Most of the decisive molecular events in biology take place at the protein-water interface. The dynamical properties of the hydration layer are therefore of fundamental importance. To characterize the dynamical heterogeneity and rotational activation energy in the hydration layer, we measured the (17)O spin relaxation rate in dilute solutions of three proteins in a wide temperature range extending down to 238 K. We find that the rotational correlation time can be described by a power-law distribution with exponent 2.1-2.3. Except for a small fraction of secluded hydration sites, the dynamic perturbation in the hydration layer is the same for all proteins and does not differ in any essential way from the hydration shell of small organic solutes. In both cases, the dynamic perturbation factor is <2 at room temperature and exhibits a maximum near 262 K. This maximum implies that, at low temperatures, the rate of water molecule rotation has a weaker temperature dependence in the hydration layer than in bulk water. We attribute this difference to the temperature-independent constraints that the protein surface imposes on the water H-bond network. The free hydration layer studied here differs qualitatively from confined water in solid protein powder samples.


This paper presents information filters in Riccati recursions and in array algorithms for descriptor systems subject to parameters uncertainties. The filters are developed in filtered and predicted forms. The inversion of the state matrix is avoided in the new information recursive formulas. Therefore, it turns out clear that the invertibility of the state matrix, usually considered in the state-space information recursions, is not necessary. A numerical example is provided to illustrate the performance of the proposed robust array algorithms


Introduction: Type 2 diabetes mellitus problem is progressively rising every day. The adherence to the treatment approaches and health-seeking make major difference in case of diabetics particularly elderly. Visual tools improve the involvement of patients in their care, especially among populations with low health literacy. Objective: To evaluate the effectiveness of color-coded diabetic control monitoring charts on glycemic control among elderly diabetics. Methodology: 144 elderly diabetic patients attending rural primary care geriatric clinics were randomized into two groups. Those randomized to the intervention group received the color-coded diabetic monitoring chart and a health education package in addition to the usual consultation services. Baseline and 1-year follow-up glycated hemoglobin (HbA1C) values were used to assess the effectiveness of the intervention. Results: The results of multivariate linear regression analysis showed that there was an average reduction of 0.265% in HbA1C value in the intervention group when compared to the nonintervention group when adjusted for baseline HbA1C and number of visits during the intervention period (β coefficient = 0.265,P < 0.05). Conclusion: Color-coded diabetes charts are effective in achieving glycemic control among elderly diabetics, and steps should be made to inculcate visually appealing management approaches in case of elderly diabetic patients.


Few studies on adjudicative competence explore the relationship between diagnosis, treatment, and restorability. Most focus on demographics and major psychiatric diagnosis with very few exploring the diagnoses common to the forensic population (i.e., personality disorders and substance abuse). Our study of 365 defendants who were incompetent to stand trial at a state psychiatric facility indicates that non‐restored defendants have a greater likelihood of cognitive disorders, misdemeanor charges, and histories of prior hospitalization, and less likelihood of personality disorders. In addition, the odds of having a substance use disorder and being medication non‐adherent was greater among restored defendants. The mean length of time to restoration (LOR) of 56 days was significantly different from the mean length of time to adjudication (LOA) for those not restored (88 days). This study supports prior literature on restorability while distinguishing those treated for psychosis from those treated for substance use and personality disorder. In its novel focus on medication adherence, the study expands the remediable factors available to clinical and forensic professionals and supports interventions that improve treatment and shorten the time to restoration.


Rationale: Research supports the use of screening protocols to identify patients who are candidates for weaning from mechanical ventilation, and the use of spontaneous breathing trials (SBTs) to predict ability to breathe spontaneously. However, once daily screening is poorly aligned with 24-hour continuous care in the intensive care unit (ICU) environment and the most effective SBT technique is not known. The optimal strategy to liberate our sickest patients from ventilators remains to be determined. Objectives: To assess our ability to recruit critically ill adults and adhere to the screening and SBT protocols. Methods: We propose a pilot, factorial design, randomized trial comparing once-daily versus at least twice daily screening and pressure support (PS) ± positive end-expiratory pressure (PEEP) (inspiratory ± expiratory support) or T-piece (no support) as the SBT technique in critically ill adults who are invasively ventilated for at least 24 hours in 11 North American ICUs. Respiratory Therapists (RTs) will screen all enrolled patients between 06:00 and 08:00 hours daily to identify SBT candidates. Patients in the at least twice daily screening arms will also be screened between 13:00 and 15:00 hours; additional screening will be permitted at clinician's discretion. Once a screening assessment is passed, an SBT will be conducted with the assigned technique. Outcomes: The study will be considered feasible if at least 1 to 2 patients per ICU per month are recruited and if the screening and SBT protocols are adhered to >80% of the time. Relevance: The availability of RTs in ICUs presents an important opportunity to screen patients more frequently, conduct more frequent SBTs, and reduce the duration of invasive ventilation and ICU stay. FAST Trial Registration: Clinical Trials.gov NCT02399267.


A sarcoidal reaction in a tattoo may be an isolated finding or it may represent a cutaneous sign of systemic disease. Two cases of systemic sarcoidosis with granulomatous reactions in tattoos are reported. In each the presenting complaint was the development of a nodule within a tattoo of many years duration. The diagnosis was suspected when histological examination of an intracutaneous nodule revealed a granulomatous reaction of the sarcoidal type. Further studies such as biopsy of lymph nodes, chest x-ray films, and culture studies established the diagnosis. The need for complete evaluation of patients with sarcoidal reactions in tattoos is stressed.


PDGF and TNF-alpha are both known to play important roles in inflammation, albeit frequently by opposing actions. Typically, TNF-alpha can attenuate PDGF beta-receptor signaling. Pretreatment of mouse 3T3 L1 fibroblasts with TNF-alpha greatly diminished their proliferative response to PDGF. However, TNF-alpha affected neither the binding of PDGF-BB to cell surface receptors nor the total amount of PDGF beta-receptor in the cells, but decreased the PDGF-induced in vitro kinase activity of the receptor. The phosphatase inhibitor ortho-vanadate did not prevent this effect. Ortho-phosphate labeling of cells prior to TNF-alpha treatment and PDGF-BB stimulation confirmed a decrease of in vivo phosphorylation of the PDGF beta-receptor. Two-dimensional mapping after tryptic cleavage as well as phosphoamino acid analysis demonstrated a general decrease in phosphorylation of all known tyrosine residues in the PDGF beta-receptor. The exact mechanism for this suppression remains to be clarified.


The threat-capture hypothesis posits a threat-detection system that automatically directs visual attention to threat-related stimuli (e.g., angry facial expressions) in the environment. Importantly, this system is theorised to operate preattentively, processing all input across the visual field in parallel, prior to the operation of selective attention. The threat-capture hypothesis generates two predictions. First, because the threat-detection system directs attention to threat automatically, threat stimuli should capture attention when they are task-irrelevant and the observer has no intention to attend to them. Second, because the threat-detection system operates preattentively, threat stimuli should capture attention even when it is engaged elsewhere. This thesis tested these predictions using behavioural measures of attention capture in conjunction with the N2pc, an event-related potential (ERP) index of attention selection. Experiment 1 tested the first prediction of the threat-capture hypothesis – that threat stimuli capture attention when they are task-irrelevant. Participants performed a dot-probe task in which pairs of face cues – one angry and one neutral – preceded a lateral target. On some trials, the faces were Fourier phase-scrambled to control for low-level visual properties. Consistent with the threat-capture hypothesis, an N2pc was observed for angry faces, suggesting they captured attention despite being completely task-irrelevant. Interestingly, this effect remained when faces were Fourier phase-scrambled, suggesting it is low-level visual properties that drive attention capture by angry faces. Experiments 2A and 2B tested the second prediction of the threat capture hypothesis – that threat stimuli capture attention when it is engaged elsewhere. Participants performed a primary task in which they searched a column of letters at fixation for a target letter. The perceptual load of this task was manipulated to ensure that attentional resources were consumed by this task. Thus there were high and low perceptual load conditions in these experiments. Task-irrelevant angry faces interfered with task performance when the perceptual load of the task was high but not when it was low (Experiment 2A). Similarly, angry faces elicited an N2pc, indicating that they captured attention, but only when perceptual load was high and when faces were phase-scrambled (Experiment 2B). These experiments further suggest that low-level visual factors are important in attention capture by angry faces. These results appear to be inconsistent with the threat-capture hypothesis, and suggest that angry faces do not necessarily capture attention when it is engaged elsewhere.


In this article, I focus on the circular relationship that, in his 1998 encyclical, Jean Paul II argued there is between faith and reason. I first note that this image of circularity needs some explaining, because it is not clear where exactly the circular process begins and ends. I then argue that an explanation can be found in Aquinas's reflection on the gift of understanding. Aquinas referred to the virtue of faith as caused by God, which promotes human reason, and this in turn strengthens the certainty of faith.


Objective: The purpose of this study was to deepen our understanding of the cognitive bases of human tool use based on the technical reasoning hypothesis (i.e., the reasoning-based approach). This approach assumes that tool use is supported by the ability to reason about an object's physical properties (e.g., length, weight, strength, etc.) to perform mechanical actions (e.g., lever). In this framework, an important issue is to understand whether left-brain-damaged (LBD) individuals with tool-use deficits are still able to estimate the physical object's properties necessary to use the tool. Method: Eleven LBD patients and 12 control participants performed 3 original experimental tasks: Use-Length (visual evaluation of the length of a stick to bring down a target), Visual-Length (to visually compare objects of different lengths) and Addition-Length (to visually compare added lengths). Participants were also tested on conventional tasks: Familiar Tool Use and Mechanical Problem-Solving (novel tools). Results: LBD patients had more difficulties than controls on both conventional tasks. No significant differences were observed for the 3 experimental tasks. Conclusion: These results extend the reasoning-based approach, stressing that it might not be the representation of length that is impaired in LBD patients, but rather the ability to generate mechanical actions based on physical object properties.


In the context of content-based multimedia indexing gender identification using speech signal is an important task. Existing techniques are dependent on the quality of the speech signal making them unsuitable for the video indexing problems. In this paper we introduce a novel gender identification approach based on a general audio classifier. The audio classifier models the audio signal by the first order spectrum's statistics in 1s windows and uses a set of neural networks as classifiers. The presented technique shows robustness to adverse audio compression and it is language independent. We show how practical considerations about the speech in audio-visual data, such as the continuity of speech, can further improve the classification results which attain 92%.


Background In rare cases, Behcet's disease (BD) can cause severe aortic regurgitation (AR) or aortic root destruction that might have lethal outcomes. Conventionally, simple aortic valve replacement (AVR) is performed for the management of severe AR in BD patients; however, the reoperation rate is as high as 78 to 100%, while mortality rate range from 20 to 47%. Recently, several series of case reports showed that compared to AVR, aortic root replacement (ARR) improved the surgical outcomes of AR in BD patients. Objectives To identify the factors associated with the long-term surgical outcomes of AR in BD patients. Methods We identified 23 patients who had been surgically treated for AR caused by aortic root involvement of BD from January 1996 through December 2013. We evaluated the occurrence of post-surgical adverse events, which were defined as follows: death, aortic valve/graft problem, infective endocarditis, cerebral infarction, and/or re-operation of aortic valve or root. Types of surgery were classified as simple aortic valve replacement (AVR), bioprosthesis aortic root replacement (bARR), and mechanical valved composite graft aortic root replacement (cARR). Clinical parameters including baseline characteristics, C-reactive protein (CRP), erythrocyte sedimentation rate, and medications were extracted from electronic medical records. Results Appropriate aortic valve or root surgery cases were 35 in total, with a mean follow up duration of 11±5 years in 23 patients. Out of the 11 cases that underwent AVR, post-surgical events were observed in 8 (73%) cases. Out of the 12 bARR cases (xenograft in 5 cases and homograft in 7 cases), 9 (75%) cases had post-surgical adverse events. Out of the 12 cARR cases, post-surgical adverse events occurred in 4 (33%) cases. Multivariable cox proportional hazards model indicated that levels of CRP at 1 month after discharge and age at operation were independent prognostic factors associated with event-free probability. Notably, performing cARR was the most significant factor that affected the surgical outcome (HR (95% CI) 0.147 (0.028 – 0.766), p=0.023). Conclusions In BD patients with severe AR, the occurrence rate of post-surgical adverse events was associated with the levels of CRP at 1 month after discharge, age at operation, and type of surgery. cARR may be a better surgical option in BD patients with aortic root involvement References Jeong DS, Kim KH, Kim JS, Ahn H. Long-term experience of surgical treatment for aortic regurgitation attributable to Behcet's disease. Ann Thorac Surg. 2009;87(6):1775–82. Song JK, Kim MJ, Kim DH, Song JM, Kang DH, Lee I, et al. Factors determining outcomes of aortic valve surgery in patients with aortic regurgitation due to Behcet's disease: impact of preoperative echocardiographic features. J Am Soc Echocardiogr. 2011;24(9):995–1003. Liu Q, Ye W, Liu C, Li Y, Zeng R, Ni L. Outcomes of vascular intervention and use of perioperative medications for nonpulmonary aneurysms in Behcet disease. Surgery. 2016;159(5):1422–9. Disclosure of Interest None declared


Performance of Auto regressive integrated moving average model (ARIMA) is evaluated for the prediction of highly stochastic time series of rainfall for an area which has a very significant topographical feature in causing orographic precipitation. Performance is calculated mainly on the basis of three important machine learning (ML) parameters Fit Percentage estimation (FPE), Mean Squared Error (MSE) and Mean Absolute Error (MAE). The model presented here shows minimum value of prediction error as a prediction of ten steps ahead.


Recent studies have suggested that accurate predictions of particle export flux can be derived from satellite-based estimates of phytoplankton biomass and net primary production (NPP), combined with models of the food web. We evaluate the performance of this approach using the output of a high-resolution, basin-scale coupled physical-biogeochemical model. There is tight correlation between the annual mean export flux simulated by the biogeochemical model and that predicted by the satellite-based algorithm driven by NPP from the model. Although the satellite-based approach performs well on the annual average, there are significant departures during the course of the year, particularly in spring. NPP and export flux can also become decoupled at the mesoscale, when the dynamics of fronts and eddies cause export to be displaced in space and/or time from the productivity event generating the particulate material. These findings have significant implications for the design of field studies aimed at reducing uncertainties in estimates of export flux.


Specially tailored polyelectrolytes are becoming important as energy-related materials. Here we explore a synthetic strategy to prepare fully aromatic polymers containing single phenylene rings in the backbone functionalized with four sulfonic acid groups. Thioether bridges of semifluorinated poly(arylene thioether)s were oxidized to sulfone bridges, followed by substitution of all fluorines by NaSH and quantitative oxidation of the resulting thiol groups. This gave poly(arylene sulfone)s containing octasulfonated biphenyl units, reaching ion exchange capacities up to 8 meq g−1 and unprecedented high local sulfonic acid concentrations. These polyelectrolytes are stable up to 300 °C under air and achieve proton conductivities of up to 90 mS cm−1 at 120 °C and 50% relative humidity. Despite the excellent performance of this unique new class of hypersulfonated polymers, our data suggests that incomplete proton dissociation may ultimately limit the conductivity of highly sulfonated polymers.


30 March-3 April 1998 Basic Clinical Allergy. Venue: National Heart & Lung Institute (Imperial College School of Medicine), London, England, UK. Contact: Conference Centre, Imperial College School of Medicine at National Heart & Lung Institute, Dovehouse Street, London SW3 6LY (tel. 0171 351 8172 (international +44 171 361 8172); fax 0171 376 3442 (international +44 171 376 3442); email firstname.lastname@example.com).


Malaria is a parasitic infection caused by a parasite that spends part of its life in people and the rest in mosquitos. Malaria continues to be one of the world's worst killers, threatening the lives of more than a third of the world's population. Treatments with organophosphates and insect growth regulators are the main control tools against Anopheles larvae, but they have negative effects on human health and the environment. Green control tools are a priority in this circumstance and are required for mosquito control. In this present study, Positive and negative controls were orally provided in mice for 24 hours before several tests were conducted out in the current investigation to evaluate the Treatment of Ethanolic extracts of Eichhornia crassipes. Mice were used in the Acute Toxicity Tests, the Early Malaria Infection Test, and the Established Infection Method Test. Asthenia, piloerection, ataxia, anorexia, urination, diarrhoea, lethargy, and coma were among the behavioural signs of toxicity observed in the mice. As a result, Eichhornia crassipes extract appears to have significant malarial activity. As a result, Eichhornia crassipes could be used as a natural antiplasmodial agent for the fight against Malaria.


Standard TCP is unable to differentiate loss due to packet corruption from that due to network congestion. Networks with higher bit error rates, such as those with wireless links, violate many of the assumptions made by TCP, causing degradation of end-to-end performance. In this paper we present TCP Montenegro in order to improve performance of TCP congestion control in wireless and wired environment. It is modification of well known TCP LogWestwood+ congestion control with using loss discrimination algorithm in the presence of errors in wireless link. The main idea is to make different levels of aggressiveness in the case of congestion loss and in the case of wireless loss. Simulation experiments show that the proposed scheme can effectively mitigate the negative impact of wireless link errors on the performance of standard TCP.


Despite significant progress in image-based 3D scene flow estimation, the performance of such approaches has not yet reached the fidelity required by many applications. Simultaneously, these applications are often not restricted to image-based estimation: laser scanners provide a popular alternative to traditional cameras, for example in the context of self-driving cars, as they directly yield a 3D point cloud. In this paper, we propose to estimate 3D scene flow from such unstructured point clouds using a deep neural network. In a single forward pass, our model jointly predicts 3D scene flow as well as the 3D bounding box and rigid body motion of objects in the scene. While the prospect of estimating 3D scene flow from unstructured point clouds is promising, it is also a challenging task. We show that the traditional global representation of rigid body motion prohibits inference by CNNs, and propose a translation equivariant representation to circumvent this problem. For training our deep network, a large dataset is required. Because of this, we augment real scans from KITTI with virtual objects, realistically modeling occlusions and simulating sensor noise. A thorough comparison with classic and learning-based techniques highlights the robustness of the proposed approach.


Peripheral blood mononuclear cells (PBMCs) were isolated from the whole blood of cheetahs (Acinonyx jubatus ; n=3) and stimulated with lipopolysaccharides (LPS) to induce the production of proinflammatory cytokines TNF-α, IL-1β, and IL-6 for establishment of cross-reactivity between these cheetah cytokines and feline-specific cytokine antibodies provided in commercially available Feline DuoSet® ELISA kits (R&D Systems, Inc., Minneapolis, Minnesota 55413, USA). This study found that feline-specific cytokine antibodies bind specifically to cheetah proinflammatory cytokines TNF-α, IL-1β, and IL-6 from cell culture supernatants. The assays also revealed that cheetah PBMCs produce a measurable, cell concentration-dependent increase in proinflammatory cytokine production after LPS stimulation. To enable the use of these kits, which are designed for cell culture supernatants for analyzing cytokine concentrations in cheetah serum, percent recovery and parallelism of feline cytokine standards in cheetah serum were also evaluated. Cytokine concentrations in cheetah serum were approximated based on the use of domestic cat standards in the absence of cheetah standard material. In all cases (for cytokines TNF-α, IL-1β, and IL-6), percent recovery increased as the serum sample dilution increased, though percent recovery varied between cytokines at a given dilution factor. A 1:2 dilution of serum resulted in approximately 45, 82, and 7% recovery of TNF-α, IL-1β, and IL-6 standards, respectively. Adequate parallelism was observed across a large range of cytokine concentrations for TNF-α and IL-1β; however, a significant departure from parallelism was observed between the IL-6 standard and the serum samples (P=0.004). Therefore, based on our results, the Feline DuoSet ELISA (R&D Systems, Inc.) kits are valid assays for the measurement of TNF-α and IL-1β in cheetah serum but should not be used for accurate measurement of IL-6.


In this study we present AI Prediction of Equatorial Plasma Bubbles (APE), a machine learning model that can accurately predict the Ionospheric Bubble Index (IBI) on the Swarm spacecraft. IBI is a correlation (R2) between perturbations in plasma density and the magnetic field, whose source can be Equatorial Plasma Bubbles (EPBs). EPBs have been studied for a number of years, but their day‐to‐day variability has made predicting them a considerable challenge. We build an ensemble machine learning model to predict IBI. We use data from 2014 to 2022 at a resolution of 1s, and transform it from a time‐series into a 6‐dimensional space with a corresponding EPB R2 (0–1) acting as the label. APE performs well across all metrics, exhibiting a skill, association and root mean squared error score of 0.96, 0.98 and 0.08 respectively. The model performs best post‐sunset, in the American/Atlantic sector, around the equinoxes, and when solar activity is high. This is promising because EPBs are most likely to occur during these periods. Shapley values reveal that F10.7 is the most important feature in driving the predictions, whereas latitude is the least. The analysis also examines the relationship between the features, which reveals new insights into EPB climatology. Finally, the selection of the features means that APE could be expanded to forecasting EPBs following additional investigations into their onset.


The mid Tafna wadi (N-W Algeria) is exposed to several man induced disturbances including urban, industrial, and agricultural effluents, and alteration of the natural flow regime. The recent installation of a reservoir upstream of the study area has strongly modified the flow regime by extending the period of low water level, and this stream section is only occasionally fed by water releases. Investigations on the hyporheos and benthos of this stream have allowed the comparison of densities, taxa richness and diversity, during three hydrological periods (natural high water, low flow and reservoir water releases), with the aim to highlight effects of the reservoir management on downstream hydrosystems. Species richness and abundance of stygobite crustaceans were low in the hyporheos. Surface water Crustaceans represented 53% of the overall fauna, with Cyclopoidae composing 50% of the Crustaceans. The dominance of the Cyclopoidae was also observed in the hyporheos. Daphniidae were more abundant (37%) in the benthic habitat than in the hyporheic zone. The alternation of high and low discharges appeared to affect the hyporheos more than the benthic communities. The stability concept of the hyporheic habitat does not fit with our results showing a great range of spatial (mosaic habitat) and temporal changes according to the flow regime.


The Precessions process uses an inflated membrane-tool that delivers near-Gaussian polishing spots. The tool-motion over the part can be constructed to preserve an aspheric form whilst removing damage from preceding processes, or control the form through a tool-path prescribed by numerical optimization. The process has previously been validated on surfaces up to 200mm diameter and used extensively in industrial environments. In this paper we report the first trials on a substantially larger part - a 500mm diameter f/1 ellipsoidal mirror - as part of the UK's technology-development for Extremely Large Telescopes. We draw attention to subtle problems that have arisen along the way. We also report on developing the process for free-form surfaces, in contrast to the axially-symmetric parts worked hitherto. The paper concludes with an assessment of the lessons learnt from the experiments, as they may impact on realization in a practical ELT segment fabrication facility.


Telemedicine has recently been used for diagnosis and interventions inpatients with autism spectrum disorder (ASD), traditionally performed in-person, but little attention has been paid to user expectations prior to its use. The aim of this study is to compare the expectations and concerns of 50 healthcare professionals and 45 parents of children with ASD regarding the use of telemedicine for diagnostic or treatment purposes. Parents have higher expectations for the use of telemedicine as an alternative (p = 0.0223) and supplement (p = 0.0061) to in-person diagnosis of ASD, as well as a supplement to traditional intervention (p ≤ 0.0001). In addition, while they also have greater hope for improvement in family routines (p = 0.0034) and parenting skills in child management (p = 0.0147), they express greater concern about the need for active parental involvement/supervision during telemedicine services (p = 0.015) and changes in the behaviour of the child with ASD during telemedicine services (p = 0.049). On the other hand, healthcare professionals are more concerned about barriers such as lack of devices (p = 0.000), unfamiliarity with the technology (p = 0.000), poor quality of internet connection (p = 0.006), and severity of ASD (p = 0.000). To achieve promising healthcare for ASD patients, the telemedicine service should try to meet the needs and preferences of both healthcare professionals and parents, as well as identify and, if possible, reduce perceived barriers.


Background Student engagement can predict successful learning outcomes and academic development. Expansion of simulation-based medical education will bring about challenges to educators and require them to help medical students to engage themselves in a simulation-based learning environment. Methods We conducted semi-structured interviews with ten medical students to explore their learning types and characteristics in the simulation-based learning environment. The thematic analysis was used to analyze the data. Results The interviews were thematically analyzed to form three types of student engagement in the simulation-based learning environment: reflective engagement, performance engagement, and interactive engagement. The analysis also identified eight sub-themes: active, persistent, and focused thinking engagement; self-directed-learning thinking engagement with the purpose of problem solving; active "voice" in class; strong emotional experience and disclosure; demonstration of professional leadership; interaction with realistic learning situations; support from teammates; and friendship-like facilitator-student interaction.Conclusions The findings explain the mechanisms behind student engagement in the simulation-based learning environment from two perspectives: the two-way construction of individuality and space in learning along with the interdependence of the learner and the learning community. That is, expanding the learning space centering around "inquiry" helps strengthen reflective communication and dialogue. It also facilitates imagination, stimulates empathy, and builds an inter-professional learning community. In this way, medical students are expected to learn from the two-way transmission of information, cultivate and reshape the interpersonal relationship, so as to improve engagement in the simulation-based learning environment.


Propagation of a signal beam in an AlGaAs/GaAs waveguide multiple-prism light deflector is theoretically investigated by solving the scalar Helmholtz equation to obtain the dependences of the temporal and spatial resolvable characteristics of the ultrafast deflector on the material dispersion of GaAs including group velocity dispersion and angular dispersion, interface reflection, and interface scattering of multiple-prism deflector. Furthermore, we experimentally confirm that, in this ultrafast beam deflection device, the deflecting angle of the signal light beam is linear with the pump fluence and the temporal resolution of the ultrafast deflection is 10 ps. Our results show that the improvement of the temporal and spatial resolvable performances is possible by properly choosing the structural parameters and enhancing the quality of the device.


A dynamic modelling chain, coupling the Symuvia dynamic traffic model (LICIT, Ifsttar / ENTPE) and the Noisemodelling noise level prediction tool (UMRAE, Ifsttar / Cerema), is developed in this paper to assess the impact of road traffic on noise environments at the scale of an urban traffic network of about 10 km2 located in Lyon/Villeurbanne. The simulation, which reproduces 3 hours of a morning rush hour scenario, highlights the increase in noise levels associated with the increase in travel demands. It also highlights that the increase in noise levels is not uniformly distributed over the network and has a greater impact on the streets where traffic is reported. In addition, noise dynamics are modified: background noise is particularly sensitive to the increase in vehicle density on the network, so periods of calm on the network are rare. A more detailed analysis of this dynamic is possible locally through the analysis of the evolution of the LAeq,1s and the study of specific acoustic indicators. Desirable improvements to the model are discussed, with a view to assessing the currently unknown acoustic impact of road traffic management strategies at the scale of an urban network.


This article examines Romania's kin-state policies after it became an EU member state in 2007. After 2007, Romania expanded its kin-state obligations and strengthened its kin-state role. First, the article discusses the current understanding of its kin-state responsibility. And second, by examining the grounds, subject and scope of Romania's policies, and evaluating the limits of its kin-state responsibility against dominant liberal views on reparations for historical injustice and state support for culture, the article shows that Romania's kin-state policies remain highly discretionary and raise important questions over its liberal commitments within and beyond its borders.


Increased loading of nitrogen (N) and phosphorus (P) from agricultural and urban intensification has led to severe degradation of inland and coastal waters. Lakes, reservoirs, and wetlands (lentic systems) retain these nutrients, thus regulating their delivery to downstream waters. While the processes controlling N and P retention are relatively well‐known, there is a lack of quantitative understanding of how these processes manifest across spatial scales. We synthesized data from 600 lentic systems around the world to gain insight into the relationship between hydrologic and biogeochemical controls on nutrient retention. Our results indicate that the first‐order reaction rate constant, k [T−1], is inversely proportional to the hydraulic residence time, τ [T], across 6 orders of magnitude in residence time for total N, total P, nitrate, and phosphate. We hypothesized that the consistency of the relationship points to a strong hydrologic control on biogeochemical processing, and validated our hypothesis using a sediment‐water model that links major nutrient removal processes with system size. Finally, the k‐τ relationships were upscaled to the landscape scale using a wetland size‐frequency distribution. Results suggest that small wetlands play a disproportionately large role in landscape‐scale nutrient processing—50% of nitrogen removal occurs in wetlands smaller than 102.5 m2 in our example. Thus, given the same loss in wetland area, the nutrient retention potential lost is greater when smaller wetlands are preferentially lost from the landscape. Our study highlights the need for a stronger focus on small lentic systems as major nutrient sinks in the landscape.


When Escherichia coli was incubated with xanthine oxidase and acetaldehyde, the killing of E. coli was accelerated by iron-EDTA but inhibited by hematin or hemoglobin. On the other hand, when E. coli was incubated with human neutrophils in the presence of phorbol myristate acetate (PMA), all of these iron species at concentrations of a few micromolar accelerated the inactivation of neutrophils and in so doing protected the E. coli from being killed by the neutrophils. The inactivation of the neutrophils was accompanied by an increase in lipid peroxidation and by a decrease in viability measured with trypan blue. This inactivation was inhibited by scavengers such as deoxyribose, mannitol, or thiourea. Desferrioxamine B and 5,5-dimethyl-1-pyrroline-1-oxide (DMPO) both inhibited the inactivation mediated by iron-EDTA, but had no effect on the hematin- or hemoglobin-mediated inactivation. Vanadium (vanadyl ion), an effective Fenton reagent, behaved in the same way as iron-EDTA relative to the effects of DMPO on neutrophil inactivation. These results led us to conclude that neutrophils were inactivated during PMA stimulation by OH radicals in the presence of iron-EDTA and by some other oxidizing species when hematin or Hb is present. Ascorbate enhanced the inactivation of neutrophils mediated by these iron species. Catalase was very effective in inhibiting neutrophil inactivation. Superoxide dismutase was not as effective but the combination with catalase was most effective.


Waveguide coupling of SAW resonators is widely used to make low loss compact filters. The classically used structure for this kind of device consists of two tracks separated by a common ground bussbar. To obtain a balanced drive using this structure, it is necessary to split the transducer in two parts connected electrically in series. This can result in load and source impedances which are too high for system requirements. We present a new multitrack balanced drive waveguide coupled resonator filter structure exhibiting both low impedances and small crystal sizes. A general analysis procedure has been developed to analyse this new structure. This procedure is suitable for an arbitrary number of layers and for any number of electrical ports. Results of a GSM/DCS 1800 IF filter at 188 MHz using the new structure are presented. Typical performances are a 3 dB bandwidth of 250 kHz, a 20 dB bandwidth of 500 kHz and a 6 dB insertion loss.


Background: Since poor pump function and left ventricular dilatation both contribute to the development of heart failure, improving pump function and limiting left ventricular dilatation are both important therapeutic targets. The aim of this study was to investigate the effect of cardiac rehabilitation based on aerobic and aerobic-resistance exercises on the biomechanical function of cardiac myocardium (MI, PCI and CABG). Methods: In this quasi-experimental study, 51 middle-aged male patients aged 55.73±5.92 were followed by MI, CABG, and PCI randomly and equally in three groups of aerobic training, aerobic-resistance training and control were divided. The experimental groups performed sub-maximal aerobic exercises for 8 weeks. The training protocol consisted of three sessions per week of rehabilitation exercises and each activity session consisted of three sections: warm-up, core activity, and cooling. Aerobic-resistance group In addition to aerobic training, they performed resistance training twice a week for 15 minutes. Results: Significant improvement in all biomechanical performance indices of myocardium including: ejection fraction (P=0.001), end diastolic volume (P=0.001) and end systolic volume (P=0.001), left ventricular end diastolic (P=0.001), left ventricular end systolic (P=0.001), inter-ventricular septal thickness (P=0.001), and left ventricular posterior wall thickness (P=0.001). Both aerobic and aerobic-resistance training groups were significantly better than the control group. This improvement was more pronounced in the aerobicresistance group. Conclusion: Exercise-based cardiac rehabilitation program, especially using aerobicresistance training for at least 8 weeks, significantly improves the biomechanical function of cardiac muscle in patients. Conflicts of interest: None Funding: AJA University of Medical Sciences Keywords


Summary
Before the anti-stegomyia campaigns in Havana, Panama and Guayaquil, epidemics of yellow fever were not uncommon in the towns and cities of Colombia along the coast and in the Magdalena valley. Following the last known outbreak in a coastal town, which occurred in Buenaventura in 1920, the country appeared to be entirely free of the disease until the unexplained appearance of urban yellow fever in Bucaramanga in 1923. After six quiet years, the disease broke out unexpectedly again in Socorro in 1929. Immunity surveys carried out by the newly discovered mouse protection test in 1931 and 1932 gave evidence that yellow fever might be endemic in some rural areas of Boyaca and Santander. As a result of a systematic study which was begun in Colombia in 1934, cases of jungle yellow fever have been found each year since in zones comprised of the departments of Antioquia, Boyaca, Caldas, Cundinamarca, Santander and Tolima, and the Intendencia del Meta. The results of an extensive immunity survey during this period confirm this distribution of yellow fever and make it appear probable that the disease has existed in recent years in other widely separated parts of the country such as the Atrato valley and the Colombian Amazon drainage. With the exception of a very small epidemic in Buenavista, Caldas, in 1937, no incidence of yellow fever transmitted by Aedes aegypti has been observed in Colombia since 1929.


This article illustrates the philosophy of Alain Badiou through Pixar's 2008 animation 'WALL-E'. The fictional story tells of a toxic planet Earth long abandoned following an ecological disaster. Humanity now exists in a floating brave new world; a spaceship whose passengers' everyday existence is drowned by a consumptive slumber. That is, until a robot named WALL-E comes aboard and changes things forever. The purpose of making this connection between philosophy and film is not to trivialize Badiou's work, but rather to open it up, pull it apart, and synchronize it with a movie that is saturated with Badiouian themes. Beneath the complexities of Being and Event's set-theory and the Logics of Worlds' algebra, lay a set of ideas that are fizzing with creativity and disruptive potential. WALL-E gives these political and philosophical ideas a lived expression to a wide audience. The central motif of the article is that the finitude of appearance in a world is constantly overrun by the infinitude of being, and this requires a new theorization of site-based geographies. From the miraculous discovery of a plant growing on a dead Earth, to the tumultuous arrival of WALL-E onboard a spaceship that he never belonged to, the stability of a world is always threatened by a 'point of excess', called the site. Three interrelated concepts of Badiou's will be animated in this article: atonic and tensed worlds, sites, and subjects


The future development of advanced sensor and microsystems technologies for use in agriculture is briefly discussed, within a general appraisal of the industrial requirements and the potential economic and ecological benefits to be derived from the employment of novel sensing systems in sustainable agricultural practices, such as precision farming. It is proposed that these technologies are potentially important monitoring tools for farmers and growers, and that a concerted programme of research and development is required to satisfy the future requirements of the agricultural industry.


We present a revised model for the formation of southwest Pacific backarc basins from 120 Ma to the present day. Our aim is to improve our understanding of the tectonic regime operating in the region and Its consequences for global plate motions. Such an understanding helps explain present-day structures observed on the continental and oceanic lithosphere and the underlying mantle. Regional plate reconstructions were created using gravity and magnetic data from backarc basins, plate-circuit closure, global tomography and existing geological data. Our model predicts convergence between the Australian and Pacific Plates along the Norfolk Ridge from 120 to 100 Ma, followed by the fragmentation of East Gondwana. East-dipping subduction east of Australia was initiated at ca 90 Ma along the Loyalty-Three Kings Ridge and may have trapped Cretaceous quiet-zone crust in the Norfolk Basin. The inception of this subduction system may have provided a driving mechanism for the opening of the Tasman Sea by means of slab pull. A jump in subduction to the east was subsequently initiated along a west-dipping subduction system at ca 45 Ma driven by the collision of the Loyalty Arc with New Caledonia. Consequently, spreading in the North Loyalty Basin occurred by anticlockwise rotation of the subduction hinge between chrons 20 and 16 (43.8-35.3 Ma). This was concurrent to Norfolk Basin opening and formation of the Cook Fracture Zone. Backarc-basin formation then transferred to the South Fiji Basin where magnetic anomalies from chron 12 to 7N (30.9-25.2 Ma) have been identified as two contemporaneous triple junctions. The complex spreading regime witnessed in the South Fiji Basin appears analogous to the North Fiji Basin and may represent the surface expression of a hot, shallow mantle consistent in character to a superswell. The South Flji Basin ceased forming at ca 25 Ma in response to a major plate reorganisation coinciding with the inception of the Alpine Fault, docking of the Ontong Java Plateau with the Melanesian Arc and transpressional obduction of the Northland ophiolite. A lull in basin formation throughout most of the Miocene was followed by the reinitiation of backarc basin formation in the Lau Basin (during the past -7 million years) and North Fiji Basin (during the past -10 million years). All these apparent episodes of backarc-basin formation during the past 45 million years are possibly related to mantle-slab Interaction at the 670 km discontinuity.


Geologic studies during recent open-pit mining at Summitville, Colorado, have provided new information on an epithermal acid sulfate Au-Ag-Cu deposit formed in a volcanic dome. Geologic mapping, geochemical studies of whole-rock samples from blast holes, and geologic and geochemical traverse studies refine the details of the evolution of the Summitville deposit. Six distinct events followed emplacement of the quartz latite volcanic dome and define the development of the Summitville deposit: (1) an early stage of acid sulfate alteration, (2) subsequent Cu sulfide and gold mineralization, (3) widespread hydrothermal brecciation, (4) volumetrically minor, base metal sulfide-bearing barite veining, (5) volumetrically minor, kaolinite matrix brecciation, and finally, (6) supergene oxidation. Events 1 and 2 were the most important for the formation of the Summitville deposit. Acid sulfate altered rock is primarily found in the quartz latite volcanic dome rock and consists of vuggy silica (central), quartz-alunite, quartz-kaolinite, argillic, and propylitic (distal) zones. Ore deposition (event 2) of enargite, luzonite, covellite, pyrite, native sulfur, marcasite, and minor sphalerite, native gold, + or - barite and galena overprinted the acid sulfate altered rocks. Events 3, 4, and 5 are geologically important but rarely formed units large enough to be considered mineable ore by open-pit mining. The final supergene oxidation event affected much of the near-surface portion of the deposit and leached copper and sulfide minerals forming oxide zones. Near-surface oxide zones contain the highest Au grades and decrease progressively with depth.Fractures were important fbr localizing both the acid sulfate altered rock and ore deposition at Summitville. Such fracture control is apparent despite a lack of distinct throughgoing open-space quartz veins; instead, laterally and vertically extensive ore zones are identified by their highly silicified character that can be traced laterally for up to 500 m and vertically up to 200 m. Ore zones strike parallel to regional faults related to rifting and basin and range development, suggesting that hydrothermal fluids followed preexisting fractures. Ore zones follow two northwest trends, a N 30 degrees W + or - 20 degrees trend, and a N 60 degrees W trend. Most fractures and faults in the open pit dip steeply from 65 degrees to vertical. Ore zones intersect near the center of the deposit to form a large zone approximately 150 by 400 m. Ore zones form a rough radial pattern located near the center of the deposit and a discontinuous arcuate feature on the northern side. This radial pattern, arcuate feature, and the intersection of ore zones near the center of the deposit are probably related to the intrusion of a porphyry below the deposit. The overall low Au-grade, high-tonnage character of the Summitville deposit is related to low permeability in the quartz latite volcanic dome rock and absence of well-developed open-space hydrothermal veins.Gold analyses of development drill holes and blast hole samples, in conjunction with geologic mapping in the open pit, indicate that vuggy silica, quartz-alunite, and quartz-kaolinite altered rock constitute most of the Au ore. Vuggy silica averaged 2.4 ppm Au, quartz-alunite averaged 1.2 ppm Au, and quartz-kaolinite averaged 0.86 ppm Au during open-pit mining. Grades for argillically altered rock were usually below the ore cutoff of 0.34 ppm Au. Propylitically altered rock rarely contained detectable Au concentrations (0.03 ppm Au) and constituted only waste rock. Although volumetrically minor, event 4 base metal sulfide-bearing barite veins and event 5 kaolinite matrix breccias contained high Au grades (up to about 800 ppm Au), producing approximately 5 to 15 percent of the total Au mined in the deposit.Geochemical studies of samples collected across traverses of altered and mineralized ore zones indicate that Te, Bi, and Pb are characteristic trace elements, in addition to Au, Ag, Cu, and As that are typical of acid sulfate mineral deposits. Anomalous Te is associated with Cu sulfides and gold in vuggy silica zones. Anomalous Bi and Pb concentrations correlate most consistently with quartz-alunite zones. Thallium is also anomalous at Summitville. Highest concentrations of Tl are found in argillic rock, whereas silicified zones are depleted in it. The anomalous Tl in distal zones is similar to observations in some porphyry Cu systems. Pronounced lateral zonation of Ag/Au ratios is present in the deposit. The Ag/Au ratios vary from about 2:1 near the center of the orebody to greater than 20:1 on the periphery.The Summitville deposit is located in the midlevel portion of a mineralized volcanic dome, with a porphyry system at depth, and a hot springs environment at the surface. Drill holes through the volcanic dome intersected a quartz monzonite porphyry approximately 600 m below the surface that is altered to sericite and pyrite similar to some porphyry deposits. Laterally extensive cristobalite and opal replacing quartz latite are found southwest of the deposit and represent a hot-spring environment. Bedded siliceous sinter, some of which contains plant debris, overlies the cristobalite and opal at some localities. These deposits may represent surface vents for the fluids responsible for acid sulfate alteration or mineralization of the volcanic dome.


Viable cancer cells expose elevated levels of phosphatidylserine (PS) on the exoplasmic face of the plasma membrane. However, the mechanisms leading to elevated PS exposure in viable cancer cells have not been defined. We previously showed that externalized PS may be used to monitor, target and kill tumor cells. In addition, PS on tumor cells is recognized by macrophages and has implications in antitumor immunity. Therefore, it is important to understand the molecular details of PS exposure on cancer cells in order to improve therapeutic targeting. Here we explored the mechanisms regulating the surface PS exposure in human cancer cells and found that differential flippase activity and intracellular calcium are the major regulators of surface PS exposure in viable human cancer cells. In general, cancer cell lines with high surface PS exhibited low flippase activity and high intracellular calcium, whereas cancer cells with low surface PS exhibited high flippase activity and low intracellular calcium. High surface PS cancer cells also had higher total cellular PS than low surface PS cells. Together, our results indicate that the amount of external PS in cancer cells is regulated by calcium dependent flippase activity and may also be influenced by total cellular PS.


A therapeutic community for antisocial adolescents is discussed. The facility's tribulations before instituting a designed program, including a treatment plan for each client, and the results of such a program are described. Also discussed are the inherent problems of such facilities in our culture and the built-in-failure which seems inevitable.


Abstract Recent studies have indicated that arachidonic acid (AA) is metabolized by the cytochrome P4504A (CYP4A) enzymes in cerebral arteries to produce 20-hydroxyeicosatetraenoic acid (20-HETE) and that this compound has effects on cerebral vascular tone that mimic those seen following subarachnoid hemorrhage (SAH). In this regard, 20-HETE is a potent constrictor of cerebral arteries that decreases the open state probability of Ca2+-activated K+ channels through activation of protein kinase C (PKC). It increases the sensitivity of the contractile apparatus to Ca2+ by activating PKC and rho kinase. The formation of 20-HETE is stimulated by angiotensin II (AII), endothelin, adenosine triphosphate (ATP) and serotonin, and inhibited by NO, CO and superoxide radicals. Inhibitors of the formation of 20-HETE block the myogenic response of cerebral arterioles to elevations in transmural pressure in vitro and autoregulation of cerebral blood flow (CBF) in vivo. 20-HETE also plays an important role in modulating the cerebral vascular responses to vasodilators (NO and CO) and vasoconstrictors (AII, endothelin, serotonin). Recent studies have indicated that the levels of 20-HETE in cerebrospinal fluid (CSF) increase in rats, dogs and human patients following SAH and that inhibitors of the synthesis of 20-HETE prevent the acute fall in CBF in rats and reverse delayed vasospasm in both dogs and rats. This review examines the evidence that an elevation in the production of 20-HETE contributes to the initial fall in CBF following SAH and the later development of delayed vasospasm.


Binocular depth perception, or stereopsis, depends on matching corresponding points in two images taken from two vantage points. In random-dot stereograms the features to be matched are individual pixels. We have used the recurrent backpropagation learning algorithm of Pineda (1987) to construct network models with lateral and feedback connections that can solve the correspondence problem for random-dot stereograms. The network learned the uniqueness and continuity constraints originally proposed by Marr and Poggio (1976) from a training set of dense random-dot stereograms. We also constructed networks that can solve sparse random-dot stereograms of transparent surfaces. The success of the learning algorithm depended on taking advantage of translation invariance and restrictions on the range of interactions.


Carcinoma of the penis is the commonest cancer of males in Uganda, particularly among the different uncircumcised ethnic groups. The great variations in frequency among those groups, however, suggest that other factors may play an important role. These factors may be infections, so that circumcision may act only by permitting better penile hygiene. Condylomata acuminata are also common in Uganda and can resemble carcinoma both clinically and histologically.


One area in which experimental economics methods have been used to study operations problems is supply-chain management. We survey results from a series of human experiments based on the popular beer distribution game and find cognitive limitations on the part of managers, in particular an underweighting of the supply line. We suggest mechanisms that may alleviate this bias, including sharing inventory and point-of-sale data, and reducing ordering and shipping delays. Our research provides managerial lessons and identifies supplychain issues that need further experimental study. (Games: group decisions. Inventory-production: multi-echelon.)


The LMF100 consists of two independent general purpose high performance switched capacitor filters. With an external clock and 2 to 4 resistors, various second-order and first-order filtering functions can be realized by each filter block. Each block has 3 outputs. One output can be configured to perform either an allpass, highpass, or notch function. The other two outputs perform bandpass and lowpass functions. The center frequency of each filter stage is tuned by using an external clock or a combination of a clock and resistor ratio. Up to a 4th-order biquadratic function can be realized with a single LMF100. Higher order filters are implemented by simply cascading additional packages, and all the classical filters (such as Butterworth, Bessel, Elliptic, and Chebyshev) can be realized. The LMF100 is fabricated on National Semiconductor's high performance analog silicon gate CMOS process, LMCMOSTM. This allows for the production of a very low offset, high frequency filter building block. The LMF100 is pin-compatible with the industry standard MF10, but provides greatly improved performance.


The only book of its kind in any language, Travel in the Ancient World offers a lively, comprehensive history of ancient travel, from the first Egyptian voyages recorded in Old Kingdom inscriptions through Greek and Roman times to the Christian pilgrimages of the fourth and sixth centuries. Rich in anecdote and colorful detail, it now returns to print in paperback with a new preface by the author.


With the continued development of the economy, the income gap among Chinese rural households continues to widen. The land system plays a decisive role in developing "agriculture, rural areas and farmers" and land circulation is a factor in the increase in income inequality among farm households. Based on the 2013 China Household Income Project (CHIP), this article used the re-centered influence function (RIF) regression method to empirically test the impact of rural land circulation on the income gap of rural households in China in three regions: the central, eastern and western regions. The quantile regression tested the impact mechanism of income inequality of rural households from the perspective of labor mobility and land circulation. The empirical results showed that land circulation increases the income inequality of rural households. The theoretical mechanism test proved that the dynamic relationship between land circulation and labor mobility increases rural household income. However, this increase has a greater effect on rural households with a high income and a small effect on rural households with a low income, resulting in a further widening of the income gap. Therefore, while increasing the income of rural households through land circulation, the government should also consider income equity. Finally, this article puts forward the policies and opinions on land reform and provides a brief discussion on the future direction of development.


Using a simple density functional theory (DFT) the height of the free energy barrier for forming a droplet of the liquid phase from the metastable gas phase is determined for a model colloidal fluid exhibiting competing interactions. The pair potential has a hard core of diameter σ, is attractive Yukawa at intermediate separations, and is repulsive Yukawa at large separations. It is found that even a very weak long-range repulsive tail in the pair potential has a profound effect on nucleation: increasing the amplitude of the repulsive Yukawa tail reduces significantly the free energy barrier height and therefore increases the liquid droplet nucleation rate. The method introduced for calculating the droplet density profile and free energy employs a fictitious external potential to stabilize a liquid droplet of the desired size, i.e. with a given excess number of particles. For the critical droplet, corresponding to an extremum of the grand potential, this fictitious potential is everywhere zero. The decay of the droplet density profiles into the bulk gas is examined. For a range of nucleation state points the DFT predicts exponentially damped, long wavelength oscillatory decay for systems exhibiting long-range repulsion, contrasting sharply with the monotonic decay found when the pair potential has only an attractive Yukawa piece. The changes in nucleation properties found for small amplitudes of the repulsive Yukawa tail reflect the propensity of the fluid to form modulated structures such as clusters or stripes.


The clustering of historical electricity consumption data is an effective means of developing representative load profiles for long-term energy planning. This paper presents a multi-dimensional approach for clustering, considering scattering and separation metrics and the number of clusters. A novel hybrid approach to solve the clustering function is also proposed: a combination of Invasive Weed Optimization (IWO) and wavelet mutation strategy. The hybrid method is applied to half-hourly metered electricity consumption data from the Civic Centre of a large local (municipal) government in Perth, Western Australia, to create representative seasonal load profiles. The novel clustering approach is then tested against the well-known k-means method using Davies-Bouldin and silhouette indices. In each seasonal clustered profile, the hybrid method is found to outperform the k-means method. The hybrid method has been identified as an effective clustering approach for analyzing the behavior of loads and assisting the identification of suitable energy efficiency initiatives.


In the present study, a hierarchical nanostructure of Fe3O4-porous hydrochar (p-Fe/HC) core shell nanocomposite was readily synthesized via a facile hydrothermal carbonization route followed by a KOH activation. In our new invention, hydrothermally formed core–shell nanoparticles underwent KOH activation to create micro- and mesopores forming porous hydrochar outer-shell on Fe3O4 nanoparticles core for improving capacitance performance. These porous structures eventually could act as potential electrolyte-accessible pathways which led to the contribution of pseudocapacitance connecting from the core (reaction at Fe3O4/electrolyte interface). Based on our electrochemical capacitive performance evaluation, p-Fe/HC nanocomposite electrode which comprised of 5 wt% Fe3O4 nanoparticles (±45 nm) could reach the specific capacitance of 259.3 F g−1 with a superior wide potential window of 1.8 V in 1 mol L−1 Na2SO4 aqueous electrolyte. By comparing KOH activation of pristine porous hydrochar and p-Fe/HC, an exceptionally high specific surface area (1712.8 m2 g−1) with bimodal type pores size distribution was observed. In addition, p-Fe/HC displayed a maximum energy density of 29.2 W h kg−1 at a power density of 1.2 kW kg−1, which is about 26% higher energy density than that of pristine porous hydrochar. In this manner, the synthesized porous hydrochar outer-shell could provide additional electrochemical stability to Fe3O4 core, preventing volume change at high current loading as well as conductive coating to enhance pseudocapacitance performance. Consequently, a symmetrical nanocomposite cell was successfully designed, with high capacitance retention of 95.1% after 5000 cycles.


It is sometimes very difficult to differentiate between slow crack growth (SCG)/creep rupture and environmental stress cracking (ESC) when observing a fracture surface. There is a wide spectrum of chemical effects on crack growth with different critical stresses for different polymer/chemical combinations. If the critical stress is high, one observes more micro-ductility on the surface. If the critical stress is low, one observes a more glassy fracture surface. Thus, the level of ESC contribution to the failure ranges from very little effect to very aggressive effects. This uncertainty is often reflected in the published resistance tables, as evidenced by the use of terms like "minor effect", "slight corrosion", "moderate effect", "softening", "caution", or a number rating from 1 to 10 for resistance to chemical attack (with 1 representing very poor resistance and 10 representing no effect). [1]


In this research, cross-sectional data for the township level obtained from the 1990 and 2000 Population and Housing Census are used to study the phenomenon of high housing vacancy rates in Taiwan. Three simultaneous equations for housing price, vacancy rate, and moving rate are derived and estimated using 3SLS. The estimation results show that, in 1990, in a booming market situation, both expected housing price and current housing price had a strong, positive impact on the vacancy rate; however, the housing vacancy rate did not display a negative impact on housing price as expected. The results for 2000 show that housing price did not significantly affect the vacancy rate; however, the vacancy rate had a negative impact on housing price that was highly statistically significant. This result reflected the fact that housing market operation had swung to another extreme after the real estate bubble that started in the late 1980s and burst in the mid-1990s. The natural vacancy rate for each township can be obtained from the estimation results. The average rate for 2000 was 0.11 to 0.12, compared to an actual vacancy rate of 0.158, which implied that 75% of townships had an excess supply of housing. Only Taipei City, Kaohsiung City and townships in areas inhabited by Taiwan's indigenous peoples had, on average, a relatively low excess supply rate.


Abstract This paper reports on the stepwise development of a new questionnaire for measuring work-home interaction, i.e. the Survey Work-home Interaction—NijmeGen, the SWING). Inspired by insights from work psychology, more specifically from Effort-Recovery Theory (Meijman & Mulder, 1998), we defined work-home interaction by differentiating between the direction and quality of influence. Four types of work-home interaction were distinguished and measured by using 22 (including 13 self-developed) items. By using data from five independent samples (total N=2472), validity evidence was provided based on the internal structure of the questionnaire. The results showed that the questionnaire reliably measured four empirically distinct types of work-home interaction, and that this four-dimensional structure was largely invariant across the five samples as well as across relevant subgroups. Validity evidence was also provided based on the relations with external (theoretically relevant) variables (i.e. job characteristics, home characteristics, and indicators of health and well-being). The results generally supported the hypothesized relationships of these external variables with negative work-home interaction. Less support was found, however, for the hypothesized relationships with positive work-home interaction. This contributes to current literature as it employs a relatively broad conceptualization of work-home interaction and offers a promising tool that measures its multiple components across a wide variety of workers.


UNLABELLED
Hyper-functioning parathyroid glands with autonomous overproduction of PTH is the most frequent cause of hypercalcemia in outpatient populations with primary hyper-parathyroidism. It is generally caused by a solitary adenoma in 80%-90% of patients. Despite the various methodologies that are available for preoperative localization of parathyroid lesions, there is still no certain preoperative imaging algorithm to guide a surgical approach prior to the management of primary hyper-parathyroidism (P-HPT). Minimally invasive surgery has replaced the traditional bilateral neck exploration (BNE) as the initial approach in parathyroidectomy at many referral hospitals worldwide. In our study, we investigated diagnostic contributions of SPECT-CT combined with conventional planar scintigraphy in the detection of hyper-functioning parathyroid gland localization, since planar imaging has limitations. We also evaluated the efficacy of preoperative USG in adding to initial diagnostic imaging algorithms to localize a parathyroid adenoma.

METHODS
A total of 256 consecutive surgically naive patients with hyper-parathyroidism diagnosis were included in the following preoperative localization study. The study consisted of 256 consecutive patients with HPT, with a selected 154 patients who had neck surgery with definitive histology reports. All patients had 99mTc-methoxyisobutylisonitrile (99mTc-MIBI) double-phase scintigraphy. The SPECT-CT procedure, combined with standard 99mTc-MIBI planar parathyroid scintigraphy with a pinhole and parallel-hole collimator to evaluate whether the SPECT-CT procedure was able to provide additional information in the localization of the pathology, caused hyper-parathyroidism in both P-HPT and S-HPT.

RESULTS
In the 154 P-HPT patients, 168 lesions (142 adenomas including 2 intrathyroidal and 2 double adenoma, 2 carcinoma, and 22 hyperplastic glands (four patients had MEN I, each with four hyperplastic glands)), were found at surgery. SPECT-CT detected more lesions than planar imaging in P-HPT (97.8% vs. 87.6%). SPECT-CT detected all adenomas and increased sensitivity, particularly in small lesions. Regardless of their size, the number of detected hyperplastic glands by SPECT-CT was remarkably higher than planar imaging.


The concept of 'strategic dalliances'– defined as non-committal relationships that companies can 'dip in and out of,' or dally with, while simultaneously maintaining longer-term strategic partnerships with other firms and suppliers – has emerged as a promising strategy by which organizations can create discontinuous innovations. But does this approach work equally well for every sector? Moreover, how can these links be effectively used to foster the process of discontinuous innovation? Toward assessing the role that industry clockspeed plays in the success or failure of strategic dalliances, we provide case study evidence from Twister BV, an upstream oil and gas technology provider, and show that strategic dalliances can be an enabler for the discontinuous innovation process in slow clockspeed industries. Implications for research and practice are discussed, and conclusions from our findings are drawn.


BCI is fastest developing technology in advance computing.The main purpose behind BCI is to form the connection between homosapien brain and the technology.This is very effective technology which receives and control logical devices which works on familier part of the body.This technich mainlydesign for abnormal peoples.using this technology disable person developes themselves as like normal person.By studying this we introduce human brain with its anotomy.
BCI technology developes a theory of hardware and software.BCI measures the activities of human brain.BCI evaluates the signal which control the brain.It convert signal generated by brain to machine signals.
Concept of BCI gives us knowledge of various technologies like invasive and non-invasive.person gives instruction in signals which are recive by BCI.This techniques has widest scope.It has many neuroscience application.


Healthy volunteers without nickel hypersensitivity were given 5.6 mg nickel orally. The nickel concentration was assayed in urine, serum and saune‐provocated sweat from hands and trunk before and after nickel ingestion. The nickel concentration in serum increased in all subjects, and in most cases in urine, but not decisively in sweat.


Physical activity (PA) parenting, or strategies parents use to promote PA in children, has been associated with increased PA in children of all ages, including preschool-aged children. However, little is known about the circumstances under which parents adopt such behaviors. This study examined family ecological factors associated with PA parenting. Low-income parents (N = 145) of preschool-aged children (aged 2 to 5 years) were recruited from five Head Start centers in upstate New York. Guided by the family ecological model (FEM), parents completed surveys assessing PA parenting and relevant family and community factors. Hierarchical regression analysis identified independent predictors of PA parenting. Parent depressive symptoms, life pressures that interfere with PA and perceived empowerment to access PA resources were associated with PA parenting. Community factors, including neighborhood play safety and social capital, were not independently associated with PA parenting in the multivariate model. Together, family ecological factors accounted for a large proportion of the variance in PA parenting (R 2 = .37). Findings highlight the need to look beyond cognitive predictors of PA parenting in low-income families and to examine the impact of their broader life circumstances including indicators of stress.


There is widespread agreement that medical care offered at the end of a life ought to accord with the preferences of the person whose life it is, at least if the care requested would not be futile. There is considerable evidence, too, that making care more "patient-centered" in this way would tend to lower the cost of care, for the simple reason that people in those straits often prefer to avoid the most intrusive and therefore most expensive care. So patient-centered care could be a win-win of sorts: there could be a collective benefit of lowering costs along with the individual benefit of conforming care better to what the patient wants. But to what degree should the collective benefit be an express goal of health reform, in light of the fact that a given patient might want whatever intrusive, aggressive interventions stand a chance of prolonging life? This question animates several items in this issue of the Report.


Evolution![Figure][1]

CREDIT: ISTOCKPHOTO.COM

The origin and evolution of Gossypium hirsutum , the most widely planted cotton species, is an unsolved puzzle because of its hybrid origin from Old and New World species. To better understand the evolution of cotton, Palmer et al. shotgun sequenced 454 2000-year-old archaeological samples of cotton from Africa and South America. On the basis of their results and comparisons with genetic data from extant species, they assigned the African lineage to the species G. herbaceum and the South American lineages to the species G. barbadense . From these data, the authors show that G. barbadense shows overall genome stability with few changes in the placement and number of transposable elements over the past 2000 years. In contrast, G. herbaceum showed significant differences in transposable element composition over time. On the basis of these results, the authors postulate that the ancient G. herbaceum lineage is more like the ancestral form of one of the original species parents of G. hirsutum than that of the extant lineages. Furthermore, they suggest that cotton genome evolution is characterized by bursts of transposable element activity followed by genome stability.

Mol. Biol. Evol. 29 , 10.1093/molbev/mss070 (2012).

 [1]: pending:yes


The Potato virus Y (PVY) is responsible for huge economic losses for the potato industry worldwide and is the fifth most consequential plant virus globally. The main strategies for virus control are to limit aphid vectors, produce virus-free seed potatoes, and breed virus-resistant varieties. The breeding of PVY-resistant varieties is the safest and most effective method in terms of cost and environmental protection. Rychc, a gene that confers extreme resistance to PVY, is from S. chacoense, which is a wild diploid potato species that is widely used in many PVY-resistant breeding projects. In this study, Rychc was fine mapped and successfully cloned from S. chacoense accession 40-3. We demonstrated that Rychc encodes a TIR-NLR protein by stably transforming a diploid susceptible cultivar named AC142 and a tetraploid potato variety named E3. The Rychc conferred extreme resistance to PVYO, PVYN:O and PVYNTN in both of the genotypes. To investigate the genetic events occurring during the evolution of the Rychc locus, we sequenced 160 Rychc homologs from 13 S. chacoense genotypes. Based on the pattern of sequence identities, 160 Rychc homologs were divided into 11 families. In Family 11 including Rychc, we found evidence for Type I evolutionary patterns with frequent sequence exchanges, obscured orthologous relationships and high non-synonymous to synonymous substitutions (Ka/Ks), which is consistent with rapid diversification and positive selection in response to rapid changes in the PVY genomes. Furthermore, a functional marker named MG64-17 was developed in this study that indicates the phenotype with 100% accuracy and, therefore, can be used for marker-assisted selection in breeding programs that use S. chacoense as a breeding resource.


In this work, we present a novel method, named AV2vec, for learning audio-visual speech representations by multimodal self-distillation. AV2vec has a student and a teacher module, in which the student performs a masked latent feature regression task using the multimodal target features generated online by the teacher. The parameters of the teacher model are a momentum update of the student. Since our target features are generated online, AV2vec needs no iteration step like AV-HuBERT and the total training time cost is reduced to less than one-fifth. We further propose AV2vec-MLM in this study, which augments AV2vec with a masked language model (MLM)-style loss using multitask learning. Our experimental results show that AV2vec achieved comparable performance to the AV-HuBERT baseline. When combined with an MLM-style loss, AV2vec-MLM outperformed baselines and achieved the best performance on the downstream tasks.


Modern enterprises are large complex systems operating in an increasingly dynamic environment and are tasked to meet organisational goals by adopting suitable course of actions or means. This calls for deep understanding of the enterprise, the operating environment, and the change drivers reactive as well as proactive. Traditionally, enterprises have been relying on human experts to perform these activities. However, the sole reliance on humans for decision making is increasingly unviable given the large size of modern enterprises, fast dynamics, and the prohibitively high cost of incorrect decisions. To address this challenge, we propose a method that leverages existing enterprise modelling (EM) tools to improve the agility of organisational decision-making as well as reducing the analysis burden on human experts. The proposed method artifact employs a design science research methodology and the method is validated using a realistic industrial case to bring out its strengths as well as limitations.


Abstract With an increasing number of Coronavirus Disease 2019 (COVID‐19) cases outside of Hubei, emergency departments (EDs) and fever clinics are facing challenges posed by the large number of admissions of patients suspected to have COVID‐19. Therefore, it is of crucial importance to study the initial clinical features of patients, to better differentiate between infected and uninfected patients outside Hubei. A total of 116 patients suspected of having COVID‐19 who presented to two emergency departments in Anhui for the first time between 24 January 2020 and 20 February 2020 were enrolled in the study. The initial clinical data of these patients, such as epidemiological features, symptoms, laboratory results, and chest computed tomography (CT) findings were collected using a standard case report form on admission. Thirty‐two patients were diagnosed with COVID‐19; the remaining 84 patients were referred to as negative cases. The median age of the diagnosed patients was 46 years, but only 35 years for negative cases. History of exposure to Wuhan or COVID‐19 patients in the previous 2 weeks was observed in 63% of the diagnosed and 44% of negative cases. Median time from illness onset to ED admission was 5 days for all patients, diagnosed patients, and negative cases, respectively. Fever was observed in 27 (84%) and 57 (68%) diagnosed and negative cases, respectively. Nineteen (59%) diagnosed and 24 (29%) negative cases had lymphopenia on admission in ED. A chest CT scan on admission revealed the presence of pneumonia in the majority of the diagnosed patients (30 out of 32, 94%) and in 56 (67%) negative cases. Bilateral involvement and ground‐glass opacity (GGO) were present in 91% and 47% of the diagnosed patients. Thirty‐two patients were diagnosed with COVID‐19; the remaining 84 patients were referred to as negative cases. The median age of the diagnosed patients was 46 years, but only 35 years for negative cases. History of exposure to Wuhan or COVID‐19 patients in the previous 2 weeks was observed in 63% of the diagnosed and 44% of negative cases. Median time from illness onset to ED admission was 5 days for all patients, diagnosed patients, and negative cases, respectively. Fever was observed in 27 (84%) and 57 (68%) diagnosed and negative cases, respectively. Nineteen (59%) diagnosed and 24 (29%) negative cases had lymphopenia on admission in ED. A chest CT scan on admission revealed the presence of pneumonia in the majority of the diagnosed patients (30 out of 32, 94%) and in 56 (67%) negative cases. Bilateral involvement and GGO were present in 91% and 47% of the diagnosed patients.


This comprehensive qualitative examination of two groups of Canadian picture books, 57 titles published in 2005 and 120 titles published in 2015, offers comparative data that demonstrate patterns related to authors, illustrators, characterization, genres, audiences, and particular elements of Radical Change. Following book collection, content analysis was conducted with a consideration of Dresang's notion that books for children are evolving with respect to forms and formats, perspectives, and boundaries. Our process for analysis was developed from Berg's framework of systematic content analysis based on predetermined as well as emerging categories. There is much recent research exploring particular content in children's literature, supporting the central importance of literature in the classroom and community. Comparative Canadian studies across decades, however, are rare, and are increasingly important as a way to track and describe the changes that are taking place with respect to books for young people. It is interesting that in both 2005 and 2015, picture books tended to feature children as protagonists, with the highest number of books from the 2005 set utilizing the fantasy genre (at 34%) or realistic fiction (at 28%) and the highest number of books from the 2015 set occurring in non-fiction (at 34%, up from 16% in 2005) or fantasy (at 31%). Historical fiction in both years presented comparatively low, at 12% and 3%, respectively. Findings of this study support and extend the notion of Radical Change. The research team noted marked innovations within the 2015 group related to forms and formats, boundaries, and perspectives. Of particular note are the increasing numbers of books that present Indigenous content and perspectives. While many of the changes appearing in Canadian picture books between 2005 and 2015 might be predicted through the standard categories of Radical Change (Dresang, 1999), other findings also emerged that suggest new Radical Change considerations. Continuing to examine children's literature as artifacts of a culture can illuminate particular aspects of that culture and offer opportunities to engage authors, illustrators, and publishers in filling gaps where particular perspectives or topics are missing. Advocacy is important as children's literature continues to be a source of tension for what it portrays and presents as well as its missing voices. A knowledge of patterns and trends in relation to available content and resources supports classroom practice as well as encourages classroom research and further explorations of the evolving landscape of children's books.


Sign language is the preferred method of communication among the deaf and the hearing impaired people all over the world. Recognition of sign language can have varying degree of success when used in a computer vision or any other methods. Sign language is said to have a structured set of gestures in which each gesture is having a specific meaning.


Recently, there has been much attention on tools and tech- niques for visualizing and acquiring new knowledge and insights. In the VAST 2018 competition, one of the challenges is to discover the fraudulent group of employees at Kasios, a furniture manufacturing company. In this work, we use a graph-based approach that analyzes the data for suspicious employee activities at Kasios. Graph based approaches en- able one to handle rich contextual data and provide a deeper understanding of data due to the ability to discover patterns in databases that are not easily found using traditional query or statistical tools. We focus on graph based knowledge dis- covery in structural data to mine for interesting patterns and anomalies. Our approach first reports the normative patterns in the data, and then discovers any anomalous patterns associated with the previously discovered patterns. For visualizing the suspicious patterns, we also use the enterprise graph database Neo4j. Neo4j Browser provides a way to visualize graph struc- tures.


Respiration is a key vital sign used to monitor human health status. Monitoring respiratory rate (RR) under non-contact is particularly important for providing appropriate pre-hospital care in emergencies. We propose an RR estimation system using thermal imaging cameras, which are increasingly being used in the medical field, such as recently during the COVID-19 pandemic. By measuring temperature changes during exhalation and inhalation, we aim to track the respiration of the subject in a supine or seated position in real-time without any physical contact. The proposed method automatically selects the respiration-related regions from the detected facial regions and estimates the respiration rate. Most existing methods rely on signals from nostrils and require close-up or high-resolution images, while our method only requires the facial region to be captured. Facial region is detected using YOLO v3, an object detection model based on deep learning. The detected facial region is divided into subregions. By calculating the respiratory likelihood of each segmented region using the newly proposed index, called the Respiratory Quality Index, the respiratory region is automatically selected and the RR is estimated. An evaluation of the proposed RR estimation method was conducted on seven subjects in their early twenties, with four 15 s measurements being taken. The results showed a mean absolute error of 0.66 bpm. The proposed method can be useful as an RR estimation method.


Introduction: Understanding the virus transmission patterns and routes of transmission among Healthcare Workers (HCWs) is limiting the amplification events in health care facilities. Aim: To estimate the secondary infection rate and to describe the clinical presentation of infection and the risk factors for infection among healthcare worker contacts of Coronavirus Disease-2019 (COVID-19) cases. Materials and Methods: A descriptive cross-sectional study was conducted from June 2020 to July 2021, at a tertiary care centre, in central Kerala, India, among all the healthcare workers with exposure to a COVID-19 confirmed cases within the institution, between 15 July 2020 to 15 August 2020. Data including demographic details, information on contact and possible exposure with the COVID-19 infected patient was obtained using a questionnaire adapted from the World Health Organisation (WHO) questionnaire. Data was entered into Microsoft Excel and analysed using International Business Machines (IBM) Statistical Package for Social Sciences (SPSS) version 22.0. Results: A total of 433 healthcare workers (382 females and 51 males, mean age: 34.33±10.79 years) were found to be exposed to COVID-19 confirmed cases in the institution. The 21.1% of the healthcare worker contacts were exposed while working in non-COVID Intensive Care Unit (ICU) setting. Out of the 433 HCWs who were exposed to COVID-19 patients, 9 tested positive for COVID-19 (secondary infection rate was 2.07% with a Confidence Interval (CI) of 0.7-3.4%). All 9 of the positive HCWs were females, of which 88.89% were symptomatic. Conclusion: Healthcare workers are at risk of transmission of COVID-19 while providing care, hence further explorative studies, including serologic studies are recommended to further understand the epidemiology.


This article summarizes the conceptual-methodological aspects that are the basis for the formation of intercultural competence for secondary school students. The curricular approach to intercultural education is a relatively new field for Romania. More specifically, from the 2017-2018 school year it is studied in secondary classes, in this case in the sixth grade, one hour a week in the common trunk. In 2016, the new framework curricula for the secondary were adopted, approved by the order of the Minister of National Education and Scientific Research no. 3590 / 05.04.2016. These are applied from the 2017-2018 school year to the 5th and 6th grades, starting with the 2019-2020 school year to the 7th grade, and from the 2020-2021 school year to the 8th grade. The purpose of school education is based on the acquisition of key competencies by students and the formation of the profile of the graduate, able to integrate socially and professionally. One of the eight key competences contained in the 2006 Council of Europe Recommendation is the intercultural competence. In essence, intercultural competence is formed within several disciplines of study, but not only at the level of intercultural education. Thus, we claim that it is "polished" in an organized and systematic way through formal and non-formal activities by teachers. A series of teaching methods are the basis for the formation of intercultural competence in secondary school students are mentioned here. These have been successfully applied by the author in the classroom.


Do you love to read? Do you and your friends meet to discuss the most recent book? Get some tips, tools and tricks for finding your next great read! And, make your book discussion group one of the best. Find information about authors and criticism about their works.


If they are to meet the diverse needs of the ageing population, healthcare practitioners require a greater understanding of the experiences of older lesbians and gay men. The provision of respectful, compassionate, accessible healthcare is as important to them as it is to anyone else. However, to date only a limited number of studies of older lesbians and gay men have been undertaken in the UK, and therefore their experiences and needs have remained largely hidden. This paper reports on the findings of a participative research project, involving older lesbians and gay men, which was one of the firstto use this methodology within the UK. Key themes include issues of 'coming out' and concerns about heterosexism in care. These are discussed in terms of the need to adopt a more person-centred approach within healthcare that promotes an emphasis on valuing individual identity and diversity.


Sherborne Developmental Movement is a methodology that uses creative movement and physical contact to stimulate children's development. This methodology is assumed to contribute to improving attachment between child and parent. At this moment Jarabee, a welfare organisation for children in Twente, the Netherlands, currently provides Sherborne Developmental Movement as a part of the Intensive Orthopedagogical Family Treatment (Intensieve Orthopedagogische Gezinsbehandeling, IOG). IOG is an intensive family preservation program for families with multiple problems. This program is designed to increase a family's resilience and burdens (empowerment). The study examines the added value of the Sherborne Developmental Movement within the IOG. In this survey two groups have been compared. The Sherborne group consisted of eight families that received IOG in combination with Sherborne Developmental Movement. The control group consisted of five families that received regular IOG. To try and objectively assess the effects of treatment the following measures were used: satisfaction with treatment, reduction in behavioural problems of the child, reduction in stress perception of the mother and improvement in contact between parents and child. Results are based on interviews with the mothers and on various questionnaires (CBCL/SDQ and NOSI/NOSI-K)

 The study found that the effectiveness of Sherborne in combination with IOG is not clearly different or improved compared to the effectiveness of regular IOG. The families in both groups appeared satisfied with the treatment and indicated improvements in the contact between parent and child. Half of the mothers who received Sherborne Developmental Movement attributed improvements that occurred in the family specifically to this methodology. The other mothers, however, experienced comparable improvements and attributed this to other interventions within the IOG. No clear effect on the behaviour of the child and the stress perception of the mothers due to Sherborne Developmental Movement has been demonstrated. However, data appeared to be insufficient to exclude a positive effect of Sherborne Developmental Movement.

 Another finding from the study is that Sherborne Developmental Movement is not suitable for all parents and children. It is possible that added value can be demonstrated through further research examining which parents and children benefit from this methodology. The social worker must also support the theory and activities of Sherborne Developmental Movement. At this moment it does not seem meaningful to train all social workers in Sherborne Developmental Movement. The provision of Sherborne Developmental Movement as a supplementary intervention within the IOG, however, can indeed be valuable for individual families.


Background Approximately in 5 to 10% of FMF patients there is insufficient response and/or intolerance to colchicine treatment. Several reports have pointed out the efficacy of IL-1 blockade in colchicine resistant FMF subgroup. Objectives To review the patients followed in our center with FMF who received Anakinra, an anti-IL-1 receptor antagonist, in terms of outcome and side effects. Methods 43 FMF patients who were treated with Anakinra were retrospectively reviewed with regard to indication, effect on disease activity and acute phase response, adverse events and patient global assessment. Results There were 43 patients with FMF (20 M/ 23 F) who were treated with Anakinra for various indications (colchicine resistant recurrent febrile attacks in 39, colchicine related side effects in 3, both in 1). The mean age of the patients was 31.73±9.56 years. The mean duration of the disease was 19.90±10.52 years. There were various co-existing pathologies among this study group like Ankylosing Spondylitis (4), Psoriasis (1), Behçet's disease (1), Gout (1), Vasculitis (1), Adult-onset Still's disease (1), Polyarthritis Nodosa (1) and Celiac disease (1). The mean colchicine dose was 1.84±0.31 mg/d. As for the dosage, 35 patients were on 100 mg/day, 6 were 100 mg on alternate days, 2 were on 200 mg/day. The mean duration of anakinra treatment was 10.76±13.64 months. After the initiation of anakinra 29 patients became attack-free, 9 patients reported more than 50% decrease, 3 patients less than 50% decrease, and 2 patients no change in the frequency of the attacks. Mean patient global assessment decreased from 7.55±2.34 to 2.82±2.63 under Anakinra treatment (p<0.001). As for the adverse events, eight patients (%18) had allergic reactions under Anakinra treatment (severe disseminated rash in 1 patient and severe injection site reaction in 4 patients and tolerable injection side reaction in 3) which necessitated termination of treatment in 5 patients. Anakinra was stopped because of genital warts and urinary tract infection in one other patient. Worsening of psoriatic lesions was observed in another patient. There were no adverse events in the remaining 41 patients during the course of treatment. On the other hand, treatment was terminated due to inadequate response in 11 (25%), remission in 2 and patient preference in 3 patients. Nineteen patients are still on Anakinra treatment for 10.09±14.51 months. Conclusions Anakinra is an effective and relatively safe alternative treatment in FMF patients with inadequate response or intolerance to colchicine, however approximately one fourth of the patients stop anakinra for insufficient response. Disclosure of Interest None declared


Individuals frequently exploit "flexibility" built into decision environments to give less. They use uncertainty to justify options benefiting themselves over others, they avoid information that may encourage them to give, and they avoid the ask itself. In this paper, we examine whether a reluctance to give may arise even when such explicit flexibility is absent. We investigate whether merely alerting individuals to an upcoming prosocial ask — that is neither avoided nor occurs in an environment with flexibility — results in reduced prosocial behavior. That is, we investigate whether individuals use time to quickly find ways to decline prosocial asks and thus whether surprising individuals with prosocial asks increases compliance. Results from a field study and complementary online studies provide a clear answer: yes.