase 2b validation study (n = 537) revealed that concentrations of plasma thrombospondin-2 (THBS2) discriminated among all stages of PDAC consistently. The receiver operating characteristic (ROC) c-statistic was 0.76 in the phase 1 study, 0.84 in the phase 2a study, and 0.87 in the phase 2b study. The plasma concentration of THBS2 was able to discriminate resectable stage I cancer as readily as stage III/IV PDAC tumors. THBS2 plasma concentrations combined with those for CA19-9, a previously identified PDAC marker, yielded a c-statistic of 0.96 in the phase 2a study and 0.97 in the phase 2b study. THBS2 data improved the ability of CA19-9 to distinguish PDAC from pancreatitis. With a specificity of 98%, the combination of THBS2 and CA19-9 yielded a sensitivity of 87% for PDAC in the phase 2b study. A THBS2 and CA19-9 blood marker panel measured with a conventional ELISA may improve the detection of patients at high risk for PDAC.


Abstract Introduction Implementation of evidence-based infection control practices is the need of the hour for every institute to reduce the device-associated infections, which directly reflects the quality of care. As catheter-associated urinary tract infection (CAUTI) is the most common nosocomial infection, the study was planned to evaluate the impact of the catheter care bundle in reducing CAUTI incidence. Material and methods The prospective interventional study before and after the trial study was carried out in adult intensive care units over a period of 9 months (April–June 2017—pre-implementation phase; July–September 2017—training of healthcare worker and implementation of catheter care bundle; October–December 2017—post-implementation phase). Catheter-associated urinary tract infection rates pre- and post-implementation were expressed as incidence rates with Poisson confidence interval. Results Statistically significant reduction was found in the incidence of CAUTI (60%—from 10.7 to 4.5 per 1,000 catheter days). The key factors that contributed were significant reduction in device utilization ratio (from 0.71 to 0.56) and average catheter days per patient (from 4.8 to 3.7). This holistic approach has resulted in less incidence of CAUTI even among patients with risk factors and prolonged catheter days. Neuro ICU showed drastic improvement compared to other ICUs due to the poor baseline status of their care practices. Conclusion Adherence to all elements of care bundle brought a significant decrease in CAUTI. Implementing care bundle and auditing the adherence to each element should be included as a part of routine hospital infection control committee (HICC) practices. Clinical significance Hospital-acquired infection directly reflects on the quality care of the hospital. Bundle care is an "all or none" phenomenon. Adherence to each element will have some influence in reducing CAUTI in terms of reducing the device utilization ratio and average catheter days per patient. Auditing the care bundle adherence is having a positive influence on the outcome. How to cite this article Soundaram GVG, Sundaramurthy R, Jeyashree K, Ganesan V, Arunagiri R, Charles J. Impact of Care Bundle Implementation on Incidence of Catheter-associated Urinary Tract Infection: A Comparative Study in the Intensive Care Units of a Tertiary Care Teaching Hospital in South India. Indian J Crit Care Med 2020;24(7):544–550.


The provision of open spaces within a residential development is often seen as unimportant. The Malaysian Government targeted to provide 2 hectares of open space per 1000 population to be achieved as a developed nation status by the year 2020. This vision can be seen as the Government attempt to ensure the sustainability of open spaces in Malaysia. The Federal Department of Town and Country Planning, Peninsular Malaysia (FDTCP) has produced a planning standard guideline to supervise the implementation of the open space policy in Malaysia. According to FDTCP; until December 2009, Malaysia has achieved a percentage of 1.19 hectares of open space per 1000 population. Achieving the standard requires commitment of local authorities to implement the open space policy. However, the adoption of open spaces policy differs among local authorities, from a simplistic general approach of land ratio techniques to an ergonomics method. The paper examines the local allocation practices using 5 different approaches and it argues that implementation of open space by local planning practices requires the knowledge of and understanding by planning profession towards a long term sustainable green objectives.


Project Purpose. To enhance technological and topical information transfer in support of industry and government efforts to increase geothermal energy use in the United States (power production, direct use, and geothermal groundsource heat pumps). Project Work. GRC 2003 Annual Meeting. The GRC convened the meeting on Oct. 12-15, 2003, at Morelia's Centro de Convenciones y ExpoCentro in Mexico under the theme, International Collaboration for Geothermal Energy in the Americas. The event was also sponsored by the Comision Federal de Electricidad. ~600 participants from more than 20 countries attended the event. The GRC convened a Development of Geothermal Projects Workshop and Geothermal Exploration Techniques Workshop. GRC Field Trips included Los Azufres and Paricutin Volcano on Oct. 11. The Geothermal Energy Association (Washington, DC) staged its Geothermal Energy Trade Show. The Annual Meeting Opening Session was convened on Oct. 13, and included the governor of Michoacan, the Mexico Assistant Secretary of Energy, CFE Geothermal Division Director, DOE Geothermal Program Manager, and private sector representatives. The 2003 Annual Meeting attracted 160 papers for oral and poster presentations. GRC 2004. Under the theme, Geothermal - The Reliable Renewable, the GRC 2004 Annual Meeting convened on Aug. 29-Sept. 1, 2004, at the Hyatt Grand Championsmore » Resort at Indian Wells, CA. Estimated total attendance (including Trade Show personnel, guests and accompanying persons) was ~700. The event included a workshop, Geothermal Production Well Pump Installation, Operation and Maintenance. Field trips went to Coso/Mammoth and Imperial Valley/Salton Sea geothermal fields. The event Opening Session featured speakers from the U.S. Department of Energy, U.S. Department of the Interior, and the private sector. The Geothermal Energy Association staged its Geothermal Energy Trade Show. The Geothermal Education Office staged its Geothermal Energy Workshop. Several local radio and TV station interviews were conducted during the event. Technical Program included 136 technical papers. All were published in Volume 28 of the GRC Transactions. Volume 28, GRC Transactions Pblished as a high-quality, durable casebound volume, Volume 28 of the Transactions published 119 out of 136 technical papers (692 pp) presented at the GRC 2004 Annual Meeting. The papers were submitted by geothermal experts and professionals from around the world. The papers were reviewed over a 2-day period by 25 volunteer (in-kind) geothermal experts from the private sector and DOE National Laboratories. GRC staff received and cataloged the papers, and maintained interaction with authors for revisions and corrections. DOE Geothermal Technologies Newsletter The Office of Geothermal Technologies quarterly newsletter, Geothermal Technologies, is produced at the National Renewable Energy Laboratory (NREL). This 2-color, 4- to 16-page newsletter summarizes federal geothermal research and development projects and other DOE geothermal news. The GRC receives newsletter disk copy and color-key proof from NREL for each newsletter, then follows through with print production and distribution. Circulation is 1,000 per issue (plus 300 copies of the newsletter shipped to NREL for internal and public distribution). During the project period, the GRC printed, stitched and bound the Geothermal Technologies newsletter into the Sept/Oct 2003, Jan/Feb 2004, and May/June 2004 editions of the GRC Bulletin. Multiple copies (300) of the newsletter sans magazine were provided to NREL for internal DOE distribution. GRC Geothermal Research Library The GRC has built the largest and most comprehensive library in the world devoted to geothermal energy. The GRC Geothermal Library provides rapid accessibility to the majority of technical literature crafted over the past 30 years, and preserves hard copy and on-line databases for future use by geothermal researchers and developers. A bibliography for over half of the physical library's citations is available through keyword search on the GRC web site (www.geothermal.org). The GRC maintains one employee to catalog donated libraries, thus increasing the number of available citations. Document collection is ongoing, with regular database additions. Continuing development of the GRC On-Line Library includes: 1) data entry and development of keywords for additional citations; 2) filing library publications; 3) maintaining and enhancing the website; 4) purchase of publications and geothermal articles; and 5) maintenance of computer and other equipment. Page hits were 243,000 per month in November 2003.« less


Urinary tract sensory symptoms provide an additional symptomatic burden for women with fibromyalgia. The urogenital symptoms of both fibromyalgia and interstitial cystitis have been described as non-infective sensory disorders, suggesting the existence of substantial clinical overlap between the two conditions. Research suggests that although interstitial cystitis has been treated as a specific bladder condition, it may be part of the disorder of central processing of sensory information as seen in fibromyalgia. The interstitial cystitis symptom index and problem index (ICSI/ICPI) have been used to measure lower urinary tract symptoms and to examine the impact of these symptoms in patients with interstitial cystitis. This current two phase study was designed to test the ICSI/ICPI for use within a population of women diagnosed with fibromyalgia known to be experiencing sensory bladder symptoms. Phase I involved focus group interviews and discussions with women who reported fibromyalgia and bladder irritability (N=lO). This phase was designed to identify whether the key indicators and the way in which women experienced bladder irritability were indexed by the ICSI/ICPI instrument. The second phase of the study tested the ICSI/ICPI within the fibromyalgia population for reliability and validity. Phase II data was derived via a self-administered questionnaire issued to women (N=90) who had been diagnosed with fibromyalgia by a rheumatologist and who were experiencing lower urinary tract sensory symptoms. Data analysis revealed two separate components in urinary symptom/problem combinations within the fibromyalgia population. These components were distinct from those described in the ICSI/ICPI. Subsequently, two separate subscales were developed to form the Fibromyalgia Bladder Index (FBI). The development and testing of the FBI within the fibromyalgia population has provided an accurate measure for assessing the symptoms and symptom impact of urinary symptoms for women with this condition. The FBI has been developed as an adjunct to clinical assessment and as an outcome measure for intervention therapies for patients with fibromyalgia and bladder irritability. Outcomes of this study form the basis to the following recommendations: further refinement of the FBI; utilisation of the index in fibromyalgia assessments; development of fibromyalgia educational, support and self help programs; pelvic fitness awareness and intervention studies.


INTRODUCTION
Blood derivatives are clinical products that are currently used, for which their lack of availability, clinical relevance and presence of associated side effect that make it necessary to known and evaluate their utility rigorously are characteristic.

OBJECTIVE
To analyze knowledge of attitudes, knowledge and behavior on transfusional policy in the different Spanish Intensive Care Units (ICU).

DESIGN
A mail-based survey (electronic and conventional) in the ICUs.

DURATION
The study was planned in 2005 and conducted during the year 2006.

SETTING
Spanish ICUs.

PATIENTS AND METHOD
A 27-question questionnaire.

RESULTS
Most are middle-sized ICUs (10-20 beds), with predominantly medical activities. The staff member, alone or with the resident, generally decides the transfusion based on his/her experience, although with a tendency to follow the scientific guidelines. Generally, there is no transfusional committee. When red blood packs are transfused, generally between 2 to 4 units are used. The hemoglobin value is orientative, although the decision is clear if < 7 g/dl (10 g/dl if there is heart disease). Drug alternatives to transfusion are not generally used due to lack of evidence and price. In 50% of cases, the association between transfusion and increase in mortality is considered to be certain.

CONCLUSIONS
Strong consideration must be made about transfusion and its over use should be avoided. For this purpose, educational guidelines and consensus meetings are necessary to establish recommendations on the use of blood products and their pharmacological alternatives.