Protocols for cooling or freezing goat semen usually recommend centrifugation for seminal plasma removal. However, little is known about the effect of this process on goat sperm viability and functionality. The present study evaluated the effects of centrifugation force on the plasma membrane, acrosomes, and DNA integrity of goat semen. Four ejaculates from each of the four different Anglo Nubian male goats were used. Semen samples were obtained using artificial vagina, and immediately after collection, ejaculates were diluted using Ringer's sodium lactate solution and split into three groups: Control (CG, without centrifugation), G1 (centrifugation 600 x g/10 min), G2 (centrifugation 1200 x g/10 min). After centrifugation, seminal plasma was removed, the sperm pellets were resuspended using Tris-egg yolk extender (80 x 106 spermatozoa/mL) and the sperm morphology was analyzed. Samples were cooled at 5°C for 5, 24, 36, and 48 h and then sperm plasma membrane and acrosome integrity (PMAI, %) and sperm DNA fragmentation index (SDF, %) were evaluated at each time-point, using a flow cytometer. Additionally, sperm movement was determined using computer semen analysis (CASA) after 5, 24, and 48 h of refrigeration period. The semen centrifugation did not induce additional sperm morphology defect or reduction in sperm kinetics in the experimental groups. Differences were not observed (p > 0.05) in PMAI and SDF among different groups, in any of each timepointof the cooling process. In conclusion, centrifugation, even at high speeds, did not affect goat sperm integrity and functionality when submitted to refrigeration process.


While it has long been recognized that software process improvement requires measuring both the process and its performance, experience has also shown that few universal metrics exist. The most effective measurement tools are specialized to some aspect of the task or domain being measured. The metrics as measures of code have often been related to external factors, such as software quality in the sense of defects. Software metrics studies often use single snapshots of a software project. Examining a project over a longer time frame allows consideration of other software quality facets, such as reuse and maintainability.


When dealing with complex environmental datasets, it is also difficult to establish the strength of the input-output relation among variables. Correlation analysis may yield a preliminary indication, but is limited to the linear case. Mutual Information (MI) is a more powerful method which can establish input-output dependence regardless of the nature of their interaction. However, to avoid the heavy computational demand of MI, a simple method is presented based on fuzzy clustering and Bayes' rule. After a preliminary conditioning phase, the data are grouped by fuzzy clustering and approximated with the value of the most relevant centroid. Then the prior and likelihood probabilities are computed by frequentist methods by counting the occurrences of each sample with respect to the precomputed clusters. In this way the MI can be quickly computed, to yield the relative importance of the informative content of each input.


This article describes the role of Hinduism in modern Indonesia and the ways in which it has been adapted to fit the government9s definition of religion as a prophetic monotheism with revealed texts and a universal ethic. It gives a brief background on Indonesian history and analyzes the structure and theology of Agama Hindu Dharma Indonesia. It discusses whether a governmental reorganization of an ancient religion can be considered a new religious movement, and some approaches that might be useful from the field of religious studies. It suggests that the definition of new religious movement be changed to fit the case in which a modern religion considered to be a revealed religion also acts as a civil religion.


Most of the new and interesting services that can be implemented over the B-ISDN networks include the transmission of variable bit rate (VBR) video traffic. Generally, the nature of this kind of services implies the need of a high quality of service (QoS). Unfortunately, to provide this high QoS to the VBR video traffic with a high efficiency in bandwidth utilization is not a trivial problem. This is due to the bursty nature of the VBR video traffic on different time scales. This traffic behavior is named self-similarity. In order to improve channel utilization, some services with bandwidth renegotiation have been proposed. In this work, a new mechanism to accomplish bandwidth renegotiation over ATM networks for VBR video traffic is presented. The mechanism is based on a previous characterization of the MPEG VBR video traffic at the group of pictures (GoP) level by means of a bidimensional Markov modulated fluid process (MMFP). A new element, with supervision and control functions, is proposed and validated. Moreover, the achieved benefits in terms of the bandwidth gain that can be expected with the renegotiation system are analytically computed using the fluid flow approximation. Finally, the applicability of the supervisor and controller elements and its parameters are studied using four long MPEG VBR sequences.


This paper presents a mathematical model investigating the physics behind pressure-compensating (PC) drip irrigation emitters. A network of PC emitters, commonly known as drip irrigation, is an efficient way to deliver water to crops while increasing yield. Irrigation can provide a means for farmer to grow more sensitive, and profitable crops and help billions of small-holder farmers lift themselves out of poverty. Making drip irrigation accessible and economically viable is important for developing farmers as most face the challenges of water scarcity, declining water tables and lack of access to an electrical grid. One of the main reasons for the low adoption rate of drip irrigation in the developing world is the relatively high cost of the pumping power. It is possible to reduce this cost by reducing the required activation pressure of the emitters, while maintaining the PC behavior. The work presented here provides a guide of how design changes in the emitter could allow for a reduction in the activation pressure from 1 bar to approximately 0.1 bar. This decrease in the activation pressure of each emitter in turn decreases the system driving pressure. This reduction of driving pressure will decrease the energy need of pumping, making a solar-powered system affordable for small-acreage farmers.This paper develops a mathematical model to describe the PC behavior in a commercially available emitter. It is a 2D model that explains the relationship between the pressure, structural deformation and fluid flow within a PC emitter. A parametric study has been performed to understand the effects of geometric and material parameters with regards to the activation pressure and PC behavior. This knowledge will help guide the designs and prototypes of optimized emitters with a lower activation pressure, while also providing the PC behavior.Copyright © 2015 by ASME


Shape memory alloys (SMA) are of increasing interest in research and industry due to their outstanding properties. Besides the shape memory effect (SME), these properties include high mechanical strength and biocompatibility, which is of high importance for medical applications. The SME offers new possibilities in the design of implantable components, e.g. in the field of fracture healing. Conventional implants, which are connected to bones, cannot change mechanical properties such as stiffness, length and torsion resistance without additional surgeries once implanted. Implants made of SMA instead may change their properties by contactless application of heat from the outside by induction. This paper presents a possible design for an osteosynthetic implant made from NiTi elements. Obviously, it is necessary to machine these elements from the NiTi sheet material by suitable processing methods that allow for a high precision and keeping the SME. Therefore, laser welding has been investigated due to its local energy distribution and small heat affected zones. Temperature measurements and metallographic investigations are presented to show the affected area where the SME is lost. Using a specially designed induction coil, the remaining SME is evaluated, the shape change is detected, and the design of the implant is iteratively improved.Shape memory alloys (SMA) are of increasing interest in research and industry due to their outstanding properties. Besides the shape memory effect (SME), these properties include high mechanical strength and biocompatibility, which is of high importance for medical applications. The SME offers new possibilities in the design of implantable components, e.g. in the field of fracture healing. Conventional implants, which are connected to bones, cannot change mechanical properties such as stiffness, length and torsion resistance without additional surgeries once implanted. Implants made of SMA instead may change their properties by contactless application of heat from the outside by induction. This paper presents a possible design for an osteosynthetic implant made from NiTi elements. Obviously, it is necessary to machine these elements from the NiTi sheet material by suitable processing methods that allow for a high precision and keeping the SME. Therefore, laser welding has been investigated due to its loca...


Urban production in the sense of producing and processing material goods in densely populated areas (Brandt et al. 2017) has been gaining in importance again in recent years. Reasons for this include more resource-efficient and lower-emission manufacturing processes, shorter transport and work routes, or proximity to research and educational institutions. While many studies on urban production refer to agglomeration areas, there is a lack of knowledge on less densely populated regions and also on small and medium-sized cities. This article will take a look at this focus and present the initial findings of a research project that identifies framework conditions and networks together with companies in small and medium-sized towns in Saxony.


In the summer of 2005, while Atlantic hurricanes battered coastlines from Cuba to Mexico, the Eastern Caribbean baked under a relentless sun with barely a breeze to cool the air. Tourists and locals alike wilted in the heat, and below the sea, marine life and corals in particular suffered as well. The windless calm settled in just as a buildup of unusually warm water began accumulating in the region. Ordinarily, easterly trade winds would have churned the sea, helping it to cool. But thanks to an unprecedented heat wave beginning in May—the result of a confluence of factors related to climate change, scientists say—water temperatures in the Eastern Caribbean climbed and stayed high for months, reaching levels that by September would be warmer than any recorded in 150 years.

The heat disturbed a symbiotic partnership that coral animals normally maintain with a type of algae called zooxanthellae. Zooxanthellae supply corals with essential nutrients produced by photosynthesis, particularly carbon, in return for the shelter and access to sunlight provided by the reefs. The algae also impart color to the corals, which themselves are colorless. But as sea temperatures rose, the zooxanthellae disappeared, leaving their carbon-deprived hosts behind to starve. The reefs turned snow white, the color of the underlying stonelike structures they had built up over centuries, in a phenomenon known as coral bleaching.

As the heat wave progressed, it left a trail of bleached reefs the likes of which had never been seen in the Caribbean. By year's end, coral cover ranging from 90% in the Virgin Islands to 52% in the French West Indies was affected.

Coral bleaching isn't always fatal—if water temperatures cool in time, the zooxanthellae might return, allowing corals to recover. But in parts of the Eastern Caribbean, the reefs never got a chance. Almost as soon as their recovery started, they were attacked by diseases affecting a range of coral species down to 60 feet. By 2007, roughly 60% of the coral cover in the Virgin Islands and 53% in Puerto Rico's La Parguera Natural Reserve was dead—an unprecedented tragedy.

The Eastern Caribbean disease outbreak came on the heels of what's been a rough several decades for coral reefs worldwide. Long suffering from land-based pollution, habitat destruction, and overfishing, coral reefs now must also contend with climate change, which has accelerated their global decline. This puts a wealth of biodiversity at risk. Reefs support up to 800 types of coral, 4,000 fish species, and countless invertebrates. Reef-dwelling species numbering in the hundreds of thousands may not even be catalogued yet, some scientists speculate.

The implications of these declines could be as disastrous for human health as they are for marine life. Globally, reefs provide a quarter of the annual fish catch and food for about 1 billion people, according to the United Nations Environment Programme. Reefs protect shorelines from storm surges, which could become more powerful as sea levels rise with climate change. Tourism—a mainstay of coastal economies in the tropics, worth billions in annual revenue—could suffer if reefs lose their appeal.

Reefs are also a long-standing source of medicines to treat human disease. Being attached to reefs, corals and other immobilized marine animals can't escape predators, so they deploy a range of chemical compounds to deter hunters, fight disease, and thwart competing organisms. Two antiviral drugs (vidarabine and azidothymidine) and the anticancer agent cytarabine were developed using compounds extracted from Caribbean reef sponges. Another product called dolastatin 10, isolated from the sea hare (Dolabella auricularia) of the Indian Ocean, has been investigated as a treatment for breast and liver cancers and leukemia. Many more lifesaving medicines and useful chemical products could one day be derived from reef dwellers, experts say.

Saving these ecosystems is imperative on a range of levels, says Caroline Rogers, a marine ecologist with the U.S. Geological Survey in St. John, U.S. Virgin Islands. "We have to save them for economic, ecological, aesthetic, and even spiritual reasons," she says. "People need to feel connected with nature and with systems that are bigger than they are. Coral reefs are awe-inspiring—we're losing something that we barely understand."


The purpose of this study is to clarify characteristics of the grief process, and the adjustment to a new life of an elderly woman who encountered the unexpected death of her spouse at home. Semi-structured interviews were conducted and data were analyzed using Steps for Coding and Theorization (SCAT). The elderly woman experienced difficulties in thinking and acting in an ordered way. The response of the police and the autopsy imaging procedure had confused and irked her, and she had not been given much time to bid her husband farewell before his body was removed. Features related to the unexpected death scene were "unforgettably shocking" for her, but more that, the personality and memories of her husband became "unforgettably important and precious." This was one of the facilitative factors of grief work. Her current life was constructed as a mixture of "a life that can be continued without being aware of the absence of the spouse," "a life of recognizing the absence of the spouse," and "a life of acquiring a new object of love or a new role." She adjusted to a new life, by rendering various matters and the local community, such as traditional customs of death and cooperation of locals, useful as the facilitative factors of grief work. As the size and role of the local community had diminished, it became evident that it was necessary to focus on other facilitative factors of grief work. This included resilience, prior relationship with the spouse, family's functioning, and role acquisition.


There has recently been a rapid expansion of interest in the econometrics of program evaluation, both within Australia and around the world. We provide a review of the key issues and recent developments in this field. A central feature of recent developments is the attempt to allow for program impacts that vary across individuals. This contrasts with earlier econometric approaches that implicitly assumed a homogeneous treatment effect. We survey alternative nonexperimental estimation strategies and note that they can be characterised by (1) an assumption about how untreated outcomes vary across individuals: this assumption in turn suggests how the counter-factual untreated outcomes of program participants should be estimated, and (2) the way in which the estimator aggregates or weights the program impacts of different individuals in the treatment group. We also emphasise the importance of good data. Copyright 2003. The Economic Society of Australia.


How much? What kind? Should I? These are questions often asked by pregnant women concerning their exercise and sport activities during pregnancy, but there is, to date, very little research in the area of biomechanics and pregnant women in sport. According to Dr. Lynne Pyrie (1987), cycling is a sport made for pregnant women. Cycling was found to strengthen the pelvic floor muscles used to propel the baby through the birth canal. However, Freyder (1989) described how with the progression of pregnancy, the center of gravity was shifted back over the pelvis to prevent falling forward causing a new, unstable posture. It is also mentioned in the literature the effects of the hormones progesterone and relaxin which cause softening of the ligaments and thus less joint stability. The purpose of this study was to compare the biomechanical changes that occurred during and following pregnancy in the sport of cycling. The subject in this study was an avid cyclist and was familiar with and trained on bicycle rollers. While cycling on a set of bicycle rollers, the subject was videotaped (60 fps) in the frontal and sagittal planes three times from two to seven months in gestation and two times during the three months after childbirth. Each performance was then digitized and analyzed using the PEAK Performance 2- dimensional movement analysis system interfaced with a Panasonic AG-7350 recorder, Sony PVM-1341 monitor, and Zenith 486 microcomputer. The horizontal and vertical linear displacements of the center of gravity and angular displacements of the right and left hips were compared. It was found that as pregnancy progressed: (a) horizontal and vertical displacements of the center of gravity increased as well as variability, (b) angular displacements of the hips increased, and (c) additional external stabilization of the performer was required. It was concluded that as pregnancy progressed, stability on the bicycle decreased gradually to the point that during the last trimester additional support was required. This research adds to the literature which supports pregnant women continuing their exercise programs that are non-weight bearing during the first two-thirds of their pregnancy but also supports the literature that cautions about the increased risk of injury due to greater instability during the latter stages.


A new nematode species of the genus Parasitodiplogaster was recovered from syconia of Ficus religiosa at the Guangxiao Temple, Guangzhou, China. It is described herein as P. religiosae n. sp. and is characterised by possessing the longest and thinnest spicule of all currently described males in the genus, an elongated laterally "ε-shaped" and ventrally rhomboid-like gubernaculum, a stoma without teeth, consisting of a ring-like cheilostom with indistinct anteriolateral projections, a tube-like gymnostom and a funnel-like stegostom, monodelphic with a mean vulval position of 66%. There are three pre-cloacal and six post-cloacal male genital papillae with the arrangement P1, P2, P3, (C, P4), P5, P6d, P7, P8, P9d, Ph. This new species was easily differentiated from other members of the genus by DNA sequences of partial small subunit rRNA gene (SSU) and the D2-D3 expansion segments of the large subunit rRNA gene (LSU). Phylogenetic analysis also corroborated its reasonable placement within a well-supported monophyletic clade with other Parasitodiplogaster species and within the australis-group that includes P. australis and P. salicifoliae that are all associates of fig wasp pollinators (Platyscapa sp.) of figs of the subsection Urostigma.


During the past two decades, increased research attention has been directed toward understanding the adolescent who is confronted with challenges such as poverty or substance abuse. Accordingly, pediatric oncology nurse researchers and clinicians are increasingly becoming interested in understanding the experience of resilience in the adolescent with cancer. Research and clinical reports have shown that many adolescents with cancer are resilient even though they experience multiple stressors. That is, even in the face of adversity, they develop into well-adapted individuals. The purpose of this article is to develop a conceptual understanding of resilience in adolescents with cancer. Areas that are addressed include the following: (a) an historical overview of the major theoretical paradigms used to understand the pediatric cancer experience; (b) a summary of definitional issues related to the construct of resilience; and (c) a conceptual model of resilience. New insights are provided that may lead pediatric oncology nurse researchers and clinicians to examine resilience in the adolescent with cancer from a variety of perspectives.


We consider the problem of bipartite community detection in networks, or more generally the network biclustering problem. We present a fast two-stage procedure based on spectral initialization followed by the application of a pseudo-likelihood classifier twice. Under mild regularity conditions, we establish the weak consistency of the procedure (i.e., the convergence of the misclassification rate to zero) under a general bipartite stochastic block model. We show that the procedure is optimal in the sense that it achieves the optimal convergence rate that is achievable by a biclustering oracle, adaptively over the whole class, up to constants. The optimal rate we obtain sharpens some of the existing results and generalizes others to a wide regime of average degree growth. As a special case, we recover the known exact recovery threshold in the $\log n$ regime of sparsity. To obtain the general consistency result, as part of the provable version of the algorithm, we introduce a sub-block partitioning scheme that is also computationally attractive, allowing for distributed implementation of the algorithm without sacrificing optimality. The provable version of the algorithm is derived from a general blueprint for pseudo-likelihood biclustering algorithms that employ simple EM type updates. We show the effectiveness of this general class by numerical simulations.


Glamorous "Vogue" magazine editor-in-chief Anna Wintour is the most powerful style-maker in the world. She influences designers, wholesalers, and retailers globally from Seventh Avenue to the elegant enclaves of L:Avenue Montaigne. And every month millions of "Vogue" readers turn the pages of the chic and trendy style wish book that she has controlled with an iron hand in a not always so velvet glove. Now in her mid fifties, as she nears her remarkable quarter century at the helm of "Vogue", comes this revealing biography that will shock and surprise both Anna's fans and detractors alike. Based on scores of interviews, "Front Row" chronicles the insecure and creative climb of this powerhouse to the top of the bitchy, competitive fashion magazine world, exposing for the first time how she artfully crafted and reinvented herself along the way.


A sample of 23 million BB events collected with the BABAR detector at the PEP-II collider is used in a search for direct CP violation in charmless two-body B decays, quasi two-body B decays, and the radiative penguin decays B → K * γ. No evidence for direct CP violation is found in the considered modes and 90 % confidence level limits are reported. We also present a limit on the branching fraction of the decay B 0 → γγ.


Summary
A wild-type isolate (WT) of soil-borne wheat mosaic virus (SBWMV, isolate JT) (RNA I 6·9 kb and RNA II 3·6 kb) was successively transferred to wheat plants by mechanical inoculation and a deletion mutant (DM) (RNA I 6·9 kb and RNA II 2·1 kb) was produced. In wheat germ extracts, RNA I of both WT and DM directed synthesis of polypeptides having mol. wt. of 220000 (220K) and 150K, and RNA II of both WT and DM directed synthesis of 25K and 19K polypeptides. Incubation in wheat germ extracts of WT or DM virions purified with an alkaline buffer also gave 220K, 25K and 19K polypeptides as major products and a 150K polypeptide as a minor product. In rabbit reticulocyte lysates, RNA I of both WT and DM directed synthesis of only the 220K polypeptide, whereas WT RNA II produced 100K, 46K, 25K and 19K polypeptides and DM RNA II, 31K, 25K and 19K polypeptides. SBWMV DM antiserum precipitated polypeptides of 100K, 31K, 25K and 19K but not 220K and 46K. The 19K polypeptide was identified as the capsid protein from its electrophoretic mobility and its reaction with antiserum to virus particles. Thus, the differences between the in vitro translation products of WT and DM SBWMV were confined only to those coded by RNA II.


Border protection is thought to be a major impediment to trade, especially in agriculture. There are also many other forces shaping the global network of partner trade. This study uses the generalized gravity framework to distinguish among the different drivers of trade. The analysis focuses on dyadic determinants that either resist or aid partner trade in total merchandise and in selected agricultural markets. The global dataset used consists of bilateral trade among 70 countries in 1986, 1996, 2000, and 2004. Collectively, the 70 countries account for 85 percent of the world's cross-border trade in agriculture and 96 percent of its GDP. Empirical results lend support to the Heckscher-Ohlin explanation of trade, namely that relative factor endowments motivate cross-border trade. The results also show that tariff protection has not had an appreciable effect on either total merchandise or aggregate agricultural trade. However, trade in specific agricultural goods, such as meat and rice, was found to be severely constrained by the presence of bilateral tariffs.


Background Grief is a normal response following a loss and not all people who are bereaved will need support or counselling [Graves, 2009]. Bereaved people approach their grief in a variety of different ways. Terry Martin and Kenneth Doka recognised that there are different patterns to grieving, these might or might not be related to male or female gender characteristics, and be more about coping strategies that a person develops. The traditional way of formally supporting people who have been bereaved is telephone support or face-to-face/one to-one counselling. Many people who are bereaved who consider support choose not to access these traditional services due to their own individual way of grieving; different coping strategies, and limited alternative support services available. Results In response to the literature and requests from bereaved family members, Marie Curie Hospice, West Midlands has developed a broader range of bereavement support services that has scope to encompass individual ways of grieving. These include the traditional one-to-one support; family support sessions and remembrance services. In addition the Hospice Bereavement Support service also offers a hospice choir; a Walk and Talk group; a Men's Shed group, a Bereaved Social Group and a Children's Therapeutic Group. The broader range of support provides greater choice where people who have been bereaved can come together regardless of what point on the bereavement pathway they are on and meet others who are going through a similar life event. The uptake of the new services has been positive, with activity continually increasing. More men are now accessing bereavement support services and with the on-going development of a volunteer team, we are now able to offer children the opportunity to meet together and share their own experiences in a safe environment.


Data, characterising quantitatively the effect of substituents on the reactivity and physicochemical properties of five-membered nitrogen-containing heterocyclic compounds, which have accumulated in the literature during the last 15 years, are compiled in the review and discussed. The possibility of applying the Hammett and Jaffe equations in the determination of the direction of transmission of the electronic effects of substituents is analysed and the likely usefulness of this approach to the study of electronic influences by taking into account separately the inductive and resonance constants is demonstrated. The bibliography includes 215 references.


Steel structures have been allowed to have fatigue damage tolerance in fact. If it would be assessed whether fatigue crack is growing or not and How fast fatigue crack is propagating, we should make a rational decision on methods and a period of reinforcement in the maintenance. In this study, fatigue crack growth tests on two kinds of through-thickness cracked steel plates and a out-of-plane gusset welded joint were conducted to evaluate fatigue crack growth rate using the COD(Crack Opening Displacement), and COD measurement using strain gauges was examined to offer a practical method. As a result, we proposed a reasonable assessing method for fatigue crack growth rate using the COD and it was experimentally proved practical to estimate the COD through measuring strains.


Aryl sulfides are common and ubiquitous motifs in natural products and pharmaceuticals. Presented herein is the first example of the synthesis of diaryl sulfide derivatives via dehydroaromatization under simple basic conditions. Dehydroaromatization reactions between indolines or cyclohexanones with aryl thiols are performed in an environmentally benign manner by the use of air (molecular oxygen) as the oxidant, with producing water as the only byproduct. The methodology provides a simple and practical route to diaryl sulfides with wide functional groups in good to excellent yields. Preliminary mechanistic studies suggest that a radical process is involved in the transformation.


Both episcopal and abbatial authority were of fundamental importance to the development of the Christian church in Anglo-Saxon England. Bishops and heads of monastic houses were invested with a variety of types of power and influence. Their actions, decisions, and writings could change not only their own institutions, but also the national church, while their interaction with the king and his court affected wider contemporary society. Theories of ecclesiastical leadership were expounded in contemporary texts and documents. But how far did image or ideal reflect reality? How much room was there for individuals to use their office to promote new ideas? The papers in this volume illustrate the important roles played by individual leading ecclesiastics in England, both within the church and in the wider political sphere, from the late seventh to the mid eleventh century. The undeniable authority of Bede and Bishop Athelwold is demonstrated but also the influence of less-familiar figures such as Bishop Wulfsige of Sherborne, Archbishop Ecgberht of York and St Leoba. The book draws on both textual and material evidence to show the influence (by both deed and reputation) of powerful personalities not only on the developing institutions of the English church but also on the secular politics of their time. Contributors: Alexander R. Rumble, Nicholas J. Higham, Martyn J. Ryan, Cassandra Rhodes, Allan Scott McKinley, Dominik Wassenhoven, Gale R. Owen-Crocker, Debby Banham, Joyce Hill.


Battelle has completed Phase I of the DOE program to evaluate cleaning methods for the Nested Fiber Filter (NFF). The results of the investigations into fly ash bonding mechanisms, and mechanical vibration and acoustic vibration techniques led to the conclusion that acoustic cleaning with a pulse combustor is the preferred integrated system for high-temperature, high-pressure applications.


Introduction: In order to address health disparities, it is important to understand how vulnerable individuals seek information. This study used an adapted version of the Health Information National Trends Survey (HINTS) administered in English, Spanish, and Chinese to describe the behaviors and preferences of a diverse group of vulnerable urban residents. Methods: We administered a modified HINTS survey in English, Spanish, and Chinese and used purposive sampling to ensure 50% were non-English speakers evenly divided between Spanish and Chinese speakers, and 50% of English-speakers identified as Black. We used multivariable logistic regression to determine characteristics associated with sources used for health information and preferences for delivery of health information. Results: Among 1027survey respondents (514 English, 256 Spanish, 260 Chinese), 55% had adequate health literacy, and 50% reported household income <$20,000, but 77% reported owning a smartphone. A plurality sought health information on the Internet (39%) or from a health care provider (36%). In multivariable analyses, smartphone ownership predicted higher odds of seeking health information on the Internet [odds ratio, (OR) 2.98; 95% confidence interval (CI), 1.81–4.91]. Participants most preferred email (41%) and brochures (40%) for delivery of health information, but non-English survey respondents were less likely to prefer email: Spanish (OR, 0.30; 95% CI, 0.11–0.83) and Chinese (OR, 0.25; 95% CI, 0.09–0.71). Smartphone ownership predicted an email preference (OR, 2.19; 95% CI, 1.43–3.36). Conclusions: Among vulnerable populations, smartphone ownership and language preferences impact preferences for seeking and receiving health information. These preferences need to be considered in designing health messages.


Background: We aimed to verify safety and effectiveness of certoparin real-world use and to identify predictors of thromboembolic events or bleeding. Methods: This was a non-interventional study documenting patients at hospital- or office-based physicians. Results: Patients' (n = 1407) mean age was 53.7 ± 16.1 years. Reason for certoparin use was prophylaxis of venous thromboembolism in 1331 (94.6%) patients and treatment in 76 (5.4%) patients. In only 11.4% of those receiving prophylaxis and 13.2% of those receiving treatment dosing, duration and schedule of certoparin were within label. There were 2 patients with deep venous thrombosis ([DVT], no pulmonary embolism [PE]), and 51 patients (3.8%) with minor (nonmajor) bleeding complications in patients receiving prophylaxis. Two patients treated with certoparin had recurrent DVT and one had PE (one patient with minor bleeding). Conclusions: Certoparin is very effective in real world. This also applies to patients in whom clinical decision making leads to an alteration of recommended application.


The demand and consumption of energy is expected to be doubled in the coming 50 years and meanwhile the energy cost is also expected to rise significantly. Fossil fuels, currently the leading source of energy, subsidize a lot of CO2 to the environment causing many environmental issues including greenhouse effect. To address these challenges, 'H2' based economy is one of the vital scientific and political debate being a cleanest of all the fossils fuel with highest mass energy density (120-140 MJ/Kg). Water, being a renewable source, is a promising candidate in this regard because of its ability for the production of H2 (HER) and O2 (OER). OER is the 4e�? multistep process with a demand of 240-600 mV extra energy, which makes it more sluggish kinetically. Until now, RuO2 and IrO2 are among the best electrocatalysts for OER with minimum overpotential. It is generally believed that molecular nanoclusters (MNCs) are the strongest candidate in this regard because of their unique optical, catalytic, magnetic and electronic properties. These unique properties due to various factors including electronic shell closing (Jellium model), geometric shell closing, high surface to volume ratio and super atomic behavior unlike their bulk counterparts and are thus worth exploring not only to enhance their electrocatalytic activity due to their synergistic effect but also their expected recycling potential. In this talk, I will present our recent results on the development of earth abundant and cost-effective transition metal/metal oxide nanoclusters based electrocatalysts and their hybrid, which have a great potential to make water a sustainable source of energy


Global navigation satellite systems (GNSS) are widely used for the localization and the navigation of unmanned and remotely operated vehicles (ROV). In contrast to ground or aerial vehicles, GNSS cannot be employed for autonomous underwater vehicles (AUV) without the use of a communication link to the water surface, since satellite signals cannot be received underwater. However, underwater autonomous navigation is still possible using self-localization methods which determines the relative location of an AUV with respect to a reference location using inertial measurement units (IMU), depth sensors and even sometimes radar or sonar imaging. As an alternative or a complementary solution to common underwater reckoning techniques, we present the first results of a feasibility study of an active-imaging-based localization method which uses a range-gated active-imaging system and can yield radiometric and odometric information even in turbid water.


Multiple way tables in which items can be placed on several buckets are used in many computing applications. Some examples are cache memories and multiple hash tables structures. In most cases, the items are stored in electronic memories that are prone to soft errors that can corrupt the stored items. To avoid data corruption, memories can be protected with a parity bit or with an error correction code. It is shown that most single bit errors can be detected in multiple way tables without adding a parity bit. This can be done by placing the items in a predetermined order in the multiple ways of the table.


This paper presents a cost-function based predictive voltage control strategy with a prediction horizon of two samples to effectively control the output voltage of three-phase four-leg inverter used for the standalone power systems. The three-phase inverter with an additional leg is developed to deliver symmetrical sinusoidal three-phase voltages irrespective of the arbitrary consumer load profiles. The proposed controller uses the discrete model of the inverter and RLC filter for two-step prediction of output voltage for each switching state of the inverter. The control method chooses a switching state that minimizes the error between the output voltage and its reference. The proposed controller offers an excellent reference tracking with less voltage harmonic distortion for balanced, unbalanced and nonlinear loading conditions. The feasibility of the proposed control scheme has been verified by MATLAB/Simulink.


Severe rubs between gas turbine blades and engine casings can in extreme cases result in damaging blade vibration levels and rapid loss of casing lining material. Even for more minor rubs, the wear in the lining material will result in increase tip gaps and a consequent loss in efficiency. Major rub events are extremely rare in practice, and there is seldom any useful diagnostic evidence of the root cause of the behaviour. Moreover, traditional analysis methods are not suitable for exploring the wide range of potential conditions under which an unstable vibration response might be initiated. A new modelling technique has been developed for modelling blade casing rubs which includes a detailed model of the interaction with liner wear. The method is time based, but is very efficient, enabling a wide range of initiating conditions to be explored. A series of examples have been developed to firstly: demonstrate the method is robust and reliable, and secondly: to investigate potential interaction phenomena under representative simulated conditions. The method has been applied to a real blade example, for which severe wear is known to have occurred. The method predicts that instability may occur above a threshold level of tip rub severity, and also demonstrates the improvement in an alternative blade design for which rub tolerance is known to be superior.© 2011 ASME


The squashing factor of a magnetic field, Q, is commonly used as an indicator of magnetic reconnection, but few studies seek to evaluate how reliable it is in comparison with other possible reconnection indicators. By using a full, self-consistent, three-dimensional, resistive magnetohydrodynamic experiment of interacting magnetic strands constituting a coronal loop, Q and several different quantities are determined. Each is then compared with the necessary and sufficient condition for reconnection, namely the integral along a field line of the component of the electric field parallel to the magnetic field. Among the reconnection indicators explored, we find the squashing factor less successful when compared with alternatives such as Ohmic heating. In a reconnecting magnetic field devoid of null points, our work suggests that Q, being a geometric measure of the magnetic field, is not, in some configurations, a reliable indicator of the onset or a diagnostic of the location of magnetic reconnection.


Object. Gender and disease course specific incidences were studied in high- and medium-risk regions of MS in Finland. Methods. Age- and gender-specific incidences with 95% CIs were calculated in 10-year periods from 1981 to 2010. Poser diagnostic criteria were used and compared with the McDonald criteria from 2001 to 2010. Association between age and diagnostic delay over time was assessed by using the Kruskal-Wallis test. Results. 1419 (89%) RRMS and 198 (11%) PPMS cases were included. RRMS incidence increased with the female to male ratio (F/M) from 4,2/105 (F/M 1.9) to 9,7 (2.3), while that of PPMS decreased from 1,2 (1.6) to 0,7 (1.2). The use of McDonald criteria did not change the conclusion. The decreasing diagnostic delay and age at diagnosis in RRMS were associated within the 10-year periods and contrasted those in PPMS. Increasing female risk in RRMS was observed in the high-risk region. Conclusion. Increasing RRMS incidence and high female ratios shown in each age group indicate gender-specific influences acting already from childhood. A more precise definition of the risk factors and their action in MS is needed to provide a better understanding of underlying pathological processes and a rationale for the development of new preventive and treatment strategies.


We report the clinical and molecular abnormalities in a 19‐year‐old woman with Rapp–Hodgkin ectodermal dysplasia syndrome. The physical features include mid‐facial hypoplasia, uncombable hair, cleft palate and bifid uvula, lacrimal duct obstruction and dry skin. Sequencing of the p63 gene reveals a new heterozygous frameshift mutation, 1787delG, in exon 14. The frameshift results in changes to the tail of p63 with the addition of 68 missense amino acids downstream and a delayed termination codon that extends the protein length by 21 amino acids. These changes are predicted to disrupt the normal repressive function of the transactivation inhibitory domain leading to gain‐of‐function for at least two isoforms of the p63 transcription factor. The expanding p63 mutation database demonstrates that there is overlap between Rapp–Hodgkin syndrome and several other ectodermal dysplasia syndromes, notably Hay–Wells syndrome, and that characterization of the functional consequences of these p63 gene mutations at a molecular and cellular level is likely to provide further insight into the clinical spectrum of these developmental malformation syndromes.


Republic of Turkey Constitution, Article 102 of the governing presidential elections, the Constitutional Court by the elections of deputies at a rate of at least two-thirds needed to join is in the form of comments. This interpretation is in line to cancel the elections and was president of the election crisis. Following this interpretation of the Constitutional Court, replaces the Constitution, the President elected by the people and the future is envisaged to create a system to other problems are. This work is transferred only to the Constitution and the regulations to indicate problems that may arise. Especially in the field of public support with a strong president of the Council of Ministers and the Parliament would be likely to come out fighting.


Nanotechnology, the manipulation of matter on a molecular scale, is all around us in our everyday lives. Chocolate, non-dairy creamer, and sunscreen are examples of consumer products with a high content of nanoparticles. Nanotechnology holds great potential for environmental applications like wastewater treatment and nanobionic engineering of plants. Due to their unique and adaptable properties for targeted therapeutic payload delivery, nanoparticles are also emerging as promising tools for innovative pharmaceutical treatment. Nevertheless, licensing regulations specifically for nanomaterials are lacking, and the long-term effects of nanoparticles on both the environment and human health need to be further clarified.


In both CF and PCD, lung disease is caused by impaired mucociliary clearance. In CF it is a result of airway surface liquid depletion and in PCD, of ciliary defects in the structure and/or function. CF-PS patients are diagnosed at a later age, have better nutritional status and survival compared to CF-PI. PCD patients do not have PI and are diagnosed at a later age than patients with CF-PI; hence, are expected to have a disease similar to CF-PS. Aim: To correlate clinical status, microbiological, FEV 1 , and HRCT-Total Brody Score (CT-TBS) between patients with PCD, CF-PI and CF-PS. Methods: Patients with CF-PI, CF-PS and PCD were included. Data on FEV 1 , HRCT, sputum cultures and BMI were collected as part of their routine assessment. Results: Overall, 145 patients (79-CF-PI, 43-CF-PS, 23-PCD) participated in this study. The age of the CF-PS group was markedly higher compared to the other groups. BMI was notably lower in the PCD group compared to both CF groups. FEV 1 had a strong negative correlation with age in the CF groups, not in the PCD group. Sputum colonization rates of P. aeruginosa (PA) were similar in the CF-PI and PCD groups, lower in the CF-PS group. CT-TBS showed the most severe structural disease in CF-PI, followed by the PCD and the CF-PS group. In both CF groups there was a strong negative correlation between TBS and FEV 1 , not observed in the PCD group. Conclusion: In PCD, FEV 1 does not correlate with age, BMI, rate of PA infection and CT-TBS. Therefore, opposed to CF, in PCD, FEV 1 is not a reliable predictor of severity of lung disease. Further studies are needed to delineate the pathogenesis and progression of lung disease in PCD


The Velislav Bible is one of the most beautiful medieval Bohemian manuscripts. It is a heavily illustrated manuscript that contains only short selections of the text, that instruct the reader about the story depicted. The last picture in the manuscript shows a man kneeling before St. Catherine, identified as Velislav, hence the name of the manuscript. The Bible comprises stories from the Books of Genesis and Exodus, visions of Daniel, and the stories of Samson as well as of Judith. The narrative of the Antichrist precedes the Christological part. The New Testament continues with the Book of Revelation, stories following the Ascension of Christ, and key events from the lives of St. Peter and St. Paul. The manuscript closes with the legend of St. Wenceslas, the patron saint of Bohemia. The essays in The Velislav Bible, Finest Picture-Bible of the Late Middle Ages: Biblia depicta as Devotional, Mnemonic and Study Tool analyze the manuscript from historical, textual, art-historical, and iconographic perspectives. However, a shared concern of all the authors is to think about its functions. An edition of the Latin titulis is being published here for the first time.


This article explores experiences and perceptions of women concerning the utilising a waiting mothers' shelter at Bonda Mission Hospital in the Manicaland province of Zimbabwe. It draws on a phenomenological qualitative research design. This incorporated in-depth interviews and key informant interviews with purposively selected fifteen women who have used the waiting mothers' shelter since 2015 and eight healthcare practitioners respectively. The paper is guided by Alfred Schutz's (1972) social phenomenology. While the findings reveal that most women acknowledged the importance of waiting mothers' shelters in improving access to skilled birth attendance and maternal health outcomes, there are still factors that militate the use of such innovations. Several socio-cultural and economic factors such as constrained decision making among women, mistreatment and lack of privacy in the shelters are some of the deterrent factors. The article concludes that, although waiting mothers' shelters are facilities proven to be beneficial in rural communities, they continually face the risk of not being used. There is a need for a multi-stakeholder approach to address the barriers that deter women from utilising the waiting mothers' shelters and improve access to facility-based delivery, access to skilled birth attendants and enhance the maternal health outcomes in rural communities in Zimbabwe.


By analyzing their own and each other's health security performance, countries can develop strategies and methods to increase their health security performance. Therefore, it is important to provide the said performance measurement in order to raise awareness of the health security performance of the countries. In this context, the health security performances of the European Union countries were measured by the MAIRCA method over the values of the Global Health Security Index (GHSI) components for the latest and current 2019. In the research, the relationships were calculated between the health security performance values of the countries determined by the GHSI and MAIRCA method and some multi-criteria decision making (MCDM) methods (ARAS, BTA, COPRAS, EDAS, MAUT, ROV, TOPSIS, WASPAS, Gray Relational Analysis). According to the findings, it was determined that the first three countries with the highest health and safety performance were Sweden, the Netherlands and Denmark, while the first three countries with the lowest health and safety performance were Bulgaria, Romania and Cyprus. In the study, it was also observed that the countries of Bulgaria, Czechia, Cyprus, Croatia, Italy, Lithuania, Luxembourg, Hungary, Malta, Poland, Romania, Slovenia and Greece were below the average health protection performance value. Accordingly, it has been concluded that these countries need to increase their health safety performance in order to be in compliance with other European Union countries on health safety. Apart from these, it has been determined that GHSI and MAIRCA methods have significant, positive and very high correlations with each other and with other MCDM methods except MAUT method. Therefore, according to this finding, it was evaluated that GHSI and MAIRCA method could be explained with each other and with other methods except MAUT method.


The Galmoenan massif, a classic example of an Ural–Alaskan-type zoned intrusive body, is a known source for currently mineable placer-type deposits of platinum. The geology, petrography, geochemistry and PGE mineralization of the Galmoenan massif as well as the applied aspects of PGE mineralogy and ore beneficiation are the focus of this paper. It has been established that Pt–Fe alloys are the principal contributors of PGE in all rock types. They are associated with minor amounts of intermetallic compounds belonging to the system Pt–Fe–Cu and with a paragenesis of PGE-bearing sulfides, arsenides and sulfarsenides. The PGM occur in two major associations: 1) accessory, belonging to the platinum mineralogical–geochemical type, and dispersed in fine-grained dunite, pyroxenite and gabbro, and 2) ore, belonging to the iridium–platinum mineralogical–geochemical type, and related to recrystallized coarse-grained dunite and associated chromitites. The southern part of the Galmoenan intrusion contains important platinum mineralization, and holds the greatest potential for the delineation of an economic, medium-size platinum deposit. The applied mineralogy and beneficiation characteristics of this PGE mineralization, which have not previously been investigated for Ural–Alaskan-type intrusions and which refer to a new economic type of ore, metallic platinum-type ore, are presented.


The development and application of two methods for the determination of sterilization residues in ethylene oxide sterilized steroids, vitamins, and antibiotics are described. One method is based on the separation and concentration of ethylene oxide (ETO) by distillation and measurement by internal standard gas liquid chromatography. The other method, based ultimately on the colorimetric determination of formaldehyde, permits determination of total glycol as well as specific ETO and glycol after ion exchange or extraction separation procedures. The mechanism of retention is discussed, with particular emphasis on solvation phenomena.


Injuries to zone III of the carotid artery, located between the angle of the mandible and the skull base, are uncommon, associated with a high risk of adverse neurologic events and mortality, and challenging to treat. These lesions are difficult to access and treat surgically due to their anatomic location. Therefore, endovascular and hybrid open and endovascular techniques have emerged as a minimally invasive, and in many cases, safer and more effective alternative to open surgery. Endovascular techniques for use in this anatomical region include balloon catheter tamponade, embolization, balloon angioplasty, and endovascular stenting. Selection of the most appropriate treatment strategy is dependent on the: 1) concomitant injuries of the patient, 2) location (external versus internal carotid artery) and nature (intimal tear, dissection, pseudoaneurysm, transection, occlusion, or arteriovenous fistula) of the injury, and 3) whether the operating surgeon believes it is necessary to revascularize or sacrifice the injured carotid artery. The purpose of this article is to review the present endovascular and hybrid open and endovascular therapies available for zone III penetrating and blunt carotid trauma. We begin by describing the clinical presentation and diagnosis of these injuries and then discuss management of an undifferentiated zone III vascular injury. This is followed by a discussion of the management of zone III external and then internal carotid artery injuries. We conclude by describing postoperative management, follow up, and future directions.


BACKGROUND
In vitro fertilisation (IVF) as treatment for male factor subfertility is associated with lower fertilisation and pregnancy rates than for other indications. Since the late 1980s several assisted fertilisation techniques have emerged and have been rapidly developed to try to enhance results for couples with male factor subfertility, or to help couples with severe male factor for whom conventional IVF was not possible. The techniques of partial zona dissection (PZD) and of subzonal microinjection of spermatozoa into the perivitelline space (SUZI) are by far surpassed by the technique of intra-cytoplasmatic sperm injection (ICSI). ICSI has proven to be the therapy of choice for couples with severe male factor subfertility.

OBJECTIVES
To investigate whether ICSI improves livebirth rate in comparison to IVF in couples with non-male subfertility.

SEARCH STRATEGY
We searched the Cochrane Menstrual Disorders and Subfertility Group trials register (searched 30 May 2002), the Cochrane Controlled Trials Register (Cochrane Library Issue 2, 2002), PubMed (January 1992 to July 2002) and reference lists of articles.

SELECTION CRITERIA
Trials were included if they compared the effects of these techniques on livebirths, pregnancy and fertilisation outcomes. Only randomised studies were included in this review.

DATA COLLECTION AND ANALYSIS
One study met the inclusion criteria for this review. The study compared ICSI with IVF within couples with non-male infertility. Data was extracted independently by two reviewers.

MAIN RESULTS
There were no randomised data comparing livebirth rates. The single identified study did not find a difference in pregnancy rates (OR 1.4, 95% CI 0.95 to 2.2). There were no randomised data on miscarriage rates, or on other adverse events such as congenital malformations that may be of concern.

REVIEWER'S CONCLUSIONS
Whether ICSI should be preferred to IVF for cases of non-male factor subfertility remains an open question. Further research should report livebirth rates and adverse events.


Appropriate heteroatom doping and pore structure optimization are cost-effective technologies to improve the electronic conductivity and ion diffusion kinetics of hard carbons (HCs). Here, we report an ion-catalyzed synthesis of N/O co-doped carbon nanorods (NOCNRs) with abundant hierarchical pores, achieving high-capacity and high-rate Na-ion storage (336 mA h g-1 at 0.1 A g-1 and 196 mA h g-1 at 20.0 A g-1).


Sea ice thickness is a key parameter in the polar climate and ecosystem. Thermodynamic and dynamic processes alter the sea ice thickness. The Multidisciplinary drifting Observatory for the Study of Arctic Climate (MOSAiC) expedition provided a unique opportunity to study seasonal sea ice thickness changes of the same sea ice. We analyzed 11 large-scale (∼50 km) airborne electromagnetic sea thickness and surface roughness surveys from October 2019 to September 2020. Data from ice mass balance and position buoys provided additional information. We found that thermodynamic growth and decay dominated the seasonal cycle with a total mean sea ice thickness increase of 1.4 m (October 2019 to June 2020) and decay of 1.2 m (June 2020 to September 2020). Ice dynamics and deformation-related processes, such as thin ice formation in leads and subsequent ridging, broadened the ice thickness distribution and contributed 30% to the increase in mean thickness. These processes caused a 1-month delay between maximum thermodynamic sea ice thickness and maximum mean ice thickness. The airborne EM measurements bridged the scales from local floe-scale measurements to Arctic-wide satellite observations and model grid cells. The spatial differences in mean sea ice thickness between the Central Observatory (<10 km) of MOSAiC and the Distributed Network (<50 km) were negligible in fall and only 0.2 m in late winter, but the relative abundance of thin and thick ice varied. One unexpected outcome was the large dynamic thickening in a regime where divergence prevailed on average in the western Nansen Basin in spring. We suggest that the large dynamic thickening was due to the mobile, unconsolidated sea ice pack and periodic, sub-daily motion. We demonstrate that this Lagrangian sea ice thickness data set is well suited for validating the existing redistribution theory in sea ice models. Our comprehensive description of seasonal changes of the sea ice thickness distribution is valuable for interpreting MOSAiC time series across disciplines and can be used as a reference to advance sea ice thickness modeling.


Fruit rot in winterberry is associated with a complex of fungal pathogens. Among them, Diaporthe ilicicola plays a unique role by infecting flowers at bloom, resulting in symptom development in mature fruit. This research aimed to identify at what stage of maturation Ilex fruit can develop disease symptoms, and correlate changes in fruit physiology (sugar and phenolic content) and the environment (temperature and light intensity) with disease incidence. Correlation data informed in vitro studies testing the ability of putative factors to alter growth of D. ilicicola and select opportunistic fungi within the fruit rot complex: Alternaria alternata, Colletotrichum fioriniae, and Epicoccum nigrum. Results indicated that Ilex fruit do not develop symptoms until 81-108 days after inoculation. Temperature and fruit phenolic content were negatively correlated with disease incidence, while fruit sugar concentration and light intensity were positively correlated. In vitro assays revealed that sugar concentration had no effect on the growth of D. ilicicola but increased light intensity increased hyphal growth and pycnidium formation. Additionally, phenolics extracted from fruit inhibited spore germination in A. alternata, induced secondary conidiation in C. fioriniae, and late season phenolic extracts increased hyphal melanization and pycnidial formation in D. ilicicola. Finally, drops in field temperatures, when replicated in vitro, resulted in a decrease in hyphal growth and spore germination for all fungi. These results suggest that changes in Ilex fruit phenolics during maturation, and the increased exposure to light following defoliation, may play a role in symptom development by altering D. ilicicola growth within the fruit.


Numerical simulations by the code of Object-Oriented PIC (Particle-in-Cell) and the Monte Carlo Collision (MCC) method were carried out in order to obtain an insight into the characteristics of plasmas generated by glow discharges in low pressure helium in a four-anode DC glow discharge device. The results show that, the pressure, the external mirror magnetic field, and the virtual breadth of the annular electrode affect the radial distribution of the plasma density and temperature. The simulations are instructive for further experiments.


Guillain-Barre syndrome (GBS) is related with significant morbidity and also mortality. Little is known about the long term outcome of GBS patients who survived. The objective of this study is to determine the lasting outcome and consequences of GBS patients. This is a cross-sectional study of patients who diagnosed GBS and managed at the Intensive Care Unit of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2004 to December 2017. All survived patients were invited for a structured interview, questionnaires, and full neurologic exam to record their current clinical condition focused on complaints and symptoms, neurological deficits, disabilities, behaviour, and quality of life. Thirty-eight patients participated, with a median age of 20 years (range 4-39 years) and a median interviewed time of 7 years (range 1-13 years). Residual complaints were reported by 24(63%) patients, including paresthesias (10.5%), unsteadiness of gait (37%), painful hands or feet (29%), and severe fatigue (13%). Questionnaires identified a wide range of behavioural problems. Most Patients showed good recovery of neurological deficits after GBS, but many have persisting long-term residual complaints and symptoms that may lead to psychosocial problems interfering with participation in daily life.


Nonthermal plasma generated by parallel-plate dielectric-barrier discharge with 60-kHz high-voltage power was used to sterilize the bacteria in atmospheric air. Two kinds of typical bacteria, gram-negative E. coli (ATCC8099) and grampositive S. aureus (ATCC6538), were used as test strains. Bacteria cells held by cover-glass were placed on the bottom electrode. By adjusting the applied voltage, gap spacing, and treatment time, the effects of plasma and electric field on bacteria inactivation were investigated. The transmission electron microscope was used to observe the damage of cells treated by plasma. The concentrations of K+, protein, and nucleic acid leaked from cells were measured for detecting the cytoplasm status after plasma treatment. Experimental results showed that almost 100% of S. aureus and E. coli strains were killed in less than 10- and 7-s plasma treatment, respectively. It is concluded that the reactive oxygen species (ROS) in plasma play a dominant role in the inactivation process but not the electric field. It is supposed that the ROS can oxidize the cell membrane and then damage the protein and nucleic acid inside the cells and, thus, kill the bacteria.


The productivity improvement is indispensible to shipbuilding industry for maintaining the world's No. 1. Simulation based production recently has been an issue as prat of efforts to high efficiency production and Korean shipyards requests simulation system tools specialized in a shipbuilding industry. IT convergence project between conventional shipbuilding industry and IT simulation technology has been carried out and integrated simulation framework was proposed as a way to overcome sporadic developments. The framework would provide reusability of kernels and modules and also ensure for expansibilities to other production simulations. The fact that production simulation system should reflect shipyard requirement would be most important. We suggest an analysis process of customer requirements and functional requirements for production simulations. It is partially based on concepts of software engineering and axiomatic design. The process is applied to a design of configuration for simulation framework.


A theory is presented for the strong enhancement of graphene-on-substrate band gaps by attractive interactions
mediated through phonons in a polarizable superstrate. It is demonstrated that gaps of up to 1 eV can be formed for
experimentally achievable values of electron-phonon coupling and phonon frequency. Gap enhancements range
between factors of 1 to 4, indicating possible benefits to graphene electronics through greater band-gap control
for digital applications, lasers, light-emitting diodes, and photovoltaics through the relatively simple application
of polarizable materials such as SiO 2 and Si 3 N 4 .


Lung cancer is the leading cause of cancer death worldwide. Recent data suggest that cyclic nucleotide phosphodiesterases (PDEs) are relevant in various cancer pathologies. Here, we elucidate the pathophysiological role of PDE4 and its therapeutic prospects in lung cancer. We exposed 10 different non-small cell lung cancer cell lines (adenocarcinoma, squamous, and large cell carcinoma) to hypoxia and assessed the expression and activity of PDE4 by quantitative real-time PCR, immunocytochemistry, western blotting, and PDE activity assays. Expression and activity of distinct PDE4 isoforms (PDE4A and PDE4D) increased in response to hypoxia in eight of the studied cell lines. Furthermore, we determined various potential hypoxia-responsive elements (HRE) in PDE4A and PDE4D. Silencing of hypoxia-inducible factor subunits (HIF1A and HIF2) by siRNA reduced hypoxic induction of PDE4A and PDE4D. Vice versa, using a PDE4 inhibitor (PDE4i), a cAMP-elevating agent, cAMP analogs, PKA activator/inhibitor, and EPAC activator, we demonstrated that PDE4-cAMP-PKA/EPAC axis regulates HIF signaling as measured by HRE reporter gene assay and expression of HIF target genes (LDHA, PDK1, VEGFA). Notably, PDE4i or PDE4A-/PDE4D-selective siRNA reduced human lung tumor cell proliferation in vitro and colony formation and altered the expression of cell-cycle regulators. Moreover, PDE4i treatment reduced hypoxia-induced VEGF secretion in human cells. In vivo, PDE4i inhibited tumor xenograft growth in athymic nude mice by altering proliferation and angiogenesis. Collectively, our findings suggest that PDE4 is overexpressed in lung cancer, exerts crosstalk with HIF pathways, and promotes lung cancer progression; thus, PDE4 may represent a therapeutic target for lung cancer therapy. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 1839. doi:1538-7445.AM2012-1839


Objectives Systematic Reviews (SRs) are the cornerstone of evidence-informed healthcare decision making. However, they are extremely resource-intensive and commonly take 2 to 3 years to complete. One of the solutions put forward to support reviewers and reduce the time required to conduct SRs is automation. With recent advancements in artificial intelligence and machine learning, many tools have been, and are currently being, developed to support different stages of SR process. To date, the range of automated tools available, and their effectiveness, is unclear. To remedy this gap, we have undertaken a methodological systematic review. The specific objectives of this methodological SR are to: Classify existing tools according to the automation approach, the stage of SR supported and the level of automation. Compare the available tools according to each stage that they support and identify their strengths and limitations. Determine the effectiveness of the tools. Present and appraise evaluations of automated tools. Method This review is based on the Preferred Reporting Items for Systematic review and Meta-Analyses (PRISMA-P) Guidelines. We reviewed all published articles, grey literature, reports and software manuals that evaluate automated and semi-automated tools that support healthcare-related SRs, from screening to write-up. Only tools that are fully developed were eligible for inclusion. The systematic review toolbox (SR ToolBox), PubMed, Google and Google were systematically searched. Titles, abstracts and full articles were reviewed for inclusion independently by two reviewers. Data extraction and quality appraisal were undertaken independently by two reviewers, with disagreements resolved by consensus or by arbitration by a third reviewer if necessary. Tools' characteristics and performance metrics reported in the included studies were extracted and tabulated. To enable comparisons, tools were grouped according to stages of SR they support, and the type of algorithms deployed in them. Results This review is currently in the data extraction stage and will be completed by the first week of June 2019. This presentation will focus on the evidence available on automated tools that support the screening, data extraction, quality appraisal and write-up phases of SRs. For each phase, we will present data on the number of tools that have been developed and the number of studies that have evaluated them. We will discuss the strengths and limitations of the methods and standards used to evaluate existing tools, and implications for future research and SR practice. Conclusions This review constitutes an important step in easing the transition of SR production from a primarily manual process to a semi-automated one. It will inform current collaborative efforts aimed at the development of evidence-informed integrative automated systems for conducting high quality SRs in healthcare research.


If there are no constraints on the process of speciation, then the number of species might be expected to match the number of available niches and this number might be indefinitely large. One possible constraint is the opportunity for allopatric divergence. In 1981, Felsenstein used a simple and elegant model to ask if there might also be genetic constraints. He showed that progress towards speciation could be described by the build‐up of linkage disequilibrium among divergently selected loci and between these loci and those contributing to other forms of reproductive isolation. Therefore, speciation is opposed by recombination, because it tends to break down linkage disequilibria. Felsenstein then introduced a crucial distinction between "two‐allele" models, which are subject to this effect, and "one‐allele" models, which are free from the recombination constraint. These fundamentally important insights have been the foundation for both empirical and theoretical studies of speciation ever since.


BACKGROUND
The climacteric or perimenopause is the transitional phase during which reproductive function ceases. The average age of the menopause is 51.4 years with a duration of two years. Symptomatology include: vasomotor, psychological, urogenital/sexual, skin, menstrual irregularities and others. The objective was to study the attitude of these women towards menopause.

METHODS
In this cross-sectional study, 500 women were included.

RESULTS
Palpitations and headaches were found in 30% and 32% respectively in perimenopausal women compared to 16% and 20% in postmenopausal women. Irritability, anxiety and lethargy affected every 3 in 10 women while 24% reported forgetfulness and 12% had loss of libido in the peri menopausal group. The incidence of the above symptoms was much lower in the postmenopausal group, irritability being on the top (16%) followed by forgetfulness (12%), lethargy in 10% and loss of libido in 3%. Dyspareunia was reported by 18% of perimenopasual and 8% of menopausal women. Urinary complaints were found in 9% and 3% of the perimenopausal and menopausal women respectively. About 2 in 10 complained of dryness of skin. Menstrual irregularities affected 3 in 10 women and the commonest form of abnormality was delayed cycles (23%). Concerning their attitude towards menopause 46% perimenopausal and 76% of the postmenopausal women did not perceive menopause as a medical condition and were found satisfied as they had accepted it as a natural ageing process. Some 20-40% of women who were worried or dreading menopause were those who linked impairment of vision with menopause.

CONCLUSIONS
Attitude of women in our society was found positive towards menopause.


BACKGROUND
Patient satisfaction has rarely been defined. It is a multi-dimensional concept and relates to expectations and preferences for care. This paper reports the findings of a study to determine the expectations and preferences of rheumatology patients for their follow-up monitoring care.

AIMS AND OBJECTIVES
To identify the dimensions of satisfaction important to rheumatology patients in the provision of their care in two locations; primary and secondary. The objectives were to determine the expectations and preferences of this group and to gather data to inform a larger study of patient satisfaction.

DESIGN
This small qualitative study used semi-structured interviews with a convenient sample of 10 patients; five from each location.

METHODS
Interviews were recorded and transcribed. Qualitative data analysis revealed a framework and conceptual categories.

RESULTS
Empathy, specialism, information provision, technical aspects, time, and continuity of care were identified as being important in the provision of care for this group of patients.

CONCLUSIONS
These categories had already been found in a validated questionnaire and justified the use of this tool in the larger comparative study.

RELEVANCE TO CLINICAL PRACTICE
Patient satisfaction cannot be accurately assessed unless important categories of care are identified and used in the measurement tool.


Cerebral vascular disorders are one of the leading causes of disability and mortality in patients with chronic kidney disease (CKD). The article presents the currently available data on risk factors (RF) for the development of cerebrovascular disorders in pre-dialysis patients with CKD. Two groups of RF are identified: traditional and non-traditional (specific). Traditional RF, which include arterial hypertension, diabetes mellitus and hypercholesterolemia, independently affect the cerebral vascular bed and get worse against the background of CKD. Specific RF is associated with features of the CKD pathogenesis. It includes increased blood levels of homocysteine, β2-microglobulin, impaired calcium-phosphorus metabolism, accumulation of uremic toxins and toxins of intestinal bacteria, anemia and other factors. In the present review, special attention is paid to specific RF and pathogenetic mechanisms of the development of cerebrovascular disorders in predialysis patients with CKD. Timely detection of cerebral risk factors may lead to the improvement of early diagnosis and prevention of cerebral vascular disorders, optimization of therapy for patients with CKD.


The objective of this introduction to Colombeau algebras of generalized functions (in which distributions can be freely multiplied) is to explain in elementary terms the essential concepts necessary for their application to basic nonlinear problems in classical physics. Examples are given in hydrodynamics and electrodynamics. The problem of the self-energy of a point electric charge is worked out in detail: the Coulomb potential and field are defined as Colombeau generalized functions, and integrals of nonlinear expressions corresponding to products of distributions (such as the square of the Coulomb field and the square of the delta function) are calculated. Finally, the methods introduced in Gsponer (2007 Eur. to deal with point-like singularities in classical electrodynamics are confirmed.


This article analyses the findings of an empirical study carried out in Lithuania. The aim of this study was to determine transsubjective understanding of the purpose of pre-school and pre-primary education, and to evaluate how the participants of education – pedagogues, children's parents, and specialists – perceive different purposes of such education. The study was based on two theoretical perspectives: the paradigm of child centered education, and the concept of community management. A quantitative written questionnaire-based inquiry of the participants of pre-school and pre-primary education was performed, consisting of 14 socio-demographic items (independent variables) and 44 content items (dependent variables). In total, 4,690 filled questionnaires were received from 79 pre-school and pre-primary educational institutions. Factor analysis was performed in order to validate the reliability and validity of the findings, and to group the dependent variables. Pre-school and pre-primary education in Lithuania is experiencing contradictions between the purposes and the real life. These contradictions are systemic, since they are characteristic more of the system of pre-school and pre-primary education rather than individual persons or institutions. The majority of the participants of pre-school and pre-primary education (pedagogues, children's parents, and specialists) were satisfied with the assurance of the minimal of children's education – i.e. the most important thing for them was that the children were occupied and safe under the supervision of people with educational experience and qualification – the pedagogues. A large part of the parents were oriented towards the competition-based model of education. The parents exerted pressure on the pre-school and pre-primary educational institutions to ensure that these institutions prepared their children for school by teaching writing, reading, and the ability to successfully compete for the "place under the sun". According to such parents, the purpose of pre-school and pre-primary educational institutions is their children's preparation for school rather than the development of their dignity, self-perception, and self-determination. Only the parents from groups that are seen as alternative to the traditional ones strongly expressed the principles of child-oriented pedagogy and rejected those of the adult-dominated pedagogy, although these groups were not very similar in other value-based aspects. The absence of the child's voice – also called the child's perspective or vision – in kindergartens is an especially problematic issue. The parents and the pedagogues did not see a child's opinion as important in making decisions concerning the aims and the organization of education. The children neither have the power to participate in the decision-making processes nor are they seen as experts of their situation.


The MESFET-gate-conductor interruption, often representing a device lifetime limitation, has been characterised by measuring the activation energy Ea and material drift velocity nu B for several types of narrow Al conductors regarding electron wind voiding. The Arrhenius temperature dependence law for current-guided diffusion has been found to hold good and Ea has been measured to be 0.16 eV and 0.14 eV for Al directly on GaAs and for Al on GaAs with a thin intermediate Cr layer, respectively. This result indicates that the presence of a chromium interface is detrimental to the stability and lifetime of Al gate structures.


All women in The Netherlands who are planning a pregnancy were recently advised to take 0.5 mg of folic acid per day for 4 weeks prior to conception and during the first 8 weeks of pregnancy. In this study we sought to determine whether women were willing to use folic acid or not, and the factors that affected this willingness. Questionnaires were sent to 327 women. The response rate was 57%. The results of this study showed that the majority of women (65.5%) were willing to use folic acid. The main reason for this is that women "would like to have a healthy child". Another important reason is the fear of having regrets afterwards.


Background : The rapid increase in the number of people living in urban areas is among the most important global health issues of the 21st  century. Also, most developing countries are facing the task of planning and ensuring a sustainable, sane and healthy development of cities. Objective : To review the relationship between urbanization and health with emphasis on approach and options for the promotion of healthy  behaviours and safety. Methodology : The main sources of information were online journals, Pub Med/Medline and Google. Additionally, publications from the World Health Organisation and public libraries were consulted for articles on urbanization and its impacts on health. Results : The health of urban populations has changed as cities have  evolved as a result of such factors as features of the social environment, the physical environment, and provision of and access to health and social services. The urban context of particular cities may also affect health as  well as modify the effect that unexpected stressors have on a city. Reliable urban health statistics are largely unavailable globally. However, available data indicate a range of urban health hazards and associated health risks that cut across different sectors, including health, environment, energy, transportation and urban planning. Conclusions : Governments are grappling with the challenges posed by the speed at which urbanization has outpaced their ability to provide essential infrastructure. There is need for planned urbanization to help avert the  negative effects of urban living on health.


Interventional treatment in various vascular beds has advanced tremendously. However, there are several problems to be considered. We searched the literature and tried to analyze major parts of it. One is safety and applicability of coronary proven methods in other vascular beds. An unresolved problem is the functional assessment of intermediate lesions, as far as various target organs have quite different circulation from the coronary one and the functional tests should be modified in order to be applicable and meaningful. In the majority of the acute vascular syndromes, the culprit lesion is of intermediate size on visual assessment. On the other hand, a procedurally successfully managed high-degree stenosis is not always followed by clinical and prognostic benefit. In vascular beds, where collateral network naturally exists, the readings from the functional assessment are complicated and thus the decision for interventional treatment is even more difficult. Here come into help the functional assessment and imaging with IVUS, OCT, high-resolution MRI, and contrast enhanced CT or SPECT. The focus of the current review is on the functional assessment of intermediate stenosis in other vascular beds, unlike the coronary arteries.


The performance of the proposed radial basis function (RBF) assisted turbo-coded adaptive modulation scheme is characterized in a wideband channel scenario. We commence by introducing the novel concept of the Jacobian RBF equalizer, which is a reduced-complexity version of the conventional RBF equalizer. Specifically, the Jacobian logarithmic RBF equalizer generates its output in the logarithmic domain and hence it can be used to provide soft outputs for the turbo-channel decoder. We propose using the average magnitude of the log-likelihood ratio (LLR) of the bits in the received transmission burst before channel decoding as the channel quality measure for controlling the mode-switching regime of our adaptive scheme.


Women often migrate within developing countries for different reasons than men and female migrants tend to be very differently distributed across economic sectors as compared to male migrants. This paper provides some of the first evidence on the labour market impacts of female internal migration, examining effects in both the productive and household sectors. I merge large sample migration data from South African censuses with detailed labour force survey data, and exploit substantial time-variation in female migrant inflows into over 200 districts. To identify the causal effects of migration on labour market outcomes, I make use of the unique history of South Africa to construct a plausibly exogenous shift-share instrument for female migrant concentration based on earlier male migration flows from reserves during the Apartheid period. I firstly find that this migration increases the employment and hours worked of high-skilled women (but not men). I demonstrate that this effect is driven by substitution in household work as many female migrants find work as domestic helpers. I also find that female migration leads to a (short-term) reduction in the employment of low-skilled female non-migrants suggesting an increase in competition at the bottom of the economic ladder.


As the number of students increases and the unit of resource is stretched, academic staff are finding that the pressure on traditional forms of assessments is mounting. Consequently a number of unintended consequences arise as a result of the coping strategies that are frequently adopted by both staff and students. Evidence of these unintended consequences comes from our own internal audit processes, which reveal all the symptoms of overassessment. These may be summarised as follows: -Slow feedback to students -Little meaningful feedback -Almost no formative assessment by which students can learn from their mistakes -Learning outcomes assessed several times with little or no rationale for this. -No correlation between credit points and student workload on assignments -No correlation between credit points and staff workload on assignments -No mechanisms for co-ordinating assessment between modules resulting in students being assessed in the same way for almost all their modules. -"Bunching" of assessments which results in students "opting out" of classes or assessments What the internal quality processes reveal are some if not all of the above symptoms. The paper then outlines a number of possible strategies discussed in the research literature for streamlining assessment. These can be summarised as: 1. Strategic Reduction of Summative Assessment 2. Front-end loading 3. In Class Assessment 4. Self and Peer assessment 5. Group Assessment 6. Automated assessment Each strategy is examined and examples are given of how these might be implemented. At several points case studies are presented from within the University to illustrate what is going on elsewhere. Whilst there is no panacea for the problems posed by over assessment it is hoped that staff will at least experiment with some of these techniques. The paper concludes with a question for all of us: The next time you sit down to mark 250 essays or lab. reports or examination scripts ask your self just one simple question. Can I do this differently in a way, which makes my assessment more efficient and more effective?


The purpose of the study was to establish the effect of organizational strategy on performance of companies listed in NSE in Kenya. The theoretical framework that was anchored on the study includes chaos and complexity theory and industrial organizational economic theory. The study objective was to determine how organizational strategy affects performance of companies listed in NSE. The study tested the null hypothesis that organizational strategy does not significantly affect performance of companies listed in Nairobi Securities Exchange. The study used a cross sectional survey design on 64 companies listed in the NSE in Kenya with a sample of 38 companies covering five years (2013-2017) as at 30th June, 2017. Purposive sampling technique was used on 4 senior managers namely, Chief Executive Officers, heads of divisions in Human Resource, Finance and Marketing from the listed companies in NSE giving a sample size of 152 managers. Pre-testing was conducted on 15 respondents and reliability coefficient(r) was above the recommended threshold of 0.7.The study used five point Likert Scale to measure organizational culture and performance. Secondary data was obtained from published sources and primary data was obtained from the semi-structured questionnaire. The analysis comprised descriptive statistics, Pearson's correlation, and hypothesis testing and regression analysis using ANOVA. The study determined that organizational strategy had a significant positive effect on performance of companies listed in Nairobi Securities Exchange. The study concluded that organization strategy needs to be adopted by companies as this helps in coming up with strategic plans either short term or long term that propels the company to better performance in the changing business environment. The study recommended that management should adopt organizational strategy that develops competitive market strategy that builds long-term objectives and annual corporate goals which defines key performance indicators for the companies listed in NSE. Further studies may also consider inclusion of either moderating variables or mediating variables which may affect the relationship between organizational strategy and performance of companies listed in NSE in Kenya.


Abstract Russia contains the world's largest gas reserve. During the next few years, various projects are planned to bring gas out of Russia, southward to the rapidly growing markets of China, the Korean peninsula and other nearby areas. This paper discusses some of the challenges involved in these projects and how they are being addressed: geopolitics, and the bringing together of many countries into long term ventures construction and operation of giant, long distance gas pipelines financing of multi-nation gas projects organising the gas customers and marketplace development schemes and techniques for the remote gas reservoirs of Far East Russia The project that currently ranks no.1 in bringing Russian gas southward into China and Korea is the development of the giant Kovyktinskoye gas condensate field. This field is located in eastern Siberia and has reserves of around 50 Tcf and 400 MMb of condensate. The development scheme involves production of around 3Bcf/d of gas that is transported to markets in China and South Korea by a pipeline more than 3000 km in length. Regions of Russia, and potentially Mongolia and Japan, are also markets. The gas is expected to be mostly used in power generation and petrochemicals. The total development costs are around US $10 billion. The field covers an area of more than 5000 km2, with the main braidplain and tidal deltaic pre-Cambian sandstone reservoirs lying at a depth of around 3000 m in remote forested hills. The climate is extreme; the area is snow covered for more than 150 days every year, and temperatures during the winter are typically -10 to -50°C. More than 200 wells will likely be needed, most with horizontal reservoir completions, and up to 5 km stepout. Production is expected to last at least 30 years and could easily be 50 years or more. A Feasibility Study for the field is nearing completion, a PSA is being developed, a pipeline route is being finalised and gas pricing discussions are ongoing. Presented at: 2003 South East Asia Petroleum Exploration Society (SEAPEX) Conference, Singapore, 2003


Analytic expressions for bridge backwater and constriction scour are presented for subcritical flow through five commonly occurring bridge crossings. To assess the effects of constriction scour on bridge backwater, a known cross-section technique is employed. Based on the analytic expressions, bridge backwater and constriction scour are numerically simulated over a wide range of flow conditions. Regression analysis is used to develop simplified explicit relations for bridge backwater as a function of Froude number, pier energy-loss coefficient, constriction ratio, and conveyance ratio. The resulting regression equations are sufficiently accurate for preliminary hydraulic analyses of bridge waterways in a feasibility study. Simplified expressions are not intended for detailed design analysis. Practical application of the simplified expressions is illustrated through a step-by-step design procedure. (Author)


To enable safe and efficient operation of a large number of Unmanned Aerial Vehicles (UAVs) as envisioned in future commercial operations, a novel networked-based air traffic control paradigm is needed to provide for autonomous route optimization and cooperation to enable deconfliction. This system would need to ensure deconfliction from nearby manned and unmanned operations and would need the capability to respond to unexpected close-proximity aircraft, known as interlopers. This network-based control paradigm will require that operators be able to oversee a network of cooperative and autonomous UAVs capable of maneuvering at low altitudes. Such a network would need new algorithms and increased autonomy to best support cooperative deconfliction and high level supervisory control, and one that also allows operators the ability to both understand local and global behavior of a network of UAVs. To this end, we propose a paradigm-shifting multi-layer distributed air traffic control concept focused on low altitude, high density UAV operations. This new architecture would include a group of analysts that perform a global analysis of the UAV network at a strategic level and more tactical, local controllers manipulating the UAV network, who are advised by the analysts. The proposed operational support system would include methods for the automatic identification of issues within the network, as well as a method for the automatic distribution of effective tasks to the most suitable personnel. This architecture would be a combination of current air traffic control techniques as well as those troubleshooting techniques found in other domains like network and cloud computing management.


Objective: To describe a case of pneumolabyrinth secondary to tympanic membrane/ossicular trauma and the subsequent recovery of sensorineural hearing loss managed with conservative measures. Patients: A 15-year-old boy presented to an outside hospital with signs and symptoms of acute hearing loss, vertigo, and tinnitus after penetrating injury to his right tympanic membrane. In addition, computed tomography demonstrated air density within the vestibule. Interventions: The patient was managed conservatively with bed rest, avoidance of straining, corticosteroids, and antibiotics. Main Outcome Measures: Computed tomography, audiologic testing. Results: Patient recovered near-normal hearing subjectively. There was closure of the air-bone gap (≤20 dB) along with resolution of air within vestibule. Conclusion: We presented a case of a patient with pneumolabyrinth secondary to penetrating trauma to his tympanic membrane. With supportive treatment, air within the labyrinth resorbed, and the patient recovered sensorineural function. Comparing with the mixed successes of surgical repairs, we propose that initial management for traumatic pneumolabyrinth should be first treated conservatively in the absence of worsening symptoms.


In this article, the author explores the Canadian law of religious freedom in light of Canada's commitments to multiculturalism. Though these commitments are aspirational and imprecise, the author argues that two stable notions emerge from Canada's Constitution and legislated multiculturalism policies: recognizing minority cultural communities and fostering inter-cultural dialogue. The author goes on to examine the Canadian case law on religious freedom, arguing that there are at least three recurring themes that run through the prevailing decisions. First, the courts' treatment of religion is individualistic, using the individual litigant's sincerity of religious belief as the touchstone of whether a particular practice will benefit from constitutional protection. Second, the courts are highly concerned with the prevention of coercion and subjecting members of minority groups to the "tyranny of the majority." Third, in justifying their decisions, courts rely heavily on the discourse of tolerance. Using each of these themes as a springboard for critical analysis, the author argues that the legal doctrine of religious freedom is inconsistent with Canada's multicultural ideals. The individualism of the case law fails to take into account the collective and public dimensions of religious experience, and thus fails to recognize important aspects of the identities of minority groups. The strong incentive to adopt particular language in order to be successful may coerce litigants into adopting arguments that are inconsistent with their religious views. The language of tolerance may subtly reinforce social hierarchies by implying that minorities are tolerated rather than full members of Canadian society and impede cross-cultural dialogue by essentializing and marginalizing members of minority groups. The author concludes that these "side-effects" of well-intentioned judicial doctrines are worth taking seriously in order for Canada to make good on its multicultural promises.