Turnover represents a problematic phenomenon due to both staff management and costs related to the quality of care. Turnover is quite studied in other Countries, but it is still little studied in Italy. The aim of this study was to analyzing psychosocial factors related to intention to leave the hospital, by using theoretical models from literature and applying them in the health context. The study involved 1295 nurses from North-Italy. The results showed that intention to leave may be considered the most direct predictor of turnover behavior. In fact, the demand for mobility to another hospital was requested by nurses with high level of intention to leave. Among examined individual and organizational characteristics, we found that young nurses with high education had higher turnover intention than old nurses. Moreover, nurses with high level of intention to leave not only perceived a low affective commitment to the unit, but also a low quality of relationship with both supersiors and physicians. The findings have important implications for both nurses and hospitals by helping to promote effective work environments, thus reducing turnover intention.


The changes in the market of motor drives over the last few years, especially the wish to complete the portfolio toward the satisfaction of most of the customer needs, have brought a new thrust in the area of drives and have favored the realization of procedures that were known from academic discussion. Under certain conditions, the injection sensorless control schemes that exploit the anisotropy of the AC machine and inject a test signal are now found in drives with permanent magnet synchronous machine, while the fundamental wave procedures seem to be the most common solution in the case of induction machines. In this paper, different aspects regarding the state of the art of sensorless drives in industrial applications and the reasons that determine the acceptance or refusal of the different solutions on the side of manufacturers of motor drives are explained and discussed.


Design and performance analysis of propeller for solar-powered HALE UAV, EAV-3 are conducted. Experiment points of design variables are obtained by using Design of Experiment(DOE) and Kriging meta-model is generated for objective and constraints function. The geometry of propeller is designed by evaluating the response surface with requirement and restrictions. The validity of the design is verified by meta-model based optimization. Computational analyses are carried out by using commercial CFD code and the results are compared with those from a design code and wind tunnel test. The results showed good agreement with predictions of the design code at the design altitude. Also, it is confirmed that the blockage effect due to the measurement device and support strut is included in the test data and the results including this effect compare well with the test data.


The use of integrated skills tasks in language tests has been debated for many years and international English test developers such as Educational Testing Service (ETS) and Pearson Tests of English (PTE) already use such tests to assess English as a foreign language (EFL) learners' language proficiency. Empirical research has rarely investigated the influence of the integrated skills task on test takers' preparation strategies. The study presented here set out to investigate the extent to which the introduction of integrated skills tasks may change students' test preparation strategies and the resources that they choose to use. The research focused on two integrated test types developed by PTE Academic: 'repeat-sentence' and 're-tell lecture', which assess both speaking and listening skills concurrently. Data on test-takers' strategies and resources were collected by using Oxford's (1990) Strategy Inventory for Language Learning (SILL). The findings indicated that the integrated skills test influenced participants in relation to both their choice of preparation strategies and the resources chosen. These choices seemed to vary in line with participants' awareness of different aspects of the new test. Thus, there appeared to be an association between participants' choices of learning strategies and resources and their awareness of which skills were being assessed and the nature of the audio input in the new formats. Finally, despite evidence that the new integrated skills test had some impact on participants' approaches to their language learning, this did not necessarily mean that the participants completely abandoned existing learning strategies and resources, in particular those appropriate to the previous test formats.


Based on a 'national collection of the national instrument' now assembled in National Museums Scotland, this book offers an account of the musicology of the bagpipe in its European context, including the remarkable influence of the Baroque on Scotland's musical traditions. The record is meagre for the evolution of the bagpipe in Scotland and perceptions of the 'national instrument' have depended on a stereotype Great Highland Bagpipe assumed to have a continuous history from a distant past. The evidence, as far as it goes, suggests that Scotland adopted a 'great pipe' from the European bagpipe tradition and made it, through the strength of the Gaelic language and its music, very much its own.
The CD-ROM makes available for the first time the database of the National Museums Scotland collection together with some sound clips.


A parallel study on (BN)n and (HAlNH)n (n = 11–22) clusters is presented herein with ab initio HF/6-31G* method. Two types of structures, i.e. cage-like and needle-shaped, are constructed. The calculated results indicate that the classical cage-like geometry is energetically more favourable for (BN)n while the needle-shaped (HAlNH)n structures are more stable than their cage-like counterparts. It is suggested that the nanostructures with higher structural similarity to the corresponding bulk phases possess greater stability. This idea leads to the viable way to intercept segment from bulk materials to construct models for theoretical study of complex nanostructures.


Many generalizations of soft topology were studied in the literature, an
 infra soft topology is the recent one of these generalizations. In this
 paper, we put on view two classes of soft separation axioms in the frame of
 infra soft topologies, namely infra pp-soft Tj and infra pt-soft Tj-spaces
 (j = 0, 1, 2, 3, 4). Both of them are formulated with respect to distinct
 ordinary points such that the first class defined using partial belong and
 partial non-belong relations, and the second one defined using partial
 belong and total non-belong relations. Following systematic lines of this
 type of study, we first show the relationships between them with the aid of
 examples. We also establish main properties and explore their behaviour
 under some special types of infra soft topologies. Transmission of these
 classes between infra soft topology and its parametric infra topologies are
 amply studied. Moreover, we scrutinize their features in terms of hereditary
 and topological properties, and finite product of soft spaces.


Extensive and comprehensive examination of all recorded earthquakes occurring during 1913–1988 in the intraplate regions of the Pacific Ocean crust shows that Pacific Basin intraplate earthquakes are much less frequent than previous catalogs and maps have suggested "Wysession et ai, 1991". Of the 894 earthquakes considered for study that were not part of localized swarms (which account for another 838 teleseismic earthquakes, not including Hawaii), less than half—403—were found to be genuinely intraplate. The examination involved relocating over 500 earthquakes initially identified by other sources—ISC, NEIC, BCIS, etc.—and found that 304 of the supposed intraplate events were actually mislocated plate boundary earthquakes. The remaining listings were typographical bulletin errors, presumed or confirmed nuclear tests, or they contained insufficient data for location). These results, before and after relocation, are shown in Figure 1.


We report on the discovery of a star-forming galaxy at z = 6.33 in the Subaru Deep Field. This object is selected as a candidate of an i′-dropout high-redshift galaxy around z = 6 because of its red i′ - z′ color in our deep optical imaging survey in the Subaru Deep Field. Our follow-up optical spectroscopy reveals that this object is a strong Lyα emitter with only very faint ultraviolet continuum. The rest-frame equivalent width of the detected Lyα emission is as much as 130 Å. Thus the light detected in our z′ image is largely attributed to the Lyα emission, i.e., ~40% of the z′-band flux is the strong Lyα emission, giving a very red i′ - z′ color. This is consistent with the photometric property of this object because the narrowband data obtained with the NB921 filter show a significant depression, z′ - NB921 = -0.54 mag. By using the photometric data, we show that some other objects among the 48 i′-dropout high-redshift galaxy candidates found in the Subaru Deep Field also show a significant NB921 depression. We briefly discuss the nature of these NB921-depressed objects.


MDCK cells are cultured using wide-ranging conditions and can produce variable results. To develop a standard protocol for studying saquinavir transport using MDCKII cells, stably transfected MDCKII cells overexpressing human Pgp (MDCKII-PGP) and MDCKII wild-type cells (MDCKII/wt) were used to evaluate the combined effects of seeding density (6.9 x 10(5) or 5 x 10(4) cells/cm2), substratum (polycarbonate +/- collagen coating) and saquinavir presence on monolayer integrity, Pgp expression, and saquinavir transport. The saquinavir efflux ratio (ratio of BL --> AP/AP --> BL permeability) for MDCKII-PGP cells (6.9 x 10(5) cells/cm2) was 57 with variable mannitol permeabilities. Consistent mannitol permeabilities and higher saquinavir efflux ratios were obtained with 5 x 10(4) cells/cm2 on polycarbonate (78) or collagen-coated polycarbonate (126). The MDCKII/wt saquinavir efflux ratio was 9. Saquinavir presence increased paracellular permeability for all treatments relative to cells seeded onto collagen-coated membranes. Collagen coating caused increased Pgp expression and saquinavir efflux ratios correlated (r2 = 0.96) with Pgp expression levels [MDCKII-PGP (on collagen-coated polycarbonate) > MDCKII-PGP (on polycarbonate) > MDCKII/wt (on collagen-coated polycarbonate)]. These results directly and quantitatively link interrelated differences in cell culture conditions to changes in monolayer integrity, transporter expression, and active transport; and emphasize the critical application of controls in cell culture models.


Healthcare providers, such as general practitioners, pharmacists, physiotherapists, providers of exceptional medical care under the Exceptional Medical Expenses Act, hospitals and convalescent…


Susceptibility of Streptococcus pneumoniae (pneumococci) to oxacillin and ceftriaxone was compared using disk diffusion and E-test methods. A total of 206 children attending Gertrude's Children's Hospital (GCH) were recruited. Sterile Copan Flocked Swabs were used to obtain nasopharyngeal swabs. Samples were inoculated on gentamicin blood agar and initial identification was done on the basis of colony morphology. Optochin test was performed to definitively identify the isolates as pneumococci. Antibiotic testing was done using disk diffusion and E-test methods on Muller Hinton agar enriched with 5% defibrinated sheep blood. A total of 42 (20%) isolates were recovered from the samples. Based on disk diffusion method, 74 and 40% of the isolates were resistant to oxacillin and ceftriaxone while; on the basis of E-test, 45 and 14% of the isolates were resistant to oxacillin and ceftriaxone, respectively. About 40% (n=17) of isolates that had zone diameters ≥ 20 mm which is considered susceptible to oxacillin by disk diffusion, had MICs ≤0.06 µg/ml correspondingly susceptible by E-test. Most isolates deemed susceptible to (≤0.5 µg/ml) ceftriaxone by E-test (72%, n=30) also exhibited susceptibility (≥27mm) to the antimicrobial agent by disk diffusion. E-test presents more sensitive results compared to disk diffusion. Isolates that exhibit resistance to penicillin and ceftriaxone by disk diffusion should be confirmed by E-test before being reported as resistant.

 Key words: E-test, disk diffusion, antibiotic resistance, ceftriaxone and oxacillin.


Agriculture remains the most important occupation and source of livelihood for the majority of the population in our country. The study of cropping patterns, diversification and production is important in agricultural development. Cropping pattern is the proportion of area under various crops while crop diversification refers to the raising of various crops. Agricultural productivity is an input-output ratio that facilitates efficient comparison. These concepts are influenced by various geo-climatic, socio-economic and institutional factors. Tarai region is a marshy moist area lying between Himalayan foothills and Gangetic plains. In Uttar Pradesh, the region extends over 7 districts from Pilibhit to Maharajganj. This region is predominantly agrarian. The present paper aims to study the cropping pattern, Spatio-temporal pattern of crop diversification and production of crops at the district level in the Tarai region of Uttar Pradesh for the period of 2007-08 to 2017-18. The study is based on agricultural data collected from Statistical Abstract of Uttar Pradesh. 13 crops under 4 categories are selected in total. The study uses the location quotient technique for calculating crop concentration, the Gibbs-Martin (1962) method for calculating crop diversification and other statistical measures for analysis. It was found that cropped area of the region has decreased in the reference period and the region is dominated by the cultivation of cereal crops and sugarcane. Low crop diversification was recorded in the region due to similar physical conditions and the practice of traditional agriculture. Production and productivity of crops have greatly increased primarily due to the increasing production of sugarcane. It is believed that the present study will help ascertain the ground reality of agriculture in the study region.


The Joint Fire Science Program has initiated regional consortia to deliver science to managers and other natural resource stakeholders. Given the diversity and complexity of forest management and policy, there is a need to understand and reframe fire science user audiences. In this article, we assess fire science use in the US Northwest (Oregon and Washington) to describe these diverse users and how they perceive, access, and apply fire science. We found that user needs range widely and are sometimes contradictory because of their professions, roles, and relationships, as well as the networks in which they are embedded. Contradictions included desires for both generality and specificity, for social and personal learning, and for science to remain an expert arbiter even as it may increasingly come from nonexpert or potentially partial sources. These factors suggest that fire science delivery should address audiences not only by user typologies but also as a set of dynamic, shifting uses. There is a clear need for intermediary organizations and networks to organize, interpret, and deliver science. These may be most relevant and useful if they offer multiple delivery formats that appeal to the various ways that fire science users learn both as individuals and socially in interactive settings.


The AROM locus of A. nidulans, which governs five consecutive steps in pre-chorismate aromatic amino acid biosynthesis, has been cloned in a bacteriophage vector. The nucleotide sequence of the locus reveals a single, open reading-frame of 4,812 base-pairs, apparently without introns. An internal segment of the A. nidulans AROM sequence has extensive homology with the E. coli aroA gene that encodes the 5-enolpyruvylshikimate 3-phosphate synthase.


The Connecticut State Department of Education has established three levels of educational technology competencies for teachers. Over the past several years researchers at the University of Connecticut had developed a number of performance assessments to measure the extent to which teachers possess these educational technology competencies. This report describes the development and validation of an early version of the Level 1 technology assessment. Level 1 competencies include basic computer skills and the use of typical productivity software. It also describes how technology competence or accuracy scores related to teachers self-efficacy concerning the tasks assessed by the performance measure as well as their interest in the use of technology. Data were obtained from 61 teachers from 2 metropolitan school districts. Scores from the Level 1 performance measure have been found to be a valid and reliable means of assessing teacher educational technology competence. The measure has also been well-received by teachers. The research has uncovered significant positive correlations between educational technology competency and self-efficacy as expected. Unexpected, however, are the low correlations between interest scores and both teacher competency and self-efficacy. Differences were also found between the correlations of technology competency and self-efficacy scores taken before and after the technology competency measure was administered. Correlations are generally higher at posttest than at pretest, implying that teachers assessments of their own technology skills align more closely with the performance measure of these skills after they have taken an assessment designed to measure these skills. (Contains 5 tables and 22 references.) (Author/SLD) Reproductions supplied by EDRS are the best that can be made from the original document.


Background There are conflicting data regarding the benefit of primary prevention implantable cardioverter‐defibrillators (ICDs) in patients with diabetes mellitus and heart failure (HF) with reduced ejection fraction. We aimed to assess the comparative effectiveness of ICD placement in patients with diabetes mellitus and HF with reduced ejection fraction. Methods and Results Data were obtained from the Get With the Guidelines–Health Failure registry, linked with claims from the Centers for Medicare & Medicaid Services. We used a Cox proportional hazards model censored at 5 years with propensity score matching. Of the 17 186 patients with HF with reduced ejection fraction from the Centers for Medicare & Medicaid Services claims database (6540 with diabetes mellitus; 38%), 1677 (646 with diabetes mellitus; 39%) received an ICD during their index HF hospitalization or were prescribed an ICD at discharge. Patients with diabetes mellitus and an ICD (n=646), as compared with those without an ICD (n=1031), were more likely to be younger (74 versus 78 years of age) and have coronary artery disease (68% versus 60%). After propensity matching, ICD use among patients with diabetes mellitus, as compared with those without an ICD, was associated with a reduced risk of all‐cause mortality at 5 years after HF discharge (54% versus 59%; multivariable hazard ratio, 0.73; 95% CI, 0.64–0.82; P<0.0001). Ischemic heart disease did not modify the association between ICD use and all‐cause mortality (P=0.95 for interaction). Similar results were seen in patients without diabetes mellitus. Conclusions Primary prevention ICD use among older patients with HF with reduced ejection fraction and diabetes mellitus was associated with a reduced risk of all‐cause mortality. Our analysis supports current guideline recommendations for implantation of primary prevention ICDs among older patients with diabetes mellitus and HF with reduced ejection fraction.


Background:Hypnic headache is regarded by most authors as a primary headache, but in some cases it was considered secondary to hypophysis, brain stem, or posterior fossa lesions. Case:We report a case of a 69-year-old woman with a history of a headache that fulfils all International Classification of Headache Disorders-II criteria for hypnic headache, with 2 years of evolution, whose complementary investigation with magnetic resonance and magnetic resonance angiography revealed a dolichoectasia of the basilary artery. She was treated with verapamil with excellent response. Conclusions:To the best of our knowledge, this is the first described case of a patient with hypnic headache and a dolichoectasic basilar artery. The relation between these 2 entities is questionable, but we raise some possible explanations for this relationship.


This article addresses educators' concerns about using asynchronous online discussions in lieu of face-to-face discussions. Drawing from research on asynchronous online education and Bloom's taxonomy, the authors introduce the system of "original examples" and "value-added comments" that they have developed to promote engaging and meaningful discussions in which students learn course material from one another. The authors describe how to integrate this system into an online course and provide guidelines for instructor facilitation. They offer evidence that online asynchronous discussions facilitate students' learning and may be more inclusive than face-to-face discussions for some students. Finally, the authors share their observations and suggestions for implementation.


Human Rights and Rights of Miorites areattractive slogans in the  global canvas. In the history of human beings many religions, their leaders, empires, and institutions claimed that they provided many human rights to the citizens of their countries, but the truth is that they failed to provide a complete code of rights to their minorities. In this regard the Treaties of the Holy Prophet Muhammad (Peace Be Upon Him) are a road line for all the Human beings , giving the fundamental rights, specially to non- MuslimMinoritess in the first Muslim state of Madinah. It has been highlighted in the Medina pact, contract with the Christian, people of Najran, letter of protection (Amman Nammah) for the people of Yamman, Maqna, Honain, Khaibar, Eilah, Ummay Hani, contract with Majoos, providing and sending them " Letter of protection" to the people of Hajjar(Bihrin). There are many sayings in the books of Siah sittah and others giving the rights to the non-Muslim Minorities. This Paper ends by giving main principles of human right and providing some suggestions to solving the non-Muslims issues in mslim state in the light of treaties of the Holy Prophet ( Peace Be Upon Him).


The performance of maximum-likelihood (ML) decoded binary linear block codes is addressed via the derivation of tightened upper bounds on their decoding error probability. The upper bounds on the block and bit error probabilities are valid for any memoryless, binary-input and output-symmetric communication channel, and their effectiveness is exemplified for various ensembles of turbo-like codes over the additive white Gaussian noise (AWGN) channel. An expurgation of the distance spectrum of binary linear block codes further tightens the resulting upper bounds


Abstract The article presents the possibilities of using easily accessible and inexpensive educational sets in scientific research and the process of robotics education. Such kits allow the exploration of theoretical and practical knowledge taking into account aspects of engineering, such as: mechanics, drive systems, sensor systems, control and programming of robots. Models of robots built from inexpensive components can also be used to test new solutions in the field of construction or control algorithms before they are used in real applications. As an example, the model of the palletizing manipulator for self-assembly was shown, the control of which was based on the Arduino Uno controller, while the drives were implemented using low-cost hobby-grade servos. For the kinematic structure of this manipulator, the forward and inverse kinematics task for the position has been discussed. This constituted the basis for the development of a manual control algorithm implemented in the controller – using a joystick and programmed – based on the data sent to the controller using serial communication from a PC. The article presents the results of the computer simulation of the manipulator kinematics, the hardware and software implementation of the robot model and the effects of its operation. The possibility of expanding the control system with additional elements to increase its functionality was indicated.


Being 'technically vital,' proficient in a hot speciality, or retrained does not guarantee a job in today's market. This report recounts problems faced by laid-off engineers. Through their eyes, it also addresses such questions as: how successful has keeping technically vital been in making these individuals immune to layoffs? What hot new job areas have they found or not found? How well does the defense-to-commercial conversion appear to be working? In this article the case studies are highly personal views. Nonetheless, the experiences of these engineers suggest that, at least in certain contexts in today's work world while some commonly believed assumptions may be facts, others are myths.<<ETX>>


The present work proposes a self-consistent reduced-order NLTE kinetic model for radiating plasmas found in the outer layers of stellar atmospheres. A detailed collisional-radiative kinetic mechanism is constructed by leveraging the most up-to-date set of ab initio and experimental data available in the literature. This constitutes the starting point for the derivation of a reduced-order model, obtained by lumping the bound energy states into groups. In order to determine the needed thermo-physical group properties, uniform and Maxwell–Boltzmann energy distributions are used to reconstruct the energy population of each group. Finally, the reduced set of governing equations for the material gas and the radiation field is obtained based on the moment method. Applications consider the steady flow across a shock wave in partially ionized hydrogen. The results clearly demonstrate that adopting a Maxwell–Boltzmann grouping allows, on the one hand, for a substantial reduction of the number of unknowns and, on the other, to maintain accuracy for both gas and radiation quantities. Also, it is observed that, when neglecting line radiation, the use of two groups already leads to a very accurate resolution of the photo-ionization precursor, internal relaxation, and radiative cooling regions. The inclusion of line radiation requires adopting just one additional group to account for optically thin losses in the α, β, and γ lines of the Balmer and Paschen series. This trend has been observed for a wide range of shock wave velocities.


PURPOSE
Biosimilars are clinically equivalent to branded products yet cost significantly less. Interchangeability is a US Food and Drug Administration (FDA) designation that allows generic drugs to be substituted for reference drugs at the pharmacy, without a physician's consent. Currently, no oncologic biosimilar has FDA approval for interchangeability.

METHODS
Building on pharmacy auto-substitution processes with therapeutic interchange, Plan-Do-Study-Act methodology was used to automate conversions from reference biological products to Pharmacy and Therapeutics-/Physician-approved biosimilars. After establishing the baseline metrics, cycle 1 focused on full staff education (completed July 2020) with systematic pharmacy-driven biosimilar conversion initiated in September 2020 for rituximab, trastuzumab, and bevacizumab. Physician-initiated conversion of Neulasta biosimilar products was encouraged but not mandated. During cycle 2 (May 1, 2021-November 30, 2021), pharmacy-driven Neulasta biosimilar conversion was mandated. In cycle 3 (December 1, 2021-April 30, 2023), stakeholder education was reinforced and the sustainability of conversions was confirmed.

RESULTS
Systematic pharmacy-driven conversion to biosimilar products improved over cycles 1 and 2 from baseline: 1.8% to 90.3% for rituximab, 9.2% to 89.7% for trastuzumab, and 20.5% to 96.1% for bevacizumab. Physician-driven biosimilar conversion for Neulasta was lower at 12.7% through April 2021. Pharmacy-driven Neulasta biosimilar conversion was initiated during cycle 2, resulting in a conversion rate of 39.7%. The conversion rates remained sustainable through April 2023.

CONCLUSION
Pharmacy-driven auto-substitution of biosimilar products results in rapid and statistically significant biosimilar adoption. The pharmacy-based substitution approach was found to be far more effective than physician-driven substitution. Rapid conversion from branded products to FDA-approved biosimilar is feasible, measurable, and sustainable and can be scaled. Barriers to Neulasta conversion warrant further investigation.


Erythrocyte band 4.1 is an important protein in the control and maintenance of the cytoskeleton. Skate erythrocyte band 3, the anion exchanger, appears to play a pivotal role in the regulation of volume-stimulated solute efflux during volume expansion. Because band 4.1 interacts with band 3, we tested whether their interaction might change during volume expansion. Skate red blood cells were volume-expanded in either hypotonic media (one-half osmolarity) or were swollen under isoosmotic conditions by inclusion of ethylene glycol or ammonium chloride in the medium. Microsomal membranes isolated from red cells under volume expanded conditions demonstrated a significant decrease in the amount of band 4.1 bound to band 3. In unstimulated cells, approximately one third of the binding of band 4.1 occurred to band 3. This binding was characterized as being sensitive to competition by the peptide IRRRY. The majority of band 4.1 is bound to glycophorin (as demonstrated in other species), and this binding does not change during volume expansion. The alteration in band 4.1:band 3 interaction occurs within 5 min after volume expansion and is transient, returning to near normal interaction within 60 min. Two drugs that promote band 3 oligomerization, pyridoxal-5'-phosphate and DIDS, also decreased band 4.1 interaction with band 3. Band 4.1 and ankyrin binding to band 3 may be reciprocally related as high-affinity ankyrin binding sites to band 3 observed under volume-expanded conditions are decreased by inclusion of band 4.1 in the binding reactions. J. Exp. Zool. 289:177-183, 2001.


HYPOTHESIS
Replacing a 24-hour regimen with a 1-dose antibiotic prophylaxis for elective surgery would not increase rates of surgical site infection and would decrease costs.

DESIGN AND SETTING
Before-after trial in a tertiary, private general hospital in Ribeirão Preto, São Paulo, Brazil.

PATIENTS
Surgery was performed on 6140 consecutive patients from February 2002 through October 2002 (period 1) and 6159 consecutive patients from December 2002 through August 2003 (period 2). Studied surgeries included orthopedic, gastrointestinal, urology, vascular, lung, head and neck, heart, gynecologic, oncology, colon, neurologic, and pediatric surgeries. The study excluded patients with infection at the time of surgery.

INTERVENTION
Decreasing the 24-hour prophylactic antibiotic regimen to 1-dose antibiotic prophylaxis.

MAIN OUTCOME MEASURES
Surgical site infections in both periods measured by in-hospital surveillance and postdischarge surveillance; compliance with 1-dose prophylaxis; and costs with cephazolin.

RESULTS
We followed up 12,299 patients during their hospital stay; postdischarge surveillance increased significantly from 2717 patients (44%) to 3066 patients (50%, P<.001). One-dose prophylaxis was correctly followed in 6123 patients (99% compliance). The rate of surgical site infection did not change in either period (2% and 2.1% respectively, P = .67). The number of cephazolin vials purchased monthly decreased from 1259 to 467 with a corresponding monthly savings of $1980.

CONCLUSIONS
One-dose antibiotic prophylaxis did not lead to an increase in rates of surgical site infection and brought a monthly savings of $1980 considering cephazolin alone. High compliance to 1-dose prophylaxis was achieved through an educational intervention encouraged by the hospital director and administrative measures that reduced access to extra doses.


Study Design. Retrospective review. Objective. To report the results of vertebral body stapling (VBS) with minimum 2-year follow-up in patients with idiopathic scoliosis. Summary of Background Data. While bracing for idiopathic scoliosis is moderately successful, its efficacy has been called into question, and it carries associated psychosocial ramifications. VBS has been shown to be a safe, feasible alternative to bracing for idiopathic scoliosis. Methods. We retrospectively reviewed 28 of 29 patients (96%) with idiopathic scoliosis treated with VBS followed for a minimum of 2 years. Inclusion criteria: Risser sign of 0 or 1 and coronal curve measuring between 20° and 45°. Results. There were 26 thoracic and 15 lumbar curves. Average follow-up was 3.2 years. The procedure was considered a success if curves corrected to within 10° of preoperative measurement or decreased >10°. Thoracic curves measuring <35° had a success rate of 77.7%. Curves which reached ≤20° on first erect radiograph had a success rate of 85.7%. Flexible curves >50% correction on bend film had a success rate of 71.4%. Of the 26 curves, 4 (15%) showed correction >10°. Kyphosis improved in 7 patients with preoperative hypokyphosis (<10° of kyphosis T5–T12). Of the patients, 83.5% had remaining normal thoracic kyphosis of 10° to 40°. Lumbar curves demonstrated a success rate of 86.7%. Four of the 15 lumbar curves (27%) showed correction >10°. Major complications include rupture of a unrecognized congenital diaphragmatic hernia and curve overcorrection in 1 patient. Two minor complications included superior mesenteric artery syndrome and atelectasis due to a mucous plug. There were no instances of staple dislodgement or neurovascular injury. Conclusion. Analysis of patients with idiopathic scoliosis (IS) with high-risk progression treated with vertebral body stapling (VBS) and minimum 2-year follow-up shows a success rate of 87% in all lumbar curves and in 79% of thoracic curves <35°. Thoracic curves >35° were not successful and require alternative treatments.


AIM
Gingival inflammation may be caused by injury or plaque-related diseases and reduction in inflammation can be a useful indicator of gingival recovery. There has been little research on development of non-index methods to measure gingival condition. The aims of the study were to investigate the reliability of the measurement of changes in gingival redness and swelling, using image analysis, and to compare this approach with an established method for assessing gingival overgrowth [J Clin Periodontol 28 (2001) 81].

METHOD
Twenty volunteers with gingival inflammation were recruited and digital images were taken. Duplicate measurements were made on the first visit by two examiners. At a subsequent visit following periodontal treatment, second images were taken. Gingival changes were determined by assessing redness and tooth surface area visible between the level of the inter-proximal papillae and the gingival margin. Tooth area measurements were compared with the established gingival overgrowth method.

RESULTS
The method showed excellent reliability for both intra- and inter-examiner measurements of 0.968-0.998 and 0.769-0.947, respectively, according to the classification by Donner and Eliasziw of the Fleiss coefficient of reliability (repeat measures taken during the patients' first attendance). High correlation was found for gingival encroachment when compared with the established gingival overgrowth method.

CONCLUSION
This technique proved a reliable method for investigating changes in gingival redness. High correlation was found for gingival encroachment when compared with an established method.


Background: Osteitis fibrosa cystica is a rare benign, lytic bone lesion attributed to hyperparathyroidism. The high level of parathyroid hormone cause rapid bone loss.Case presentation: The patient is a 50-year-old male complaining of severe sustained pain of the right knee joint. Imaging studies were suspicious for a benign tumor of the right distal femur. Biopsy under CT guidance showed numerous osteoclast aggregation and hemosiderin deposition around the bone trabeculae. Blood tests disclosed significantly elevated parathyroid hormone, serum calcium, serum alkaline phosphatase. Parathyroid ultrasonography and CT scan showed a solid mass in front of the trachea at the thoracic entrance plane. After resection of the mass, the clinical symptoms were relieved and the radiological findings were significantly improved, which further confirmed the diagnosis.Conclusions: Metabolic diseases-associated bone lesions require a comprehensive diagnosis of multiple inspection items.An interprofessional team approach to the diagnosis and treatment of Osteitis fibrosa cystica will provide the best outcome.


With the flourishing advancement of ICT, it has changed our daily life in a lot of aspects including economic development, politic, social life, as well as education. The incorporation of ICT in education, especially the Internet changed the teaching and learning model. By using the Internet, e-learning was developed rapidly. This study explored the students' e-learning experience in using Learning Management System (LMS). A total of 314 students from Universiti Putra Malaysia (UPM) were randomly selected from a stratified cluster sample. The research evaluated students' e-learning experience using seven constructs which included quality of teaching, student interaction and engagement, clarify of goals and standard, quality of online resources, appropriate workload, student management and overall satisfaction with online experience. The finding showed that positive e-learning experience was identified in this study suggesting that the respondents had positive perception and were satisfied in using LMS.


Open domain neural dialogue models, despite their successes, are known to produce responses that lack relevance, diversity, and in many cases coherence. These shortcomings stem from the limited ability of common training objectives to directly express these properties as well as their interplay with training datasets and model architectures. Toward addressing these problems, this paper proposes bootstrapping a dialogue response generator with an adversarially trained discriminator. The method involves training a neural generator in both autoregressive and traditional teacher-forcing modes, with the maximum likelihood loss of the auto-regressive outputs weighted by the score from a metric-based discriminator model. The discriminator input is a mixture of ground truth labels, the teacher-forcing outputs of the generator, and distractors sampled from the dataset, thereby allowing for richer feedback on the autoregressive outputs of the generator. To improve the calibration of the discriminator output, we also bootstrap the discriminator with the matching of the intermediate features of the ground truth and the generator's autoregressive output. We explore different sampling and adversarial policy optimization strategies during training in order to understand how to encourage response diversity without sacrificing relevance. Our experiments shows that adversarial bootstrapping is effective at addressing exposure bias, leading to improvement in response relevance and coherence. The improvement is demonstrated with the state-of-the-art results on the Movie and Ubuntu dialogue datasets with respect to human evaluations and BLUE, ROGUE, and distinct n-gram scores.


Hemilabile ligands are known to impart remarkable properties to their metal complexes. Herein, we present arene half-sandwich complexes of RuII, OsII, and IrIII with "click"-derived 1,2,3-triazole (L1) and 1,2,3-triazol-5-ylidene (L2) ligands containing a potentially hemilabile thioether donor. Structural elucidation of the complexes revealed localization of double bonds within the triazole in L1 and a delocalized situation within the triazolylidene ring of L2. For complexes with L1, unusual coordination occurs through the less basic nitrogen "N2" of the 1,2,3-triazole. All complexes were applied for the catalytic oxidation of benzyl alcohol to benzaldehyde using N-methylmorpholine N-oxide as sacrificial oxidant. Furthermore, oxidation of diphenylmethanol to benzophenone was also achieved by using low catalyst loadings in very good yields. These are rare examples of OsII–triazole, as well as of OsII–triazolylidene complexes with "click"-derived ligands.


Dr. Jean Mohammadi-Aragh is an assistant professor in the Department of Electrical and Computer Engineering at Mississippi State University. Dr. Mohammadi-Aragh investigates the use of digital systems to measure and support engineering education, specifically through learning analytics and the pedagogical uses of digital systems. She also investigates fundamental questions critical to improving undergraduate engineering degree pathways. . She earned her Ph.D. in Engineering Education from Virginia Tech. In 2013, Dr. Mohammadi-Aragh was honored as a promising new engineering education researcher when she was selected as an ASEE Educational Research and Methods Division Apprentice Faculty. Abstract Providing real-time feedback to novice programmers is critical to their ability to learn to program. Higher enrollment in introductory computer science courses reduces the amount of time for individual student-instructor interaction. Reduced interaction time equates to a reduction in the time for and amount of instructor feedback. Building on our work involving manual classification and analysis of student source code comments, in this full paper we explore how machine learning techniques can be leveraged to provide automated feedback to students with regards to their computational thinking processes. This paper discusses the initial classification of student source code comments using supervised machine learning methods. In this phase of classification, we focus on whether a comment is sufficient or insufficient . The classification process is broken down into three steps: text processing, data exploration, and comment classification using the Multinomial Naïve Bayes Classifier and a Random Forest Classifier. We detail the text processing requirements, including how to prepare the raw student data using natural languages processing techniques such as stop word filtration, tokenization, and lemmatization. We also show how the data preparation process can affect the final classification outcome. Using Multinomial Naïve Bayes we achieved a precision rate of 82%. Using a Random Forest classifier and lemmatization we achieved a classification precision of 90%. We conclude with a description of how the current classification results can be used to provide real-time feedback to students while they are learning to program. Towards our ultimate goal of providing comprehensive real-time feedback to students, we describe future research plans, which include using unsupervised machine learning techniques to move beyond basic binary classification.


ABSTRACT: Buddington (1959) pointed out that the construction of large crustal magma chambers involves complex internal processes as well as multiple country rock material transfer processes (MTPs), which reflect large horizontal, vertical and temporal gradients in physical conditions. Thus, we have attempted to determine the relative importance of different magmatic and country rock MTPs at various crustal depths, and whether country rock MTPs largely transport material vertically or horizontally, rather than seeking a single model of magma ascent and emplacement. Partially preserved roofs of nine plutons and in some cases roof–wall transitions with roof emplacement depths of 1·5–11 km were mapped. During emplacement, these roofs were not deformed in a ductile manner, detached or extended by faults, or significantly uplifted. Instead, sharp, irregular, discordant contacts are the rule with stoped blocks often preserved immediately below the roof, even at depths of 10 km. The upper portions of these magma chambers are varied, sometimes preserving the crests of more evolved magmas or local zones of volatile-rich phases and complex zones of dyking and magma mingling. Magmatic structures near roofs display a wide variety of patterns and generally formed after emplacement. Transitions from gently dipping roofs to steep walls are abrupt. At shallow crustal levels, steep wall contacts have sharp, discordant, stepped patterns with locally preserved stoped blocks indicating that the chamber grew sideways in part by stoping. Around deeper plutons, an abrupt transition (sometimes within hundreds of metres) occurs in the country rock from discordant, brittle roofs to moderately concordant, walls deformed in a ductile manner defining narrow structural aureoles. Brittle or ductile faults are not present at roof–wall joins. Near steep wall contacts at shallow to mid-crustal depths (5–15 km), vertical and horizontal deflections of pre-emplacement markers (e.g. bedding, faults, dykes), and ductile strains in narrow aureoles (0·1–0·3 body radii) give a complete range of bulk strain values that account for 0–100% of the needed space, but average around 30%, or less, particularly for larger batholiths. A lack of far-field deflection of these same markers rules out significant horizontal displacement outside the aureoles and requires that any near-field lateral shortening is accommodated by vertical flow. Lateral variations from ductile (inner aureole) to brittle (outer aureole) MTPs are typically observed. Compositional zoning is widespread within these magma bodies and is thought to represent separately evolved pulses that travelled up the same magma plumbing system. Magmatic foliations and lineations commonly cross-cut contacts between pulses and reflect the strain caused either by the late flow of melt or regional deformation. Country rocks near the few examined mid- to deep crustal walls (10–30 km) are extensively deformed, with both discordant and concordant contacts present; however, the distinction between regional and emplacement-related deformation is less clear than for shallower plutons. Internal sheeting is more common, although elliptical masses are present. Lateral compositional variations are as large as vertical variations at shallower depths and occur over shorter distances. Magmatic foliations and lineations often reflect regional deformation rather than emplacement processes. The lack of evidence for horizontal displacement outside the narrow, shallow to mid-crustal aureoles and the lack of lateral or upwards displacement of pluton roofs indicate that during emplacement most country rock is transported downwards in the region now occupied by the magma body and its aureole. The internal sheeting and zoning indicate that during the downwards flow of country rock, multiple pulses of magma travelled up the same magma system. If these relationships are widespread in arcs, magma emplacement is the driving mechanism for a huge crustal-scale exchange process.


The purpose of this study is to examine and compare the acoustic properties of the lateral approximant /l/ in two different languages, English and French. Among various dialects of the two languages, General American English (GA) and Metropolitan French (MF) are explored. The two dialects are most commonly found in each language and, arguably, considered as standard in both languages. Based on a production study, several acoustic properties were compared, including temporal duration, the three formants - F1, F2 and F3 -, the trajectories of laterals and darkness of the lateral by comparing the difference between the second and the first formants. The experiment showed that unlike the English one, the French lateral approximant is characterized by significant consonantal release that is consistently found at the end of the lateral articulation. English lateral itself is mostly longer than French one while the combined length of the lateral and the release is longer in French. The F2 of the French lateral was found to be significantly higher than that of the English one. Also, English laterals are darker than French ones. Time-normalized trajectories showed that each formant value varies at the onset phrase of the lateral articulation but the various formant values become merged as the lateral articulation proceeds.


This chapter contrasts the Restatement (Third) of Torts: Liability for Physical Harm's Chapter Five (on Factual Cause) and Chapter Six (on Scope of Liability) with the treatment of causation in the Restatement (Second) of Torts' Chapter 16 ("Legal Cause"). It was written for a book on causation in both common law and civilian jurisdictions. The chapter examines in some detail the arguments that led the Reporters of the Third Restatement to reject the expression "substantial factor" and how the work done by this phrase in the domain of cause-in-fact was handled by and expanded conception but-for causation to which was added the idea of the "causal set model", or NESS Test. The work done by the phrase "substantial factor" in the domain of proximate cause is now done by the concept of "scope of the risk" and variants of the risk rule. The chapter emphasizes the seriousness with which the Third Restatement sought to remove from the question of cause-in-fact any subjective judgment it deemed a matter of proximate cause. The chapter points argues that this focus on rendering cause-in-fact judgments purely objective, when combined with the causal set model, produces a final product where much of the normative work that was once done in causation is now pushed off into questions of apportionment.


The aim of the study was to determine surgical indication and complication of subtotal thyroidectomy in patients being treated for Graves' disease at King Khalid University Hospital Riyadh Saudi Arabia in the period between January 1996 and December 2005. Twenty-five out of 194 adult patients with Graves' disease had thyroidectomy for hyperthyroidism during the 10-year period representing 13% comprising 11 males and 14 females. Mean age at presentation for all the patients was 28±12 years. Males had higher serum T4 77.7±20.7 than females 49.8±21.9 pmol L-1; p<0.05. Serum T3 levels were similar in both groups 31.9±15.2 for males and 29.4±15.7 pmol L-1 for females, p = NS. Failure of antithyroid and/or radioiodine along with severe ophthalmopathy (52%), patient preference (12%) and large goiter alone (8%) were major indications for thyroidectomy in this group. Permanent remission occurred in 15 patients (60%) following the surgery. Hypothyroidism and relapse were observed in 16 (64%) and 4 (16%) of patients, respectively. One patient (4%) each experienced permanent recurrent laryngeal nerve palsy and hypoparathyroidism. It was concluded that more males than females with severe hyperthyroidism had thyroidectomy and that failure of antithyroid/radioiodine treatment and severe ophthalmopathy were the commonest indications for surgery in patients in patients with Graves' disease while post surgical permanent hypoparathyroidism and recurrent laryngeal nerve palsy were uncommon.


Making the aviation industry cluster, a typical trans-regional innovation cluster, as the research object and based on the characteristics of the aviation industry cluster, this study suggests that the innovative action of aviation industry cluster is characterized by diversified innovation subjects, trans-regional, omnibearing, cooperative and three-dimensional innovative methods, and a huge amount of knowledge transfer. This study, based on the analysis on the subjects and external environment of the cooperative innovation of the aviation industry, builds up the cooperative innovation system model of the aviation industry. It is believed in this study that the innovation of the aviation industry is a process during which all trans-regional innovation subjects cooperate and interact with each other and make use of their mutual complementary advantages under the restrictions of the external environment.


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Objectives: Sufficient knowledge and positive attitudes are crucial to the prevention of COVID-19. However, little is known about public awareness and attitudes regarding COVID-19 in China. The impact of COVID-19 on the societal well-being and anxiety levels of the public has never been documented. The aim of this study was to survey the knowledge, attitudes, impact, and anxiety levels of the people of China in relation to the COVID-19 outbreak. Method: A cross-sectional population survey using an online questionnaire was undertaken between Jan 24 and Feb 24, 2020. The study participants were residents of mainland China over the age of 18 years. The attitude items in this study measured the perceived threat of COVID-19 based on the Health Belief Model. Anxiety was measured with the State-Trait Anxiety Inventory (STAI), a self-reported questionnaire that measure both state (STAI-S), and trait anxiety (STAI-T) Results: A total of 2,446 completed responses were received. The mean and standard deviation (SD) for the total knowledge score was 20.3 (SD ± 2.9) out of a possible score of 23. The social disruption and household economic impact were notable, particularly in provinces with higher cumulative confirmed cases. The majority of responses indicated a low perceived susceptibility of being infected (86.7% [95%CI 85.4–88.1]), with a fair proportion of respondents perceiving a higher severity (62.9% [95% CI 61.0–64.8]). The mean total impact score was 9.9 (SD ± 3.8) out of a possible score of 15. The mean score for STAI-S was 48.7 (SD ± 10.8), whereas the mean STAI-T score was 45.7 (SD ± 8.5). By demographics, women reported significantly higher odds for higher levels of both STAI-S (OR = 1.67) and STAI-T (OR = 1.30) compared to men. People of a younger age were also more likely to experience higher STAI-S and STAI-T. Higher perceived susceptibility and severity and impact were strong predictors of higher levels of STAI-S and STAI-T. Conclusion: Our findings can assist in tailoring public communication to change people's knowledge and attitudes. The present study also underlined the importance of the promotion of mental health during infectious disease outbreaks to help in moderating the perceived threat, social and household economic impact, targeting the vulnerable segment of the population.


Becoming a father for the first time might cause great changes in a man's identity and lifestyle. Teenage fathers must strive to balance two competing roles: the teenage role and the father role. The current study design followed grounded theory methodology to gain a deeper understanding of how Thai teenage fathers reason about becoming and being a father from a gender equality perspective. Participants were selected from a heterogeneous group of fathers until saturation was reached (n = 25). Most of the fathers were cohabiting with their partner in an extended family. An interview guide was developed, a pilot study was undertaken, and interviews were performed on two different occasions: once during the second trimester of pregnancy and again when the baby was 5 to 6 months old. The core category, "Male breadwinners involved in parenting," encompassed persons making the transition from being solely a teenager to being a teenage father. Most of the fathers accepted the unintended pregnancy and took on the expected breadwinning responsibility of a father. They prepared for fatherhood and changed their lifestyle. Their families provided support. Nevertheless, the fathers sought to avoid further unplanned parenthood by learning about family planning. The teenage fathers emphasized breadwinning first, then involved himself in the child and the housework. These findings provide an increased understanding of Thai teenage fathers.


Background Targeted delivery to inflamed joint and site specific drug release are the key factors for effective therapy against inflammatory arthritis. The critical dose-limiting factor for methotrexate, an anchor drug for inflammatory arthritis, is toxicity on the liver and bone marrow, which may overcome by targeted delivery based on the microenvironment. Objectives The aim of this study is to investigate intracellular delivery and in vivo efficacy of modified hyaluronic acid nanoparticles (HANPs) as a carrier for methotrexate. Methods As a potential carrier of methotrexate (MTX), HANP were synthesized by self-assembly from hydrophobic HA derivatives and chemically modified including PEGylation and mineralization to enhance target selectivity in inflammatory arthritis. Cellular uptake was evaluated using human monocytes/macrophages and sinusoidal endothelial cells (HSEC) and murine macrophages derived from CD44- and stabilin-2-deficient mice. Biodistribution and therapeutic efficacy were evaluated in collagen-induced arthritis (CIA) mice. Results In release kinetic studies, a sustained release pattern of MTX was observed for MTX-loaded bare HANPs, which was not dependent on the pH. Release of MTX from mineralized PEGylated HANP (mpHANP), however, was much higher in acidic condition compared with HANP and PEGylated HANP (pHANP). Both differentiated macrophages and HSEC effectively endocytosed HANP-Cy5.5, which was inhibited by wortmannin and chlorpromazine, but not by dynasore, amiloride, nystatin, or LY294002. Rifampin, an inhibitor of organic acid transporter, inhibited suppressed the cellular uptake of HANP in cooperation with wortmannin. Intracellular accumulation of HANP was not reduced in murine macrophages from CD44- and stabilin-2-deficient mice. Subcellular trafficking of HNAP was studied using Rab5, lysotracker, endoplasmic reticulum tracker, and mitotracker. HANP-Cy5.5 colocalized with early endosomes which later colocalized with lysosomes, implicating that MTX enclosed in HANP may be released at late endosomes in macrophages. Systemic administration of HANP-Cy5.5 revealed accumulation on inflamed joints as well as liver on the real-time optical imaging. Ratios of fluorescence intensities over paw and liver in CIA mice were significantly improved with mpHANP compared to HANP and pHANP. Histologic evaluation confirmed the enhanced selectivity for joint accumulation of mpHANP-Cy5.5. Treatment of CIA mice with high dose of MTX (50 mg/kg) resulted in serious toxicity as well as therapeutic efficacy. In contrast, repeated treatment with MTX in mpHANP (50mg/kg of MTX) did not have toxicity on body weight measurement and biochemical and hematological evaluation, but with remarkable efficacy in ameliorating arthritis. Conclusions The present study showed that mpHANP nanocarrier for MTX, which release MTX in a pH-responsive manner after receptor-mediated endocytosis, remarkably enhanced target selectivity to inflamed joint tissues and thus may serve as a promising carrier for MTX in inflammatory arthritis. Acknowledgements This study was supported by a grant from the Korea Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (A101706). Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.3589


The process of European integration has been studied and analysed at great length in a variety of academic disciplines. The main focus of this endeavour is usually to try to explain institution-building, policy integration or policy outputs at the European level. In the main theories of integration, domestic politics is a central explanatory factor of the integration process. For example, in the early 'neo-functionalist' theory of Ernst Haas and his followers, one of the driving forces of the delegation of policy functions to the European level was the battle between domestic interest groups, political parties and rival groups of elites. In the contemporary 'liberalintergovernmental' approach of Andrew Moravcsik, the integration process is driven by competition and bargaining between the European nationstates, but 'national' preferences emerge from the on-going processes of domestic politics, where rival interests compete for control of the policy agenda.


This paper describes work carried out to assess the elastic performance of microelectromechanical (MEMS) test structures in a post-CMOS (complementary metal oxide semiconductor) metal oxide process. Electrostatic pull-in measurements are used to extract the residual stress, elastic modulus and stress-gradient for the process. Results are presented for metal structures and for composite metal/oxide structures. The extracted parameters are compared with values obtained from blanket film measurements and from analysis based on bulk material properties. Test structures have also been tested for cycling repeatability. A drift is observed in successive cycles of electrostatic actuation and this drift is attributed to charge trapping in the nitride passivation of the underlying CMOS process. A charge-balance model is used to estimate the trapped charge and the effect of actuation voltage polarity is also discussed. The results indicate that satisfactory elastic performance of mechanical structures is dependent on process conditions but can be achieved. The stability of electrical operating characteristics is dominated by nitride charge trapping effects. This effect can be quantified using a basic model. To minimize problems due to charge trapping dielectric properties must be investigated and operating characteristics modified.


This collection of essays examines alternative theories about persons and personal identity at the beginning and end of life. The contributions seek to answer the important question, When does a person begin and cease to exist? While the concept of personhood has figured prominently in contemporary debates over abortion and stem cell research, this is the first anthology to combine in a single volume both various theoretical perspectives and consideration of the more practical, bioethical issues. These essays are gathered from a rich tradition of philosophical and religious readings on the subject, from Rene Descartes's Meditations on First Philosophy and John Locke's Essay concerning Human Understanding to more modern discussions on persons living with dementia and on the definition of death. Organized chronologically, these works address three broad topics: theories of persons, persons at the beginning of life, and persons at the end of life. The first section offers differing views on the nature of persons that have influenced ontological and bioethical discussions of the subject. Essays in the next section track the debate over abortion and the moral status of embryos. The last section explores alternative definitions and determinations of death. Defining the Beginning and End of Life is a useful resource for examining the connection between theoretical and bioethical considerations about persons. It will engage bioethicists and philosophers as well as inform policy and law regarding issues at the beginning and end of life.


Type-2 Diabetes remains a progressive chronic disease that takes more and more lives every year. Small studies are beginning to show that a lifestyle approach could reverse type-2 diabetes in most individuals. The key discoveries from these studies are captured and formulated into a System Design Map for Prevention, Early Detection, and Reversal of Type-2 Diabetes using Collective System Design. Collective System Design describes systems as four aspects that interrelate: tone, thinking, structure and work. The tone in Collective System Design fosters an environment that views human failure as a failure of the system design itself. The thinking in Collective System Design is communicated by Axiomatic Design (AD).With the Collective System Design Approach, a model for prevention, early detection, and reversal of chronic disease is developed. The motivation for this paper is the ability to save millions of lives through a sustainable lifestyle program by identifying the required diet and exercise.


In this paper we present an application and extension of the upwind schemes with source terms decomposed, developed by Bermudez, Vazquez, Hubbard, and Garcia-Navarro, to the one-dimensional open channel flow equations with general, i.e., nonprismatic and nonrectangular, geometries. Our specific numerical approximations for terms that appear in these equations and are related to the channel's geometrical properties are quite straightforward and natural, and at the same time respect the balancing of the flux gradient and the source term. As a consequence, the resulting upwind schemes have the exact conservation property. In several test problems we illustrate the achieved improvement, particularly significant for applications to natural watercourses due to their irregular riverbed geometries.


The author of the article using methodological theoretical analysis of scientific works identifies theideological basis of the process of scientific and pedagogical cognition as a structural component of the generalizedmodel of the paradigm of education.The author found out that the research activities of scientists and educational activities of practicingeducators in a particular historical period is determined by ideological generalizations (philosophical, ontological,epistemological, methodological, logical, axiological, culturological, etc.), which form a philosophical views ofscientists and practicing educators on the general scientific worldview, types of material and spiritual systems, lawsof functioning and development of nature and society, the essence of human existence.It was emphasized that the fundamental worldview generalizations that determine the specifics of theeducational process in the postmodern era are: the definition of science as the dominant value determinant of theprogressive development of mankind; civilizational role of educational processes; understanding of the third millenniumman as a subject of his own life, history and culture; substantiation of the philosophy of education as a methodologicaland theoretical basis for the development of the world and national educational systems; synergetic guidelines of nationaleducation in the context of the phenomenon of globalization; causation of the nature of formation of social and economicrelations by natural resource, territorial and social potential of sustainable development of Ukraine.


Perception experiments suggest that natives judge non-native unfilled pauses as indiscriminate and indecisive. Multiple regression analyses of unfilled pauses indicate a connection between syntactic structure and pause location and duration. Native speakers uniformly pause at large syntactic breaks with marked duration, whereas non-natives' unfilled pauses are spread over various locations, possibly reflecting limited syntactic planning. Our method might be used to synthesize appropriate unfilled pauses in text-to-speech systems, and to train pausing behavior in automated pronunciation learning systems for non-native learners.


[eng] This work aims to analytically understand the impact of two diametric opposite environments on protein structure and dynamics and compared them to the most common solvent on earth: water. The first environment is a popular denaturing solution (urea 8M), which has served for years in protein-science laboratories to investigate protein stability; still many open questions regarding its mechanism of action remained unclear. The second environment instead moves towards a more physiological representation of proteins. The cell interior, in fact, is a crowded solution highly populated prevalently by proteins, but studies on protein structure and dynamics have lead so far to confusing or even opposite observations. The lack of a consensus view in both phenomena possibly derives from the bias of the system under study. This work is an attempt of a comparative study using the most general systems: a diverse spectrum of proteins folds, different stages along the reaction path (early stages or end-point) and/or different protein force-fields. Our main objective was to derive common pattern and general rules valid at proteome level, focusing on three major aspects of proteins: the structure, the dynamic and the interactions with the solvent molecules. Molecular dynamics simulation appeared then as the most suitable tool because of its ability to i) analyze proteins at broad range of resolutions; ii) access the direct time-resolved dynamic of the system and iii) dissect the specific interactions that arise in the new settings. Specifically, the case of urea-induced unfolding needs a system for which is possible to clearly identify folded and unfolded state – globular proteins are then the most suitable ones. We extracted general rules on the folded/unfolded transition by studying independently the two end-points of folded/unfolded reaction. We simulated the urea-induced unfolded state of a model protein, ubiquitin to understand the energetics stabilizing unfolded structures in urea. We found that the unfolded ubiquitin in 8M urea is fully extend and flexible and capturing efficiently urea molecules to the first solvation shell. Dispersion, rather than electrostatic, appear the main energetic contribution to explain the stabilization of the unfolded state. We then simulated the early stages of urea-induced unfolding on a large dataset of folded proteins, which represent the major folds of globular proteins, aiming also to investigate the kinetic role of urea in triggering the protein unfolding. We found that partially unfolded proteins expose the apolar residues buried in the protein interior, mainly via cavitation. Similar to the unfolded state, it is the dispersion interactions that drive urea accumulation in the solvation shell but here urea molecules take advantage of microscopic unfolding events to penetrate the protein interior. Macromolecular crowding instead is a phenomenon that universally affects all the proteins. We simulated a system that included as crowding agents proteins with different conformational landscapes (a globular protein, an intrinsically disordered proteins and a molten globule) arranged to reach cell-like concentrations. We conclude that the universal effect of crowding, valid for all the proteins types, is exerted via the aspecific interactions and favors open and moderately extended conformations with higher secondary structure content. This phenomenon counterbalances the volume-exclusion, which prevails at higher crowding concentrations. The impact of crowding is proportional to the degree of disorder of the protein and for folded protein crowding favors structural rearrangements while unfolded structures experience a stronger stabilization and a higher secondary structures content. The synthetic crowder PEG doesn't reproduce any of these effects, arising concerns about its employment in study cell-like environments.


Compared with one-way wave equation migration and ray-based migration, reverse time migration (RTM) using two-way wave propagation information can produce accurate imaging results for complex structures. Its computational accuracy and efficiency are mainly determined by numerical methods for wavefield simulation. When using traditional regular grids for seismic modeling, scattering artifacts may occur due to the stepped approximation of layer interfaces and rugged topography. On the other hand, irregular grids require a complex grid generation algorithm, despite having certain geometric flexibility. Mesh-free RTM can effectively reduce the scattered noise under regular grids and avoid the extra computation in the process of irregular grid generation. For implementation of the mesh-free RTM method, an algorithm with fast generation of node distributions is used to discretize the underground velocity model, and radial-basis-function-generated finite difference is used to realize the numerical simulation of wave propagation; the crosscorrelation imaging condition is adopted for imaging. The mesh-free RTM method, which has the flexibility of the simulation region and an abundance of wavefield information, reduces the storage required for RTM, shows the potential of high-accuracy migration in the case of an undulating surface, and provides more accurate migration imaging results for oil and gas exploration under complex geologic conditions.


Currently, evaluation of biometric authentication systems depends on biometric databases. Such databases usually consist of biometric data collected in cooperation with a lot of volunteers. If the number of volunteers involved in a database becomes very large and if the database is circulated from a organization to other, there arises a new threat that the privacy of the volunteers might be infringed in case of database abuse. To protect the privacy of volunteers and to build a freely circulated biometric database, we propose a new method to construct synthetic biometric examples from real examples. In this paper, first we analyze the requirement of biometric database for evaluation and show the guidelines to build a synthetic biometric database. Then we show the preliminary case study on face database. The case study includes the data distribution analysis in a PCA subspace of 330 volunteer faces. Finally, we show some examples synthesized by our method.


A successful polymer electrolyte membrane for fuel cell application must have efficient proton conductivity as well as good water retention capability. The viability of using composite membranes prepared by blending 85% deacetylated chitosan (CS) and Nafion® in proton exchange membrane fuel cells (PEMFCs) was investigated based on the concept of hydrophilicity and the water uptake characteristics of CS. These membranes were characterized by infrared spectroscopy and field-emission scanning electron microscopy to investigate their intermolecular interactions and morphology, respectively. Absorption studies were carried out to evaluate the interactions of the membranes with water. Titrimetric ion exchange capacity analysis indicated the availability of active sites in the membrane. The CS/Nafion® blend was found to be suitable for PEMFC applications because of its relatively high proton conductivity compared to that of regular Nafion®. Above all, the cost-effectiveness and simple fabrication of such composite membranes make their use in low-temperature PEMFCs very attractive and economical.


Fluorescent sensors DJ-1 and DJ-2 with a large Stokes shift (SS) based on a combination of PET (photo-induced electron transfer) and FRET (Fo¨rster resonance energy transfer) have been developed for the detection of water in organic solvents. DJ-1 is composed of anthracene-(aminomethyl)phenylboronic acid ester as the PET-type donor fluorophore and a BODIPY skeleton as the acceptor fluorophore in the FRET process. In contrast, DJ-2 is composed of an anthracene skeleton as the donor fluorophore and a BODIPY-(aminomethyl)phenylboronic acid ester skeleton as the PET-type acceptor fluorophore in the FRET process. In fact, the addition of water to organic solvents containing DJ-1 or DJ-2 caused both PET suppression and energy transfer from the donor fluorophore to the acceptor fluorophore through the FRET process, thus resulting in an enhancement of the fluorescence band originating from the BODIPY skeleton. In addition, the pseudo-SS values of DJ-1 and DJ-2 between the photoabsorption maximum of the anthracene fluorophore and the fluorescence maximum of the BODIPY fluorophore are 7563 cm (cid:2) 1 (141 nm) and 8017 cm (cid:2) 1 (153 nm), respectively, which are significantly higher than those of a typical PET-based fluorescent sensor. It was found that the FRET efficiency for DJ-1 is quantitative, but that for DJ-2 was estimated to be ca. 50% based on time-resolved fluorescence lifetime measurements. Moreover, the detection limit of DJ-1 for water is superior to that of DJ-2 . Based on the fluorescence sensing mechanism of DJ-1 and DJ-2 for water, we propose that a combination of a PET-type donor fluorophore and an acceptor fluorophore in the FRET process is one of the most promising molecular designs to create an efficient fluorescent sensor for the detection of water in organic solvents.


Abstract We review the literature on adolescent breast development, including the physiological sequence of normal female adolescent breast development, and the psychological responses to such development of the adolescent, her family, and her peers. Breast development is a line of developmental growth neglected by psychiatrists, pediatricians, and other health professionals. It is critical that those dealing with adolescents both note and discuss with the female her feelings about her physical development in relationship to herself, her peers (male and female), and her family.


A fundamental aspect of institutional design is how much society chooses to delegate unchecked power to its leaders. If, once elected, a leader cannot be restrained, society runs the risk of a tyranny of the majority, if not the tyranny of a dictator. If a leader faces too many ex post checks and balances, legislative action is too often blocked. As our critical constitutional choice we focus upon the size of the minority needed to block legislation, or conversely the size of the (super) majority needed to govern. We analyse both 'optimal' constitutional design and 'positive' aspects of this process. We derive several empirical implications, which we then discuss.


The quantised inverter amplifier concept is introduced, where an input signal is sliced and amplified by an array of amplifiers. This strategy expands the dynamic range of the amplifier and relaxes the power demand of the following stages as the total output swing can virtually exceed the supply voltage. Moreover, using multiple amplifiers helps to linearise the input–output transfer characteristic. Simulations results confirm the presented theory.


For a number of years the NRC group has been working on a laboratory protocol for the analysis of gas hydrate that has been recovered from various natural sites. The expectation was that a comprehensive set of techniques would become available for the general use of hydrate researchers around the world. With the current set of available techniques a good picture of natural gas hydrates can be obtained, although the emerging complexity of the hydrate-mineral system still demands additional work. Here we present a suite of techniques that will take a researcher from preservation techniques to hydrate occurrence, gas/water/sediment ratios, gas and isotope analysis, P-T behaviour, structure, composition, degree of water conversion to hydrate, hydrate homogeneity and decomposition behaviour. As more detailed studies become possible a variety of more subtle features are revealed, for instance the role of minor gas components in hydrate stability, decomposition behaviour and heterogeneity in structure and composition.


Numerous network compression methods have been proposed to deploy deep neural networks in a resource-constrained embedded system. Among them, block-circulant matrix (BCM) compression is one of the promising hardware-friendly methods for both acceleration and compression. However, it has several limitations; (i) limited representation due to the structural characteristic of circulant matrix, (ii) limitation of the compression parameter, (iii) need to specialize the dataflow for BCM-compressed network accelerators. In this paper, rank-enhanced and highly-pruned block-circulant matrices compression (RP-BCM) framework is proposed to overcome these limitations. RP-BCM comprises two stages: Hadamard-BCM and BCM-wise pruning. Moreover, a dedicated skip scheme is introduced to processing element design for exploiting high-parallelism with BCM-wise sparsity. Furthermore, we propose specialized dataflow for a BCM-compressed network on a resource-constrained FPGA. As a result, the proposed method achieves parameter reduction and FLOPs reduction for ResNet-50 in ImageNet by 92.4% and 77.3%, respectively. Moreover, the proposed hardware design achieves $3.1\times$ improvement in energy efficiency on the Xilinx PYNQ-Z2 FPGA board for ResNet-18 on ImageNet compared to the GPU.


During the 1990s, rural health became more prominent on the political agenda. Through the 20th century, the NSW Department of Health and its antecedents contributed to subsidies raised by local communities to attract and retain doctors; progressively increased its rural workforce; and, especially in the period following the Second World War, constructed many small rural hospitals. In the 1970s, the NSW Health Commission took the initial structural steps to decentralise health service administration to the regions.


The article presents a theoretical and empirical analysis of the phenomenon of youth values in the context of social and ethno-cultural transformations of Russian society. The results of focus groups conducted with the youth of the Saratov and Samara regions aged 18 to 35 showed the contexts of the manifestation of terminal values – family, health, self-development, freedom and personal and professional self-realization, acting as the basic guidelines of the younger generation and the characteristics of the relationship to ethnocultural differences.


We investigate the dielectric and ferroelectric properties of Sr1−xBixTi1−xFexO3 solid solutions (x = 0, 0.05, 0.1, 0.15 and 0.2) together with their structures. Through the analysis of Rietveld refinement of powder x-ray diffraction, a cubic structure in space group Pm3̄m is determined for all the compositions. An obvious dielectric relaxation peak differing from SrTiO3 is observed in the present ceramics. The peak temperature Tm increases with increasing x, and it approaches room temperature at x = 0.2. The Vogel—Fulcher law and Curie—Weiss law fittings further confirm the relaxor ferroelectricity in the present ceramics.


The timely sharing of raw sensing information in the vehicular networks (VNETs) is essential to safety. In order to improve the freshness of sensing information, joint scheduling of multi-dimensional resources such as communication and computation is required. However, the complex relevance among multi-dimensional resources is still unclear, and it is difficult to achieve efficient resource utilization. In this paper, we present a theoretical analysis for a novel metric Age of Information (AoI) on a communication and computation assisted spatial-temporal model. An uplink VNETs scenario where Road Side Units (RSUs) are deployed with computational resource is considered. The transmission and computation process is unified into a two-stage tandem queue and the expression of the average AoI is derived. The network interference is analyzed by modeling the VNETs as Cox Poisson Point Process based on stochastic geometry and the closed-form solution of the coverage probability and the expected data rate performance under the constraints of transmission resources is obtained. The simulation results reveal the basic relationship between communication and computation capacity and show that communication and computation should reach a tradeoff to improve resource utilization while ensuring real-time information requirement.


The presence of debris disks around young main-sequence stars hints at the existence and structure of planetary systems. Millimeter-wavelength observations probe large grains that trace the location of planetesimal belts. The Formation and Evolution of Planetary Systems Spitzer Legacy survey of nearby young solar analogues yielded a sample of five debris disk-hosting stars with millimeter flux suitable for interferometric follow-up. We present observations with the Submillimeter Array (SMA) and the Combined Array for Research in Millimeter-wave Astronomy at ∼2″ resolution that spatially resolve the debris disks around these nearby (d ∼ 50 pc) stars. Two of the five disks (HD 377, HD 8907) are spatially resolved for the first time and one (HD 104860) is resolved at millimeter wavelengths for the first time. We combine our new observations with archival SMA and Atacama Large Millimeter/Submillimeter Array data to enable a uniform analysis of the full five-object sample. We simultaneously model the broadband photometric data and resolved millimeter visibilities to constrain the dust temperatures and disk morphologies, and perform a Markov Chain Monte Carlo analysis to fit for basic structural parameters. We find that the radii and widths of the cold outer belts exhibit properties consistent with scaled-up versions of the Solar System's Kuiper Belt. All the disks exhibit characteristic grain sizes comparable to the blowout size, and all the resolved observations of emission from large dust grains are consistent with an axisymmetric dust distribution to within the uncertainties. These results are consistent with comparable studies carried out at infrared wavelengths.


Bread characteristics are dependent upon the chemical composition and fiber content of the wheat flour used. A healthy diet can help prevent chronic diseases, where whole grains and fewer calories from fat are components of a healthy diet. The aims of this study were to determine the centesimal composition of wheat flour samples (whole, refined, and flour blends) along with their farinographic parameters (water absorption, development time and stability) and also to verify the specific volume, crumb texture profile and digital imaging of bread loaves made with 60% whole wheat flour and 3% fat or fat replacer. Increasing the whole wheat flour percentage in the blends also increased levels of protein, ash and insoluble fiber. All the farinographic parameters were also increased. Enzymatically modified starch was found to be an effective fat replacer in whole wheat loaves. The loaves made using fat replacer had the same specific volume and higher cell density as those made with fat, but exhibited different texture profile parameters such as higher hardness value and lower springiness value.


The plasmodial form of slime mould Physarum polycephalum is a macroscopic acellular organism that is capable of apparently intelligent behaviour, yet it lacks any features usually associated with intelligence. In this investigation, we study the morphology of the plasmodial actin cytoskeleton and formalise its network topology in efforts to correlate cytoskeletal morphology with slime mould computational abilities. The plasmodial actin network is a highly abundant, complex structure which links the functional components of the cell, whose topology may be approximated with a range of proximity graphs, depending on the physiological and environmental conditions within the plasmodium. Its topology is highly dynamical and is likely to rapidly alter in response to environmental stimuli to maximise network efficiency. We conclude by discussing the nature of the computational process in organic networks.


It is clear from the outset that Wacquant has a particular "theoretical" ax to grind—one with an ideological blade—and that in doing so he seriously misreads Code of the Street, distorting its findings to fit his polemical purposes. At best, he seriously misunderstands my work; at worst, he willfully misrepresents it in his review. Regardless, Wacquant fails to engage the main thrust of the book: As a result of the breakdown or weaknesses of civil law in the most distressed inner-city communities, a survival strategy with implications for local public order has emerged—a "code of the street" that relies on "street justice," whose transactions involve a currency of reputation, respect, retribution, and retaliation. Because civil law has been so compromised and eroded locally, people often rely on themselves and their reputations for protection, a situation that leads to high rates of urban violence. A legacy of institutionalized racism, joblessness, and alienation suffuses distressed inner-city neighborhoods and exacerbates these conditions. In some of Philadelphia's most distressed ghetto areas, the community divides itself into two opposing status groups—"decent" and "street" —each with its own value orientation. "Decency" is most often associated with the wider, conventional society, whereas "street"—or its own descriptive analogue, "ghetto"—is often used as an epithet (especially by those identifying themselves as decent) and strongly associated with the most troublesome aspects of ghetto life. In the name of "keeping it real,"


This paper presents a maneuver analysis of a full-vehicle featuring electrorheological(ER) suspension and ER brake. In order to achieve this goal, an ER damper and an ER valve pressure modulator are devised to construct ER suspension and ER brake systems, respectively. After formulating the governing equations of the ER damper and ER valve pressure modulator, they are designed and manufactured for a middle-sized passenger vehicle, and their field-dependent characteristics are experimentally evaluated. The governing equation of motion for the full-vehicle is then established and integrated with the governing equations of the ER suspension and ER brake. Subsequently, a sky-hook controller for the ER suspension and a sliding mode controller for the ER brake are formulated and implemented. Control performances such as vertical displacement and braking distance of vehicle are evaluated under various driving conditions through computer simulations.


In this paper we study the shape characteristics of a polymer chain in a good solvent using a mesoscopic level of modelling. The dissipative particle dynamics simulations are performed in 3D space at a range of chain lengths N. The scaling laws for the end-to-end distance and gyration radius are examined first and found to hold for N⩾10 yielding a reasonably accurate value for the Flory exponent ν. Within the same interval of chain lengths, the asphericity, prolateness and some other shape characteristics of the chain are found to become independent of N. Their mean values are found to agree reasonably well with the respective theoretical results and lattice Monte Carlo (MC) simulations. We found the probability distribution for a wide range of shape characteristics. For the asphericity and prolateness they are quite broad, resembling in form the results of lattice MC simulations. By means of the analytic fitting of these distributions, the most probable values for the shape characteristics are found to supplement their mean values.


The inverse signal-to-noise ratio (SNR) problem is defined as determining the average SNR X required to achieve a specified probability of detection P/sub d/, given P/sub fa/ the false alarm probability, N the integration number, and K a target fluctuation parameter that encompasses the Swerling and Marcum models. Although exact expressions exist for the standard problem of determining Pd given X and the other parameters, these expressions cannot be inverted. We present here approximations for the required SNR over a wide range of parameter values. Over most of the specified parameter ranges, the magnitude of the error in these approximations is less than 1 dB, in fact mostly less than 0.5 dB. If the resulting accuracy is insufficient, then an iterative procedure is necessary and the approximate value X/sub ap/' can be used as a starting value. The Marcum case results apply directly to the radiometry inverse problem as well.


This chapter reviews the application and characterization of material that uses the microwave waveguide systems. For macroscopic characterization, three properties of the material are often tested: complex permittivity, complex permeability and conductivity. Based on the experimental setup and sub-principle of measurements, microwave measurement techniques can be categorized into either resonant technique or nonresonant technique. In this chapter, calibration procedures for non-resonant technique are described. The aperture of open-ended coaxial waveguide has been calibrated using Open-Short-Load procedures. On the other hand, the apertures of rectangular waveguides have been calibrated by using Short-Offset-Offset Short procedures and Through-ReflectLine calibration kits. Besides, the extraction process of complex permittivity and complex permeability of the material which use the waveguide systems is discussed. For one-port measurement, direct and inverse solutions have been utilized to derive complex permittivity and complex permeability from measured reflection coefficient. For two-port measurement, in general, the material filled in the waveguide has been conventional practice to measure the reflection coefficient and the transmission coefficient by using NicholsonRoss-Weir (NRW) routines and convert these measurements to relative permittivity, εr and relative permeability, μr. In addition, this chapter also presents the calculation of dielectric properties based on the difference in the phase shifts for the measured transmission coefficients between the air and the material.


Service failure breeds customer dissatisfaction leading to customer churn. However, the customers? perception of the service recovery effort of the firm significantly impacts customers' satisfaction. An effective service recovery has the potential to turn an upset, irritated customer into a loyal one. The present study uses structural equation model to develop the strategy for highest impact service recovery effort for various service failure contexts. It draws on the dimensions of equity theory to understand the causal motivators for customers? behavior under different service failure situations. Use of the longitudinal research design adds to the empirical robustness of the study. The study finds that at the first instance of service failure both interactional justice as well as distributive justice has significant impact on customer satisfaction with the service recovery effort. However in case of successive service failures, interaction justice is no longer significant. In case of repeat service failure, only distributive justice is significant in achieving customer satisfaction with the service recovery effort.


Tumor necrosis factor (TNF) inhibitors have produced improvements in clinical, radiographic, and functional outcomes in rheumatoid arthritis (RA) patients. However, it remains unclear whether factors affecting physical functions remain following TNF therapy. The objective of our study was to assess factors affecting improvement of physical functions and to shed light on relations to disease activity and structural changes in patients with RA treated with etanercept. The study enrolled 208 patients, all of whose composite measures regarding clinical, radiographic, and functional estimation both at 0 and 52 weeks after etanercept therapy were completed. Mean disease duration of 208 patients was 9.6 years, mean Disease Activity Score for 28 joints (DAS28) was 5.4, and mean van der Heijde modified total Sharp score (mTSS) was 94.6. Mean Health Assessment Questionnaire Disability Index (HAQ-DI) improved from 1.4 at 0 weeks to 1.0 at 52 weeks after etanercept therapy, a 31% reduction, which was much less than changes in DAS28 and mTSS. By multivariate analysis, HAQ-DI and mTSS at baseline were significantly correlated HAQ remission. Median HAQ-DI improved in 100 versus 20% of the HAQ-DI ≤0.6 versus ≥2.0 groups, respectively. The mTSS cutoff point at baseline to obtain HAQ remission was 55.5. During etanercept treatment in the mTSS <55.5 versus >55.5 groups, median HAQ-DI improved in 70 versus 39%; remission was achieved in 59 versus 33%; and there was no improvement in14 versus 30%, respectively. HAQ-DI improvement was significantly correlated with that of DAS28 but not of mTSS. In conclusion, higher HAQ and mTSS at baseline inhibits HAQ-DI improvement within 1 year of etanercept treatment, and the cutoff point necessary for mTSS to improve physical functions in patients with RA was 55.5.


100 women ranging in age from 26-34 years were followed up for 4-21 months after undergoing sterilization by tubal occlusion using intraluminal threads and silver clips. The number of children/woman ranged from 1-5 with 80% having 2. 31 women underwent sterilization postmenstrually 11 midmenstrually 28 premenstrually 12 after abortion and 8 during lactation. The timing was unknown in 8 cases. The silver clips used were hook eye "db" shaped 3 mm wide .5 mm thick and 70 100 or 150 mg in weight. Local anesthesia suprapubic small abdominal incision and oviduct delivery were the usual procedures. The clips were placed where the tube is relatively straight and avascular often near the isthmus or ampulla. No. 4 nylon thread was drawn through the tube and a silver clip was put on each tube and tightened until the threads could no longer be moved. The extra thread was snipped off about 3 mm from the clip. There were no pregnancies among 95 patients followed up. 18 patients had varying degrees of lumbago or leg pain and 1 complained of serious lower abdominal pain especially after coitus. Pelvic examination in 74 patients showed 1 case of slight thickening in the right appendix region but no pelvic masses. Hysterosalpingography in 22 patients showed 1 case with incomplete occlusion on 1 side. The method is believed to be safe and suitable for use in smaller hospitals and outpatients. Reversibility has been demonstrated in rabbits.


This study uses U.S.-level time-series data (1935-2015) to test the present value model of farmland prices. Following Engle and Granger (1987) we test each individual time-series for non-stationarity. We subject real farmland prices per acre, real returns per acre, and real interest rates (log-log form) to a set of unit root tests designed to test for (weak) stationarity. We find evidence from some of these tests to support stationarity (KPSS test) and also evidence to support non-stationarity. We also find that structural breaks in the data series may at least partly explain why we cannot reject the null that farmland prices and returns/acre are cointegrated. The observed breaks may be due to changes in the required risk premium on farmland investments, such as during the US farm financial crisis of the early 1980s. Also, the standard unit root and co-integration tests may not be powerful enough to detect co-integration.