The present paper argues that we are witnessing an increase of the tensions between the three main goals of social security systems (poverty alleviation, securing living standards and prevention) and that, as a consequence, the poverty-reducing capacity of social transfers has come under pressure. The paper focuses on the working age population in 25 EU countries and on the good years before the crisis. Three different data sources are used: ECHP, its successor EU-SILC and the German SOEP. The paper augments the traditional pre-post approach by considering more direct policy indicators such as spending levels, observed average benefit levels and theoretical tax benefit packages and by focussing on the distinction between work-poor and work-rich households. We find that in many countries the relative decline in poverty reduction has primarily affected work-poor households. This observation is confirmed by more direct policy indicators. It may support the hypothesis that in many countries the poverty alleviation function of social protection has come under pressure as a consequence of a shift of attention towards preventing benefit dependency by recommodification on the one hand and 'securing living standards' for working families on the other hand.


This paper uses random assignment in professional golf tournaments to test for peer effects in the workplace. We find no evidence that playing partners' ability affects performance, contrary to recent evidence on peer effects in the workplace from laboratory experiments, grocery scanners, and soft-fruit pickers. In our preferred specification we can rule out peer effects larger than 0.043 strokes for a one stroke increase in playing partners' ability. Our results complement existing studies on workplace peer effects and are useful in explaining how social effects vary across labor markets, across individuals, and with the form of incentives faced.


Abstract Is it possible to organize well-being in an educational setting? The paper examines some possible conditions and forms by using the example of Japanese preschools and tries to track down the logic of the organization of well-being. Playful, but systematically learned selective rituals and routines, the specific handling of conflicts and the restraint of the educators create an environment, in which the children are able not only to play enthusiastically, but also to adjust their common activities to a large extent on their own. Well-being in a relaxed and happy social coexistence in the group - on the one hand an indispensable condition for all further educational processes, on the other hand also end in itself - is staged as joint task, for which everybody should try for together.


Abstract Objective We sought to describe the evaluation, treatment, and follow-up of adolescents who presented to a single institution with chest pain and an elevated troponin I value in the absence of typical symptoms of pericarditis or myocarditis. Materials and methods We performed a retrospective review of patients in the age group of 10–18 years of age with no history of significant heart disease admitted to our institution from 2000 to 2010 after presenting with chest pain and an elevated troponin I value. Results A total of 16 patients were identified with a median age of 16.5 years (range 11.2–17.8 years). Of these 13 (81%) were male and 10 (63%) showed evidence of localised ST elevations on electrocardiogram. The median peak troponin I level was 17.8 nanograms per millilitre (range 0.89–227, normal less than 0.4). There were eight patients (50%) with a diagnosis of coronary vasospasm, three patients (20%) with atypical myopericarditis, one patient with coronary anomaly, one patient with hypercoagulable disorder, and one patient with prolonged supraventricular tachycardia. In two patients, no definitive diagnosis was made. There was one patient who needed catheter-based intervention, which involved stenting of a coronary artery after a procedure-related complication. Conclusions In our cohort of adolescents without history of significant cardiac disease, chest pain and elevated troponin I levels were attributed to a variety of causes. Although coronary vasospasm and atypical myopericarditis were seen most commonly, coronary anomaly was identified in one case. Magnetic resonance imaging proved a useful diagnostic tool to assess coronary artery anatomy and myocardial changes suggestive of myocarditis. On the basis of these results and a review of the literature, a general evaluation algorithm is presented.


Background: Musculoskeletal disorders, an increasing concern among school going children, primarily affect muscles and tendons. They lead to secondary damage to nerves and joints in the neck, upper back, shoulders, arms, and hands, etc. The objective of this study was to determine the association of carrying heavy school bags with musculoskeletal discomfort among primary school children in government schools of Islamabad, Pakistan. Material and Methods: This cross-sectional survey was conducted in different government schools of Islamabad, Pakistan from June 2018 to November 2018. After an informed consent from parents, 377 healthy school going children aged 6-14 years were included in this study. Data was collected through Backpack Questionnaire. Chi square test was used to compare the frequency of musculoskeletal discomfort with demographic characteristics and backpack -related features. P-value less than .05 was considered statistically significant. Results: Mean age of the school children was 9.49 ± 1.53 years with 179 (46.9%) male and 203 (53.1%) female students. Majority of students (89.8%) were found with school bags more than 15% of their body weight. Shoulder pain was the most commonly reported complaint (67.3%). There was a significant association between pain and perceived backpack weight (P=.001), and between pain and self-perceived posture (P=.001). Leaning forward (66.2%) was the most commonly adopted posture followed by leaning sideways (15.4%) and stooping (2.9%), respectively. The association between pain and duration of carrying backpack from home to school was insignificant (P=.055) in contrast to pain and duration of carrying bag from school to home (P=.007), respectively. Conclusions: Musculoskeletal discomfort was found commonly among primary school children with shoulder pain being the most frequent, as maximum students were carrying heavy school bags.


Interleaved Reed–Solomon codes admit efficient decoding algorithms which correct burst errors far beyond half the minimum distance in the random errors regime, e.g., by computing a common solution to the Key Equation for each Reed–Solomon code, as described by Schmidt et al. If this decoder does not succeed, it may either fail to return a codeword or miscorrect to an incorrect codeword, and good upper bounds on the fraction of error matrices for which these events occur are known. The decoding algorithm immediately applies to interleaved alternant codes as well, i.e., the subfield subcodes of interleaved Reed–Solomon codes, but the fraction of decodable error matrices differs, since the error is now restricted to a subfield. In this paper, we present new general lower and upper bounds on the fraction of error matrices decodable by Schmidt et al.'s decoding algorithm, thereby making it the only decoding algorithm for interleaved alternant codes for which such bounds are known.


ABSTRACT Textural observation of quartz dissolution at mica-quartz interfaces in sandstones from the Norwegian continental shelf show that mica grains have penetrated into quartz grains without being significantly deformed. Theoretical calculations of the mechanical properties of the mica suggest that quartz dissolution takes place at pressures less than 10 bars, i.e., at pressures only a fraction of the overburden load. Cathodoluminescence and element mapping show that K-and Al-bearing material (probably illitic and/or micaceous clay) is present at all interfaces where quartz-to-quartz dissolution and interpenetration is observed. Because illitic and micaceous clay is likely to have an effect upon quartz dissolution similar to that of mica, this suggests that what has been considered to be a ressure-solution process may instead be a clay-induced dissolution process. Because quartz-to-quartz dissolution is not observed in the absence of illitic or micaceous clay, this suggests that quartz dissolution is not mainly controlled by pressure. In a quartz-mica or quartz-illite system the rate of quartz precipitation, which is strongly controlled by the temperature, may therefore be the main control on quartz cementation (Oelkers et al. 1992, and in press).


Due to the importance of feature extraction and scene representation in classification tasks, this paper presents an approach for unsupervised feature learning using Independent Subspace Analysis. The optimization process of feature bases is incorporated into the framework of incremental learning to cope with the learning difficulty with large or dynamic samples. The proposed method could automatically learn image features and accomplish scene classification with Spatial Pyramid Matching model. Also, the influence of related parameters in optimization and classification is discussed. Experiment shows the proposed method constructs efficient scene description and outperforms several previous methods in classification on OT scene dataset.


In the present scenario, the social media network plays a significant role in
sharing information between individuals. This incorporates information about news and events that are
presently occurring in the worldwide. Anticipating election results is presently turning into a fascinating
research topic through social media. In this article, we proposed a strategy to anticipate election results
by consolidating sub-event discovery and sentimental analysis in micro-blogs to break down as well as
imagine political inclinations uncovered by those social media users.

This approach discovers and investigates sentimental data from micro-blogs to anticipate the
popularity of contestants. In general, many organizations and media houses conduct a pre-poll review and
obtain expert's perspectives to anticipate the result of the election, but for our model, we use Twitter data to
predict the result of an election by gathering information from Twitter and evaluate it to anticipate the result
of the election by analyzing the sentiment of twitter information about the contestants.

The number of seats won by the first, second, and third party in AP Assembly Election
2019 has been determined by utilizing Positive Sentiment Scores (PSS's) of the parties. The actual
results of the election and our predicted values of the proposed model are compared, and the outcomes
are very close to actual results. We utilized machine learning-based sentimental analysis to
discover user emotions in tweets, anticipate sentiment score, and then convert this sentiment score to
parties' seat score. Comprehensive experiments are conducted to check out the performance of our
model based on a Twitter dataset.

Our outcomes state that the proposed model can precisely forecast the election results with
accuracy (94.2 %) over the given baselines. The experimental outcomes are very closer to actual election
results and contrasted with conventional strategies utilized by various survey agencies for exit polls and
approval of results demonstrated that social media data can foresee with better exactness.

In the future, we might want to expand this work into different areas and nations of the
reality where Twitter is picking up prevalence as a political battling tool, and where politicians and
individuals are turning towards micro-blogs for political communication and data. We would likewise
expand this research into various fields other than general elections and from politicians to
state organizations.


This paper presents DroneChase, an automated sensing system that monitors acoustic and visual signals captured from a nearby flying drone to track its trajectory in both line-of-sight and non-line-of-sight conditions under mobility settings. Although drone monitoring has been an active research topic, most of the existing monitoring systems focus only on line-of-sight conditions and do not perform well under blockage conditions. Inspired by the human ability to localize objects in the environment using both visual and auditory signals, we develop a mobile system that integrates the information from multiple modalities into a reference scenario and performs real-time drone detection and trajectory monitoring. Our developed system, controlled by the Raspberry Pi platform, collects acoustic signals from 6 hexagonal channels placed 5 cm away from each other and video signals from an HD RGB camera. The monitoring system is placed in a moving vehicle and is able to track the drone even when it is flying/hovering behind the bush or trees. Furthermore, the portability of the system enables continuous chasing of the drone, allowing for uninterrupted monitoring and tracking even while on the move. In addition, the proposed system performs reliably in both day and night conditions.


The endemic Banggai cardinalfish (Pterapogon kauderni) is an Indonesian conservation priority with Endangered species. The goal of this research was to develop a site-based conservation concept appropriate from a bio-ecological viewpoint, based on the unusual characteristics of this species, in particular: (i) mouthbrooder with direct development, leading to reproductively isolated stocks and fine scale genetic structure; (ii) high level of reliance on habitat, in particular symbiosis with benthic animals providing protective micro-habitat. Methods used include review and analysis of published literature and unpublished data, including an analysis using the Marxan spatial planning software. We suggest several policy options and identify research needs, including: (i) base P. kauderni conservation (protection, rehabilitation and sustainable use) on stocks as the basic management unit; (ii) use data on P. kauderni genetic stocks in the zonation of the proposed Banggai Archipelago marine protected area (MPA); (iii) undertake further research to identify stocks/stock boundaries; (iv) apply the "BCF gardens" concept to fine-scale rebuilding of P. kauderni populations and enabling sustainable use through micro-habitat rehabilitation, with a community-based approach supported by a multi-phase scientific research program. The outputs from this study should support efforts towards sustainable management of the Banggai cardinalfish, particularly in the context of strategies to develop and manage an effective sub-national MPA.


For several years the authors have been part of an effort developing automated techniques for examining the syntax of protocols for the absence of various errors. Recently, we have turned our attention to trying to prove various functional properties of protocols used in ring-topology systems. Ring systems have a number of properties that distinguish them from the more general computer networks towards which our earlier validation work was directed. We report here on the resulting changes in the protocol models and validation techniques, together with extensions used to prove that the protocol being examined has the various desirable functional properties demanded of it.


The rise of city commercial banks (CCBs) in Chinese cities provides a unique opportunity to study the finance and growth nexus at the city level. Given the notorious inefficiency of China's "Big Four" state banks, policymakers attempted to correct the situation in 1995 through the creation of a new kind of local bank designed to promote local growth by lending to small and medium-sized enterprises. Using 1990-2009 panel data for 283 prefectural-level cities and four provincial-status municipalities, we find that the establishment of CCBs significantly reduced local economic growth overall. We suggest this outcome stems from the ability of firms to bribe local government officials to obtain credit from their local CCBs. In our proposed model for crony banking relations, large firms spend disproportionately larger amounts of time and bribe money cultivation relations with local officials involved in CCB lending decisions, so we expect large firms to have easier access to credit than small firms even if it results in inefficient lending. Using data on 206,771 firms for 1999-2007, we find that cities with CCBs had significantly lower overall growth rates. Small firms, in particular, were negatively impacted by the presence of CCBs, while large firms benefited from their presence. In the cities with CCBs, large firms, even those with relatively poor return-on-assets ratios, obtained more credit than small firms in aggregate. Using data from the 2005 World Bank Business Environment Survey, we find that an increase in a firm's crony relations with the government, measured in terms of the average number of days a month top managers of the firm spend interacting with government officials, increases the likelihood a firm will be granted bank credit. This effect was quite distinct for cities with CCBs.


In normal human liver, glutamine synthetase (GS) is expressed in a rim of hepatocytes surrounding hepatic veins. GS expression is decreased in cirrhosis and increased in chronic hepatitis, focal nodular hyperplasia, peritumoural hyperplasia and some hepatocellular neoplasms. For the non‐neoplastic conditions, there is limited information available on histological pattern of altered GS expression and the mechanisms of these changes.


Population consequences of parasites in wild birds are rarely documented. One exception is the decline of British finch populations due to an epidemic caused by the protozoan parasite Trichomonas gallinae. Finch trichomonosis has recently spread from the UK to northern Europe, but its consequences for local finch populations have not been studied. We assessed the extent to which the trichomonosis epidemic affected the Finnish population sizes of European Greenfinch Chloris chloris, Common Chaffinch Fringilla coelebs and a control species, Great Tit Parus major, and the body condition of Greenfinches. The disease was first documented in Finland in 2008 and epidemics were observed mainly in southwestern Finland. Greenfinches showed a significant decline of 47% in breeding numbers and 65% in wintering numbers in southern Finland during 2006– 2010. Breeding Chaffinch numbers showed a slight decline (4%) during the same study period that was significant only in central Finland. Great Tit did not show a significant change in breeding numbers. During the initial disease epidemic the body condition of all demographic groups of Greenfinches decreased equally, which suggests that the disease was not selective in respect of age or sex. There were no encounters of Finnishringed Greenfinches or Chaffinches in the UK, which could indicate that the parasite has not necessarily been transferred directly from the UK, but perhaps by migrants from Sweden and Germany.


This exploratory research addresses educational management model for the universities. Its applicability was successfully verified and validated through survey data from leading tertiary educational institutions around the world. The proposed model was developed based on the analysis of literature, past theoretical frameworks, interviews with stakeholders. Model constructs were identified and confirmed by 493 respondents, representing university administrators, faculty and staffs, employers, and graduates. The resulting model was subsequently evaluated for accuracy and validity by multiple linear regression (MLR) analysis and the structural equation modeling (SEM) technique. The study revealed education development, education assessment, research development, and research assessment as four main activities in educational management. Four aspects of each activity, namely programs establishment, university culture, faculty capabilities, and facilities were investigated at strategic, planning, and operating levels. The conceptual model for the universities provides a novel approach for prospective investors or current university administrators to review and appraise their performance toward fulfillment of ultimate goals, i.e. producing high-caliber graduates and high-impact research outcomes for the betterment of the society. The research model represents two contributions to the society including human resource contribution and research contribution.


Virtual Reality (VR) has become one of the emerging technologies over the past decade for improving the quality of life in human experiences. It has exciting and popular applications in entertainment, sports, education, and even digital documentation of notable or historical sites, allowing users to immerse themselves in an alternate reality. By combining the principles of software development and immersive VR, real-life VR experiences seek to transport users to an interactive environment where they can view, observe, and experience historical events and artifacts in a new way. There are several steps involved in VR development of cultural and historical sites that require a solid understanding for adaptable and scalable design. This paper is a review of the VR development process for notable historic preservation VR projects. This process can be used to create immersive VR experiences for other cultural sites.


The orphan nuclear receptor Nurr1 is essential for the development of meso-diencephalic dopamine (mdDA) neurons and is required, together with the homeobox transcription factor Pitx3, for the expression of genes involved in dopamine metabolism. In order to elucidate the molecular mechanisms that underlie the neuronal deficits in Nurr1-/- mice, we performed combined gene expression microarrays and ChIP-on-chip analysis and thereby identified Dlk1, Ptpru and Klhl1 as novel Nurr1 target genes in vivo. In line with the previously described cooperativity between Nurr1 and Pitx3, we show that the expression of Ptpru and Klhl1 in mdDA neurons is also dependent on Pitx3. Furthermore, we demonstrate that Nurr1 interacts with the Ptpru promoter directly and requires Pitx3 for full expression of Ptpru in mdDA neurons. By contrast, the expression of Dlk1 is maintained in Pitx3-/- embryos and is even expanded into the rostral part of the mdDA area, suggesting a unique position of Dlk1 in the Nurr1 and Pitx3 transcriptional cascades. Expression analysis in Dlk1-/- embryos reveals that Dlk1 is required to prevent premature expression of Dat in mdDA neuronal precursors as part of the multifaceted process of mdDA neuronal differentiation driven by Nurr1 and Pitx3. Taken together, the involvement of Nurr1 and Pitx3 in the expression of novel target genes involved in important neuronal processes such as neuronal patterning, axon outgrowth and terminal differentiation, opens up new avenues to study the properties of mdDA neurons during development and in neuronal pathology as observed in Parkinson's disease.


This paper introduces a novel fingerprint matching algorithm using both ridge features and the conventional minutiae feature to increase the recognition performance against nonlinear deformation in fingerprints. The proposed ridge features are composed of four elements: ridge count, ridge length, ridge curvature direction, and ridge type. These ridge features have some advantages in that they can represent the topology information in entire ridge patterns existing between two minutiae and are not changed by nonlinear deformation of the finger. With the proposed ridge features and conventional minutiae features (minutiae type, orientation, and position) we propose a novel matching scheme using a breadth first search to detect the matched minutiae pairs incrementally. Following that, the maximum score is computed and used as the final matching score of two fingerprints. The proposed method achieved higher matching scores. Thus, we conclude that the proposed ridge feature gives additional information for fingerprint matching with little increment in template size and can be used in conjunction with existing minutiae features to increase the accuracy and robustness of fingerprint recognition systems.


Unmanned aerial vehicles (UAVs) can be used as flying base stations (BSs) to offload Macro-BSs in hotspots. However, due to the limited battery on-board, UAVs can typically stay in operation for less than 1.5 hours. Afterward, the UAV has to fly back to a dedicated charging station that recharges/replaces the UAV's battery. In this letter, we study the performance of a UAV-enabled cellular network while capturing the influence of the spatial distribution of the charging stations. In particular, we use tools from stochastic geometry to derive the coverage probability of a UAV-enabled cellular network as a function of the battery size, the density of the charging stations, and the time required for recharging/replacing the battery.


Adrenoleukodystrophy (ALD) is a progressive neurological demyelinating disease associated with adrenal insufficiency. Pathognomonic lamellar profiles and clear clefts have been observed in several organs and tissues. We describe similar ultrastructural lamellar lipid profiles in white blood cells from 2 patients with ALD. It is suggested that electron microscopy of white blood cells may be a simple and effective screening method in patients presenting with a clinical picture suggestive of ALD.


Incorporating the areas of the rocky Kimberley Coast, flanked by the deltaic gulfs of Cambridge Gulf and King Sound, as well as the Dampier Peninsula, the Kimberley region host a complicated coastal zone with a plethora of coastal habitats. The smallest scale of habitat includes rocky cliff, scree slopes, gravelly/bouldery shore, sandy beaches, spits, dunes, tidal mud flats, alluvial fans, and the contact between some of these habitats and freshwater. The main vegetation units include mangroves, shrubby chenopods (which include succulent halophytic shrubs), saline marsh, sedgelands, rushlands, dune scrub, dune grasslands, and teatree thickets. The spatially and temporally variable landscape, sediments/soils, and hydrochemistry expressed at the coast mean that the coastal vegetation habitats are the most complex habitats in the Kimberley region. This review found that to date these have not been fully explored or described botanically.


It is generally agreed that adipocytes originate from mesenchymal stem cells in what can be divided into two processes: determination and differentiation. In the past decade, many factors associated with epigenetic signals have been proved to be pivotal for the appropriate timing of adipogenesis progression. A large number of coregulators at critical gene promoters set up specific patterns of DNA methylation, histone acetylation and methylation, and nucleosome rearrangement, that act as an epigenetic code to modulate the correct progress of adipocyte differentiation and adipogenesis during adipogenesis. In this review, we focus on the functions and roles of epigenetic processes in preadipocyte differentiation and adipogenesis.


The evaluation of programs in the public sector has been problematic and often invalid, primarily due to the fact that the evaluation plans or designs are lacking. The broad field of program evaluation is reviewed along with attempts to synthesize and systematize the steps necessary to develop valid and comprehensive evaluation designs. First, a design framework is identified which links program characteristics to design elements through an expanded set of threats to validity. Second, the various design elements are grouped into five systematically convenient components, including test hypotheses, selection scheme, measures framework, measurement methods, and analytic techniques. Third, it is proposed that the different types of evaluation can be contained in an evaluation taxonomy composed of eight measures-related classifications. Finally, the paper should be regarded as only an initial step toward a systematic approach to program evaluation design; a basis for further discussion is provided.


Transcription factors (TFs) regulate gene expression in both prokaryotes and eukaryotes by recognizing and binding to specific DNA promoter sequences. In higher eukaryotes, it remains unclear how the duration of TF binding to DNA relates to downstream transcriptional output. Here, we address this question for the transcriptional activator NF-κB (p65), by live-cell single molecule imaging of TF-DNA binding kinetics and genome-wide quantification of p65-mediated transcription. We used mutants of p65, perturbing either the DNA binding domain (DBD) or the protein-protein transactivation domain (TAD). We found that p65-DNA binding time was predominantly determined by its DBD and directly correlated with its transcriptional output as long as the TAD is intact. Surprisingly, mutation or deletion of the TAD did not modify p65-DNA binding stability, suggesting that the p65 TAD generally contributes neither to the assembly of an "enhanceosome," nor to the active removal of p65 from putative specific binding sites. However, TAD removal did reduce p65-mediated transcriptional activation, indicating that protein-protein interactions act to translate the long-lived p65-DNA binding into productive transcription. Author Summary To control transcription of a certain gene or a group of genes, both eukaryotes and prokaryotes express specialized proteins, transcription factors (TFs). During gene activation, TFs bind gene promotor sequences to recruit the transcriptional machinery including DNA polymerase II. TFs are often multi-subunit proteins containing a DNA-binding domain (DBD) as well as a protein-protein interaction interface. It was suggested that the duration of a TF-DNA binding event 1) depends on these two subunits and 2) dictates the outcome, i.e. the amount of mRNA produced from an activated gene. We set out to address these hypotheses using the transcriptional activator NF-κB (p65) as well as a number of mutants affecting different functional subunits. Using a combination of live-cell microscopy and RNA sequencing, we show that p65 DNA-binding time indeed correlates with the transcriptional output, but that this relationship depends on, and hence can be uncoupled by altering, the protein-protein interaction capacity. Our results suggest that, while p65 DNA binding times are dominated by the DBD, a transcriptional output can only be achieved with a functional protein-protein interaction subunit.


Metamodels provide an efficient means for the approximation of response surfaces of systems, particularly for resource-intensive experiment designs. It is oftentimes the case that interest is focused on a specific region of the parameter space. We propose an efficient recipe for the local approximation of response surfaces using Polynomial Chaos techniques. For systems embedded in high-dimensional settings, a basis-adapted spectral representation is exploited locally for dimension reduction. The proposed approach comprises an initial heuristic global solution for parameter space exploration using an approximate global Polynomial Chaos metamodel, followed by a local design being refined through an active learning scheme. The problem of turbulent flow around a symmetric airfoil is considered. Statistical estimators based on the local, active, basis-adapted approach show less bias and faster convergence as compared to the estimators from a global solution.
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Reconstruction of experimental axisymmetric equilibria is an important part of tokamak data analysis. Fourier expansion is applied to reconstruct the vessel current distribution in EFIT code. Benchmarking and testing calculations are performed to evaluate and validate this algorithm. Two cases for circular and non-circular plasma discharges are presented. Fourier expansion used to fit the eddy current is a robust method and the real time EFIT can be introduced to the plasma control system in the coming campaign.


In the present study, we examined the longitudinal associations between residential environmental factors and glycemic control in 182,756 adults with diabetes in New York City from 2007 to 2013. Glycemic control was defined as a hemoglobin A1c (HbA1c) level less than 7%. We constructed residential-level measures and performed principle component analysis to formulate a residential composite score. On the basis of this score, we divided residential areas into quintiles, with the lowest and highest quintiles reflecting the least and most advantaged residential environments, respectively. Several residential-level environmental characteristics, including more advantaged socioeconomic conditions, greater ratio of healthy food outlets to unhealthy food outlets, and residential walkability were associated with increased glycemic control. Individuals who lived continuously in the most advantaged residential areas took less time to achieve glycemic control compared with the individuals who lived continuously in the least advantaged residential areas (9.9 vs. 11.5 months). Moving from less advantaged residential areas to more advantaged residential areas was related to improved diabetes control (decrease in HbA1c = 0.40%, 95% confidence interval: 0.22, 0.55), whereas moving from more advantaged residential areas to less advantaged residential areas was related to worsening diabetes control (increase in HbA1c = 0.33%, 95% confidence interval: 0.24, 0.44). These results show that residential areas with greater resources to support healthy food and residential walkability are associated with improved glycemic control in persons with diabetes.


BACKGROUND
Hypercholesterolaemia is a major risk factor for coronary heart disease (CHD) especially in industrialized societies. Coronary heart disease is becoming an increasing cause of death even in the developing world.

OBJECTIVE
To determine the prevalence of dyslipidaemia in apparently healthy professionals in a developing economy.

METHOD
One hundred apparently healthy professionals were recruited from several professions by stratified random sampling. This population was believed to be at higher risk of dyslipidaemia considering their more likely "western diet" lifestyle. Total cholesterol, LDL-cholesterol, HDL-cholesterol and Triglycerides were determined using standard cholesterol LDL precipitating reagents/kits.

RESULTS
The mean age of the subjects was 41.59 +/- 8.22 years (range 29 to 58 years) with male to female ratio of 1:1.2. Mean total cholesterol was 180.69 +/- 36.248 mg/dl (4.67 +/- 0.94 mmol/L), LDL cholesterol 122.68 +/- 44.42 mg/dl (3.17 +/- 1.15 mmol/L), HDL-cholesterol 37.47 +/- 9.91 mg/dl (0.96 +/- 0.26 mmol/L) and Triglyceride 83.139 +/- 66.888 mg/dl (0.94 +/- 0.76 mmol/L). Using the Third Report of the NCEP Expert Panel on Detection. Evaluation and Treatment of high blood cholesterol in Adults (ATP III) definition and risk classification, 5% of the study population had hypercholesterolaemia, 23% elevated total serum cholesterol, 51% elevated LDL-cholesterol and 60% low HDL-cholesterol, with females recording better overall lipid profile.

CONCLUSION
Dyslipidaemia was highly prevalent in the population studied, with low HDL-cholesterol being the most frequent lipid abnormality. Dyslipidaemia is becoming a serious health problem in the developing world also, even among the apparently healthy, and necessitates periodic lipid profile screening.


The characteristics of laser-triggered spark gaps, initiated by a switched-out pulse of about 7 ps from a model-locked Nd: glass laser system, are investigated. The formation time delay of breakdown across the gap can be of the order of 1 ns and is found to increase as the gap voltage is reduced. Comparison with spark gaps triggered by Q-spoiled nanosecond laser pulses is made. Finally, a comparison of the agreement between the experimental results and theory suggests that the initiation of gap breakdown is due to the production of only a few free electrons from the electrode surface on which the laser beam is focused.


Abstract. Strongly coupled nonlinear phenomena such as those described by Earth System Models (ESM) are composed of multiple component models with independent mesh topologies and scalable numerical solvers. A common operation in ESM is to remap or interpolate results from one component's computational mesh to another, e.g., from the atmosphere to the ocean, during the temporal integration of the coupled system. Several remapping schemes are currently in use or available for ESM. However, a unified approach to compare the properties of these different schemes has not been attempted previously. We present a rigorous methodology for the evaluation and intercomparison of remapping methods through an independently implemented suite of metrics that measure the ability of a method to adhere to constraints such as grid independence, monotonicity, global conservation, and local extrema or feature preservation. A comprehensive set of numerical evaluations are conducted based on a progression of scalar fields from idealized and smooth to more general climate data with strong discontinuities and strict bounds. We examine four remapping algorithms with distinct design approaches, namely ESMF Regrid, TempestRemap, Generalized Moving-Least-Squares (GMLS) with post-processing filters, and Weighted-Least-Squares Essentially Non-oscillatory Remap (WLS-ENOR) method. By repeated iterative application of the high-order remapping methods to the test fields, we verify the accuracy of each scheme in terms of their observed convergence order for smooth data and determine the bounded error propagation using the challenging, realistic field data on both uniform and regionally refined mesh cases. In addition to retaining high-order accuracy under idealized conditions, the methods also demonstrate robust remapping performance when dealing with non-smooth data. There is a failure to maintain monotonicity in the traditional L2-minimization approaches used in ESMF and TempestRemap, in contrast to stable recovery through nonlinear filters used in both meshless (GMLS) and hybrid mesh-based (WLS-ENOR) schemes. Local feature preservation analysis indicates that high-order methods perform better than low-order dissipative schemes for all test cases. The behavior of these remappers remains consistent when applied on regionally refined meshes, indicating mesh invariant implementations. The MIRA intercomparison protocol proposed in this paper and the detailed comparison of the four algorithms demonstrate that the new schemes, namely GMLS and WLS-ENOR, are competitive compared to standard conservative minimization methods requiring computation of mesh intersections. The work presented in this paper provides a foundation that can be extended to include complex field definitions, realistic mesh topologies, and spectral element discretizations thereby allowing for a more complete analysis of production-ready remapping packages.


Changing the attitudes of existing building users towards sustainability is a paramount strategy towards a low-carbon society. One of the challenges lies in encouraging owners to renovate their houses. Recent studies have pointed out the relevance of the homeowner's social context which, more often than not, outstrips public awareness campaigns and even techno-economic advice. The decision to renovate seems to emerge from deep social issues rather than exclusively from the simple analysis of investment return or environmental awareness. The present study aims to bring discussion to these social subjects for single-family buildings in Portugal and identify key factors which may influence decision making. Firstly, a set of in-depth interviews were conducted with a group of experts. Subsequently, and based on the interviews, a group of Portuguese single-family homeowners, who undertook at least one energyrelated piece of work, were surveyed. Together with the survey a structured observation method was put into practice. The results revealed that homeowner's stage of life, personal/family events, everyday practices, lifestyles and social network framework have a major influence on their prime intention to renovate their homes. The desire to maintain or change the routines and the way family uses the indoor spaces are common drivers, however, motivations linked to aesthetics, trends and social status were revealed to be extremely influencing. The decision process is negotiated inside the family involving not only desired domestic life conditions but also skills, understandings and social values shared by the dwellers. The energy-related renovations take place, in many cases, as a consequence of a previous decision to renovate, taken due to other reasons. It does not consist of one single event but is rather part of a practice of a "little-by-little renovation". Motivational policies should be drawn considering the energy-related renovations as any other type of renovation and not separately from the others.


In this era, the Indonesian government is committed to increase Indonesia competitiveness position towards other countries. To achieve this goal, the Ministry of Industry spur domestic industries to innovate in the face of Industry 4.0. One company that answers this challenge is Machine Vision that focuses on Industrial Internet of Things. It optimizes modernizes, and digitizes the Indonesian industry to help companies grow, maximize productivity, and promote efficiency in business processes. This new and unique type of business has difficulties that must be overcome, where it must be able to penetrate an unusual market. Therefore, this study discussed the strategy of Integrated Marketing Communication (IMC) conducted by Machine Vision. This study uses qualitative descriptive research methods with structured interview data collection techniques. The results of this study are, IMC strategy has been contributed positively to Machine Vision with the division of two groups, namely primary and secondary. The positive impact was assessed from the existence of repeat customers and client interest in content on Machine Vision's social media. But aside from those positive effects, also found several threats in the future.


Experiments were performed to determine whether central endocrine or neural regulation is primarily involved with the development of endocrine responses in fetal adipose tissue metabolism. Fetuses within one uterine horn were either decapitated (decap) or spinally cauterized at 45 d of gestation, with fetuses in the other horn serving as sham controls (intact). Fetuses were removed by cesarean section at 110 d of gestation. Slices of subcutaneous adipose tissue (100 mg) were incubated in media supplemented with radioactive glucose and insulin (1.0 mU/ml) to measure the metabolic response of the tissue to insulin. Other slices were incubated in medium supplemented with norepinephrine bitartrate (1 microgram/ml) to measure lipolytic response by glycerol release. Basal glucose utilization for oxidation, total lipid and fatty acid synthesis was higher in decap adipose tissue than intact adipose tissue. Cauterized and intact fetuses did not differ in adipose tissue glucose metabolism. Only decap adipose tissue demonstrated an insulin stimulation of glucose oxidation and lipogenesis. Norepinephrine stimulated lipolysis in both cauterized and intact adipose tissue but had no effect upon decap adipose tissue lipolysis. These results demonstrate central endocrine regulation but not central neural regulation has an important function in the development of porcine fetal adipose tissue metabolism and its responses to systemic hormones.


To evaluate whether serum Cathepsin S (Cat S) could serve as a biomarker for the diagnosis and prognosis of gastric cancer (GC), Enzyme-linked immuno sorbent assay (ELISA) was used to detect serum Cat S in 496 participants including healthy controls and patients with benign gastric diseases, gastric cancer, esophageal cancer, liver cancer, colorectal cancer, nasopharyngeal cancer and lung cancer. The levels of serum Cat S were significantly increased in cancer patients, especially in GC patients. The qRT-PCR, Western blotting, and immunohistochemical staining revealed the overexpression of Cat S in GC cell lines and tissues. The diagnostic value of serum Cat S for GC patients from controls resulted in an AUC of 0.803 with a sensitivity of 60.7% and a specificity of 90.0%. Moreover, the levels of serum Cat S were associated with GC tumor volume, lymphoid nodal status, metastasis status, and stages. Moreover, the patients with high levels of serum Cat S had a poorer overall survival. Univariate analysis revealed Cat S expression was a prognostic factor. The knockdown of Cat S significantly suppressed the migration and invasion of GC cells. This study suggested serum Cat S may be a potential biomarker for the diagnosis and prognosis of GC.


Camel milk and dates have been reported to be used for prevention and treatment of various diseases in Arab countries. A total of 40 milk samples after parturition were collected from different zones of Al-Ahsa area, KSA. The analyses of chemical and nutritional values of camel milk were performed. The samples were analysed for total solids, fat, total protein, sugears, ash, minerals as well as vitamins. Results showed 11.90± 0.11% total solids, 2.69± 0.28% protein,3.26± 0.14 % fat, 1.13.22± 0.54 (g/100g), lactose 3.22±0.04%, glucose 3.22±0.07 %.sucrose 1.93. ±0.03% and ±0.04 %0.14 % acidity. The levels of ash, Ca, Mg, Na, vitamin C and B12 were higher. however concentration of Fe, vitamin A was relatively lower. Antimicrobial agents, lactoferrin (LF) were determined and the concentarion was 1.61 ±0.19 mg/ml. Generally, camel milk presented high nutritive and therapeutic applications. Yoghurt made from camel milk was prepared by adding date palm syrup (Depis) to cultured milk. The main objective from this part was to investigate the influence of Depis on chemical characteristics (titrable acidity, total solids, fat, and protein content), microbiological and sensory properties and acceptability of the resultant yoghurt during storage for 21 days at 4° C. Addition of 1, 2.5 and 5 % of Depis did not affect yoghurt pH or protein and fat content, but decreased moisture and increased the total solids significantly. Moreover, addition of Depis improved the viablity and stabilty of satrter cultuer during storage and the total viable counts were 0.67, 7.4, 7.7 and 7.8 ×10-7for control, 1, 2.5 and 5 % of Depis, respectively.Finally, addition of 5% Depis provided yoghurt with desired sensory properties.


Addressing injury and its associated effects is a multi-dimensional and ongoing challenge. This includes recognizing that injury is a significant public health problem capable of affecting the health and wellbeing of all populations over short and longer terms, albeit in varied ways and intensities. That recognition has drawn attention to the need to take actions to avert its rate of occurrence particularly in developed nations. While in low-income countries, despite the growing burden of injury, there are few school-based studies from which to develop prevention initiatives. Thus this study describes the cause, nature and types and prevalence of injuries in a cross sectional population of students in Southern Nigeria, in order to provide data for use in developing priorities for injury prevention efforts. An interviewer-administered school-based survey of students attending schools in Southern Nigeria was conducted in 2013. The study sample involved 585 students (60.9% male, 39.2% female and overall mean age of 15 years). We inquired about participants self-reported injuries in the past one year (all injury inclusive). When reported, injuries were further assessed according to cause, intent, nature, type, place, and number of days absent from school due to injury. Overall, there were 549 self-reported injuries

 in the past one year (93.8%) among the respondents (95.5% for males and 90.8% for females, p = 0.6696). Sex wise, prevalence of injury differ by age, school setting and parents' occupation (p higher in males compared to females [206 (60.4%) vs 87 (41.8%) p = 0.002, and 10 (2.9%) vs 0 (0.0) p = 0.016] respectively. Traffic injuries and falls decrease progressively with age. Homes and schools were settings injuries occurred mostly. Over 68% of the reported injuries were unintentional. On the average, 2 days of normal school activity were lost per injured persons because of an injury. Given the high prevalence of injury reported in this study, injury like tropical diseases, should be considered a significant public health problem in Nigeria. We expect that this school-based information will be useful in establishing rational priorities for prevention, and the targeting of interventions toward responsible authorities. Also, there is a high need for safety education aiming to educate this young population on how to prevent injury.


Atmospheric remote sounding sounding from satellites is an essential component of the observational strategy deployed to monitor climate change. The Infrared Atmospheric Sounding Interferometer (IASI) is a nadir looking thermal infrared spectrometer flying on board the satellites Metop-A, Metop-B and Metop-C, launched in 2006, 2012 and 2018 respectively. Each IASI observation measures Earth's infrared radiance over 8461 channels between 645 and 2760 cm-1. Every location on Earth is observed twice a day by IASI, in the morning and in the evening, which gives us good spatial and temporal coverage. Atmospheric temperatures at different altitudes can be retrieved from the radiances measured in the carbon dioxide absorption bands at 15 μm (645 to 800 cm-1) and 4.3 μm (2250 to 2400 cm-1) by selecting channels that are most sensitive to the temperature profile. The European Organization for the Exploitation of Meteorological Satellites (EUMETSAT) already calculates atmospheric temperatures from IASI and other instruments on board of the Metop satellites. Several updates of their retrieval algorithm have had a significant effect on the atmospheric temperatures, and the whole time series has not been reprocessed back in time and therefore no homogeneous record of atmospheric temperatures exists.

In this talk, we perform our own selection of IASI channels relevant for temperature retrievals. By carefully selecting radiances, a method is then applied to the full IASI time series and trend analysis is performed. The IASI temperatures are compared to temperatures from ERA5 reanalysis to determine their quality at different atltitudes and latitudes.

This project brings continuous and independent information on atmospheric temperature which will allow us to study seasonal and spatial variability of temperature. It will also be possible to analyze the influence of natural events such as El Nino - Southern Oscillation (ENSO) on atmospheric temperature, and deduce climate change signature.


The stress field along a plate margin is one of the basic tools for forecasting the magnitude of future earthquakes. Tectonic features like faulting, folding, fracturing and volcanoes are the results of stresses that build up along different fault lines across the world. Stress drop is a fundamental parameter of earthquakes. It is important to know how much portion of stress energy is released by an earthquake. Another important source parameter of earthquakes is repeat time, or the reoccurrence period of earthquakes. The reoccurrence period or repeat time of earthquakes is controlled by the rate of tectonic loading which is the long term slip rate, stress accumulation and stress drop. Earthquakes with long reoccurrence period have a higher average stress drop than those with short repeat time. The probability of reoccurrence of earthquakes is time dependent; which defines that some period is required to recharge stresses before they are released by a large earthquake. Time dependency of reoccurrence of a large earthquake is the base of earthquake forecasting. In this project earthquake repeat time and stress drop is determine for different fault types. Results of this study provide a method to estimate important parameters of active faults including static and dynamic stress drop, rupture length, width and earthquake magnitudes. These parameters can be used for future earthquake forecasting and prediction.


Chalcones (1,3-diaryl-2-propen-1-ones) (1-13) were prepared using ClaisenSchmidt condensation, while Schiff bases (N-arylidene benzylamines) (14-20) were produced by the condensation of benzyl amine with substituted benzaldehydes. Schiff bases were added through 1,3-anionic cycloaddition to the double bond of chalcones under phase-transfer catalysis conditions to afford the corresponding heterocycles (pyrrolidines 21-30). Spectral methods were used to support the structures of the new products, while the suggested mechanisms were investigated depending on the spectral identification as well as some theoretical parameters such as heat of formation (H.F) and steric energy (S.E). The biological activity of some reactants and some final products had been tested through its effects on two kinds of bacteria.


Research realized in the field of human vision offers a tremendous potential for computer vision. In our opinion, if we are expected to write algorithms and to build models for image processing, it is necessary to take into account some features of the organization of the human visual system. In that way we have chosen to base our investigation on the retina. Indeed the retina is the first neuronal structure involved in visual perception and it is largely studied by neurobiologists as mentioned by Wandell (1995). One goal of this paper is to show how the knowledge of a particular organ implied in vision can be used to conceive new sampling operators (space-variant and morphological) to realize selective analysis of a scene.


In order to maintain a constant monochromatic synchrotron X-ray beam height for all energies, the separation between the crystals of a double-crystal monochromator is typically adjusted, via translation of the second crystal, while X-ray energy is varied, via rotation of the crystal pair. The ability to accurately translate the second crystal requires precise knowledge of the separation between the two crystals and, when present, crystal miscuts. Here, a simple method for calibrating the crystal gap from measured variation in the X-ray beam height that eliminates error in the fixed beam offset is provided.


The applied use of new technologies to enhance performance and improve health has been increasing. Initially, whole body vibration training (WBVT) was used as system to improve elite athlete performance. However, this is also used to improve body composition, especially there is a great attention on the effectiveness of WBVT to reduce fat and body weight, with a potential increase in muscle tissue. The aim of this study was to investigate the effects of a 6-week vibration-training program on total and segmental body composition in a group of physically healthy participants. The final study sample included 64 healthy young adults. Subjects were randomly allocated into the control group (CG: n = 26; 16 males and 10 females) and the experimental group (EGWBVT: n = 38; 19 males and 19 females). The program lasted six weeks with a frequency of three sessions per week and each session varied in intensity. There were not found statistically significant differences in any of the body composition variables analysed. This study suggests that a six-week vibration-training program with an increasing intensity (7.2 g-32.6 g) in healthy young adults that are not overweight did not alter total and segmental body composition.


Background: The intravascular hemolysis associated with hemolytic disorders, such as sickle cell anemia, results in the release of cell-free hemoglobin (Hb) and heme in the circulation, in turn, inducing inflammatory processes, vascular damage and endothelial activation. Angiogenesis, or the formation of new blood vessels, involves the proliferation, migration, and reorganization of endothelial cells in response to diverse physiological or pathological stimuli. Although angiogenesis is important for tissue growth and regeneration, uncontrolled angiogenesis can result in the accumulation of inflammatory cells, together with fibrosis and ischemia, and could play a role in some of the complications of hemolytic disorders. Aim: The aim of this study was to characterize angiogenic and inflammatory responses to the hemolytic process using an experimental in vivo model of acute hemolysis. Methods: C57BL/6J male mice were submitted, or not, to an osmotic hemolytic stimulus by intravascular injection of 150μL of sterile water (HEM group) or saline (CON group). After 1, 24 and 120 h, blood was collected by cardiac puncture for cell counts and plasma Hb and total heme quantification (colorimetric assays). Hemopexin, haptoglobin, inflammatory cytokines (Interleukin [IL]-6, IL-1β and IL-10) and angiogenic factors (Angiopoietin-2, Fibroblast growth factor [FGF]-basic, Platelet-derived growth factor [PDGF]-AA, PDGF-BB, Trombospondin-4, Vascular endothelial growth factor [VEGF], VEGFR2) were quantified in plasma by immunoassay. To evaluate in vivo neovascularization, a Matrigel®/ heparin mixture was injected subcutaneously into the dorsal region of the mice, two days before the administration of the hemolytic stimulus. After five more days, the Matrigel® plugs were removed, photographed and neovascularization quantified by colorimetric measurement of Hb in the plug. Results: At 1 h after the acute hemolytic stimulus, significant increases were observed in plasma Hb and heme (0.1±0.02 vs 0.2±0.03 g/L Hb, p<0.001; 32.9±1.9 vs 50.04±4.6 µM heme, p<0.01, for CON and HEM [1h], respect., n=5), indicative of the induction of hemolysis. Haptoglobin levels were almost completely depleted at 1 h after hemolysis, but recovered and were even higher at 24 h (14.2±2.9 vs 1.1±0.3 and 34.6±2.1 ng/mL for CON, HEM [1h] and HEM [24h], respect., p<0.01, n=5), before normalizing at 120 h. In contrast, circulating levels of hemopexin were not altered at any time post hemolysis (data not shown, p>0.05). Hemolysis also elevated the white blood cell count (2.2±0.2 vs 3.5±0.3 103/µL for CON and HEM [1h], respect., p<0.05, n=5) and plasma IL-10 (4.8±0.6 vs 12.4±1.7 pg/mL for CON and HEM [1h] respect., p<0.001, n=10 and n=5) within 1h, suggesting that systemic inflammation accompanied this hemolysis. The red blood cell count did not change in the HEM group at any of the time points, nor did plasma IL-1β or IL-6 levels (p>0.05). A balance of angiogenic mediators, including growth factors and inflammatory cytokines, regulates angiogenesis; at 1 h after hemolysis, plasma levels of angiopoietin-2 were decreased (2.75±0.1 vs 2.1±0.15 ng/mL for CON and HEM [1h], respect., p<0.05, n=5), while pro-angiogenic VEFG and trombospondin-4 were significantly increased (163.1±8.9 vs 233.3±15.8 pg/mL and 148.6±4.1 vs 169.4±7.1 ng/mL for CON and HEM [1h], respect., p<0.05, n=5), by 24 h levels of angiogenic markers were normalized. In association with the alterations in the molecular angiogenic profile of mice after hemolysis, the formation of new blood vessels in dorsal Matrigel® plugs was significantly elevated during the 5 days following the hemolytic stimulus, as quantified by plug Hb content (2.0±0.3 vs 3.0±0.04 µg/mL for CON and HEM mice, respect., p<0.05, n=10, 11). Conclusions: Acute intravascular hemolysis was associated with rapid alterations in circulating angiogenic and inflammatory markers in mice. In association with this pro-angiogenic profile, in vivo neovascularization was accelerated in animals following hemolysis. These data suggest that hemolysis may be a significant stimulus for angiogenic processes, which in turn may contribute to some of the clinical complications of hemolytic diseases, including pulmonary hypertension, stroke and leg ulcers. Furthermore, the angiogenic process may represent a target for the development of therapeutic strategies in disorders characterized by hemolysis.

 No relevant conflicts of interest to declare.


To combine and query ordered data from multiple sources, one needs to handle uncertainty about the possible orderings. Examples of such "order-incomplete" data include integrated event sequences such as log entries, lists of properties (e.g., hotels and restaurants) ranked by an unknown function reflecting relevance or customer ratings, and documents edited concurrently with an uncertain order on edits. This paper introduces a query language for order-incomplete data, based on the positive relational algebra with order-aware accumulation. We use partial orders to represent order-incomplete data, and study possible and certain answers for queries in this context. We show that these problems are respectively NP-complete and coNP-complete, but identify many tractable cases depending on the query operators or input partial orders.


This study was carried out in Sapele, Jesse and Oghara, Delta state to determine the groundwater potential by correlating results of seismic refraction survey and those of electrical resistivity studies. Fifteen vertical electrical sounding (VES) locations were sounded and nine seismic stations were shot to complement the study. The seismic results show that the area has generally three or four layer formations. The thin weathering layer with thickness of 1.0 - 3.5 m has velocity range of 250 – 350 m/s. while the velocities of second and third layers range from 900 -1400m/s to consolidated zone. The analysis of the VES data delineated 4 to 5 layers with HK and AKA curves types mainly and showed that the formation of the area is basically conducting which suggests the existence of heavy clay or clayey sand formations. Although the numbers of layers delineated differ, both methods indicate that viable aquifer at Sapele and Jesse is generally within 25m although false and contaminated aquifer may be intercepted at 10 -15 m. On the contrary, Oghara is more of sandy formation with aquifer above 35 m.


Recombinant Factor VIII (FVIII) products represent a life-saving intervention for patients with hemophilia A. However, patients can develop antibodies against FVIII that prevent FVIII function and directly increase morbidity and mortality. The development of anti-FVIII antibodies varies depending on the type of recombinant product employed, with previous studies suggesting that 2nd generation baby hamster kidney (BHK)-derived FVIII products display greater immunogenicity than 3rd generation Chinese hamster ovary (CHO)-derived FVIII. However, the underlying mechanisms responsible for these differences remain incompletely understood. Our results demonstrate that BHK cells express higher levels of the non-human carbohydrate a1-3 galactose (aGal) than CHO cells, suggesting that aGal incorporation onto FVIII may result in anti-aGal antibody recognition that could positively influence the development of anti-FVIII antibodies. Consistent with this, BHK-derived FVIII exhibits increased levels of aGal, which corresponds to increased reactivity with anti-aGal antibodies. Infusion of BHK-derived, but not CHO-derived, FVIII into aGal knock out mice, which spontaneously generate anti-aGal antibodies, results in significantly higher anti-FVIII antibody formation, suggesting that the increased levels of aGal on BHK-derived FVIII can influence immunogenicity. These results suggest that post-translational modifications of recombinant FVIII products with non-human carbohydrates may influence the development of anti-FVIII antibodies.


Metastatic renal cell cancer (mRCC) management has undergone a paradigm shift in recent decades. The first revolution came with the emergence of vascular endothelial growth factor inhibitors; there was a second wave with the unprecedented success of checkpoint inhibitors, and then the latest approach, which is becoming the new care standard in mRCC, of combining these two strategies in different ways. Updated results of Checkmate-214 after 42 mo of follow-up were consistent with previously published results showing the superiority of nivolumab/ipilimumab over sunitinib in progression free survival (PFS), overall survival (OS), and objective response rate (ORR) in intermediate and high-risk patients. However, several studies presented at the American Society of Clinical Oncology 2020 suggested that the best place, and so far, the only one for nivolumab/ipilimumab is the frontline setting. The update on Keynote-426 after 23 mo of follow-up showed no superiority of pembroli-zumab/axitinib over sunitinib in favorable-risk mRCC, suggesting that it should no longer be the first line of choice in low-risk patients. Finally, the phase III Checkmate 9ER trial results revealed the superiority of nivolumab/cabozantinib vs sunitinib in PFS, OS, and ORR, providing a new first-line option among all International Metastatic RCC Database Consortium risk patients. Some phase II clinical trials also presented this year showed promising results with new combination therapies such as nivolumab/sitravatinib, cabozantinib/atezolizumab, and lenvatinib/pembrolizumab, providing promising grounds upon which to start phase III studies. In addition, other works are using novel therapeutic agents with different mechanisms of action, including telaglenastat (a glutaminase inhibitor), entinostat [an inhibitor of histone deacetylases (HDACs)], and olaparib and talazoparib, poly(ADP-ribose) polymerase inhibitors widely used in other tumors. However, some questions regarding mRCC management still need to be addressed, such as head-to-head comparisons between the current options, treatment sequencing, non-clear cell mRCC, and the role of biomarkers to ascertain the best treatment choice.


The capability of nodes to broadcast their message to the entire wireless network when nodes employ cooperation is considered. We employ an asymptotic analysis using an extended random network setting under an additive white Gaussian channel model with path loss, and show that the broadcast performance strongly depends on the path loss exponent of the medium. In particular, the probability of broadcasting in a 1-D infinite network is zero for path loss exponents larger than one, and is equal to a nonzero value for path loss exponents less than one. In 2-D infinite networks, the same behavior is observed for path loss exponents above and below two, respectively.


This paper aims to present a technique to generate feasible and dynamically equilibrated ZMP-based center of mass trajectories that can be applied to bipedal robots. In this regard, we utilize the ZMP concept in the spherical coordinate frame so that we can fully exploit its properties as this strategy enables us to efficiently combine intrinsic angular momentum rate change terms with inertial force terms. That being said, this strategy has certain advantages: 1) In the case of bipedal walking, undesired torso angle fluctuations are more restrainable compared with other methods, in which angular momentum information is omitted or zero-referenced. 2) Composite rigid body inertia, which is a multibody property of robot dynamics, can be characterized during the trajectory generation task. Thus, relatively more dynamically consistent trajectories may be obtained. 3) The motion interference between the sagittal and lateral planes is naturally included. In this paper, we mainly investigate the first two advantages. Applying the method described above, we conducted bipedal walking experiments on our actual bipedal robot MARI-3. As the result, we obtained repetitive, continuous, and dynamically equilibrated walking cycles, in which undesired torso angles were well suppressed. Furthermore, ZMP error tends to decrease since inertial parameters of the robot are characterized. In conclusion, the method is validated to be efficient in inducing less ZMP error and in suppressing undesired torso angle variations, compared with both flywheel-superimposed and conventional ZMP-based trajectory generation methods.


Major surgical procedures, especially orthopedic surgeries, such as elective hip or knee replacement, are associated with a high incidence of postoperative deep vein thrombosis (DVT) and potentially fatal pulmonary embolism (PE). Although most surgeons exercise thromboprophylaxis, the length of time of prophylactic measures is at this time uncertain. With increasing shortening of in-hospital stays and thus shorter times of prophylaxis, increasing numbers of "late" PE are being recognized. These observations have raised the issue of postdischarge continuation of prophylaxis. This problem was recently addressed by four studies involving hip arthroplasty patients. In all trials prophylaxis was performed with low-molecular-weight heparins (LMWH). Two studies used enoxaparin, two used dalteparin. Duration of in-hospital treatment lasted from 7 to 15 days. The length of postdischarge prophylaxis ranged from 21 to 28 days. DVT was diagnosed by bilateral venography. In all instances there was a significant reduction in DVT in the treated patient group, compared with those who were not treated after discharge. It is assumed that this reduction also impacts the frequency of potentially fatal PE. The trials suggest that thrombosis prophylaxis should be continued in patients following discharge from hospital after major surgical procedures, especially when risk factors persist.


Fifty young adult male and female albino rats were studied for the effect of systemically administered cyclophosphamide upon chemical carcinogenesis of the submandibular gland. In 1 group of animals, pellets of 9,10-dimethyl-1,2-benzanthracene (DMBA) were implanted into the right submandibular glands. A 2nd group of animals received biweekly i.p. injections of cyclophosphamide (Cytoxan) in addition to DMBA implants into the right submandibular glands. Animals were sacrificed at 13 to 17 weeks after DMBA implantation. In the DMBA animals, well-differentiated epidermoid carcinomas developed within epidermoid cysts. In the DMBA-cyclophosphamide animals, the epidermoid carcinomas developed more rapidly and were more anaplastic histologically. In the DMBA-cyclophosphamide animals, fibrosarcomas and adenocarcinomas developed in addition to the epidermoid carcinomas. The augmentation of the salivary gland carcinogenesis was interpreted in terms of a depression of the immune response to tumor development by the cyclophosphamide.


In this paper, we consider a cognitive radio system with energy harvesting, in which the secondary user operates in a saving-sensing-transmitting (SST) fashion. We investigate the tradeoff between energy harvesting, channel sensing and data transmission and focus on the optimal SST structure to maximize the SU's expected achievable throughput. We consider imperfect knowledge of energy harvesting rate, which cannot be exactly known and only its statistical information is available. By formulating the problem of expected achievable throughput optimization as a mixed-integer non-linear programming one, we derive the optimal save-ratio and number of sensed channels with in-depth analysis. Simulation results show that the optimal SST structure outperforms random one and performance gain can be enhanced by increasing the SU's energy harvesting rate.


ABSTRACT Alcohol is an addictive substance that is often misused worldwide, including in Indonesia. Ninety percent of the alcohol that enters the body will be metabolized in the liver using the alcohol dehydrogenase (ADH) enzyme. It is important to determine the activity of ADH enzyme and ADH3 gene polymorphism on alcoholics and non-alcoholics in Yogyakarta, Indonesia. The aim of the study is to determine ADH activity and identify ADH3 gene polymorphism of alcoholics and non-alcoholics in Yogyakarta, Indonesia. This study was an observational study with a cross-sectional design method. Blood samples were taken from 71 Javanese alcoholics and 71 non-alcoholics of Javanese descent in Yogyakarta, Indonesia. The participants were initially requested to sign an informed consent form. Examination of ADH enzyme activity used the spectrophotometry method and ADH3 gene polymorphism was assessed with PCR-RFLP using Ssp I restriction enzyme. The activity of ADH enzyme in all individuals appeared to be a slower type. The average of the ethanol value of alcoholics and non-alcoholics were 0.05554 mM and 0.0758 mM respectively. Gene type of alcoholics were ADH3*2(75.4%), ADH3*1/3*2(21.5%), and ADH3*1(3.1%), and non-alcoholics were ADH3*2(88.6%), ADH3*1/3*2(10.0%), and ADH3*1(1.4%). There were no significant differences between the activity of ADH with polymorphism of ADH3 gene in either alcoholics and non-alcoholics (p>0,05). Conclusion: The activity of ADH enzyme in all participants appeared to be a slower type. Most of the ADH3 gene polymorphism of alcoholics and non-alcoholics were both ADH3*2 (75.4% and 88.6%). There was no differences of ADH enzyme activity with ADH3 gene polymorphism between alcoholics and non-alcoholics of Javanese population in Yogyakarta, Indonesia.


Benign mature cystic teratoma is a very common ovarian lesion. It commonly occurs during a woman's reproductive years and most often is benign. In approximately 1% to 3% of cases, however, it can undergo a malignant transformation with a very poor prognosis. The frequency of malignant degeneration of dermoid is related to age, with the highest in-cidence in the postmenopausal years. Squamous cell carcinoma accounts for 70-88% of all malignant tumors arising in the mature cystic teratom-as followed by the much rarer adenocarcinomas and carcinoids. Preoperative diagnosis is difficult due to the rarity of this tumor and its similarity to mature cystic teratoma. We experienced 3 cases of squamous cell carcinoma arising in mature cystic teratoma and report our cases with a brief review of the literature.


A book of fables like no other! Learn why the raven is black or how a little boy was transformed into a bird. Find out why a walrus used to have antlers and how an earth spirit pulled the first caribou from the ground. These fascinating stories will capture the imagination of young readers and introduce them to the rich mythology of the Canadian Inuit. Anthony Brennan's illustrations are like nothing you've seen in children's books. Edgy, vivid and dynamic to the extreme, the images enrich the reading experience.


ABSTRACT After the 2020 murder of George Floyd, a flood of protest activity against racial injustice ensued around the world, and a significant uptick in support for Black Lives Matter followed. This study investigated the narratives produced in news coverage of Black Lives Matter protests and how media consumption and individual predispositions help us understand public support for the movement. Combining a content analysis of news about protests and a survey of people's attitudes, we assessed if patterns in mainstream and partisan coverage have changed, and how those patterns relate to people's level of support for the movement, assessment of its effectiveness, and of police response during demonstrations. Our findings suggest that persistent negative patterns of protest coverage continued to dominate news headlines, with a major emphasis on negative actions, disruption, and violence in centerist- and right-leaning media coverage from the Associated Press, CNN and Fox News. MSNBC produced the least coverage overall, but their coverage was most legitimizing. Survey results showed that preexisting attitudes remain consistently stronger determinants of support for the movement than media coverage and suggested a possible ideological asymmetry among the general public. Conservative affiliation and news consumption are strong predictors of less support for Black Lives Matter and perceptions of police response to these protests as too lenient. Mainstream news consumption, though producing predominantly delegitimizing coverage, is correlated with more support for Black Lives Matter.


Background and aim
Appropriate end of life (EOL) management in Internal Medicine wards is challanging. The aim of this study was to analyze the burden of an educational program on EOL management in a Internal Medicine ward. Materials and methods: We retrospectively analysed characteristics and management of patients consecutively died in an italian Internal Medicine ward along one year. We compared demographic, co-morbidity, pharmacological treatment in the last 48-hours of life and procedures during hospital stay in patients died six months before and after an educational program on palliative cares and EOL management addressed to a team of physicians and nurses.

Results
Study population was composed by 354 patients (190 females), with mean age ± DS 83.5 ± 10.6 years, one half admitted after the educational program. Eighty-four percent of deaths was exepected in the last 48 hours before exitus. Demographic characteristics and causes of hospitalization were not different before and after educational program. After the educational program the sharing of palliative care program with patient, relatives and/or caregivers (97.7% vs 85.8%, p=0.0001) and written order to withdrawal vital parameters relevation (39.5% vs 22%, p=0.0005) significantly increased, while difference in pharmacological classes prescribed in the last 48 hours of life was not find. Blood (54.8% vs 67.2%, p=0.0219) and arterial gas analysis (28.8% vs 39.5%, p=0.0435) samples in the last 48 hours of life were significantly reduced. Radiological and/or endoscopic examinations, red cells or platelets transfusion were reduced and palliative therapy was increased, despite difference between the two periods was not statistically significant.

Conclusion
Educational program in Internal Medicine wards aimed to improve skills could contribute to make EOL management more appropriate and patient-oriented and it should be strongly encour-aged.


The aim of this study is to analyze the differences of constant anger and anger expression between teenagers who are doing regular sportive activities and teenagers who are not doing regular sportive activities. The sample group consists of 226 volunteers who are university students; 109 students do regular sportive activities and 117 of them do not do any regular sportive activities. In this study, Ozer's (1994) Turkish version of Spielberger's (1983) "The State-Trait Anger Scale(STAS)" was used. At the end of this study, a statistically significant difference (p<0.05) was found between students' constant anger and their anger management aspects in favor of students who do regular sportive activities. As a conclusion, sportive activities are effective in anger management and in decreasing constant anger, which is a regular situation seen in adolescence. According to the findings of this study, it can be inferred that motivating teenagers to do regular sportive activities may help them to manage their anger.


Goals and methods define intellectual disciplines and the communities associated with those disciplines. Yet what happens when there is a disjuncture between goals and methods — when there are incentives to achieve new objectives, but the tools that have been fashioned to achieve existing objectives have little relevance to the new goals?I suggest in this essay that this is what has happened in comparative law — a developmental disjuncture has occurred in the relationship between objectives and methods. Certain "traditional" objectives of those thinking about and using comparative law have shaped its current methods, but new objectives have emerged and others have become more pressing, and current methods often have limited value for achieving them.I here sketch this disjuncture between objectives and methods and some of its implications, suggest an analytical framework for responding to it, indicate how such a framework might be developed into a language for comparative law, and describe some of the potential benefits of such a development.


The article highlights modern understanding of subjectivity in primary school teachers and pupils in the theoretical and methodological discourse of the post-Soviet space. It proves that school education functions and develops, on the one hand, according to its traditional laws and regularities, and on the other hand, it represents the pedagogical system, in the centre of which there are people, namely, teachers and pupils. The article refutes an assumption that the personality of the teacher is at the centre of the educational system, and their professional self-realization as a subject of pedagogical activity is aimed at their social, intellectual and activity development. It's proved that the synergy of self-motivation and subjectivity development is inseparable from the development of a similar mental phenomenon in pupils and is the main content characteristic of teacher's activity. The essential feature by which the teacher distinguishes and affirms themselves in the space of individual, professional and historical being is their professional subjectivity, that is, self-determination and self-regulation of themselves as a subject of behavior, not only within the framework of pedagogical communication and interaction. The article summarizes innovative ideas about the tasks, roles, indicators of readiness of future teachers, which synergistically develop both their and pupils' subjectivity. Also, it outlines the prospects for further research, which lie in the theoretical and methodological development of new educational conditions for initiating the subjectivity of the actors in the educational process.


This work proposes a fuzzy trend monitoring method for the fault detection of a gas turbine engine through analyzing measured performance data trend. The proposed trend monitoring technique can diagnose the engine status by monitoring major engine measured parameters such as fuel flow rate, exhaust gas temperature, rotor rotational speed and vibration, and then analyzing their time deppendent changes. In order to perform this, firstly the measured engine performance data variation is formulated using Linear Regression, and then faults are isolated and identified using fuzzy logic.


During modern treatment of children with bone sarcomas, the children undergo multiple diagnostic imaging procedures, including bone scan (BS) with Tc99m. The aim of the BS is to establish the metastatic status of the skeletal system at the time of initial diagnosis and thereafter. We retrospectively reviewed 85 medical charts of patients with osteosarcoma (n=40) and Ewing sarcoma (n=45) who had been treated in our department between 01.01.1995 and 01.11.2009. Every patient underwent routine imaging studies including BS at the time of initial diagnosis and before local treatment. Median age of all patients was 15.5 years (range, 8 to 29). Fifteen patients had metastases at diagnosis. All patients were treated with neoadjuvant chemotherapy. No patient with localized disease developed metastatic disease to the skeletal system before local treatment; those with localized disease who developed metastases did so some time after completion of the treatment plan. As the probability of developing bone metastatic disease while receiving therapy is very low, routine BS in asymptomatic patients before local treatment may safely be omitted.


A simple, all permanent magnet, 2.45 GHz electron cyclotron resonance ion source has been developed for the production of stable beams of low charge state ions from gaseous feed materials. The source can produce ∼1 mA of low energy (3 kV) singly charged ion current in the 10−4 Torr pressure range. The source can also be operated in a more efficient low‐pressure mode at an order of magnitude lower pressure. In this latter range, for example, the ionization efficiency of Ar is estimated to be 1% with charge states up to Ar8+ present. Operation in the low‐pressure mode requires low power input (∼20 W). These features make the source especially suited for use with small accelerator systems for a number of applications including ion implantation, mass spectrometry, and atomic collision experiments where multiply charged ions are desirable. Design details and performance characteristics of the source are presented.


: The CO2-Laser finds application in Larynx-Surgery at an increasing rate. The greatest hazard still is an ignition of the endotracheal tube by a Laser beam. The different measures currently being taken in order to reduce that risk are discussed.


One of the results of new road construction is often a reduction in the price of nearby properties. In the United Kingdom property owners can be compensated for this loss through the Land Compensation Act. The appropriate level of compensation is currently determined by valuers and is mainly based upon their expertise and skill. This study aims to determine what the correct level of compensation should be. It has been specifically designed to fulfil the requirements of current legislation and can be integrated into existing compensation procedures. This was achieved through a hedonic pricing study that relates current property prices to a wide range of factors. These variables include the structure, neighbourhood, accessibility, and environment of the property, in addition to the impact of nearby roads. These were all created through GIS and large-scale digital data. The study, which is based on over 3500 property sales in Glasgow, Scotland, suggests that property prices were depressed by 0.202% for each decibel increase in road noise. This result has enabled a more streamlined compensation procedure to be developed and demonstrates that compensation claims can be estimated at the road-development stage. This would allow any compensation claims to be assessed prior to road construction and inform the design of noise-reduction measures.


PURPOSE
This study aimed to determine the relationships between occupational stress, sleep disturbance, and presenteeism in shiftwork nurses in South Korea.

DESIGN
This cross-sectional study used survey data from 442 shiftwork nurses at two hospitals in South Korea. Data were collected between March 2018 and April 2020.

METHODS
A self-reported questionnaire was used to assess shiftwork nurses' demographic and job-related information, presenteeism, occupational stress, and sleep disturbance. Data were analyzed using descriptive statistics, multiple regression, and the PROCESS macro.

FINDINGS
The mean presenteeism score was 39.52. Multiple regression analysis revealed that job insecurity, interpersonal conflict, occupational climate, lack of reward, and job demand are significantly associated with presenteeism. Sleep disturbance was related to presenteeism and had a moderating effect on the relationship between occupational stress and presenteeism.

CONCLUSIONS
This study indicates that proper occupational climate, positive interpersonal relationships, and adequate sleep can reduce shiftwork presenteeism. Therefore, individual and organizational efforts to alleviate occupational stress and sleep disturbances are essential.

CLINICAL RELEVANCE
Organizational support is needed to maintain a positive occupational climate and interpersonal relationships and ameliorate sleep disturbance among shiftwork nurses.


Determining whether someone is talking has applications in many areas such as speech recognition, speaker diarization, social robotics, facial expression recognition, and human computer interaction. One popular approach to this problem is audio-visual synchrony detection [10, 21, 12]. A candidate speaker is deemed to be talking if the visual signal around that speaker correlates with the auditory signal. Here we show that with the proper visual features (in this case movements of various facial muscle groups), a very accurate detector of speech can be created that does not use the audio signal at all. Further we show that this person independent visual-only detector can be used to train very accurate audio-based person dependent voice models. The voice model has the advantage of being able to identify when a particular person is speaking even when they are not visible to the camera (e.g. in the case of a mobile robot). Moreover, we show that a simple sensory fusion scheme between the auditory and visual models improves performance on the task of talking detection. The work here provides dramatic evidence about the efficacy of two very different approaches to multimodal speech detection on a challenging database.


We use wavelet analysis to investigate the characteristic timescales appearing in neutron monitor data and
their solar drivers. Wavelet analysis of Oulu NM data shows the well-known roughly 11-year variation in inten-
sity, but with a period contracting during solar cycle 22. This is also seen in the wavelet analysis of the interpla-
netary magnetic field magnitude data. However, this varying period is not shown in the wavelet analysis of daily
estimated sunspot numbers, a proxy for solar magnetic field strength. The time at which the wavelet transform
is found to be similar for both NM and sunspot number, but not for the interplanetary magnetic field magnitude.
This further highlights a complex relationship between cosmic rays, the heliosphere, and Earth.


In the 2011 Wincott Lecture, the author sets out a number of structural factors that have led banks to take on too much risk. The combination of limited liability for equity holders, tax biases that favoured debt over equity, the likelihood that banks would not be allowed to fail, and performance targets linked to short‐term equity returns meant that neither debt nor equity holders had an incentive to constrain bank risk taking. A number of solutions are offered which would better align these incentives with the public good. Disclaimer: The views expressed are not necessarily those of the Bank of England or the Financial Policy Committee.


To investigate the molecular epidemiological characteristics of Mycobacterium tuberculosis strains collected in Gifu Prefecture, Japan, 483 M. tuberculosis clinical isolates were used for Japan Anti-Tuberculosis Association (JATA) 18-variable number tandem repeats (VNTR) analysis during 2015-2019. To estimate the lineages of M. tuberculosis strains, JATA18-VNTR profiles were applied to a maximum a posteriori method. The results revealed that the ancient Beijing subfamily, accounting for 57.3% (277/483) was the most prevalent M. tuberculosis strain. Furthermore, 18 clusters (GC-1-GC-18) were found by minimum spanning tree analysis. The proportion of clustering strains was 9.9% (48/483), and epidemiological links to these clusters were unclear without GC-6 and GC-18. Meanwhile, interestingly, VNTR profiles of GC-7-GC-9 and GC-14 were indistinguishable from the regional epidemic strains of Nagoya City, which has a strong socioeconomic relationship with Gifu Prefecture, but did not match the nationwide epidemic strains. This study suggests that coordinated analyses within prefectures with strong socioeconomic relationships are important.


PURPOSE OF REVIEW
The use of bedside or point-of-care ultrasound (POCUS) in medical emergencies is rapidly becoming more established as an effective acute diagnostic tool. The purpose of this review is to provide an overview of the various techniques currently used that are readily available, as well as several in development. Possible caveats are also addressed.

RECENT FINDINGS
Despite its widespread use, definitive studies demonstrating improved patient outcomes are limited. The list of indications for POCUS nonetheless is increasing as practitioners acknowledge clinical benefits, and technological advancement improves diagnostic accuracy and efficiency of use.

SUMMARY
We believe that a core level of POCUS should be achievable by practicing clinicians. Ultimately, the integration of POCUS findings into a patient management strategy must be holistic, and hence requires prudent consideration of the clinical scenario.


Arterial stiffness plays a key role in the pathogenesis of cardiovascular disease. However, the relationship between lipid levels and arterial stiffness is controversial. We aimed to investigate the association between lipid parameters and brachial–ankle pulse-wave velocity (baPWV) in Chinese patients with hypertension. A total of 14 071 participants with hypertension in the China Stroke Primary Prevention Trial (CSPPT) were enrolled in the present study. Patients were assigned to 4 equal groups according to their baPWV. Participants in the highest baPWV group were older with a higher prevalence of stroke and diabetes mellitus as well as higher body mass index (BMI), blood pressure, fasting plasma glucose, uric acid, total cholesterol (TC), triglycerides (TG), homocysteine (Hcy), and vitamin B12 levels (P < .001). After adjusting for age, sex, BMI, and other cardiovascular risks, high-density lipoprotein cholesterol (HDL-C) was negatively related to baPWV (β = −0.22, P = .012), TC (β = 0.08, P = 0.001), TG (β = 0.14, P = .001); non-HDL-C (β = 0.12, P = .001) and positively related to baPWV. The effect was not observed for low-density lipoprotein cholesterol (LDL-C; β = 0.12, P = .335).These results suggested that non-HDL-C, TG, and TC were associated with arterial stiffness in a Chinese population with hypertension. HDL-C was inversely associated with arterial stiffness.


The book makes no bones about the current limitations of behavioural medicine, and this restraint is admirable. Behavioural medicine has lately become yet another bandwagon, like the "community psychiatry" of the sixties, which promised much and delivered much less than it promised. However, the reader is warned that anyone examining this book with less than 100% attention could come away with the impression that behavioural medicine has an assured and specific role, where, in fact, speculation and future research needs are the current bywords. There are many interesting conundrums for the student of behavioural medicine. For example, if behavioural medicine implies the systematic application of behavioural methods to treatment, what should be the formal training of the practitioner? He will have to have medical knowledge, of course, but can he truly understand the impact and limitations of his tools without a good grounding in experimental psychology? Second, in view of the dearth of hard facts in the field, how far is one justified in pursuing a behavioural perspective when treating someone with a potentially lethal disease? It is easy enough to mount a behavioural approach to a patient; but when does one quit? Third, how is one going to get around the difficulty of standardizing treatment techniques? One of the major contributions of a behavioural approach is the ability to describe quantitatively the essentials of a therapeutic strategy, so it may be replicated by another investigator. Yet this text reports, from time to time, the results of "group psychotherapy" where the reader will be at a loss to know just what was done to the patient which constituted therapy. All these are questions I am glad I do not have to answer, but someone is going to have to deal with them sooner or later. We live in an age where the illusion of progress is often created by coining new words. The editors of this book have taken a cautious, conservative approach to behavioural medicine. But one cannot ignore the fact that movements and undercurrents in medicine exist which are far less cautious. Terms such as "behavioural medicine" and "holistic medicine" are often used by people with considerably less definition than is afforded in this text. There are even "behavioural medicine practitioners" in the community. For these reasons, the Comprehensive Handbook is an important book, outlining accurately the achievements as well as the limitations of behavioural medicine to date, and leaving much to be resolved by future research. This book is recommended for purchase by medical libraries and by anyone working at the interface between medicine arid behavioural science. But I repeat the caveat: read it carefully, noting where fact ends and speculation begins; otherwise, it might be better not to read it at all.