Stability is one of the major concerns in advancement of Wireless Sensor Networks (WSN). A number of applications of WSN require guaranteed sensing, coverage and connectivity throughout its operational period. Death of the first node might cause instability in the network. Therefore, all of the sensor nodes in the network must be alive to achieve the goal during that period. One of the major obstacles to ensure these phenomena is unbalanced energy consumption rate. Different techniques have already been proposed to improve energy consumption rate such as clustering, efficient routing, and data aggregation. However, most of them do not consider the balanced energy consumption rate which is required to improve network stability. In this paper, we present a novel technique, Stable Sensor Network (SSN) to achieve balanced energy consumption rate using dynamic clustering to guarantee stability in WSN. Our technique is based on LEACH (Low-Energy Adaptive Clustering Hierarchy), which is one of the most widely deployed simple and effective clustering solutions for WSN. We present three heuristics to increase the time before the death of first sensor node in the network. We devise the algorithm of SSN based on those heuristics and also formulate its complete mathematical model. We verify the efficiency of SSN and correctness of the mathematical model by simulation results. Our simulation results show that SSN significantly improves network stability period compared to LEACH and its best variant.


ABSTRACT The role of market mechanisms was far from certain in the lead up to the 2015 Paris Climate Conference. The use of 'constructive ambiguity' led to Article 6 of the Paris Agreement, with Article 6.2 specifying a mechanism with limited international oversight, and Article 6.4 establishing a 'Sustainable Development Mechanism' (SDM) subject to detailed rules. Clear operationalization of these mechanisms remains a challenge, especially regarding the critical accounting issue that could not be resolved at the 2018 Katowice Climate Conference (COP24) – how to apply corresponding adjustments, especially regarding sectors not covered by targets under nationally-determined contributions (NDCs). By using fictitious examples, we explain two possible approaches to using Internationally Transferred Mitigation Outcomes (ITMOs) under Article 6.2 for achieving NDCs: a 'target-based' one where the acquiring Party adds the ITMO amount to the target level of its NDC; and a 'tally-based' one where the acquiring Party removes the ITMO amount from the final tally of its NDC. We discuss how these approaches influence the way to make corresponding adjustments and to avoid 'double counting'. The first one leads to 'target/budget-based accounting', the second one to 'emission-based accounting'. For mitigation outside the scope of the host Party's NDC, we propose using a tally-based interpretation of ITMO use, as opposed to the target-based variety used in the 1997 Kyoto Protocol, and stress the need for additionality testing. This interpretation allows for mandatory corresponding adjustments for all ITMO usage, while the host Party NDC level remains unchanged. A buffer registry is created for corresponding non-NDC adjustments of the selling party. Key policy insights Under the Paris Agreement, transfers of emissions units between two countries through the Article 6 mechanisms need a corresponding adjustment on both sides to prevent double counting. Corresponding adjustments can be applied either to emissions targets under NDCs or measured emissions levels. The transfer of emissions reduction credits generated outside an NDC should lead to a corresponding adjustment of a buffer registry of the selling country, but not its emissions level/NDC target. Such credits should only be generated if additionality of the reductions is shown.


The management of multidrug-resistant tuberculosis (MDR TB) is notably complex among patients with HIV. TB treatment recommendations typically include very little information specific to HIV and MDR TB, which often is derived from clinical trials conducted in low-resource settings. Mortality rates among patients with HIV and MDR TB remain high. We reviewed the published literature and recommendations to synthesize possible patient management approaches demonstrated to improve treatment outcomes in high-resourced countries for patients with MDR TB and HIV. Approaches to diagnostic testing, impact and timing of antiretroviral therapy (ART) on mortality, anti-MDR TB and antiretroviral drug interactions and the potential role for short-course MDR TB therapy are examined. The combination of ART with expanded TB drug therapy, along with the management of immunologic reconstitution inflammatory syndrome (IRIS), other potential HIV-associated opportunistic diseases and drug toxicities, necessitate an integrated multidisciplinary patient care approach utilizing public health case management and provider expertise in drug-resistant TB and HIV management.


he effect of time-strengthening static friction on earthquake recurrence is numerically studied based on the normalized equation of motion of a one-body spring-slider model with thermal-pressurized slip-weakening friction having the characteristic distance, Uc, which is in terms of static friction coefficient, 𝜇. Considering the time-strengthening static friction coefficient, 𝜇(𝑡) = 𝜇+𝐵×𝑙𝑜𝑔(𝑡), we assume Uc=Uco/(1+𝐵×𝑙𝑜𝑔(𝑡)). Simulation results exhibit that TR, 𝜏D, D, and Vm, which represent the recurrence time of two events, the duration time of slip of an event, the final slip of an event, and the peak value of particle velocity of an event, respectively, are all similar for five values of Uco when B<0.01 and clearly different when B≥0.01. In general, Vm, D, and TR increase with B; and 𝜏D slightly decreases with increasing B and increases with Uco. An increase in D is particularly remarkable when Uco>0.3. The earthquake recurrence is almost periodic for small Uco; while the degree of periodicity decreases when either Uco or B increases. Either the time-predictable model or the slip-predictable model can approximately interpret the simulated earthquake recurrences with small Uco and small B, yet not for those with large Uco and large B. Simulation results exhibit that time-strengthening static friction produce an opposite effect on earthquake recurrence from the time-widening slip zone.


Contrast change is a special type of image distortion; it is a very important for visual perception of image quality. Most No-Reference Image Quality Assessment (NR-IQA) metrics are designed for the quality assessment of images distorted by compression, noise and blurring. Few NR-IQA metrics exist for Contrast-Distorted Images (CDI). Existing approaches rely on global statistics to estimate contrast quality. The current No Reference Image Quality Assessment for Contrast-Distorted Images (NR-IQACDI) uses global statistics features. Room for improvement exists, especially for the assessment results using the image database called TID2013 which has poor correlation with Human Visual Perception (HVP); Pearson Correlation Coefficient (PLCC) < 0.7. In this work, instead of relying on the global statistics features, NRIQACDI is presented based on the hypothesis that image distortions may alter the local region statistics (Local patches features). Our experiments are conducted to assess the effect of using local patches features with natural scene statistics (NSS). The experiment results are based on K-fold cross validation with K range from (2 to 10). The statistical tests indicate that the performance using local statistical features are better than that of the NRIQACDI. The use of other statistical features and selection methods should be further investigated to increase the quality of prediction performance.


CYP2C9-dependent drug metabolism is subject to large interindividual variation. To some extent, this is explained by genetic polymorphism with expression of enzyme variants that differ in catalytic activity. The aim of this study was to characterize the variation in CYP2C9 phenotype in relation to genotype, with further analysis of the CYP2C9 gene in metabolic outliers. A study population of 126 healthy white subjects were recruited and genotyped for the variant alleles, CYP2C9*1-3. In CYP2C9 phenotyping with losartan, three subpopulations were distinguished that differed in the number of CYP2C9*3 alleles (0, 1, or 2). A three-fold higher metabolic ratio (MR; urinary losartan/carboxymetabolite) was found comparing CYP2C9*1/*3 (n = 20) to CYP2C9*1/*1 (n = 81), but there was considerable variation within each genotype. Subjects genotyped as CYP2C9*1/*1, but with an unexpectedly slow oxidation of losartan, were selected for DNA-sequencing analysis of the CYP2C9 gene. Interestingly, single nucleotide polymorphisms (SNPs) could not be identified either in the 5'-flanking region, the nine exons, or exon-intron boundaries. However, sequencing of the CYP2C9 gene was also carried out in patients genotyped as CYP2C9*1/*1 but with an exceptionally low steady-state clearance of S-warfarin. Here, five different SNPs were identified. In further analysis of the healthy volunteers, it became evident that women on oral contraceptives (OCs) had slower oxidation of losartan (MR of losartan: 1.7) than women without OCs (MR of losartan: 0.86). This novel finding was not explained by a different frequency of variant alleles. In summary, CYP2C9 genotype and oral contraceptives both contribute to a large interindividual variation in CYP2C9 activity.


Andes orthohantavirus (ANDV) is a New World hantavirus that is a major cause of hantavirus cardiopulmonary syndrome (HCPS; also referred to as hantavirus pulmonary syndrome) in South America, particularly in Chile and Argentina. ANDV is one of the few hantaviruses for which there is a reliable animal model, the Syrian hamster model, which recapitulates important aspects of human disease. ABSTRACT Hantavirus cardiopulmonary syndrome (HCPS) is a severe respiratory disease caused by orthohantaviruses in the Americas with a fatality rate as high as 35%. In South America, Andes orthohantavirus (Hantaviridae, Orthohantavirus; ANDV) is a major cause of HCPS, particularly in Chile and Argentina, where thousands of cases have been reported since the virus was discovered. Two strains of ANDV that are classically used for experimental studies of the virus are Chile-9717869, isolated from the natural reservoir, the long-tailed pygmy rice rat, and CHI-7913, an isolate from a lethal human case of HCPS. An important animal model for studying pathogenesis of HCPS is the lethal Syrian golden hamster model of ANDV infection. In this model, ANDV strain Chile-9717869 is uniformly lethal and has been used extensively for pathogenesis, vaccination, and therapeutic studies. Here, we show that the CHI-7913 strain, despite having high sequence similarity with Chile-9717869, does not cause lethal disease in Syrian hamsters. CHI-7913, while being able to infect hamsters and replicate to moderate levels, showed a reduced ability to replicate within the tissues compared with Chile-9717869. Hamsters infected with CHI-7913 had reduced expression of cytokines interleukin-4 (IL-4), IL-6, and gamma interferon compared with Chile-9717869-infected animals, suggesting potentially limited immune-mediated pathology. These results demonstrate that certain ANDV strains may not be lethal in the classical Syrian hamster model of infection, and further exploration into the differences between lethal and nonlethal strains should provide important insights into molecular determinants of pathogenic hantavirus infection. IMPORTANCE Andes orthohantavirus (ANDV) is a New World hantavirus that is a major cause of hantavirus cardiopulmonary syndrome (HCPS; also referred to as hantavirus pulmonary syndrome) in South America, particularly in Chile and Argentina. ANDV is one of the few hantaviruses for which there is a reliable animal model, the Syrian hamster model, which recapitulates important aspects of human disease. Here, we infected hamsters with a human isolate of ANDV, CHI-7913, to assess its pathogenicity compared with the classical lethal Chile-9717869 strain. CHI-7913 had 22 amino acid differences from Chile-9717869, did not cause lethal disease in hamsters, and showed reduced ability to replicate in vivo. Our data indicate potentially important molecular signatures for the pathogenesis of ANDV infection in hamsters and may lead to insights into what drives the pathogenesis of certain hantaviruses in humans.


Estimates of Asian emissions of air pollutants and carbonaceous aerosols and their mid-term projections have been changing significantly in the last years. The remote sensing community has shown that increase in NOx in Central East Asia is much stronger than any of the emission inventories or projections indicated so far. A number of studies reviewing older estimates appeared. Here, we review the key contributions and compare them to the most recent results of the GAINS model application for Asia and to the SRES projections used in the IPPC work. The recent projections indicate that the growth of emissions of SO2 in Asia should slow down significantly towards 2010 or even stabilize at the current level. For NOx, however, further growth is projected although it will be most likely slower that in the last decade, owing to introduction of measures in transport. Emissions of carbonaceous aerosols (black carbon and organic carbon) are expected to decline after 2010, largely due to reduced use of biofuels in residential sector and efficiency improvements. The estimates of these emissions are burdened with significantly larger uncertainties than SO2 and NOx; even for the year 2000 the differences in estimates between studies are up to a factor of 2.


The Parque Paleontologico de Sao Jose de Itaborai was established in 1995 with the goal of geoconservation. Currently the institution is suffering a revitalization process which may increase the geotourism and contribute to the socioeconomic development of the area. However, the tourism activity, in a sustainable manner, has to present low environmental impacts. In this context we analyze the public understanding of the possible socioeconomic effects of geotourism. The locals mentioned the possibility of increased trade and jobs in the Parque Paleontologico de Sao Jose de Itaborai to meet geotourism. They said that the access roads to the paleontological park, public transport, education and sanitation need improvements. They also indicated the litter as the main environmental impact of the geotourism activity. This study analyzes geoconservation and musealization strategies for the geological heritage, territorial planning and management, educational programs and the socioeconomic importance of geotourism.


The purpose of this paper is to discuss the use of a horse as a therapeutic activity in the treatment of persons with physical disabilities. Occupational therapists have traditionally used goal-directed activities for treatment to achieve for patient gains in functional independence, both in specific dysfunctions and in the holistic manner of the patient interacting with the environment. The motivation of the patient to partake actively in the therapy is seen as a significant factor in the outcome of treatment. Hippotherapy involves the active participation of the patient in specifically prescribed activities with goal-directed results. The horse and the riding ring provide a non-traditional setting which can increase motivation of the patient and be ideal for the development of perceptual-motor coordination and sensory integration. The effective treatment of physical dysfunction using a horse to facilitate positive functional changes in patients will be discussed.


Phytochromes are photoreceptors in plants, fungi, and various microorganisms and cycle between metastable red light–absorbing (Pr) and far-red light–absorbing (Pfr) states. Their light responses are thought to follow a conserved structural mechanism that is triggered by isomerization of the chromophore. Downstream structural changes involve refolding of the so-called tongue extension of the phytochrome-specific GAF-related (PHY) domain of the photoreceptor. The tongue is connected to the chromophore by conserved DIP and PRXSF motifs and a conserved tyrosine, but the role of these residues in signal transduction is not clear. Here, we examine the tongue interactions and their interplay with the chromophore by substituting the conserved tyrosine (Tyr263) in the phytochrome from the extremophile bacterium Deinococcus radiodurans with phenylalanine. Using optical and FTIR spectroscopy, X-ray solution scattering, and crystallography of chromophore-binding domain (CBD) and CBD–PHY fragments, we show that the absence of the Tyr263 hydroxyl destabilizes the β-sheet conformation of the tongue. This allowed the phytochrome to adopt an α-helical tongue conformation regardless of the chromophore state, hence distorting the activity state of the protein. Our crystal structures further revealed that water interactions are missing in the Y263F mutant, correlating with a decrease of the photoconversion yield and underpinning the functional role of Tyr263 in phytochrome conformational changes. We propose a model in which isomerization of the chromophore, refolding of the tongue, and globular conformational changes are represented as weakly coupled equilibria. The results also suggest that the phytochromes have several redundant signaling routes.


This article introduces this special issue that deals with subnational (and, in the case of the European Union, sub-supranational) global climate change politics. While recognizing the limitations that face local governments, the article discusses the importance of focusing more attention on climate policies and programs of state (prefectural, provincial), regional, metropolitan, and local levels of government, where implementation of national climate change policies and programs must occur. Four cases are examined in detail: California within the United States, Germany within the European Union, prefectures and some municipalities (Tokyo and Kyoto) within Japan, and provinces and prefectures within China. The reasons why local governments sometimes choose to act as agenda setters are considered, the ways local governments can influence national government policies are discussed, the role of international networks in diffusing policy ideas among local governments is introduced, and the obstacles to affecting deep change at the local level are considered.


Hepatitis A was prevalent in 43 villages of the suburbs of Jinan, Shandong Province in 1986. The annual morbidity rate was 1,104.46/100,000. The authors studied the development of anti-HAV among children of under 14 years of age during the early epidemic and post-epidemic periods, compared the prevalence of anti-HAV between epidemic and non-epidemic villages, and analysed the types of HAV infection. The positive rate of anti-HAV was 35.42% during the early epidemic period and was 82.1% during the post-epidemic period, while it was 79.75% in non-epidemic villages. The result indicates that, in rural area, hepatitis A is chiefly influenced by the prevalence of anti-HAV in the population. If it remains at about 80%, the occurrence of an epidemic can be prevented. The ratio of clinical, subclinical and apparent infection during the epidemic was 1:0.75:0.81.


Acute ischemic renal failure is of great clinical importance because of its frequent occurrence and the high mortality it causes. Recent observations indicate that reperfusion has its own dangers because of oxygen- derived free radicals. To study this problem, ischemia was evoked in dogs in one kidney, by clamping the left renal artery for 45 rain. This was followed by a 90-rain period of reperfusion when diuresis, GFR, PAH clearance and sodium and potassium excretion were studied. Besides a control group (n = 6), the following treatment groups were investigated. Allopurinol (n = 7): 50 mg/kg for two days p.o. and 50 mg/kg in physiological saline infusion during the experiment; a small dose of SOD (n = 6): 0.5 mg/kg in infusion, started 1 min before reperfusion and given continuously for 10 min; and a high dose of SOD (n = 7): 5 mg/kg as above. In the first 15 rain following reperfusion, the renal functions significantly worsened in all groups. Later on, the renal functions gradually improved and in the last period after reperfusion, GFR in the ischemic kidney was 64%, cPAH 59%, diuresis 60% and sodium and potassium excretion were 65% and 76%, respectively, of the basal values in the control group. Treatment with free radical scavengers did not cause any considerable changes in the renal functions. In some respects, the worst results were observed with low-level SOD treatment (cPAH, diuresis, as well as sodium and potassium excretion). At the end of reperfusion, there was a significant drop in sodium excretion by the right (intact circulation) kidney of the treated animals.


Context: The nature of Australian rules football (Australian football) predisposes both unique and common injuries compared with those sustained in other football codes. The game involves a combination of tackling, kicking, high-speed running (more than other football codes), and jumping. Two decades of injury surveillance has identified common injuries at the professional level (Australian Football League [AFL]). Objective: To provide an overview of injuries in Australian rules football, including injury rates, patterns, and mechanisms across all levels of play. Study Design: A narrative review of AFL injuries, football injury epidemiology, and biomechanical and physiological attributes of relevant injuries. Results: The overall injury incidence in the 2015 season was 41.7 injuries per club per season, with a prevalence of 156.2 missed games per club per season. Lower limb injuries are most prevalent, with hamstring strains accounting for 19.1 missed games per club per season. Hamstring strains relate to the volume of high-speed running required in addition to at times having to collect the ball while running in a position of hip flexion and knee extension. Anterior cruciate ligament injuries are also prevalent and can result from contact and noncontact incidents. In the upper limb, shoulder sprains and dislocations account for 11.5 missed games per club per season and largely resulted from tackling and contact. Concussion is less common in AFL than other tackling sports but remains an important injury, which has notably become more prevalent in recent years, theorized to be due to a more conservative approach to management. Although there are less injury surveillance data for non-AFL players (women, community-level, children), many of these injuries appear to also be common across all levels of play. Clinical Relevance: An understanding of injury profiles and mechanisms in Australian football is crucial in identifying methods to reduce injury risk and prepare players for the demands of the game.


The brittle failure assessment for five pressurized water reactor pressure vessels (RPV) of German nuclear power plants (NPP) has been revisited according to an advanced state of the art. Besides of recent innovation in fracture toughness curves and reference temperatures being already in the codes, also the effect of loss of constraint had to be considered when fracture toughness values determined from deep cracks in fracture toughness specimen with high multi-axial state of stress were transferred to crack configurations in the component. Thus, the available concepts were compared for their fitness for purpose, i.e. for their ability to give a fracture toughness representative to the crack configuration or flaw postulate in the component. The results of the investigation reveal a significant lower constraint in the component resulting in increased fracture toughness and showing that the brittle failure assessment based on the high constraint fracture toughness from the standard specimens can be very conservative. For consideration of the constraint conditions in the component besides the deterministic T-stress parameter also probabilistic local approach concepts based on the Weibull model were used which have the advantage of considering both the local stress strain field and the material volume under high loading. The loss of constraint was determined for several flaw postulates in the leading situations on the RPV being the coolant inlet nozzle corner and the flange joint. A considerable loss of constraint was demonstrated for flaw postulates with broken clad in the ferritic nozzle corner. Also in the flange joint the loss of constraint is evident for small flaws. In addition, for flaw postulates under the intact cladding the loss of constraint is remarkably higher than with broken postulated cladding. In summary, with the measured material toughness and the significant loss of constraint a considerable inherent margin against brittle failure can be demonstrated for the investigated load cases.Copyright © 2010 by ASME


An oral controlled matrix tablet of Metformin HCl was formulated by hydrophilic polymer such as hydroxy propyl methyl cellulose K100 M (HPMC K100 M) as rate retarding polymer along with pharmaceutically acceptable electrolytes. Electrolytes such as aluminium hydroxide, magnesium carbonate and sodium carbonate were used at different concentrations (40 to 60 mg / tablet) in various formulations, while the ratio of drug and polymer were maintained constantly. In this work, a attempt was made for in-situ interactions between drug and electrolytes to control the release of highly water soluble drug from oral hydrophilic monolithic system. These electrolytes were used to monitor matrix swelling and gel properties. Electrolytes at higher concentrations exhibited greater retardation in drug release from than in low concentrations for controlled release of the drug. The results indicated that the drug released at a controlled rate were due to differential swelling rate and matrix stiffening and provides a uniform gel layer. These findings indicated that the swelling and gel formation in the presence of ionisable species within the hydrophilic matrices provide an attractive alternative for controlled drug delivery from a monolithic system. Accelerated stability studies were carried out as per ICH guidelines for some selected formulations, which indicated that these formulations were stable at accelerated storage conditions.


Contextual, cultural and political differences between China and the West determine that research issues and difficulties, that may not generally be experienced and reported in the West, can occur during participative research processes in China. Disregarding these context specific issues can lead to either a complete failure of the research project or insignificant research findings (e.g. lack of response or meaningless responses to questionnaires). This paper reviews and discusses issues that obstruct researchers carrying out participative survey research in China. These include problems related with identifying an appropriate research sample, translating the survey instrument, retrieving an accurate company list, getting sufficient responses and finally getting earnest responses from participants. The causes for these potential problems are discussed in relation to the political, economic, social, historical and cultural conditions in China. This paper proposes and illustrates a set of heuristics to overcome these problems, based on the lessons learned from a questionnaire survey conducted in an ongoing PhD research project. The project aims to investigate the barriers and risks associated with the post-implementation of Enterprise Resource Planning (ERP) Systems in Chinese companies. This paper is particularly meaningful for researchers and research project supervisors, who already engage or are interested in doing research in China but are relatively unfamiliar with the research context there.


The increasing prevalence of childhood obesity is a global public health concern. Numerous experts have noted that comprehensive
treatment methods are required to address this complex condition. The Children�s Health and Activity Modification Program (C.H.A.M.P.), a 4-week
intervention delivered in a unique camp-based format, was developed for children with obesity and their families using a multidisciplinary approach. The
purpose of the current study was to investigate the short- (i.e., 1-week post-intervention) and longer-term (i.e., 3-, 6-, and 12-months postintervention)
effects of C.H.A.M.P. on children�s self-reported: (a) task and barrier self-efficacy; and (b) home-based physical activity. A secondary
purpose was to determine whether task and/or barrier self-efficacy served as predictors of self-reported home-based physical activity at any of these
time points. The Physical Activity Questionnaire for Older Children (PAQ-C; Crocker, Bailey, Faulkner, Kowalski, & McGrath, 1997) was used to
assess self-reported home-based physical activity and modified versions of the Self-Efficacy Scale and Barrier Efficacy Scale (McAuley & Mihalko,
1998) were administered to children to assess task and barrier self-efficacy, respectively. Forty participants (36 different children) completed Year 1
(n = 15; Mage = 10.6; 53% female) and/or Year 2 (n = 25; Mage = 10.6; 56% female) of the program. Results showed that participation in C.H.A.M.P.
was associated with significant increases in task and barrier self-efficacy from pre- to post-intervention, after which mean values remained significantly
higher than baseline at the 3- and 6-month follow-up assessments. No significant changes were observed from baseline to any of the post-intervention
time points for home-based physical activity. Linear regression analysis revealed that task and barrier self-efficacy explained between 18% and 34%
of the variance in self-reported home-based physical activity scores. While task self-efficacy contributed more towards the prediction of home-based
activity at baseline, 1-week post-intervention, and 3-months post-intervention, barrier self-efficacy emerged as the predominant predictor at 6- and
12-months post-intervention. These results suggest that efficacious beliefs to be physically active and to overcome physical activity-related barriers
may be important in the prediction of self-reported home-based physical activity in children with obesity. Taken together, the current findings also
emphasize the importance of targeting self-efficacy as a first step towards increasing physical activity in this young population.


No description provided

Copyright 2007 Jayne Godfrey. No part of this article may be reproduced by any means without the written consent of the publisher.


Author(s): AbuHamdi, Eliana | Advisor(s): Alsayyad, Nezar | Abstract: The influx of refugees throughout the history of Jordan, from the Circassians of 1890 to the Iraqis of 2002, created moments of interruption in city planning and subsequently the opportunity for the lapse in accountability of the various municipal administrations to their intended planning and development goals. Indeed, each moment of interruption allowed for and inspired a reinvention of the city and a new modernist vocabulary for its development. In this way, the state (albeit not a monolithic actor) employed the disruption caused by each influx of refugees as an opportunity to rewrite systems of planning. These systems however, as history reveals, were only to be interrupted by the next influx of refugees, and so, planning in Amman has been historically unregulated.Development in Amman is complicated first by these refugee interruptions, second by the inadequacies of planning savvy on the part of the Greater Amman Municipality, and finally by a continual divergence between private and public interests, mainly problematic due to the lack of state land holdings and the power of tribal land owners and the political clout of their elite. The role of the state has been thus in constant competition with the shifting allegiances within tribes and amongst their elite. The state, throughout the 20th century, during the reign of King Hussein, exerted its power in an attempt to harness the various tribal, political, and ethnic allegiances into a united front, under the arm of the state. To accomplish this, Hussein's regime attempted to dismantle established systems of tribalism, redirecting allegiance towards the monarchy and its state led modernization and liberalization efforts. Modernization produced a series of bureaucratic systems, such as the Greater Amman Municipality, limiting the reach of tribes and their elite by dismantling tribal village councils. Additionally, the 1988 Master Plan proposed a new satellite city as prototype for a modern way of life, one outside the network of tribal communalism.Further, the state utilized the continual influx of refugees and subsequent lapses in planning administration to legitimize its intervention over the city or the making of parts of the city, particularly after liberalization. To this end, I will interrogate the role of the state first as an instrument of welfare, and, later, as a collaborator in the privatized enterprise of neoliberal development. In this way, the dissertation reframes neoliberalization as a process, and presents a new understanding of the relationship between state power, capital, and the built environment.First, as a rentier state, the monarchy was able, through the dispensation of welfare funds, to purchase allegiance and maintain political quietism. Later, after the loss of rentier capital, and operating as a neoliberal state, Hussein turned to social mechanisms of moderated governance, such at the manipulation of voting rights in order to ensure the election of favorable, pro-state candidates. As a result, governance systems in Amman were highly coercive and continually rescripted in such a way as to ensure first the autonomy of the state, and second, the security of the regime.A historical analysis of the political economy of urbanism in Amman makes clear the governance structure of the state, and reveals the limitations of civic democracy that it imposed on its public. Informed by a historical perspective of Amman's moderated governance structure, I conclude that the state, during the reign of King Abdullah (Hussein's son and heir), employed its coercive voice through various political campaigns to rewrite systems of planning and development and produce two major projects with agency that act on, or neoliberalize a city.Through my research on Amman in the contemporary moment, I demonstrate that neoliberalism is not only a process, but also a placed based, or site-specific process. In this way I recognize buildings and the sites they occupy as having more agency as a neoliberal construct, as opposed to neoliberalism as solely an economic project. In so doing, the critique shifts to the built environment, and recognizes the architecture within it as a significant actor in the process of transformation. Specific to Amman, two neoliberal projects, the Jordan Gate Towers and The Abdali Plan, prompted transformation and challenge the discussion of neoliberalism as the sole agent of global change. Further, by measure of impact, these urban transformations demonstrate that neoliberal restructuring can manifest as not only a site-specific process, but also as a political project.Un-planning is a derivative of the historic condition of unregulated planning in Amman and is defined by conditions of unregulated policy, the re-scripting or continual reconceptualization of the states role in planning, and finally, the constant battle with entrenched systems of tribalism that compete with the state for allegiance, and ultimately obstruct the formation of a national identity.These three components of interrupted planning in Amman (unregulated policy, rescripting the role of the state, and the fight for allegiance) have evolved from a provisional system of planning into a system of intentional un-planning, one that allows for an informalization of planning policy that has since culminated in unregulated development in the city.The dissertation will reveal that the primary reason unregulated planning is preferred is that it allows a certain range of autonomy for the state when it is not confined to planning regulations. In so doing, the state has released itself from liability to the often-detrimental cost of development decisions made in Amman, allowing it to pursue development in terms of capital incentive rather than impact study.


Germ-line and somatic mutations in genes that promote homology-directed repair (HDR), especially BRCA1 and BRCA2, are frequently observed in several cancers, in particular, breast and ovary but also prostate and other cancers. HDR is critical for the error-free repair of DNA double-strand breaks and other lesions, and HDR factors also protect stalled replication forks. As a result, loss of BRCA1 or BRCA2 poses significant risks to genome integrity, leading not only to cancer predisposition but also to sensitivity to DNA-damaging agents, affecting therapeutic approaches. Here we review recent advances in our understanding of BRCA1 and BRCA2, including how they genetically interact with other repair factors, how they protect stalled replication forks, how they affect the response to aldehydes, and how loss of their functions links to mutation signatures. Importantly, given the recent advances with poly(ADP-ribose) polymerase inhibitors (PARPi) for the treatment of HDR-deficient tumors, we discuss mechanisms by which BRCA-deficient tumors acquire resistance to PARPi and other agents.


This paper presents two algorithms. The first algorithm predicts future control independent points in the dynamic instruction stream. A control independent point is an instruction at which the program execution paths will converge regardless of the outcome or target of the current branch. We have developed this algorithm to use for dispatching tasks in a speculative multithreading architecture we are developing. Our algorithm significantly improves prediction accuracy over current predictor from which it is inspired. Moreover, while the best current algorithm predict the earliest dynamic instruction reachable before the next statically identified control independent point, our algorithm predicts true control independence. The second algorithm is used to construct large tasks suitable for our speculative multithreading architecture.


The objective of this paper is to set up, among a group of projects and by means of multivariate techniques, a selection process that allows to choose those with the best performance and to establish the factors and variables characterising successful cases. This way, we can offer a model for the evaluation and selection of development projects. New ideas and approaches for the promotion politics of business services should come out of the extraction of common models and behaviours among the cases with best performance. More specifically, for the empirical development of this research, we have used the project portfolio of business development services of the Inter-American Development Bank between 1995 and 2002. JEL classification: Keywords: business development project, factor, cluster


Dietary flavonoids constitute an important group of potential health protective compounds from fruits, vegetables, and plant-based products such as tea and wine. The beneficial effects of a diet high in flavonoids on the risk of coronary heart disease (CHD) have been shown in several epidemiological studies but the evidence is inconclusive. One major obstacle for epidemiological studies investigating associations between flavonoid intake and risk of CHD is the estimation of flavonoid intake. There is a vast variety of flavonoids in commonly eaten food products but only limited knowledge of their content. In addition, variation in individual metabolic genotype and microflora may greatly affect the actual flavonoid exposure. The preventive effects of flavonoids on CHD are mainly ascribed to their anti-inflammatory and antioxidant activities. Several mechanisms of anti-inflammatory and antioxidant function of flavonoids have been shown in vitro; yet, only few have been confirmed in vivo. Knowledge of the bioavailability and metabolism of flavonoids is together with information from in vitro studies important steps towards identifying the compounds that are most likely to have biological activity. The present thesis was initiated with two objectives. One objective was to investigate the bioavailability and metabolism of the dietary important flavonoids hesperetin and naringenin from commercial, hesperidin-fortified, and enzymatically treated orange juice. The other objective was to explore the association between exposure to dietary flavonoids and the risk of acute coronary syndrome (ACS) in a nested case-control study. The bioavailability and metabolism of hesperetin and naringenin was investigated by analysing urine and plasma from 16 subjects after consumption of three treatments of orange juice: commercial orange juice with a natural concentration of hesperetin and naringenin rhamnoglucosides, 3-times hesperidin (hesperetin-7-O-rhamnoglucoside) fortified orange juice and orange juice enzymatically treated to yield hesperetin and naringenin-7-O-glucosides. The effect of enzymatic treatment on bioavailability was statistically significant compared to commercial orange juice and showed 3 and 4 fold increases in bioavailability of hesperetin and naringenin, respectively. A total of eight hesperetin and naringenin phase II conjugates excreted in urine was identified by comparison with synthetic standards, NMR spectroscopy and differential pH spectrophotometry. Quantification was performed on six of the eight conjugates based on calibration curves with the identical conjugates. There was no difference in the profile of the excreted conjugates according to treatment. The results demonstrated the more effective absorption of hesperetin and naringenin from the small intestine when consumed as glucosides compared to absorption in the colon VII after microbial degradation of the rhamnoglucosides. In addition it was shown that the conjugate profile was neither affected by the absorption site nor by a 3-fold change in dose. The urinary excretion of ten dietary flavonoids was analysed after enzymatic hydrolysis by LC-MS and associated to the risk of ACS in a nested case-control study with 393 case-noncase pairs. The 393 case-noncase pairs were identified in the Danish Diet, Cancer and Health cohort comprising biological samples and food frequency questionnaires (FFQs) from 57 053 cohort members. Higher urinary excretion of kaempferol was statistically significant associated with a consistent 44-60 % lower risk of ACS. The lower risk associated with urinary kaempferol excretion was probably attributable to tea consumption. There were no monotonic dose-response relations between higher excretion of any of the flavonoids and lower risk of ACS. This was the first time that flavonoid excretion was measured in spot-urine samples and associated to risk of ACS in a nested case-control study. The results indicate that the study was too limited in size to account for the variation associated with quantifying flavonoids in spot-urine samples. However, the non-monotonic, but statistically significant, association between higher kaempferol excretion and lower risk of ACS indicate that the lack of associations were not due to lack of potential cardio-protective effects of flavonoids. This should be investigated in a larger study.


An enantioselective method for the synthesis of 1,2-anti-diols has been developed. A cyclometalated chiral-at-ruthenium complex catalyzes the asymmetric ring-opening/cross-metathesis of dioxygenated cyclobutenes, thus resulting in functionally rich synthetic building blocks. Syntheses of the insect pheromone (+)-endo-brevicomin and monosaccharide ribose demonstrate the synthetic utility of the 1,2-anti-diol fragments generated in the title reaction.


Purpose To provide a rapid, non-invasive fat quantification technique capable of producing separate lipid component maps. Methods The calf muscles in 5 healthy adolescents (age 12-16 years; BMI = 20 ± 3 Kg/m2) were scanned by two different fat fraction (FF) quantification methods. A high-resolution, density-weighted concentric ring trajectory (DW-CRT) metabolite cycling (MC) magnetic resonance spectroscopic imaging (MRSI) technique was implemented to collect data with 0.25 mL resolution within 3 minutes and 16 seconds. For comparative purposes, the standard Dixon technique was performed. The two techniques were compared using structural similarity (SSIM) analysis. Additionally, the difference in the distribution of each lipid over the adolescent calf muscles was assessed based on the MRSI data. Results The proposed MRSI technique provided individual FF maps for eight musculoskeletal lipids identified by LCModel analysis (L09, L11, L13, L15, L21, L23, L53, and L55) with mean SSIM indices of 0.19, 0.04, 0.03, 0.50, 0.45, 0.04, 0.07, and 0.12, respectively compared to that of Dixon's FF map. Further analysis of voxels with zero SSIM demonstrated an increased sensitivity of FF lipid maps from data acquired using this MRSI technique over the standard Dixon technique. The trend of lipid spatial distribution over calf muscles was consistent with previously published findings in adults. Conclusion The advantages of this MRSI technique make it a useful tool when individual lipid FF maps are desired within a short scanning time.


The cellular response to hypoxia is, at least in part, mediated by the transcriptional regulation of hypoxia-responsive genes involved in balancing the intracellular ATP production and consumption. Recent evidence suggests that the transcription factor, HIF-1alpha, functions as a master regulator of oxygen homeostasis by controlling a broad range of cellular events in hypoxia. In normoxia, HIF-1alpha is targeted for destruction via prolyl hydroxylation, an oxygen-dependent modification that signals for recognition by the ubiquitin ligase complex containing the von Hippel-Lindau tumor suppressor. Three HIF prolyl hydroxylases (EGLN1, EGLN2, and EGLN3) have been identified in mammals, among which EGLN1 and EGLN3 are hypoxia-inducible at their mRNA levels in an HIF-1alpha-dependent manner. In this study, we demonstrated that apart from promoting HIF-1alpha proteolysis in normoxia, EGLN1 specifically represses HIF-1alpha transcriptional activity in hypoxia. Ectopic expression of EGLN1 inhibited HIF-1alpha transcriptional activity without altering its protein levels in a von Hippel-Lindau-deficient cell line, indicating a discrete activity of EGLN1 in transcriptional repression. Conversely, silencing of EGLN1 expression augmented HIF-1alpha transcriptional activity and its target gene expression in hypoxia. Thus, we proposed that the accumulated EGLN1 in hypoxia acts as a negative-feedback mechanism to modulate HIF-1alpha target gene expression. Our finding also provided new insight into the pharmacological manipulation of the HIF prolyl hydroxylase for ischemic diseases.


Background: To determine the pattern of surgical eye removal in a tertiary eye-care facility in Eastern India. Materials and Methods: A retrospective case review was performed for all patients who had surgical removal of the eye between February 2011 and February 2017 at our tertiary care centre. Data collected were age, sex, diagnosis, eye affected and type of surgery, time of presentation. Results: In this study 159 eyes of 159 patients underwent eye removal surgery with total number of evisceration 101(63.52%), enucleation 57(35.85%) and exenteration 1(0.63%) noted from records. Mean age was 43.7126.45 with Male:Female ratio of 1.69:1. Diagnosis was categorized into severe intractable infection 70(44.03%), trauma 34(21.38%), tumours 28(17.61%), painful blind eye 16(10.06%) and staphyloma 11(6.92%). Conclusion: Evisceration was preferred surgery in our study. Males were more commonly involved than female. Severe intractable infection was most common indication followed by trauma and tumour with retinoblastoma as the major indication. Painful blind eye and staphyloma was remaining indication. Causes are largely preventable and avoidable and with provision of adequate eye-care facilities this trend can be reversed. Key messages: Removal of eye has profound psychological, social and economical impact on an individual. To reduce this, major etiological factor prevalent in that region has to be known. Aetiology prevalent in western country or different parts of our country may not fit in our scenario and every region has its own environmental, social, educational, financial conditions and cultural beliefs that significantly affects these outcomes. Keywords:  Enucleation, evisceration and Exenteration.


PROBLEM
Nursing administrators reported that medication administration errors had continued despite the use of bar code medication administration, especially in terms of omitted medications. Nurse administrators within the study hospital identified a need to add back up safety systems in order to reduce the number of omitted medications. Interruptions and distractions were identified as leading constraints to accurate medication administration.

METHODS
This pre-post quality improvement study used a convenience sample of nurses on one medical surgical unit to observe the effect of specific protocols to decrease interruptions and distractions during medication administration. Nurses' were observed during medication administration cycles, and the medication time was measured in hours and minutes using a stop watch. The number of distractions and interruptions was counted by category. A participant survey was used to determine nurses perceptions of distractions and interruptions experienced.

FINDINGS
The five-part intervention decreased nurses interruptions and distractions by 84% compared with the control group. The results indicated the type of distractions and interruptions nurses typically experience during medication administration was highest from conversation in the environment (M = 5.0 ± 3.4) and by other personnel (M = 6.38 ± 2.6).

CONCLUSION
This process improvement project determined that a five-part protocol would reduce distractions and interruptions for nurses, save time in the process, and reduce omitted medications. Other visible symbols such as a vest with wording may show different results when combined with the other elements of the protocol. Anecdotal comments from nurses during and after observations divulged workplace issues surrounding medication delivery that may need investigation.


Lipid biosynthesis is essential for eukaryotic cells, but the mechanisms of the process in microalgae remain poorly understood. Phosphatidic acid phosphohydrolase or 3-sn-phosphatidate phosphohydrolase (PAP) catalyzes the dephosphorylation of phosphatidic acid to form diacylglycerols and inorganic orthophosphates. This reaction is integral in the synthesis of triacylglycerols. In this study, the mRNA level of the PAP isoform CrPAP2 in a species of Chlamydomonas was found to increase in nitrogen-free conditions. Silencing of the CrPAP2 gene using RNA interference resulted in the decline of lipid content by 2.4%–17.4%. By contrast, over-expression of the CrPAP2 gene resulted in an increase in lipid content by 7.5%–21.8%. These observations indicate that regulation of the CrPAP2 gene can control the lipid content of the algal cells. In vitro CrPAP2 enzyme activity assay indicated that the cloned CrPAP2 gene exhibited biological activities.


Agricultural practices depend mainly on the use of chemical fertilisers, pesticides, and herbicides which have caused serious health hazards and have also contributed to the pollution of the environment at large. The application of plant-beneficial rhizobacteria in agrarian practices has become paramount in increasing soil fertility, promoting plant growth, ensuring food safety, and increasing crop production to ensure sustainable agriculture. Beneficial rhizobacteria are soil microorganisms that are eco-friendly and serve as a modern method of improving the plant yield, protecting the plant and soil fertility that pose no harm to humans and the environment. This eco-friendly approach requires the application of beneficial rhizobacteria with plant growth-promoting traits that can improve the nutrient uptake, enhance the resistance of plants to abiotic and biotic stress, protect plants against pathogenic microorganisms and promote plant growth and yield. This review article has highlighted the multitasking roles that beneficial rhizobacteria employ in promoting plant growth, food production, bioremediation, providing defence to plants, and maintaining soil fertility. The knowledge acquired from this review will help in understanding the bases and importance of plant-beneficial rhizobacteria in ensuring agricultural sustainability and as an alternative to the use of agrochemicals.


This article examines Directive 2009/38/EC concerning the establishment of a European Works Council (EWC) or a procedure in Community-scale undertakings and Community-scale groups of undertakings for the purposes of informing and consulting employees, approved by the Parliament and the Council on 6 May 2009. Starting from the revision of the 1994 Directive, this article concentrates on the innovative aspects and 'omissions' in the new Directive. The main aims of the new Directive are the determination of the powers of the EWC, now limited to 'transnational issues'; the definitions of information and consultation; and the specification of preliminary information in the setting up of an EWC – in particular, information concerning the structure of the business (or group) and the number of employees. The most significant 'omission' in the new Directive is the lack of any reference to the negotiating activity of the EWC, that as a general rule has given rise to forms of 'transnational collective bargaining' and which, in recent years, has been the subject of numerous studies and research initiatives promoted by the European Commission. In conclusion, it is argued that the question of the (uncertain) legitimacy of EWCs as negotiating partners – and of the possible regulation of the forms of 'transnational collective bargaining' – remains complex and difficult to resolve.


Research exploring the experiences of Black women attending predominantly White institutions in the U.S. is emerging. However, scholarship centering Black women's experiences within Ivy League institutions remains elusive. This study explores the experiences of six Black women Ivy League collegians and their perceptions about how race, gender, and ethnicity shaped their sense of identity and campus interactions while attending an Ivy League institution. Using Black Feminist Thought as the theoretical framework, findings illustrate salient stressors and challenges while navigating interactions with peers, professors, and other university personnel. This study's findings broaden our understanding of Black women college student experiences within Ivy League institutions and informs institutions of higher education on strategies to best support them.


We present a discontinuous Galerkin method for moist atmospheric dynamics, with and without warm rain. By considering a combined density for water vapour and cloud water, we avoid the need to model and compute a source term for condensation. We recover the vapour and cloud densities by solving a pointwise non-linear problem each time step. Consequently, we enforce the requirement for the water vapour not to be supersaturated implicitly. Together with an explicit time-stepping scheme, the method is highly parallelisable and can utilise high-performance computing hardware. Furthermore, the discretisation works on structured and unstructured meshes in two and three spatial dimensions. We illustrate the performance of our approach using several test cases in two and three spatial dimensions. In the case of a smooth, exact solution, we illustrate the optimal higher-order convergence rates of the method.


For typical Web developers, it is complicated to integrate content from the Semantic Web to an existing Web site. On the contrary, most software packages for blogs, content management, and shop applications support the simple syndication of content from external sources via data feed formats, namely RSS and Atom. In this paper, we describe a novel technique for consuming useful data from the Semantic Web in the form of RSS or Atom feeds. Our approach combines (1) the simplicity and broad tooling support of existing feed formats, (2) the precision of queries against structured data built upon common Web vocabularies like schema.org, GoodRelations, FOAF, SIOC, or VCard, and (3) the ease of integrating content from a large number of Web sites and other data sources of RDF in general. We also (4) provide a pattern for embedding RDFa into the feed content in a "viral" way so that the original URIs of entities are included in all Web pages that republish the original content and that those pages will link back to the original content. This helps prevent the proliferation of identifiers for entities and provides a simple means for tracking the document URI at which particular content reappears.


In the search for alternative sources to replace fossil fuels, carbon nitride materials can be used in a variety of ways. In the present work, porosity is introduced to the carbon nitride material using mesoporous silica material, MCM-41 as a hard template and a mesoporous carbon nitride (MCN) material is synthesized. Further, the MCN is modified by immobilizing metal phthalocyanine (MPc, where M = Mn, Fe, Co, Ni, Cu, and Zn). The resulting MPc incorporated MCN materials (MPc@MCN) were tested for electrocatalytic oxygen reduction reaction (ORR) in acidic and basic media. Detailed studies reveal that the FePc@MCN and CoPc@MCN materials exhibit higher ORR activity than the other composites in 0.1 M KOH. FePc@MCN follows a direct four-electron oxygen reduction mechanism and shows ORR onset potential (vs. RHE) at 0.93 V (in 0.1 M KOH) which is very close to the onset potential exhibited by the state-of-the-art material, Pt-C (1.0 V) and higher than several similar composites of MPc with carbon supports tested in the similar environment. Besides, due to the inherent property of coordination through nitrogen present on the MCN, FePc@MCN shows excellent stability even after 3000 CV cycles. FePc@MCN found to have a better methanol tolerance in comparison to Pt-C in basic medium. CoPc@MCN shows a highly selective two-electron reduction reaction in both acidic and basic media at lower overpotential than many of the reported catalysts for the two-electron oxygen reduction. Therefore, these materials (FePc@MCN and CoPc@MCN) can be used as suitable alternatives to replace Pt and other expensive materials in ORR and related applications.


Worker and workplace empowerment have been enduring topics in psychological research. Recently, due to the advancements in technology and communication, new forms and types of work and organizing have emerged and challenged the traditional understandings of power and empowerment. Open source software (OSS) communities are one example of such new types of organization and collaboration. OSS communities have been celebrated as democratic, participatory and egalitarian settings where people voluntarily, freely and collaboratively develop software to serve their needs as well as the needs of others. In this paper we show that OSS communities indeed nurture empowerment in several senses. However, we also show that OSS communities pose several challenges to empowerment. As an example, we analyze numerous usability interventions in OSS development, in which usability practitioners have offered their expertise to OSS projects. We show that the usability practitioners have been empowered in certain cases and senses, but that they have also encountered numerous challenges as regards their empowerment. Moreover, we argue that critical theories on empowerment provide additional, valuable insights on empowerment in OSS development as well as elsewhere. We propose a comprehensive framework on empowerment, suitable for studies on empowerment in OSS communities as well as in other online communities and forms of distributed or online collaboration.


This study examined associations among Head Start attendance, individualized education programmes (IEPs), parental behaviours and child outcomes in a sample of five-hundred and seventy 3- to 4-year-old children with disabilities. Home language, number of disabilities and Head Start enrollment were associated with having an IEP. Parents of children with IEPs and those who participated in Head Start used more social services, while social support was more prevalent for parents of non-Head Start children with IEPs. For all children, frequent parental book reading, greater number of books in the home and greater perceived social support among parents were associated with favourable cognitive and social–emotional outcomes. Greater social service use was adversely associated with reading scores only for non-Head Start children. Findings highlight the need for inclusive IEP policies and Head Start programmes for parents regarding access to special education supports for children who demonstrate developmental concerns. Participation in Head Start may buffer negative effects of social service use on children's reading skill development, although more research is needed to uncover the specific mechanisms responsible for this association.


The first part of this paper briefly summarizes the assumptions of economic theory on the relationships between exchange rates, prices and interest rates and the same time compares these assumptions with the empirical evidence. The fact that there exist strong discrepancies, which in recent years have widened, has motivated the attempt to find new hypotheses. A detailed analysis of appreciation process of the dollar in the early 1980's leads one to the conclusion that destabilizing currency speculation does actually exist. This "bubble" process has also been identified for the period between the end of 1972 and mid 1973 and for the year of 1978.To observe the configuration of relative price levels and relative real interest levels in time leads one to a new hypothesis about exchange rate dynamics. The expectation formation and the actual movements are explained by the interaction of disequilibria in the goods and asset markets (the exchange rate is thus conceived as both a flow price and an asset price).This disequilibrium approach rejects the validity of uncovered interest parity. The most important institutional condition for destabilizing currency speculation is identified as the basic asymmetry in capital mobility between asset holders and liability holders. This explains to a large extent how (first) debtors and (then) creditors and thus the whole international system has fallen into its current troubles. Finally, this paper concludes that exchange rates remain fundamentally unstable since one price cannot clear two markets (given the condition of freely floating short-term capital).


This research has the aim of knowing the public's perception of the existence of the seaweed industry, describe social and economic changes before and after the seaweed industry, and the impact on the community on the existence of the seaweed industry. The research was carried out in April-June 2019 in Suppa District, Pinrang Regency. This type of research uses a survey research type taking samples from the research population. Sampling using simple random sampling with a sample of 30 people. Data was collected through direct interviews and questionnaires to a number of selected respondents. The data analysis used is descriptive qualitative and quantitative data analysis. The results of this study indicate a positive response from the community about the existence of a seaweed industry built in their area. As many as 50% of the community stated that they strongly agreed with the existence of the seaweed industry and 67% of the local community expressed their interest in registering as workers in the seaweed industry. The existence of the seaweed industry can reduce the unemployment rate in Suppa District, Pinrang Regency. In addition, negative impacts also occur such as land disputes, pollution and also waste from the seaweed industry.


This paper presents modified memoryless quasi-Newton methods based on the spectral-scaling Broyden family on Riemannian manifolds. The method involves adding one parameter to the search direction of the memoryless self-scaling Broyden family on the manifold. Moreover, it uses a general map instead of vector transport. This idea has already been proposed within a general framework of Riemannian conjugate gradient methods where one can use vector transport, scaled vector transport, or an inverse retraction. We show that the search direction satisfies the sufficient descent condition under some assumptions on the parameters. In addition, we show global convergence of the proposed method under the Wolfe conditions. We numerically compare it with existing methods, including Riemannian conjugate gradient methods and the memoryless spectral-scaling Broyden family. The numerical results indicate that the proposed method with the BFGS formula is suitable for solving an off-diagonal cost function minimization problem on an oblique manifold.


Telegraph from John M. Barcus to Mrs. Isaac Zachary Taylor Morris (Isabella Waters Morris). The telegraph was sent on December 11, 1914.


We give a simple and effective method for the construction of algebraic curves over finite fields with many rational points. The curves constructed are Kummer covers or fibre products of Kummer covers of the projective line.


N-doped porous carbon encapsulated NiO/Ni composite nanomaterials (N-doped NiO/Ni@C) was successfully obtained by a one-step solution combustion method. This study demonstrates a one-step combustion method to synthesize n-doped porous carbon encapsulated NiO/Ni composite nanomaterials, using carbon dioxide as the carbon source, nickel nitrate as the nickel source, and hydrazine hydrate as the reaction solution. Spherical NiO nanoparticles with a particle size of 20 nm were uniformly distributed in the carbon matrix. The load of NiO/Ni can be controlled by the amount of nickel nitrate. The range of carbon content of recovered samples is 69–87 at%. The content of incorporated nitrogen for recovered samples is 1.94 at%. As the anode of lithium ion battery, the composite material exhibits high capacity, excellent multiplier performance and stable circulation performance. N-doped NiO/Ni@C-2 was applied to lithium ion batteries, and its reversible capacity maximum is 980 mAh g−1 after 100 cycles at the current density of 0.1 A g−1. Its excellent electrochemical properties imply its high potential application for high-performance lithium-ion battery anode materials.


OBJECTIVES
We describe the medico-legal findings in a population of sexual assault cases assessed in an urban referral center, analyse the legal outcomes in each case and determine whether the medico-legal findings were associated with conviction of the assailant.

MATERIALS AND METHODS
We performed a retrospective study of medico-legal reports in all the sexual assault cases reported in Tours during a 7-year period. Legal outcomes were obtained from courtroom proceedings. The relationship between the outcomes and the circumstances of the case was analyzed by logistic regression.

RESULTS
756 cases were enrolled. 68.3% of the cases involved children under 15 years old. Genital trauma occurred in 6.8% of the girls and 6% of the boys in this group. 31.7% of all the victims were aged 15 years or more. Genital injury was documented in 11.3% of the women. 36.3% of the assailants were convicted. Examination at the request of the police authorities and previous acquaintance of the assailant by the victim were significantly associated with conviction. The presence of general body and/or genital trauma was not associated with conviction.

CONCLUSION
Non-medical variables must be thoroughly collected by the medical examiner. Physical evidence of trauma was neither predictive nor essential for conviction.


The paper contributes to literatures on settlements and institutional maintenance work. It does so by unpacking post-settlement legitimation efforts required to maintain contentious institutions between previously conflicting actors. Settlements often necessitate the maintenance of institutions from the past whose legitimacy is dubious for the new regime. We study the role played by South Africa's Truth and Reconciliation Commission in re-legitimating and maintaining the institution of the armed forces in the transition from apartheid to democracy. Maintaining this legitimacy required collaboration between the incoming government as well as the apartheid era armed forces. We term these unexpected collaborative efforts 'reluctant accommodation work'. Our findings show that the lines of allegiance may be more fluid than currently depicted in the literature. Actors that previously conflicted need to find an interest in collaborating in their efforts to shape central institutions. Second, we show that for settlements to shape the field, they need to agree on the terms of collaboration, what we term 'passage points', as well as engage in public ceremonies to broadly legitimate the settlement and the institution it seeks to preserve.


ABSTRACT Introduction Medication errors are common events that compromise patient safety and are prevalent in all health-care settings. This umbrella review aims to systematically evaluate the evidence on contributory factors to medication errors in health-care settings in terms of the nature of these factors, methodologies and theories used to identify and classify them, and the terminologies and definitions used to describe them. Areas covered Medline, Cumulative Index to Nursing and Allied Health Literature, Embase, and Google Scholar were searched from inception to March 2022. The data extraction form was derived from the Joanna Briggs Institute (JBI) Reviewers' Manual, and critical appraisal was conducted using the JBI quality assessment tool. A narrative approach to data synthesis was adopted. Expert opinion Twenty-seven systematic reviews were included, most of which focused on a specific health-care setting or clinical area. Decision-making mistakes such as non-consideration of patient risk factors most commonly led to error, followed by organizational and environmental factors (e.g. understaffing and distractions). Only 10 studies had a pre-specified methodology to classify contributory factors, among which the use of theory, specifically Reason's theory was commonly used. None of the reviews evaluated the effectiveness of interventions in preventing errors. The collated contributory factors identified in this umbrella review can inform holistic theory-based intervention development.


Purpose

With increasing pressures on hospitals, home care by visiting nurses presents a viable option for care delivery. Nurses routinely provide complex interventions at home that previously were only available in a hospital setting. Medication errors are the most common type of error to occur with potentially serious and harmful consequences. Double checking of medication by a second qualified clinician is recognised as the gold standard practice to prevent medication errors, and routinely used when dangerous drugs such as opioids are administered in the hopsital setting. In the home care setting however there is no second clinician available to double check medication. The aim of this study was to assess the feasibility of using Internet based videoconferencing to facilitate a double check at a distance. Methods

Following an efficacy study to establish feasibility of checking medication items using Internet video, we undertook a pilot study using laptop computers and mobile Internet. Six nurses were recruited to participate in this study, and received training on using laptop computers and mobile Internet. The computers were taken on scheduled home visits to patient's homes and connectivity back to a base computer located at the hospital was established at each visit. Nurses would then use the integrated web camera in the computer to double check various items associated with the clinical care of the patient. Results

During the study period, over 300 items were checked. Details of medication names, dosages and segmentations on syringes greater than 1unit were all observed accurately 100% of the time. Expiry dates and small syringes were not able to be reliably checked using this method. Conclusion

Patient saftey remains at the heart of nursing care. Providing care at home should not involve a compromise of standards. The use of technology presents and attractive option for facilitating a double check and warrants further research.


Acoustic Gaussian beam migration is an attractive imaging method because it is flexible with input geometry, efficient, and accurate in imaging multipath arrivals. However, one of the hurdles that this method must overcome in production processing is its extension to use multimeasurement data, as recently allowed by novel acquisition technologies. This is inevitable when the compensation of the ghost effect is best corrected within a true-amplitude imaging process, a necessity for amplitude-variation-with-offset work. For this purpose, I introduced a novel formalism for vector-acoustic imaging, based on Green's function theory, which can remove the ghost effect and produce amplitudes on reflectors that are proportional to the reflection coefficients. I established a theoretical framework with Gaussian beam representations of Green's functions, including theweighted beam-stacking approach that reduced the cost of computation. I extended my formulas to use the steep-descent (i.e., stationary phase) approximation. Then, I explained the impact of this approximation on the illumination and the event continuity and sharpness. I also studied the special case of acoustic imaging corresponding to using single-measurement (i.e., pressure) data. I applied the derived formulations to realistic synthetic multisensor data (North Sea) using a research code of Gaussian beam migration. The numerical examples demonstrated that I can improve the illumination of the final images and obtain wide-bandwidth reflectivity maps.


Consider a network in which each unit initially knows only its own identity and the identity of its immediate neighbors. Suppose each unit has a message intended for all other units. The authors give a distributed algorithm to accomplish this in point-to-point networks which is optimal in the number of transmissions it requires. They also show that this algorithm accomplishes this efficiently for broadcast (radio) networks, although the problem of finding a solution with the least number of transmissions, in broadcast networks, is shown to be NP-hard. >


Emergency obstetric care (EmOC) has dramatically lowered the maternal death rate in Bangladesh since the early 1990s. Rising caesarean section rates over the past ten years have had an impact on the nation's economy in addition to other signs of better mother care. According to demographic and health surveys, caesarean section rates increased from 3.5% in 2004 to 23% in 2014. Women who become pregnant after 35 years, live in cities, have a higher level of education and frequently use antenatal services have a greater average annual rate of prevalence in caesarean sections. The objective was to assess the indications and the trends of caesarean sections done over a two-month period. The study of prevalence and determinants of caesarean section was conducted in a renowned private hospital in Dhaka. Among 197 women who were admitted to the department of obstetrics and gynecology, the number of total deliveries was 175 (89% of total admission). The indications varied a little in cases of lower abdominal pain and preeclampsia. Antepartum hemorrhage (APH) and breech have a small proportion (about 5% both). The proportion of repeated caesarean sections was 47%. Recently the indication of a maternal choice is also coming up (11%). The data were compared and analyzed to determine if the indications were significant enough for cesarean delivery. Although a caesarean section is currently a relatively safe obstetrical procedure, it is advised that the indications should be carefully evaluated in order to lower caesarean section rates.
Bangladesh Pharmaceutical Journal 26(2): 195-203, 2023 (July)


This paper exposes an algorithm which leads to a fuzzy segmentation. This algorithm performs, as in the watershed method, a progressive flood of the gradient image from pixels of lowest gradients. It uses a new distance, called topographic distance. Any local minimum of the gradient norm image constitutes a seed for the region growing, avoiding the use of a marker image. These seeds constitute the cores of the initial fuzzy regions. Then the sites are gradually agglomerated to the region, while their membership degrees to the region decrease, according to the distance to the core and to the gradient norms, by the way of the topographic distance. The numerous fuzzy regions are then merged and the membership degrees of pixels to final regions are computed. Applications concern crisp segmentation of colour or gray scale images and pattern recognition from fuzzy regions.


This thesis focusses on the implementation of two elastic lidar (light detection and ranging) techniques for the monitoring of atmospheric aerosols and insects at short-wave infrared wavelengths.

Data acquisition software was developed for a time-of-flight system, housed in the Lund University Mobile Biosphere Observatory (LUMBO), with consideration to the intended entomological application. Once up and running, the background signal and noise present in the system was characterised to facilitate future data filtering and background subtraction. The acquisition of a signal from a nearby building was achieved, but revealed that the signal-to-noise ratio of the system was too poor to be able to reliably distinguish any insect events. Attempts to improve the signal-to-noise ratio were made through the construction of a transimpedance amplifier for the receiving avalanche photodiode, but were unsuccessful.

Proof-of-concept dual-band measurements on atmospheric aerosols and insects were performed with a Scheimpflug lidar system. The measurements demonstrated the high spatiotemporal resolution of the system, making possible the localisation and identification of, for example, vehicle emissions. Moreover, it was shown that the ratio between the backscattered signal in the two bands can be used to distinguish between different particle plumes, indicating the potential of the technique to identify aerosols. Furthermore, the dual-band measurements on insects demonstrated the ability of the apparatus to resolve the wing beat frequencies of the organisms in question, along with several associated higher harmonics in the Fourier transform of the time series data.


Pluripotent hemopoietic progenitors (CFU-GEMM) give rise to multilineage hemopoietic colonies in culture. We have examined the erythropoietin requirements of CFU-GEMM-derived erythroid progeny in patients with polycythemia vera (PV) and studied their proliferative activity by short-term exposure to 3HTdR. Mixed colonies with erythroid components were observed in all bone marrow and peripheral blood samples from patients with PV that were cultured without addition of exogenous erythropoietin. This response is consistent with previously reported growth patterns for CFU-E and BFU-E. The frequency of mixed colonies increased regularly when erythropoietin was added to the cultures. Short-term exposure of peripheral blood specimens to 3HTdR prior to plating yielded a reduction of the plating efficiency by 20%-70% when compared to cells that were not exposed to 3HTdR. The observation of cycling CFU-GEMM in PV contrasts with the usually quiescent behavior of CFU-GEMM in peripheral blood of normal individuals under steady-state conditions. These results support the view that the increased proliferative rate observed for CFU-GEMM may be responsible for the increased formation of blood cells in PV.


Herein, a rapid, linker-free, single-step strategy for in situ synthesis of graphene quantum dot–luminol–Ag nanoparticle (GQD–luminol–AgNP) nanocomposites was designed by reducing AgNO3 with an electrochemiluminescent reagent, luminol, in the presence of GQDs. The nanocomposites were characterized using transmission electron microscopy, UV-vis absorption spectroscopy, and EDS. The results indicated that many Ag nanoparticles (AgNPs) with an average diameter of about 5 nm were dispersed uniformly on the surface of GQD nanosheets. Luminol molecules were also decorated on the nanocomposite surface. Thus, the nanocomposites showed excellent electrochemiluminescence (ECL) activity in presence of H2O2. To build a glucose ECL-based biosensor, the prepared sensor was also modified with glucose oxidase (GOx). The GOx enzyme was covalently immobilized on the GQD–luminol–AgNP-modified glassy carbon electrode. The designed ECL biosensor showed great performance towards glucose detection in the concentration range between 25 and 250 μM with a satisfactory detection limit (8 μM).


Imidazole and compound L8027 (selective inhibitors of thromboxane synthase) produced parallel inhibition of malonaldehyde and thromboxane B2 secretion induced by collagen or thrombin in gel-filtered suspensions of human platelets. Comparing the effects of these inhibitors and aspirin on secretion of granule constituents indicated that platelet degranulation depends mainly on thromboxane production; prostaglandin endoperoxides contributed little.


The anterior hernia or the fissure of Larrey and Bochdalek hernia are exceptional in adult. We present 6 cases of congenital diaphragmatic hernia revealed in adult. Three hernia of the fissure of Larrey and three Bochdalek hernia. We discuss the different clinical, radiological, and therapeutic aspects of these hernia. We insist on the gravity of strangulated hernia and their surgical treatment.


UNLABELLED
Citral is used primarily as lemon flavoring in foods, beverages, and candies. It is also used as a lemon fragrance in detergents, perfumes, and other toiletries. Citral was nominated by the National Cancer Institute for study because of its widespread use in foods, beverages, cosmetics, and other consumer products and its structure as a representative beta-substituted vinyl aldehyde. Male and female F344/N rats and B6C3F1 mice were exposed to microencapsulated citral (greater than 96% pure) in feed for 14 weeks or 2 years. Genetic toxicology studies were conducted in Salmonella typhimurium, cultured Chinese hamster ovary cells, mouse bone marrow cells, and mouse peripheral blood erythrocytes. 14-WEEK STUDY IN RATS: Groups of 10 male and 10 female F344/N rats were fed diets containing starch microcapsules with a load of 31.3% citral. The concentration of citral in the diet was 3,900, 7,800, 15,600, or 31,300 ppm microencapsulated citral (equivalent to average daily doses of approximately 345, 820, 1,785, and 1,585 mg citral/kg body weight to males and 335, 675, 1,330, and 2,125 mg/kg to females) for 14 weeks. Additional groups of 10 male and 10 female rats received untreated feed (untreated controls) or feed containing placebo microcapsules (vehicle controls). In the second week of the study, all rats in the 31,300 ppm groups were killed moribund. Mean body weights of exposed males and females that survived to the end of the study were generally significantly less than those of the vehicle controls. Feed consumption by 15,600 and 31,300 ppm males and females was less than that by the vehicle controls during the first week of the study. Males and females in the 31,300 ppm groups exhibited listlessness, hunched posture, absent or slow paw reflex, and dull eyes. Exposure of rats to citral may have been associated with forestomach epithelial hyperplasia and hyperkeratosis, bone marrow atrophy and hemorrhage, and nephrotoxicity. 14-WEEK STUDY IN MICE: Groups of 10 male and 10 female B6C3F1 mice were fed diets containing 3,900, 7,800, 15,600, or 31,300 ppm microencapsulated citral (equivalent to average daily doses of approximately 745, 1,840, 3,915, and 8,110 mg/kg to males and 790, 1,820, 3,870, and 7,550 mg/kg to females) for 14 weeks. Additional groups of 10 male and 10 female mice received untreated feed (untreated controls) or feed containing placebo microcapsules (vehicle controls). In the second week of the study, four males in the 31,300 ppm group were killed moribund. Mean body weights of all exposed groups of males and females were significantly less than those of the vehicle controls. Feed consumption by females exposed to 7,800 ppm or greater was less than that by the vehicle controls during the first week of the study. By the end of the study, feed consumption by all exposed groups was greater than that by the vehicle controls. Mice in the 15,600 and 31,300 ppm groups were generally thin and lethargic; a few males in the 7,800 ppm group were also thin. The incidences of ovarian atrophy were significantly increased in females exposed to 15,600 or 31,300 ppm. 2-YEAR STUDY IN RATS: Groups of 50 male and 50 female F344/N rats were fed diets containing 1,000, 2,000, or 4,000 ppm microencapsulated citral for 2 years. Additional groups of 50 male and 50 female rats received untreated feed (untreated controls) or feed containing placebo microcapsules (vehicle controls). Dietary concentrations of 1,000, 2,000, and 4,000 ppm delivered average daily doses of approximately 50, 100, and 210 mg/kg to males and females. Survival of all exposed groups of males was significantly greater than that of the vehicle control group. Mean body weights of rats exposed to 4,000 ppm were generally less than those of the vehicle controls from week 49 (males) or 25 (females) to the end of the study. Feed consumption by exposed groups was similar to that by the vehicle controls. No neoplasms or nonneoplastic lesions were attributed to exposure to citral. 2-YEAR STUDY IN MICE: Groups of 50 male and 50 female B6C3F1 mice were fed diets containing 500, 1,000, or 2,000 ppm microencapsulated citral for 2 years. Additional groups of 50 male and 50 female mice received untreated feed (untreated controls) or feed containing placebo microcapsules (vehicle controls). Dietary concentrations of 500, 1,000, and 2,000 ppm delivered average daily doses of approximately 60, 120, and 260 mg/kg to males and females. Survival of exposed males and females was similar to that of the vehicle control groups. Mean body weights of mice exposed to 1,000 or 2,000 ppm were generally less than those of the vehicle controls throughout the study, and mean body weights of 500 ppm females were less from week 30 to the end of the study. Feed consumption by the exposed groups was similar to that by the vehicle controls. The incidences of malignant lymphoma occurred with a positive trend in female mice, and the incidence in 2,000 ppm females was significantly greater than that in the vehicle control group. Tissues most commonly affected by malignant lymphoma were the spleen, mesenteric lymph node, thymus, and, to a lesser extent, the ovary.

GENETIC TOXICOLOGY
Citral was not mutagenic in S. typhimurium strain TA98, TA100, TA1535, or TA1537 with or without induced rat or hamster liver S9 enzymes. In cytogenetic tests with cultured Chinese hamster ovary cells, citral induced sister chromatid exchanges with and without S9, but chromosomal aberrations were not significantly increased after exposure to citral, with or without S9. Negative results were obtained in an in vivo bone marrow micronucleus test in male B6C3F1 mice treated by intraperitoneal injection with 250 to 750 mg/kg daily for 3 days. Likewise, no increases in the frequencies of micronucleated erythrocytes were observed in peripheral blood samples collected from male and female mice within 24 hours of the final exposure in the 14-week study. In conclusion, citral gave negative results in in vitro and in vivo tests for genotoxicity, with the exception of the in vitro mammalian cell test for sister chromatid exchange induction

CONCLUSIONS
Under the conditions of these 2-year feed studies, there was no evidence of carcinogenic activity of citral in male or female F344/N rats exposed to 1,000, 2,000, or 4,000 ppm. There was no evidence of carcinogenic activity of citral in male B6C3F1 mice exposed to 500, 1,000, or 2,000 ppm. There was equivocal evidence of carcinogenic activity in female B6C3F1 mice based on increased incidences of malignant lymphoma.


Over the last years, there was a continuous fall in labor income inequality in Brazil, as measured by household survey inquiries. The major explanatory factors pointed by economists were related to the composition of the workforce (in terms of skills and productive potential) and the technological changes. Institutional and relational factors were neglected. In this work, we argue that there are interpretive and empirical gains when we take into account sociological factors such as the occupational structure and the labor market institutions. We apply some decomposition methods and build counterfactuals to test this hypothesis and contrast it to the institutional approach, based on the occupational structure and the state regulation of work contracts. We analyze these dynamics in Brazil, from 1981 to 2011. We found a "skill-biased" polarization related to the educational composition effect. However, the average income gap between the educational groups have dropped (decline of returns). We also observed that there was a great reduction in internal variance of these educational groups. As a result, the net effect of education is a decrease in inequality; despite the existence of a component of polarization. There was also a great approximation of the incomes of the formal and informal sectors -- and they both have become internally more homogeneous. Our study found that the polarization pattern was offset by other factors. This raises a question about the strength of this process guided by the demand for skill and about the necessary conditions for its occurrence.


Work in the school science laboratory has been criticized for being pseudo-experimental, resulting only in a reproduction of already well-known facts and theories. The point of departure in this pa ...


Fossil occurrences across the world are endangered by development, construction, collecting, and vandalism, even though many outstanding examples have been protected by World Heritage Sites, national parks, monuments and reserves, state and provincial parks, and local govern- ment and non-profit organizations, as well as some private individuals. The International Palaeonto- logical Association (IPA) established a PaleoParks Initiative to protect endangered sites and to catalog and make public established parks of any nature that protect fossils in the ground, a primary source of scientific data, educational opportunities and recreational activities, as well as key places protecting "living fossils". IPA has 15 aims and goals and a web site for documenting both established and proposed sites. IPA sponsored meetings and workshops at three international meetings over the past five years to discuss these problems, successful solutions, and its goals and aims. Ten examples of PaleoParks are presented in this e-book to demonstrate and document problems with established and endangered sites. They include sites in nine countries, with eight protected and two endangered examples ranging in age from Ediacaran to Late Pleistocene.


We propose an Information Integration and Informatics (III) framework for healthcare applications that leverages the parallel computing capability of a computing cloud based on a large-scale distributed batch processing infrastructure that is built of commodity hardware. Healthcare information integration and informatics presents a potential for building advanced healthcare applications given the massive scale of data which is collected by EHR systems. Traditional EHR systems are based on different EHR standards, different languages and different technology generations. EHRs are mainly designed to store individual-level data on patient-provider interactions. EHRs capture and store information on patient health and provider actions. In this paper we provide a use case of the proposed III framework for development of a healthcare application for epidemiological surveillance. Epidemiological research involves collection, analysis, and interpretation of health data for describing and monitoring a health events. We demonstrate the effectiveness of the proposed III framework for developing advanced healthcare applications that are backed by massive scale healthcare data integrated from heterogeneous and distributed healthcare systems and a scalable cloud infrastructure.


The Norwegian Scientific Committee for Food Safety (Vitenskapskomiteen for mattrygghet, VKM) has, at the request of the Norwegian Food Safety Authority (Mattilsynet; NFSA), assessed the risk of "other substances" in food supplements and energy drinks sold in Norway. VKM has assessed the risk of doses given by NFSA. These risk assessments will provide NFSA with the scientific basis for regulating the addition of "other substances" to food supplements.
"Other substances" are described in the food supplement directive 2002/46/EC as substances other than vitamins or minerals that have a nutritional or physiological effect. "Other substances" are added mainly to food supplements, but also to energy drinks and other foods. VKM has not in this series of risk assessments of "other substances" evaluated any claimed beneficial effects from these substances, only possible adverse effects.
The present report is a risk assessment of L-tryptophan and is based on previous risk assessments of L-tryptophan and scientific papers retrieved from systematic literature searches.
L-tryptophan is an indispensable amino acid in humans, which in addition to its role in protein synthesis, also participates in complex metabolic pathways where it acts as a precursor to the potent neurotransmitter serotonin, the hormone melatonin, and the vitamin niacin (vitamin B3).      L-tryptophan is available from a wide variety of protein-rich foods in the normal diet, including meat, fish, milk and dairy products, egg, beans, lentils and also bread and grains, pasta, rice, fruit and vegetables.
According to information from NFSA, L-tryptophan is an ingredient in food supplements sold in Norway. NFSA has requested a risk assessment of the following doses of L-tryptophan in food supplements: 250 mg/day, 300 mg/day, and 450 mg/day for adults, adolescents and children 10 years and above. Usual dietary intake of L-tryptophan in Norway is not known, but data from the USA and the UK suggest an average dietary intake of about 900 mg/day of which the main part is bound in food protein.
In phase 1 we have identified seven previous reports that have aimed to assess the safety of L-tryptophan supplementation in humans; the most recent was published by VKM in 2013. To complement the existing reports, a literature search was performed in MEDLINE and EMBASE to retrieve studies published in the period 2012-2015. This search retrieved two recent randomised trials with L-tryptophan. In addition, we performed a literature search concerning safety of L-tryptophan in children and adolescents with no time restriction. This search retrieved no relevant results that met the inclusion criteria.
Four aspects related to safety of L-tryptophan were identified in previous reports: 1) adverse effects reported at high doses, including appetite suppression, nausea and vomiting, faintness, dizziness, drowsiness, tremor, fatigue, and headache; 2) a suggested, but not established, increased risk of cataract; 3) the eosinophilia-myalgia syndrome (EMS), which is thought to be caused by contaminants produced in the manufacturing of L-tryptophan supplements, however this is still unresolved; 4) the risk of adverse drug reactions caused by excessive serotonergic action by concomitant use of antidepressants, including monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants and other drugs, known as the serotonin syndrome.
According to previous reports, doses of 3 to 6 g/day of L-tryptophan have been associated with adverse effects. Using an uncertainty factor of 10, conclusions in previous reports have suggested a maximum level of 220 mg/day for adults. An upper tolerable intake level (UL) of 220 mg/day was first proposed in a report by the UK Committee on the Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) in 2004, and was derived from the average dose of L-tryptophan consumed as a prescription drug against depression in the UK at the time (2228 mg/day). This level has been maintained in later reports by other committees, most recently VKM in 2013 as a tentative guidance level. Additional information from the publications retrieved in the literature search did not provide evidence of sufficient weight to change the previous conclusions concerning UL.
There is a lack of well-designed supplementation studies with L-tryptophan in humans designed to address adverse effects and dose-response relationship as primary outcome. There is also a lack of data about potential adverse health effects of L-tryptophan supplementation in children and adolescents.
Patients using antidepressant drugs constitute a specific vulnerable subgroup of the population with regard to possible adverse effects of L-tryptophan supplements, due to the potentially life-threatening drug interaction effects that occur from excessive serotonergic action.

The Norwegian Scientific Committee for Food Safety (VKM) concludes that:

In adults (≥18 years), the specified doses 250, 300, and 450 mg/day L-tryptophan in food supplements may represent a risk of adverse health effects.
In adolescents (14 to <18 years), the specified doses 250, 300, and 450 mg/day L-tryptophan in food supplements may represent a risk of adverse health effects.
In children (10 to <14 years), the specified doses 250, 300, and 450 mg/day L-tryptophan in food supplements may represent a risk of adverse health effects.
Children below 10 years were not included in this assessment.