Personal Learning Environments or PLE are student centred spaces, which take into account theirs needs, learning stylesand preferences. These spaces appear as important alternatives to overcome the shortcomings encountered with the use ofinstitutional platforms. On the other hand, there is widespread use of mobile electronic devices and Web 2.0 tools amonguniversity students, mainly for communication and leisure activities, but that could be used for educational purposes. Thisresearch aims to make a diagnosis on access to and use of electronic devices and the web tools by students of the degree ofSystems Engineering and Computer Science at Faculty of Engineering at the National University of Chimborazo inEcuador, from the viewpoint of PLE. A methodological level corresponds to a quantitative and non-experimentalresearch, ex-post-facto. The results show certain trends in the types of devices and their frequency of use, as well as theirpreferences for the tools to obtain and to find information, not only to create but to edit content and communicate withothers, where they prioritize the use of certain social networks and some tools of synchronous and asynchronouscommunication. One of the main conclusions of this study mentions the huge potential currently offered by Web 2.0 toolsto structure the PLE of college students, as well as the great potential for integration with mobile device.


Lateral motion of the magnetic tape in data storage applications misaligns the flexible medium relative to the recording head and reduces the potential for decreasing data track width and spacing, and thereby the achievable data storage density. In order to reduce the effect of misalignment between the tape and the recording head, the head is mounted on a track-following actuator that can compensate for the position error up to a frequency that is governed partly by its mechanical resonances; this bandwidth is typically 1 kHz or less for conventional voice coil-based actuators. This paper introduces the design and implementation of a track-following actuator that is piezo-electrically actuated in order to potentially achieve a significant increase of bandwidth and positioning precision. A proof-of-concept is prototyped and experimental results are presented. An H∞ controller is designed and implemented to compensate for typical disturbances such as periodic runout of packs and rollers, or non-periodic flange impacts. Preliminary closed loop experimental results with an experimental low lateral motion tape path, and conventional servo format and media demonstrate a reduction in positioning error standard deviation to 74.5 nm, with simulations indicating a potential for further improvement to 20.6 nm with the use of improved media and servo format.


Principles and Practice of Blood-Gas Analysis. A. P. Adams and C. E. W. Hahn; Franklin Scientific Projects, The Plough Brewery (516 Wandsworth Rd., London SW8 3JX); pp. 95; 230 x 220. This book contains information about various aspects of blood-gas analysis in one volume of 94 pages. In Chapters 1-4 the authors discuss the physics and physiology of gas transport. Little prior knowledge of the topic is taken for granted. The same could not be said for Chapter 5: 'Acid Base Balance'. In Chapters 7-12 electrodes, blood-gas correction factors and the measurement of oxygen content and haemoglobin saturation are discussed in a moderately technical way which is nonetheless readable. These are the chapters which the clinician will probably find the most engaging. The title of Chapter 6, 'The Clinical Approach to Blood-gas and Acid-base Problems' may suggest to the novices that it contains a clear guide to the interpretation and application of blood-gas measurements. If so, I believe they will be disappointed. I found the chapter disjointed. 'The anion gap' and 'alveolar-to-arterial oxygen tension gradients' were introduced without their relevance being adequately explained. Diagrams are plentiful and most are very good. However, the use of red and blue lines on the carbon dioxide dissociation curve to represent things other than the curves for arterial and venous blood (p. 28) proved most confusing. The book has more to offer the leisurely reader than the examination candidate. I believe it would be a valuable acquisition for a department or hospital library. B. F. HORAN


Thread count is a term used in the textile industry as a measure of how closely woven a fabric is. It is usually defined as the sum of the number of warp threads per inch (or cm) and the number of weft threads per inch. (It is sometimes confusingly described as the number of threads per square inch.) In recent years it has also become a subject of considerable interest and some controversy among consumers. Many consumers consider thread count to be a key measure of the quality or fineness of a fabric, especially bed sheets, and they seek out fabrics that advertise high counts. Manufacturers in turn have responded to this interest by offering fabrics with ever higher claimed thread counts (sold at ever higher prices), sometime achieving the higher counts by distorting the definition of the term with some "creative math." In 2005 the Federal Trade Commission noted the growing use of thread count in advertising at the retail level and warned of the potential for consumers to be misled by distortions of the d...


A 55-year-old man with a chief complaint of melena had diffusely infiltrated lymphoma from the rectum to the sigmoid colon and polyclonal hypergammaglobulinemia. Biopsy specimen obtained from the rectum revealed diffuse medium-sized lymphoma cell with plasmocytosis. Histochemical analysis with monoclonal antibodies indicated that the origin of the tumor cell to be T-lymphocyte. Chemotherapy with cyclophosphamide, vincristine and prednisolone (VEP regimen) was effective for mucosal bleeding of the colonic lesion and reduction of polyclonal hypergammaglobulinemia. Five yrs later he showed recurrence of the disease and elevation of serum alphafetoprotein, and died of pulmonary infections. Autopsy finding confirmed the diagnosis of malignant lymphoma of the colon and disclosed the association of hepatocellular carcinoma.


New data on the fauna of mayflies in the Anabar River basin are given. A total of eight species of Ephemeroptera have been identified in the fauna of North-Western Yakutia for the first time. Though the mayfly fauna in this region consists mainly of East Palaearctic species, the only seven of them are characterized by arctic-alpine distribution. In general, mayfly species richness of the studied subarctic and southern rivers of Yakutia is similar.


We present a (non‐standard) probabilistic analysis of dynamic data structures whose sizes are considered dynamic random walks. The basic operations (insertion, deletion, positive and negative queries, batched insertion, lazy deletion, etc.) are time‐dependent random variables. This model is a (small) step toward the analysis of these structures when the distribution of the set of histories is not uniform. As an illustration, we focus on list structures (linear lists, priority queues, and dictionaries) but the technique is applicable as well to more advanced data structures. © 2005 Wiley Periodicals, Inc. Random Struct. Alg., 2006


We have applied harmonic expansion to derive an analytical solution for the Lorenz-Haken equations. This method is used to describe the regular and periodic self-pulsing regime of the single mode homogeneously broadened laser. These periodic solutions emerge when the ratio of the population decay rate ℘ is smaller than 0:11. We have also demonstrated the tendency of the Lorenz-Haken dissipative system to behave periodic for a characteristic pumping rate "2CP"[7], close to the second laser threshold "2C2th"(threshold of instability). When the pumping parameter "2C" increases, the laser undergoes a period doubling sequence. This cascade of period doubling leads towards chaos. We study this type of solutions and indicate the zone of the control parameters for which the system undergoes irregular pulsing solutions. We had previously applied this analytical procedure to derive the amplitude of the first, third and fifth order harmonics for the laser-field expansion [7, 17]. In this work, we extend this method in the aim of obtaining the higher harmonics. We show that this iterative method is indeed limited to the fifth order, and that above, the obtained analytical solution diverges from the numerical direct resolution of the equations.


A binary decision diagram(BDD) is a data structure that is used to represent a Boolean function.Converting fault tree into BDD can effectively simplify counting processes and improve the accuracy and effectiveness of the results. However, due to various types of uncertainties in reliability data, we cannot obtain precise failure probabilities. In order to accurately quantify the certainties and obtain much more reliable results, we use BDD method based on fuzzy set theory for reliability quantitative analysis. In this regard, we take W-axis feeding system of heavy-duty computer numerical control(CNC) machine as a project example and adopt fuzzy BDD quantitative analysis method to analyze its reliability. The analysis results(aided by computer calculation)illustrate the effectiveness of the method proposed in this paper.


Background With the increasing survival of children with life-limiting conditions, support through teenage years and into adult services is of vital importance to children and families. The All Wales Paediatric Palliative Care Team has identified the need to implement a robust transition service. Aims Undertake a two stage service evaluation of transition support in South Wales: 1) An audit of current provision against national transition guidance from NICE (2016) and Together for Short Lives (2015) 2) A qualitative assessment of the transition process by staff and families. Method A retrospective notes audit was completed using hospice and hospital records. Care provided for 20 patients of transition age (14–17 years), and 10 patients post transition (18+) was assessed. Semi-structured interviews were conducted with eight families and 17 staff working with transition patients in a variety of roles. Results For 25% of families, transition was the main concern they had when considering their child's future. During transition planning, all families had their ethical and cultural needs considered, with family wishes/aspirations for adulthood recorded in 63% of cases. 13% had documented goals for transition. There was no documented support for developing identity/sexuality/relationships, or spiritual development. By transition age, 37% had their needs met by an appropriate adult service. Two-thirds of families felt well supported during their transition. 67% felt poorly informed regarding adult services, despite 80% having met a member of adult palliative care team. No patients had a formal transition plan. 50% of staff felt support for transition was inadequate, with 70% expressing the need for improved continuity in the service. Conclusion A clear transition process is required to ensure early planning, that needs are met by adult services, and that family goals drive the transition process. Issues of identity, sexuality and spiritual development require specific focus. Funding, training and improved key working need to be addressed. A multidisciplinary approach with improved access to adult respite services is vital.


The traditional image of New Zealand is one of verdant landscapes with sheep grazing on lush green pastures. Yet this landscape is almost entirely an artificial creation. As Britain became increasingly reliant on its overseas territories for supplies of food and raw material, so all over the Empire indigenous plants were replaced with English grasses to provide the worked up products of pasture - meat, butter, cheese, wool, and hides. In New Zealand this process was carried to an extreme, with forest cleared and swamps drained. How, why and with what consequences did the transformation of New Zealand into these empires of grass occur? 'Seeds of Empire' provides both an exciting appraisal of New Zealand's environmental history and a long overdue exploration of the significance of grass in the processes of sowing empire.


Crude oils containing large quantities of waxes, and in situations where sudden temperature drops occur, a crystalline network can be formed, generating flow difficulties in production, transfer and offloading lines. Despite the scientific and economic importance of this phenomenon, correlations between the behavior of petroleum in relation to its pour point are scarce in the literature. In this work, nine crude oil samples were characterized regarding density, water content, wax fraction (oneand two-dimensional chromatography), pour point, yield stress and wax appearance temperature. The results showed that the storage conditions and oil characteristics had a strong influence on the pour point. Yield stress was influenced by initial temperature of the sample, cooling rate and shear rate during cooling. Finally, the content of aromatic compounds in oil with low concentration of n-alkanes can contribute to increase the pour point.


In this paper we explore the possibility of using Web links to study collaborations between organisations, combining the results of qualitative analysis of interviews and quantitative analysis of linking patterns. We use case studies of scientific intermediaries, that is, organisations that mediate between the science system and other social actors (the market, the government etc) and argue that it is becoming increasingly important for such intermediaries to use the Web to indicate their strategic alliances. We analyse links between these organisations, together with primary sources such as organisational charts and internal reports, and find that these organisations indeed use outlinks to point to their collaborators and more specifically outlinks from specific depths. This supports our argument that links can be used to study the developments in science and the environment of scientific intermediaries. We discuss these findings in terms of their relevance for science studies and webometrics.


This thesis examines decisions made in one country and implemented in another. Implementation of such decisions is explored principally by means of a case study of implementation, namely implementation of the Government of India Act, 1935, passed by the British Parliament that year. The first chapter shows, that decision-making literature, in the field of international relations, has concentrated on the process by which decisions are arrived at, while implementation of such decisions has been largely neglected. Where implementation has been dealt with in the literature, it can be organised in terms of two models. A third model of implementation which describes better the implementation process, and a number of propositions about implementation derived from the existing literature are put forward. The model and propositions are tested against the case study. The method adopted is one of using case studies to build theory. The implementation of three decisions within the 1935 Act is examined; the first dealt with division of revenues between the centre and the provinces; the second, the grant of autonomy to the provinces; and the third, the establishment of an all-India federation to include both, the princely states and the provinces of British India. The model and the propositions guide the analysis of the case studies, though these are not rigidly structured in order to allow the idiosyncratic aspects of each case to be taken into account. The period having been thoroughly examined by historians, mainly secondary sources were used, though some primary material, not fully examined by historians till now, was used in the first case study. The first two decisions were implemented, while the third was not, and a comparison between the three cases is made in the concluding chapter. The chapter examines the evidence for the model and for the propositions that was found in the case studies. Comparison of the three cases enables conclusions to be drawn about factors that are conducive to successful implementation, and those that are antithetical to implementation.


Exploring intersections of spaces, practices, and representations of urbanity and the city in late sixteenth-century Istanbul, this paper traces the emergence of a new set of themes centered on the main public square, the streets, and the denizens of the Ottoman capital in illustrated court histories. It considers new visual imaginings of city and urbanity in view of three issues that resonate with the history of early modern Istanbul: modalities and the lexicon of vision as they took shape parallel to changing spatial practices; the making of a new urban public, and polyphonic forms of representation concomitant to the emergence of new publicities; the conflicted political environment that turned the city's public spaces into arenas of contestation in the later decades of the 1500s. To this end, the article focuses on narrative paintings and texts of a set of manuscripts created between the late 1580s and the turn of the seventeenth century, and with particular attention to the Sūrnāme-i Humāyūn (Book of Festivities, 1588), explores the notions and connections that shaped them.


Photonic band-gap (PBG) crystals offer new dimensions of freedom in controlling propagation of electromagnetic waves. The existence of stop-bands in the transmission characteristic of these crystals makes them a suitable element for the realization of many useful microwave and optical subsystems. In this paper, we calculate the propagation constant of a one-dimensional (I-D) photonic crystal by using an equivalent transmission-line network. The method is expanded for structures with arbitrary variation in relative permittivity. Thc effect of filling factor and relative permittivity on the width of the band-gap and its frequency is also investigated.


Temperature-induced alterations in phenology and body size are the cumulative outcome of sequential effects impacting development and are universal responses to climate change. Most studies have so far focused on phenological responses to warming in multiple taxa across space and time, or the ontogenetic effects of temperature in the laboratory. I here complement this work by investigating shifts in phenology and body size (wing length) attributable to temperature changes operating over the entire lifespan of the univoltine orange-tip butterfly Anthocharis cardamines in a single wild population over 14 generations. Phenology was affected by temperatures during three discrete periods in the year prior to emergence, corresponding to late larval/early pupal life, the onset of the chilling period required to break pupal diapause, and postdiapause pupal development prior to eclosion. Higher temperatures during late larval/early pupal life and postdiapause pupal development advanced the subsequent emergence of the butterflies, whereas higher temperatures at the onset of the chilling period retarded it. The synchronization of the butterflies' emergence schedule increased when pupae were exposed to milder midwinter temperatures. Wing length increased with warmer temperatures at distinct points in the early and midpupal periods; such direct effects of temperature on body size could complement season length effects in explaining the reversal of the temperature-size rule in univoltine insects. The periods during which temperature affected the phenology of the butterfly only partially overlapped those affecting the first flowering date of its host plants lady's smock (Cardamine pratensis) and garlic mustard (Alliaria petiolata). Observed thermal effects on flowering time, emergence timing, and emergence synchronization indicate that phenological convergence as well as phenological mismatching could affect host-plant availability and diet breadth; thermal effects on body size imply that important population-level processes could be impacted through correlated changes in fecundity and dispersal rate. In general, the combined effects of phenological and ontogenetic responses to temperature changes across the whole lifespan will likely be important in modeling the demographic responses of interacting species to climate change.


Reflecting a series of converging international trends, the tourist industry represents a vulnerability of catastrophic potential. Interview and questionnaire data obtained from 185 owners or managers in nine U.S.A. communities, provide answers to five questions: (1) What is the extent of disaster evacuation planning? (2) What factors account for the variations in this planning? (3) What behavioral patterns occur during actual evacuations? (4) What factors account for these pattern variations? and (5) What are the policy implications of these behavioral assessments? While many larger firms managed by more professional staff have completed extensive disaster evacuation planning, the overall record in very spotty. Hence, major initiatives both within the industry, and by emergency managers at all levels of government, are needed to reduce this rapidly expanding vulnerability.


Currently, the total number of harwarders in industrial roundwood and energy wood harvesting in Finnish forests is slightly over one hundred. Metsäteho Oy conducted a follow-up study of harwarders in industrial roundwood harvesting in Finland, and also investigated the transfers of the harwarders. In the study of Metsäteho, the possibilities of harwarder systems in wood harvesting in the near future in Finland were also evaluated. It was forecasted that the number of harwarders will significantly increase in the near future in Finland; within a few years, the number of harwarders engaged in industrial roundwood and energy wood harvesting may even be as much as 200–300. This development forecast is based on the following factors: I) Cost effectiveness in wood harvesting is being sought at the level of the stand marked for harvesting, as well as from the point of view of the forest machine business. II) The structural change in cuttings is setting new demands on the harvesting machinery. III) As a result of changes in the forest machine business field, the size of forest machine contracting businesses is growing and large regional responsibilities in contracting are increasing.


Inhibition of the tumor suppressor p53 diminishes tubular cell apoptosis and protects renal function in animal models of acute kidney injury (AKI). Therefore, targeting p53 has become an attractive therapeutic strategy in the approach to AKI. Although the acute protective effects of p53 inhibition in AKI have been examined, there is still relatively little known regarding the impact of acute p53 inhibition on the chronic sequelae of AKI. Consequently, we utilized the p53 inhibitor pifithrin-α to examine the long-term effects of p53 inhibition in a rodent model of ischemic AKI. Male Sprague-Dawley rats were subjected to bilateral renal artery clamping for 30 min followed by reperfusion for up to 8 wk. Pifithrin-α or vehicle control was administered at the time of surgery and then daily for 2 days [brief acute administration (BA)] or 7 days [prolonged acute administration (PA)]. Despite the acute protective effect of pifithrin-α in models of ischemic AKI, we found no protection in the microvascular rarefaction at 4 wk or development fibrosis at 8 wk with pifithrin-α administered on the BA schedule compared with vehicle control-treated animals. Furthermore, pifithrin-α administered on a PA schedule actually produced worse fibrosis compared with vehicle control animals after ischemic injury [21%/area (SD4.4) vs.16%/area (SD3.6)] as well as under sham conditions [2.6%/area (SD1.8) vs. 4.7%/area (SD1.3)]. The development of fibrosis with PA administration was independent of microvascular rarefaction. We identified enhanced extracellular matrix production, epithelial-to-mesenchymal transition, and amplified inflammatory responses as potential contributors to the augmented fibrosis observed with PA administration of pifithrin-α.


Aiming at the errors caused by the production and assembly of the robotic arm and the problem of low absolute positioning accuracy, a method of robotic arm calibration and teaching based on binocular vision is proposed in this paper. First, the joints of the robot arm is controled to rotate separately, and the motion trajectory data of the end of the robot arm is recorded by the binocular vision. Then the circle center and circle plane normal vector of each joint axis motion is optimized using Adam algorithm. After identification and calculation, accurate kinematic parameters are obtained, and then kinematically model the manipulator once again. After the calibration is completed, the user can use the teaching rod to define the trajectory under the camera, and the defined trajectory is converted to the robot arm coordinate system for inverse kinematics solution. Finally, the robotic armis controled to reproduce the trajectory. Experimental results show that the proposed method can complete the precise calibration of the kinematic parameters of the robotic arm. After calibration, the average error of the end of the robotic arm is within 1mm, and the absolute positioning accuracy is improved by more than 80%. The method proposed in this paper has low cost and simple operation, and it is easy to be popularized and applied in industrial and desktop robotic arm calibration and teaching.


More than nine out of 10 emergency medicine consultants in the United Kingdom work more than their normal planned hours, a survey by the College of Emergency Medicine has found.

The results are contained in a report, "Stretched to the limit," which says that there is an urgent need to ensure that safe and sustainable working practices are created in emergency departments.1 It adds that the present situation is unacceptable and makes it more difficult to recruit and retain doctors in emergency medicine.

The college carried out a web based survey of its fellows who are currently consultants, locum consultants, and associate specialists in England, Scotland, Wales, and Northern Ireland. A total of 1077 doctors completed the survey, a response rate of …


This article applied rhetorical analysis to an analysis of Amos' prophetic oracle against Israel's social injustices in Amos 2:6–8. The prophet uses a major rhetorical genre, namely judicial rhetoric, and several smaller rhetorical devices including the oracle against the nations, geographical chiasmus, numerical formula (the N+1 formula), the sevenfold structure, rhetorical entrapment, repetition, the war oracle, parallel structure and chiasms. These devices are utilised by Amos to make a persuasive appeal to his audience to respond to divine indictment.


Studies have pointed the relations between the deficit of social education skills of the parents and the behavior problem of their children. In relation to this subject, this research has the objective of describing the effects of the intervention process in parents aiming to promote their social educative skills. Two fathers and seven mothers contributed with this research choosing among their children the one with whom they have more relationship difficulties. For the evaluation: 1) for the parents' difficulties, a structured interview was used and 2) for the intervention procedures, it was used a) a parental social educative skills questionnaire and b) a list of social skills. The results of the comparisons made before and after the intervention of the IHS-Del Prette show a rising on the score of the groups; in the comparisons of the QHSE-P it was verified the acquisitions of educative social skills: to express positive feelings, to thank praises, to deny and negotiate limits. It is discussed the need of procedures that may lead to the promotion of educative social skills as a way to increase the social knowledge of the parents.


This is a study version composed in the studio from a single recording of a violin glissando.
It was never intended to be performed live. The final version for 7 violins was the result of this study.

for more information please see: http://ablinger.mur.at

mixed and mastered by Peter Ablinger, Berlin, 2012
total running time: 60:14
glass mastered CD in digipack, edition of 200


We study the properties of dipolar fermions trapped in one-dimensional bichromatic optical lattices and show the existence of fractional topological states in the presence of strong dipole-dipole interactions. We find some interesting connections between fractional topological states in one-dimensional superlattices and the fractional quantum Hall states: (i) the one-dimensional fractional topological states for systems at filling factor ν=1/p have p-fold degeneracy, (ii) the quasihole excitations fulfill the same counting rule as that of fractional quantum Hall states, and (iii) the total Chern number of p-fold degenerate states is a nonzero integer. The existence of crystalline order in our system is also consistent with the thin-torus limit of the fractional quantum Hall state on a torus. The possible experimental realization in cold atomic systems offers a new platform for the study of fractional topological phases in one-dimensional superlattice systems.


Female mallards (Anas platyrhynchos) emit a diverse repertoire of vocalizations. Duck hunters and callers mimic these vocalizations using artificial calls made from wood or plastic. The extent to which humans can mimic live mallards using artificial calls is unknown. We compared acoustic features of field recordings of the decrescendo calls of wild female mallards with those of duck callers. A panel of 38 duck callers used artificial calls equipped with single and double reeds that were made of 7 species of hardwoods and cast acrylic. We found that cocobolo (Dalbergia retusa), osage orange (Maclura pomifera), pecan (Carya sp.), acrylic, and bocote (Cordia alliodora) calls with double reeds produced notes acoustically most similar to female mallard decrescendos. We recommend that duck hunters and callers use calls made of acrylic or harder wood species, recognizing that double reed calls generally out-performed single reed calls in this study. We recommend that similar studies be conducted for other types of game calls, and we recommend additional future research to determine whether use of such calls influences mallard harvest and hunter satisfaction. © 2013 The Wildlife Society.


Minor Building Works Extension . Supporting Cheshire Fire & Rescue with this Minor Works remodelling project; the project embraced all trades working within a confined area, whilst maintaining client operations.


OBJECTIVE
To study the characteristics of dynamic enhanced density-time curves of recurrent nasopharyngeal carcinoma(RNPC) and radiofibrosis(RF) in spiral CT.

METHODS
Fifty cases of RF and 46 cases of RNPC were examined both before and after contrasting in spiral CT. The CT values of the regions of interest (ROI) at various acquisition time (0, 20, 30, 40, 50, 60, 90, 120, 150, 180, 210, 240, 270, and 300 sec after the beginning of the contrast injection) were collected. The difference in CT value of various acquisition time was analysed statisticaly and the dynamic enhanced density-time curves were established.

RESULTS
The typical curve in RF group was a slowly ascending-slowly descending one. Its peak CT value as seen at 210 sec postcontrast and measured 60.1 +/- 2.57 Hu. That of the RNPC was of rapidly ascending-slowly ascending-slowly descending one. Its peak CT valne was seen at 150 sec postcontrst and measured 75.4 +/- 7.2 Hu. The differences of CT values were significant between RNPC and RF from 40 to 300 sec postcontrast (P < 0.001).

CONCLUSION
The different characteristics of the dynamic enhanced desity-time curves and CT values of the ROI may provide important informations for differential diagnosis of RNPC and RF.


Multi-Agent Reinforcement Learning (MARL) is a challenging subarea of Reinforcement Learning due to the non-stationarity of the environments and the large dimensionality of the combined action space. Deep MARL algorithms have been applied to solve different task offloading problems. However, in real-world applications, information required by the agents (i.e. rewards and states) are subject to noise and alterations. The stability and the robustness of deep MARL to practical challenges is still an open research problem. In this work, we apply state-of-the art MARL algorithms to solve task offloading with reward uncertainty. We show that perturbations in the reward signal can induce decrease in the performance compared to learning with perfect rewards. We expect this paper to stimulate more research in studying and addressing the practical challenges of deploying deep MARL solutions in wireless communications systems.


Similar to any other geophysical method, seismic refraction method faces non-uniqueness in the estimation of model parameters. Recently, different nonlinear seismic processing techniques have been introduced, particularly for seismic inversion. One of the recently developed metaheuristic algorithms is bat optimization algorithm (BA). Standard BA is usually quick at the exploitation of the solution, while its exploration ability is relatively poor. In order to improve exploration ability of BA, in the current study, a hybrid metaheuristic algorithm by inclusion a mutation operator into BA, so-called mutation based bat algorithm (MBA), is introduced to inversion of seismic refraction data. The efficiency and stability of the proposed inversion algorithm were tested on different synthetic cases. Finally, the MBA inversion algorithm was applied to a real dataset acquired from Leylanchay dam site at East-Azerbaijan province, Iran, to determine alluvium depth. Then, the performance of MBA on both synthetic and real datasets was compared with standard BA. Moreover, the dataset was further processed following a tomographic approach and the results were compared to the results of the proposed MBA inversion method. In general, the MBA inversion results were superior to standard BA inversion and results of MBA were in good agreement with available boreholes data and geological sections at the dam site. The analysis of the seismic data showed that the studied site comprises three distinct layers: a saturated alluvial, an unsaturated alluvial, and a dolomite bedrock. The measured seismic velocity across the dam site has a range of 400 to 3,500 m/s, with alluvium thickness ranging from 5 to 19 m. Findings showed that the proposed metaheuristic inversion framework is a simple, fast, and powerful tool for seismic data processing.


In this study, the effects of calcium chloride (CaCl2) addition on the physical and oxidative stabilities of filled hydrogel were investigated. The results revealed that CaCl2 significantly enhanced the particle size, interfacial layer thickness, apparent viscosity, and viscoelastic behavior of filled hydrogels and decreased their light and whiteness values (p < 0.05). This phenomenon was mainly attributed to the strong binding ability between Ca2+ and protein/pectin mixtures, which were present in the interfacial area or aqueous phase, as verified by cryo-scanning electron microscopy results. Moreover, lower levels of CaCl2 (2 or 4 mM) significantly enhanced the oxidative stability of filled hydrogels (p < 0.05), particularly at a concentration of 4 mM. However, a higher level of CaCl2 (6 or 8 mM) resulted in an electrostatic shielding effect, which resulted in the aggregation of multiple droplets and the flocculation of the filled hydrogels, which negatively affected the oxidative stability of filled hydrogels. The findings of this study indicated that appropriate Ca2+ levels (4 mM) improved the physical and oxidative stability of filled hydrogel, and this finding may provide useful insights for the development of effective delivery systems for specific applications.


Background: Management of the post-operative pain after cesarean section (CS) requires a balance between the pain relief and undesirable side effects of drugs. To improve the post-operative pain management after CS, we compared analgesic efficacy of i.v nalbuphine versus i.v paracetamol for post-operative CS pain.

Aim and Objective: The aim of the study was to compare the efficacy and safety of single-dose intravenous nalbuphine versus intravenous paracetamol for post-operative analgesia CS pain.

Materials and Methods: This was a hospital-based retrospective study in the department of obstetrics, gynecology, among 120 patients of CS. We enrolled 120 patients in our prospective randomized trial after an uneventful elective CS under the spinal anesthesia. Group A patients received i.v paracetamol infusion and Group B patients received i.v nalbuphine on the first complaint of pain. The results were analyzed byt-test; P


The inaccuracy of blood volume determinations in burn patients using iodinated I 131 serum albumin (RISA-131) is well established. Accordingly, in a quest for a method to dynamically monitor hydration requirements in the acute severe burn, the central venous pressure has assumed an important role. Publications from many burn centers in the country acclaim the central venous pressure as one of the important parameters to monitor for hydration of the acute, severe burn. 1 Urine flow rate measurements have been overshadowed in the current trend towards heavy and sometimes exclusive reliance on the central venous pressure in therapy of the acute burn. Our experience contrasts sharply with the foregoing. We have found the central venous pressure an unreliable guide to fluid therapy in acute burns. Methods Patients with extensive burns fitting Lynch's 2 criteria of "critical burn," admitted to the Meadowbrook Hospital Burn Unit, are monitored with indwelling Foley catheters


In recent years, gradient-based methods for solving bi-level optimization tasks have drawn a great deal of interest from the machine learning community. However, to calculate the gradient of the best response, existing research always relies on the singleton of the lower-level solution set (a.k.a., Lower-Level Singleton, LLS). In this work, by formulating bi-level models from an optimistic bi-level viewpoint, we first establish a novel Bi-level Descent Aggregation (BDA) framework, which aggregates hierarchical objectives of both upper level and lower level. The flexibility of our framework benefits from the embedded replaceable task-tailored iteration dynamics modules, thereby capturing a wide range of bi-level learning tasks. Theoretically, we derive a new methodology to prove the convergence of BDA framework without the LLS restriction. Besides, the new proof recipe we propose is also engaged to improve the convergence results of conventional gradient-based bi-level methods under the LLS simplification. Furthermore, we employ a one-stage technique to accelerate the back-propagation calculation in a numerical manner. Extensive experiments justify our theoretical results and demonstrate the superiority of the proposed algorithm for hyper-parameter optimization and meta-learning tasks.


Objective – The aim of this study was twofold: first, to compare the experiences of health-related stress and the utilization of coping strategies between pediatric patients with different diagnoses and from distinct age-groups; and second, to examine the associations between the use of specific coping strategies and self-reported pediatric healthrelated quality of life. Materials and methods – 255 children/adolescents with a chronic health condition (asthma, epilepsy or cerebral palsy) were administered the Kidcope and the Disabkids-37 questionnaires. Chi-square tests and multivariate analyses of covariance were conducted to ascertain frequency and mean differences across clinical and developmental groups, and regression analyses were performed to examine associations between variables. Results – The experience of health-related stressors regarding physical limitation was more common for children/adolescents with asthma, while the occurrence of psychosocial stressors was more frequent in children/adolescents with cerebral palsy. There were differences in the utilization of coping strategies to deal with health-related stressors across diagnoses and agegroups, but the most frequently used strategies were consistently assessed as being the most effective. Externalizing emotional regulation was negatively related to the HRQL of pediatric patients with asthma and epilepsy, while self-criticism was negatively associated with the HRQL of children/adolescents with cerebral palsy. Conclusion – The experience of health-related stress, the utilization of coping strategies and their associations with pediatric HRQL are likely to vary across age-groups and diagnoses. Taking into account these developmental and clinical specificities is likely to improve the effectiveness of pediatric stress-coping assessments and interventions.


In this paper, an interactive medical image visualization system to support medical therapy has been introduced, where 3D organ model with the corresponding medical image is visualized interactively for diagnosis and surgical planning. To show effectiveness of the proposed system, 3D liver model generated from CT data has been utilized in consideration of its deformable characteristics by respiration as well as appearance. In addition, a hand gesture interface is applied on the graphical user interface for providing more natural and intuitive interactivity.


An analysis of the mechanism of the jumping organ of the cylindrical springtail Tomocerus longicornis and the globular springtail Dicyrtoma ornata is presented based on morphological examination and high-speed photography. Both species have a click mechanism involving deformation of the abdominal sclerites. Morphological and photographic evidence supports the hypothesis that eversion of the springing organ involves a hydroelastic mechanism based on haemocoel pressurization and increased tension in the abdominal sclerites. A computer model was used to analyse jump kinematics and energetics. This model accounts for the spin observed during jumping and shows how body planform (e.g. cylindrical versus globular) and tail length can influence direction, height, range and rate of spin.


The active digitalization of the healthcare system has given impetus to the emergence of a new type of enterprise—high-tech medical organizations (HMO). Their main distinguishing feature is the use of innovative high-tech medical equipment. However, the high cost of this equipment has become a factor slowing down the development of such organizations. This paper considers the life-cycle contract (LCC) as a special form of interaction between stakeholders and investments throughout the life cycles of equipment. Moreover, to provide technological support, continuous acquisition and life-cycle support (CALS) technologies, which are based on the same principles of working with the life cycle as LCC, are proposed. This question turned out to be a significant research gap, which was not sufficiently reflected in the available world studies. Thus, the aim of the current study is to describe the features of the use of LCC for HMO using CALS technologies and the impact of the life cycle of high-tech medical equipment on LCC, as well as to present the innovative component of the proposed model. Based on the analysis of the literature and the best world practices, the authors propose a visualization of the interaction of all stakeholders within the LCC for HMO. Such a decision is extremely relevant for developing organizations, public authorities and investors around the world.


The temperature-pressure behavior of two proteins, ubiquitin and λ-repressor, is explored using a realistically coarse-grained physicochemical model, the associative memory, water mediated, structure and energy model (AWSEM). The phase diagram across the temperature-pressure plane is obtained by perturbing the water mediated interactions in the Hamiltonian systematically. The phase diagrams calculated with direct simulations along with an extended bridge sampling estimator show the main features found experimentally, including both cold- and pressure-denaturation. The denatured ensembles in different parts of the phase diagram are characterized and found to be structurally distinct. The protein energy landscape is found to be funneled throughout the phase diagram, but modest changes in the entropy and free energy of the water are found to drive both cold and pressure induced denaturation.


BackgroundSiblings are crucial familial-ecological factors in children's language development. However, it is unclear whether sibling presence is associated with language development among young children with developmental difficulties. The aim of this study was to assess the association between sibling presence and changes in language trajectories of children with developmental delay before early school age. MethodsWe performed a retrospective longitudinal cohort study from December 2008 through February 2016. The medical records of the participants were collected from an official institution designated by Taiwan's Ministry of Health and Welfare for assessing and identifying young children with developmental difficulties. A total of 174 participants who had developmental difficulties and at least three-waves of evaluations were included in the analysis. Participants' age ranged from 10 to 90 months. The primary outcomes were receptive and expressive language delays evaluated by board-certified speech-language pathologists. ResultsOf the 174 participants (131 boys; at the first evaluation: mean [standard deviation (SD)] age, 31.74 [10.15] months) enrolled, 64.94% (n=113) had siblings and 35.06% (n=61) did not. At the age of approximately 10 months, the probability of receptive and expressive language delays was lower in participants with siblings than in those without (adjusted odds ratios, 0.19, 0.18; 95% confidence interval [CI], 0.06-0.64, 0.04-0.80; P=0.006, 0.024, respectively). However, at 10–90 months old, this probability of language delay became gradually higher in participants with siblings than in those without, exceeding that of participants without siblings (adjusted odds ratios, 1.04, 1.04; 95% CI, 1.01-1.07, 1.01-1.07; P=0.014, 0.020, respectively)ConclusionsHaving siblings does not necessarily have a positive association on the language development of children with developmental difficulties. Clinicians should consider the association of sibling presence with language development for these children in a broader familial-ecological context.


Mice were induced to produce IgA antibodies against ferritin after oral immunization. Such antibodies were detected by immunofluorescence in plasma cells in the intestinal mucosa as well as in secretory sites located elsewhere, such as the lactating mammary gland, salivary gland, and respiratory tract. The observation suggested that cells immunized locally via the gut could home to distant secretory sites. To confirm this hypothesis, lymphocyte transfer studies were done with mesenteric node (MN) versus peripheral node (PN) cells from orally immunized donors into nonimmunized recipients. IgA anti-ferritin cells from MN homed to exocrine targets, whereas IgM and IgG anti-ferritin cells homed to PN. The findings overall support the concept of a generalized and interrelated secretory immune system.


An alternative to the direct payments modulation under CAP Regulation n. 2237/2003 is presented, using a logistic function model where payments to farmers are related to economic efficiency, environmental impact of agricultural production, and farmer's income. The approach used develops into two phases: in phase one the focus is on modulation among countries; then in phase two redistribution among farmers within a Member State is contemplated.


We investigated the phenanthrene (PHE) hydrogenation (HYD) reaction over a Ni-Mo/Al 2 O 3 and a Pt-Pd/Al 2 O 3 catalyst. The catalyst deactivation in the presence of dibenzothiophene (DBT) and/or acridine (ACR) was studied. Near 300 °C, the main product of the PHE HYD reaction was 1,2,3,4,5,6,7,8-octahydrophenanthrene (1,8-OHP) in the case of the NiMo catalyst and perhydrophenanthrene (PHP) in the case of the PtPd catalyst. Further, the PHE conversion over the NiMo catalyst in the presence of DBT slightly increased with decreasing the DBT concentration (from 1 to 0 wt %). However, the reintroduction of DBT in the feed after a temporary cut did not permit recovery of the initial PHE HYD and DBT hydrodesulfurization (HDS) conversions. It was deduced that the mixed NiMoS phase deteriorated when no sulfur was present in the feed. In the case of the PtPd catalyst, the PHE conversion increased when the DBT concentration decreased. Further, the initial conversions (PHE HYD and DBT HDS) observed after a temporary DBT feed cut and a subsequent DBT reintroduction were substantially recovered. Indeed, contrary to the NiMo catalyst, the PtPd catalyst activity was hindered when sulfur was present in the system, while the absence of sulfur permitted regeneration of the active phase by reduction. In a second part, the effect of the ACR introduction was studied. The ACR introduction led to a drastic decrease in the PHE conversion over the Ni-Mo/Al 2 O 3 catalyst while the decrease was less pronounced over the PtPd catalyst. At the same time, unlike the NiMo catalyst, the Pt-Pd/Al 2 O 3 catalyst showed a drastic decrease in CHB yield (poisoning of the HYD active sites) leading to a drastic decrease in DBT conversion. Moreover, on both catalysts the activity was not fully recovered after the ACR feed was cut, indicating that some HYD catalytic sites were permanently poisoned.


A current therapy trend known as "back to nature therapy" boosts the use of essential oils and pure fragrance compounds and increases the importance thereof not only in medicine, but also in the business sphere. Marketing services involving aroma applications include for example scent logo or corporate aroma, selecting air-scent for interiors that strongly depends on the type of industry, scents used during marketing campaigns, corporate events or in outlets as those scents impact customer behaviour. In the paper there was presented a review of the reference literature on the aroma usage in food retail outlets. There was discussed the effect of aromas on the behaviours and emotions of consumers and on their perception of the environment as was the effect of aromas on the likelihood of purchase, the amount of money spent, and the evaluation of products and the outlet. It was showed that the scent applied had a positive effect on the shoppers and customers, incl. their moods, behaviours and emotions. Regarding the type of aroma, the analysis covered mostly the floral and food-based scents incl. citrus and herbal scents. It was proved that following the category-congruent olfactory cues had a positive effect on the sales of the entire product range. In general it can be inferred that modifying the environment by adding appropriate aromas has a positive effect on customers, and this can be a high potential for the food sector and for other sectors of the business sphere.


BACKGROUND
An independent panel of experts reviewed all investigator-reported cases of mitral valve leaflet adverse events (LAE) after MitraClipTM NTR/XTR in the EXPAND Study.

AIMS
We aimed to report the findings of the expert panel and standardize definitions for LAE.

METHODS
Standard definitions for different types of LAE were formulated and events adjudicated after detailed review by the expert panel.

RESULTS
Enrolling centers reported LAE in 35 cases, 11 leaflet injuries (9 tear, 2 perforation) and 24 single leaflet device attachment (SLDA). The panel confirmed LAE in 20 cases (2.0% incidence), 18 patients had SLDA and 4 had leaflet injury (2 cases had both SLDA and injury). Leaflet injury occurred during device implant and resulted in surgical valve replacement or death. SLDA-alone events were identified during implant (n=2), pre-discharge (7) or at 30 days of follow-up (7) and were resolved (£ 2+ residual MR) with additional clips in 75% of cases.

CONCLUSIONS
Mitral valve repair with MitraClipTM NTR/XTR is safe. The rate of LAE is lower than previously reported using older generation devices. The proposed definitions and findings will help differentiate leaflet injury from inadequate leaflet insertion and SLDA, and provide guidance to consistently diagnose LAE post MitraClipTM.


The effect of triparanol, an inhibitor of cholesterol synthesis, on the phenobarbital induced proliferation of the smooth endoplasmic reticulum (SER) is reported. Hepatocytes of hamsters treated with phenobarbital alone display the expected proliferation of the SER. Those given triparanol alone do not show this phenomenon but appear similar to controls with the exception of increased numbers of dense bodies characteristic of this treatment. Hepatocytes of hamsters receiving triparanol followed by phenobarbital display a SER proliferation of approximately the same magnitude as that achieved with phenobarbital alone. The effectiveness of the triparanol blockade is documented by the administration of labeled mevalonic acid and the subsequent quantitation of the amount of labeled cholesterol and labeled desmosterol. Desmosterol is the primary end product after triparanol treatment. Greater than 95% of the labeled sterol appears as desmosterol indicating a high degree of blockade. It is concluded that newly‐synthesized cholesterol is not a prerequisite for the phenobarbital induced proliferation of the SER. Several possible explanations for these results are discussed.


Structural engineer's greatest challenge in today's scenario is constructing seismic resistant structure. Uncertainties involved and behavior studies are vital for all civil engineering structures. The presence of vertical irregular frame subject to devastating earthquake is matter of concern. The present paper attempts to investigate the proportional distribution of lateral forces evolved through seismic action in each storey level due to changes in mass of frame on vertically irregular frame. As per the Bureau of Indian Standard (BIS) 1893:2002 (part1) provisions, a G+10 vertically irregular building is modeled as an simplified lump mass model for the analysis with mass irregularities at third & seventh floor. To response parameters like story drift, story deflection and story shear of structure under seismic force under the linear static & dynamic analysis is studied. This analysis shows focuses on the base shear carrying capacity of a structure and performance level of structure under sever zone of India. The result remarks the conclusion that, a building structure with mass irregularity provides instability and attracts huge storey shear. A proportionate amount of mass is advantageous to control over the storey and base shear. The soft computing tool and commercial software CSI-ETABS (version 9.7) is used for modeling and analysis.


AIM
To construct an expression vector for soluble recombinant human stem cell factor (rhSCF) gene, and optimize culture conditions for high-level expression of rhSCF in E.coli.

METHODS
hSCF cDNA was amplified by PCR with total cDNA from human lymph node as a template, followed by cloning into pMD18-T vector. The 5' terminal of the hSCF cDNA was modified by degenerative PCR to obtain high-level expression in E.coli. The biological activity of the refolded rhSCF, purified with high performance hydrophobic interaction chromatography, was examined by MTT colorimetry.

RESULTS
hSCF cDNA was amplified and cloned, and was inserted into an E.coli expression vector pBV220. The expressed rhSCF accounted for about 20% of total bacterial proteins and reached 40% of total bacterial proteins under optimal culture conditions. The expressed rhSCF appeared in bacterial lysates in the form inclusion body. The rhSCF with biological activity was obtained after solubilization of the inclusion body with 8 mol/L urea or 7 mol/L guanidine chloride, followed by preliminary refolding and purification.

CONCLUSION
hSCF was cloned and expressed in E.coli successfully. The E.coli strain expressing rhSCF can be used to produce rhSCF with biological activity on large-scale production.


This paper realizes a system that recognizes traffic safety signs by applying the principle used for game in reverse. The game used for this paper is one that expresses the shape of temporary objects intended by the maker when the maker sees the numerical image provided on (x, y) coordinates and then expresses it on the mesh. After separating the traffic safety sign image from the input image, the system is realized by outputting the content of the sign into letters by recognizing the forms and colors constituting the sign using the puzzle game above. Our system has fast process time and better rate of recognition than the existing system with black-and-white image processing and recognition without any penciling progress.


In the paper, we investigate the use of reinforcement learning in CBR for estimating and managing a legacy case base for playing the game of Tetris. Each case corresponds to a local pattern describing the relative height of a subset of columns where pieces could be placed. We evaluate these patterns through reinforcement learning to determine if significant performance improvement can be observed. For estimating the values of the patterns, we compare Q-learning with a simpler temporal difference formulation. Our results indicate that training without discounting provides slightly better results than other evaluation schemes. We also explore how the reinforcement values of the patterns can help reduce the size of the case base. We report on experiments we conducted for forgetting cases.


BACKGROUND
Asthma is one of the most common chronic inflammatory diseases in developed countries. Susceptibility to asthma is associated with interaction between multiple genes and environmental factors. Several cytokines play a major role in the pathophysiology of the disease.

OBJECTIVE
We analyzed the distribution of cytokine gene polymorphisms in a group of patients with asthma and a control group in order to determine the effect of these variants, or their combinations, on the development of clinical phenotypes.

METHODS
We genotyped 22 single-nucleotide polymorphisms (SNPs) corresponding to 13 cytokine genes (IFNG, IL1A, IL1B, IL1R1, IL1RN, IL2, IL4, IL4R, IL6, IL10, IL12B, TGFB1, and TNFA) in 376 individuals (219 asthmatic patients and 157 controls). Genetic association was evaluated using genotype and allele models for different asthma phenotypes. Gene-gene interactions were explored using multifactor dimensionality reduction.

RESULTS
Genotype AC of IL12B-1188 was associated with the presence of asthma. A significant association was detected between 2 SNPs analyzed in TNFA (-308 and -238) and atopic asthma and severe-persistent asthma. The IL1B TT haplotype (3962T and -511T) was also associated with atopy and moderate-persistent asthma.

CONCLUSION
Our data show that the presence of SNPs in IL12B, TNFA, and IL1B was significantly associated with asthma, atopy, and severity of asthma.We also highlight the importance of genetic context, haplotype, and gene-gene interaction analysis in genetic association studies.


Serverless computing has become an important model in cloud computing and influenced the design of many applications. In this article, we provide our perspective on what the recent landscape of serverless computing for scientific applications looks like. We discuss the advantages and problems with serverless computing for scientific applications and, based on the analysis of existing solutions and approaches, we propose a science-oriented architecture for a serverless computing framework that is based on the existing designs. Finally, we provide an outlook of current trends and future directions.


The ten samples of milk cake were prepared with various combinations and levels of ingredients such as sugar, deshi ghee and coagulant. Out of these samples only top five of them were selected for the cost of production, on the basis of ten point hedonic scale. And then out of these top five combinations, the sample required highest cost for production was selected to estimate the cost of production by using the packaging materials. for P1,P4 and P5 samples, Rs. 91.47 for P3 and P8, within the process combinations it is seen that with increased level of deshi ghee, the cost proportionately increased (i.e. in P3 and P8 samples). The non-dairy product such as sugar and alum also play a very important role to reduce the cost and increase the profit. Sugar contributes about 140 gm of weight in one kg. of product and cost just Rs.2.80 which helped to increase return from product because it is cheaper than the solids in the milk. The product sold in market at the rate of Rs. 110 per kg. which required net total cost for production about Rs.79.54 and Rs.82.04 without


�The objective of the study is to assess the impact of type 2 diabetes mellitus on sex differences among Punjabi population. In the present cross-sectional study, a total of 400 individuals (range in age 30 to 70), constituting 203 male and 197 female individuals were recruited. All enrolling individuals were at high risk of type 2 diabetes. The present samples were selected for particular trait, therefore, this sample may be considered as non random sample with no overlapping. Almost all studied risk factors like age, age of onset, BMI, WHR, pulse rate, socioeconomic status, occupation and blood pressure phenotypes have higher correlation (p<0.001) with the occurrence of type 2 diabetes among both sexes. The males with type 2 diabetes are accompanied by more unfavourable variables such as BMI, waist circumference, WHR, SBP and DBP as compared to female type 2 diabetic individuals. Socioeconomic status, reproductive status (pre-menopause/ post-menopause) and physical activity have significant (p<0.001) impact on the occurrence of type 2 diabetes among female individuals. The multivariate regression analysis confirmed that age, BMI, WHR and socioeconomic status are significant predictor for the occurrence of type 2 diabetes among both sexes. The present multivariate analysis with respect to many environmental variables strengthen the hypothesis that alcohol consumption, smoking, physical activity, food habits, physical fitness and hours spent in watching TV and sleeping are significantly associated with the occurrence of Type 2 diabetes. It is interestingly observed that the premenopausal or round about pre-menopausal age of females is more prone to develop Type 2 diabetes as compared to postmenopausal age of females.


Objective: to present the descriptive characteristics of TB cases in a prison and the influence of TB in the registration of AIDS cases in a penitiential centre. The materials and methods used consisted of AIDS and TB cases during the period 01.01 94-31.12.96 in Castellon prison. Variables such as age, sex, HIVand risk factor, localisation of TB, AIDS criterion in the HIV+, the number of CD4+ lymphocytes at the time of diagnosis were studied. The prevelance of TB and AIDS and the influence of TB on AIDS cases are evaluated by means of linkage of the two registers.The x2 was calculated and for the anova the Kruskal- Wallis test was used. The results led to the detection of 42 TB cases, 38 (90.5%) in HIV+. There were no age differences between HIV+ and HIV-.In the 38 HIV+, TB was the the first criterion of AIDS. The median of CD4 in the diagnostic was 195/mm3, 220/mm3 in the pulmonary TBs and extrapulmomary TBs (p=0.04). TB was the criterion for diagnosis of AIDS in 69% of the cases registered. Conclusions: TB in prisons is very common, owing to the large number of IVDUs amongst the prisoners who are infected with TB and HIV+. TB is also the most frequent criterion in diagnosis of AIDS. Improvements in methods of control are recommended along with coordination of the activities of penitientiary programs (on TB, AIDS and substance abuse) and intra and extrapenitentiary resources. Key Words: HIV.AIDS. Tuberculosis. Prison. Substance-Abuse.


Funding of public hospitals and access to quality health care is a universal problem especially in developing countries. This paper aims to examine the relationship between government financial grants, internal revenue and maternal mortality rate. Previous literature has suggested that to achieve better health outcomes, multiple factors including but not limited to finance must be taken into consideration. Secondary data from audited annual health reports (2014/15 – 2018/19) of the nine South African Provinces was analyzed with the employment of the panel data regression technique.  Internal Government Revenue was statistically significant at a 5% level of significance (p < 0.05) and Government Financial Grant was not statistically significant (p >0.05).  Maternal mortality rate is therefore dependent on internal revenue and not on government financial grants. The findings change the ancient saying that maternal health outcomes shall improve when the government pumps more finances into the health system. Instead, the study reveals that internal revenue generation has an impact on the maternal mortality rate thus bringing in another approach in the fight against maternal mortality. The study adds value to the public health administration in that it brings a different perspective on the fight against maternal mortality in South Africa.


Background and Objectives: The influenza A (H1N1) pandemic in 2009 reached more than 200 countries in different degrees of morbidity and mortality, and promoted several searches in this area, in order to help future epidemiological strategies. The use of mathematical models of infections may propitiate better comprehension of this phenomenon, and provide subsidies for intervention in public health. This study had as
aim describe the reproducibility rate (R0) through simplification of mathematical model of epidemiology, estimate the value of R0 in influenza pandemic occurred in 2009 in Brazil and in Brazilian states, and compare R0 with infected population. Methods: It is an ecological study that uses a public domain data bank with notifications of influenza
occurred in Brazil in 2009. A simplified analysis of compartmental model was proposed: Susceptible (S), Infected (I), and Recovered (R), in order to compare the viral reproducibility rate (R0) in Brazilian states. The value of R0 was also correlated with percentage of infected individuals. Results: An epidemic outbreak was configured in twelve states and in throughout Brazil, and more than one epidemic outbreak occurred in
five states and in Distrito Federal. The correlation between R0 and the percentage of infected was strong and positive (r = 0.74), and demonstrated that a higher reproductive rate is associated with higher viral contagion. Conclusion: It is possible to conclude that the athematical simplification performed in this study points to another way to identify epidemic, because it is a basic analytical tool, and there is no complexity in computational implementations.
KEYWORDS: Epidemiology. Epidemics. Computer Simulation. Influenza, Human. Communicable Diseases.


OBJECTIVE
This study investigated the proportion of psychiatric and medical patients who are impaired in their decision-making abilities in relation to each of several major legal standards for determining competence to consent to treatment.

METHOD
The subjects were hospitalized patients with diagnoses of schizophrenia (N = 75), major depression (N = 92), and ischemic heart disease (N = 82) and equal numbers of community comparison subjects matched on age, race, gender, education, and occupation. Three instruments measuring abilities related to the legal standards for competence were administered to each group. Impaired functioning was defined as scores two standard deviations below the means for all subjects combined or lower.

RESULTS
Although similar percentages of subjects with impaired performance were found for each of the measures, different groups of patients were identified as impaired depending on the measure used. The proportion of patients identified as impaired increased when compound standards were used, i.e., when impairment was defined as poor performance on any of two or three measures. Despite previous suggestions that the legal standards might form a hierarchy of rigorousness, the data did not support this hypothesis.

CONCLUSIONS
Choice of standards for determining competence, including compound standards, will affect the identity and proportion of patients classified as impaired. Clinicians should be aware of applicable standards in their jurisdictions. Use of compound standards requires independent evaluation of performance on abilities related to each relevant standard, because standards do not appear to be hierarchical. Policies relating to the characterization of persons as incompetent must be fashioned with caution.


Aims. We report on the thermal properties and composition of asteroid (2867) Steins derived from an analysis of new Spitzer Space Telescope (SST) observations performed in March 2008, in addition to previously published SST observations performed in November 2005. Methods. We consider the three-dimensional shape model and photometric properties derived from OSIRIS images obtained during the flyby of the Rosetta spacecraft in September 2008, which we combine with a thermal model to properly interpret the observed SST thermal light curve and spectral energy distributions. Results. We obtain a thermal inertia of 100 ± 50 J K ―1 m ―2 s ―1/2 and a beaming factor (roughness) in the range 0.7-1.0. We confirm that the infrared emissivity of Steins is consistent with an enstatite composition. The November 2005 SST thermal light curve is most reliably interpreted by assuming inhomogeneities in the thermal properties of the surface, with two different regions of slightly different roughness, as observed on other small bodies, such as the nucleus of comet 9P/Tempel 1. Our results emphasize that the shape model is important to an accurate determination of the thermal inertia and roughness. Finally, we present temperature maps of Steins, as seen by Rosetta during its flyby, and discuss the interpretation of the observations performed by the VIRTIS and MIRO instruments.


In this paper we introduce the concept of the global bipartite domination number $\gamma_{g b}(G)$ of a connected bipartite graph $G$ and study some of its general properties. Moreover we determine the global bipartite domination number of certain classes of graphs.


A model is developed that describes the power extraction in chemical oxygen-iodine lasers (COIL's) and CO(2) gasdynamic lasers with stable resonators when a large number of transverse Hermite-Gaussian eigenmodes oscillate. The extraction efficiency, mode intensities, and intensity distribution along the flow depend only on two parameters. The first is the ratio gamma(0) of the residence time of the gas in the resonator to the O(2)((1)D) or N(2)(v) energy extraction time and the second is the ratio of the threshold to the small-signal gain. The efficiency is maximum for gamma(0) ? infinity and decreases rapidly as gamma(0) decreases. It is found that for a range of parameters corresponding to the highest efficiencies the intensity distribution along the flow is nonuniform and has two peaks near the upstream and downstream sections of the resonator. In this case only the highest-order modes that totally fill the resonator cross section oscillate (the so-called, experimentally observed sugar scooping bimodal intensity distribution). For the range of parameters corresponding to smaller efficiencies the intensity is uniform. In this case all the modes participate in lasing; however, the intensities of the high-order modes are larger than those of the low order. The current model is compared with the plane-mirror Fabry-Perot resonator model and with the constant intraresonator intensity and rooftop models of COIL's with stable resonators. The extraction efficiency calculated with the last two models is close to that estimated from our model. However, the intensity distribution cannot be calculated correctly using the Fabry-Perot, the constant intraresonator intensity, or the rooftop model.


We report the results of optical reflectivity rneasurernents on MBelq(M =U, Ce, Th) from 0. 1 to 30 eV at T = 300 K. The dielectric function e(u) = el+i e2(~) is determined from a Kramers-Kronig analysis of the data. The intraband and interband contributions to e(c~) were separated via a low-energy Drude analysis. The following free-carrier plasma frequencies were obtained: ca&(UBel3) =5. 9 eV, co~(CeBe13) =5. 3 eV, and co~(ThBel3)=4. 4 eV. Estimated values for the optical mass of the free carriers fall in the range 1(m pt (2 for the three beryllides, consistent with the presence of a wide band at E~-. If a value of mo", =1 is chosen, the values of ~~ are consistent with 3. 4 (UBel3), 2. 8 (CeBe13), and 2. 0 (ThBe&3) free carriers per MBel~ formula unit. Prominent structure in e. &, ""d is observed in all three compounds at =2 and = 13 eV and are tentatively assigned to Be(2s~2p) transitions. M-atom-dependent structure in the spectra is also observed and identified with the d and f states near Et The re. s. ults for UBe, 3 are discussed in terms of recent energy-band calculations, but a true quantitatitve comparison of the data and theory will have to await calculation of the dielectric functions from the band-structure results.


In essays that range from the overtly political to the acutely personal, twenty-one YA authors including such well-known names as Brandy Colbert, Ellen Hopkins, and Hannah Moskowitz explore what it means to be female, both within a general patriarchal society and, more specifically, in the years following the 2016 U.S. presidential election. There's a clear effort at intersectionality, with a diverse set of women reflecting on elements beyond gender that informed their path to adulthood. The exploration of rape culture and its direct and incidental effects on young girls and women is a major theme, with many writers sharing their own encounters with toxic masculinity, some that are severely traumatic and others that have shaped the way they see themselves in more discreet but insidious ways. Race and its relation to femininity and identity is also explored, most powerfully in "Black Girl, Becoming" by new writer Tracy Deonn Walker. Although many of the essays end with a call to action, there's only one page of resources offered in the back to guide young readers to social justice activism; these therefore serve more as reflective pieces for readers interested in the topic or as discussion starters. KQG


Scientists from the United States Geological Survey, St. Petersburg Coastal and Marine Science Center (USGS-SPCMS) acquired sediment cores, sediment surface grab samples, Ground Penetrating Radar (GPR) and Differential Global Positioning System (DGPS) data from Assateague Island, Maryland, in October (FAN 2014-322-FA) 2014. The objectives were to identify washover deposits in the stratigraphic record to aid in understanding barrier island evolution. The report associated with this metadata record serves as an archive of GPR and DGPS data collected from Assateague Island in October 2014. Data products and accompanying Federal Geographic Data Committee (FGDC) metadata can be downloaded from the Data Downloads page located at, http://pubs.usgs.gov/publication/ds989/ds_data_downloads.html.


Purpose Complement alternative pathway (AP) dysregulation has been implicated in geographic atrophy, an advanced form of age-related macular degeneration. Danicopan is an investigational, first-in-class inhibitor of factor D, an essential AP activation enzyme. We assessed danicopan distribution to the posterior segment of the eye after oral dosing. Methods Tissue distribution of drug-derived radioactivity was evaluated using whole-body autoradiography following oral administration of [14C]-danicopan to pigmented and albino rats. Pharmacokinetics and ocular tissue distribution were studied in pigmented and albino rabbits following single and multiple oral dosing of danicopan. The melanin binding property was characterized in vitro. Results Radioactivity was distributed widely in rats and became nonquantifiable in most tissues 24 hours postdose except in the pigmented rat uvea (quantifiable 672 hours postdose). Danicopan binding to melanin was established in vitro. After single dosing, the maximum concentration (Cmax) and area under the curve (AUC) in neural retina and plasma were similar in both rabbit types. After multiple dosing, AUC in neural retina was 3.4-fold higher versus plasma in pigmented rabbits. Drug levels in choroid/Bruch's membrane (BrM)/retinal pigment epithelium (RPE) were similar to plasma in albino rabbits but higher in pigmented rabbits: Cmax and AUC were 2.9- and 23.8-fold higher versus plasma after single dosing and 5.8- and 62.7-fold higher after multiple dosing. In pigmented rabbits, ocular tissue exposures slowly declined over time but remained quantifiable 240 hours postdose. Conclusions The results demonstrate that danicopan crosses the blood–retina barrier and binds melanin reversibly, leading to a higher and more sustained exposure in melanin-containing ocular tissues (choroid/BrM/RPE) and in the neural retina as compared to in plasma after repeated oral dosing in pigmented animals. Translational Relevance These findings suggest that oral danicopan possesses potential for treating geographic atrophy because AP dysregulation in the posterior segment of the eye is reported to be involved in the disease pathogenesis.


Tin (Sn2+) and strontium (Sr2+) are potential replacements to lead (Pb2+) in perovskite synthesis since Sn is on the same IVA group in the periodic table as Pb while Sr is a promising alternative according to Goldschmidt's rules and quantum mechanical analysis. The crystal radii of their ions are also nearly identical with Pb2+ = 1.33 Å, Sn2+ = 1.36 Å, and Sr2+ = 1.32 Å. In this study, both Sn and Sr were explored in transforming calcite, a polymorph of calcium carbonate (CaCO3) into a leaving group in the first step of a sequential ion-exchange reaction towards perovskite formation. Instead of forming the intermediate tin carbonate (SnCO3), the reaction resulted in the formation of gypsum or calcium sulfate dihydrate (CaSO4.2H2O) and Sn in the form of oxides. These oxides, however, are useful especially when these are in the form of tin dioxide-coated CaCO3 shell-core structures—having demonstrated flame retardant and smoke suppressant properties. On the other hand, calcite was successfully transformed into strontium carbonate (SrCO3) or strontianite through the cation exchange reaction. X-ray diffraction (XRD) and X-ray Photoelectron Spectroscopy (XPS) were used to observe the resulting materials and understand the transformation of both Placuna placenta (or Capiz) shells and single-crystal calcite from the ion-exchange reactions.


We developed a personal blood pressure monitoring system for patients with hypertension or hypotension. The system can be used to measure a patient's blood pressure at home and to transmit the data automatically to a hospital database via the Internet. The accuracy of blood pressure readings using the system was assessed by comparison with readings from a standard digital sphygmomanometer in four subjects. The measurement error for the systolic readings was 1.7-2.7% and for the diastolic readings 2.7-3.2%. The system therefore appears to be a promising means of assessing blood pressure remotely.


The drug content of hair may be affected by washing, chemical or thermal treatments, the use of cosmetics, or exposure to the environment. Knowledge concerning the effect of natural or artificial light on drug content in hair can be helpful to the forensic toxicologist, in particular when investigating drug concentrations above or below pre-determined cut-offs. The photodegradation of methadone and its metabolite, 2-ethyl-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) was studied in authentic positive hair samples by comparing drug concentrations determined by liquid chromatrography-high resolution mass spectrometry before and after exposure to UVB light (in vivo study). The same approach was applied in order to investigate the light sensitivity of opiates (6-monoacetylmorphine and morphine) and cocainics (cocaine and benzoylecgonine) in true positive hair. The yields of photodegradation were calculated for each drug class in eight different positive hair samples irradiated by UVB at 300 J/cm(2) obtaining averages, ranges and standard deviations. In parallel, the photostability of all the compounds as 10(-5) -10(-4)  M standard solutions in methanol were examined by means of UVB light irradiation in the range 0-100 J/cm(2) followed by UV/Vis spectroscopic analysis and direct infusion electrospray ionization-high resolution mass spectrometry (in vitro study). In hair, methadone was shown to be significantly affected by light (photodegradation of 55% on average), while its metabolite EDDP proved to be more photostable (17%). 6-monoacetylmorphine, morphine, benzoylecgonine, and cocaine were more photostable than methadone in vivo (on average, 21%, 17%, 20%, and 11% of degradation, respectively). When irradiated in standard solutions, the target molecules exhibited a larger photodegradation than in vivo with the exception of cocaine (photodegradation for methadone up to 70%, 6-monoacetylmorphine and morphine up to 90%, benzoylecgonine up to 67%, cocaine up to 15%). Some factors possibly affecting the yields of photodegradation in hair and partially explaining the differences observed between the in vivo and the in vitro studies were also investigated, such as the colour of hair (the role of melanin) and the integrity of the keratin matrix.


Background: Quality measurement and improvement in practice are requirements for Maintenance of Certification by the American Board of Medical Specialties boards and a component of many pay for performance programs. Objective: To describe the development of the American Board of Internal Medicine (ABIM) Practice Improvement Module (PIMSM) and the average performance of ABIM diplomates who have completed the Preventive Cardiology PIMSM. Design: Observational study of self‐administered practice quality improvement. Setting: Office practices through the United States. Participants: A total of 179 cardiologists and general internists completing requirements for ABIM Maintenance of Certification from 2004 through 2005. Measurements: Physicians self‐audited at least 25 charts to obtain performance measures, patient demographics, and coronary heart disease risk factors. At least 25 patients completed surveys regarding their experience of care in the physician's practice. Physicians completed a self‐assessment survey detailing the presence of various practice systems. Results: The mean rate for systolic blood pressure control was 48%, for diastolic blood pressure 84%, and for low‐density lipoprotein (LDL) cholesterol at goal 65%. Of patients 61% rated the quality of care as excellent and 58% rated the practices excellent at encouraging questions and answering them clearly. More than 85% of patients reported "no problem" obtaining a prescription refill, scheduling an appointment, reaching someone in the practice with a question, or obtaining lab results. Targets for improvement were increasing the rates for LDL cholesterol or systolic blood pressure at goal, improving patients' physical activity, patient education, and accuracy of risk assessment. Improvement strategies included implementing chart forms, patient education, or care management processes. Limitations: Patients and charts were selected by physicians reporting their performance for the purpose of MOC. Conclusions: The Preventive Cardiology PIMSM successfully provides a self‐assessment of practice performance and provides guidance in helping physicians initiate a cycle of quality improvement in their practices.


The Corpus of Contemporary American English is the first large, genre-balanced corpus of any language, which has been designed and constructed from the ground up as a 'monitor corpus', and which can be used to accurately track and study recent changes in the language. The 400 million words corpus is evenly divided between spoken, fiction, popular magazines, newspapers, and academic journals. Most importantly, the genre balance stays almost exactly the same from year to year, which allows it to accurately model changes in the 'real world'. After discussing the corpus design, we provide a number of concrete examples of how the corpus can be used to look at recent changes in English, including morph- ology (new suffixes -friendly and -gate), syntax (including prescriptive rules, quotative like, so not ADJ, the get passive, resultatives, and verb complementa- tion), semantics (such as changes in meaning with web, green, or gay), and lexis-- including word and phrase frequency by year, and using the corpus architecture to produce lists of all words that have had large shifts in frequency between specific historical periods.


This work explores the use of multispectral imaging (MSI) techniques applied to the investigation of Late Antique (c. 250–800 AD) textiles found in Egypt. Although the use of these techniques is well-established in the study of polychrome surfaces, they have only been sparingly and often unsystematically applied to the investigation of textiles. The aim of this work is therefore to bridge this gap by showing how this non-invasive, relatively inexpensive and portable methodology can be used to map the photoluminescence and reflective characteristics of textiles under different wavelengths of light, and to provide qualitative and holistic insights into the chemical nature of the materials that compose them. Standardised acquisition and post-processing methods were applied to produce visible-reflected (VIS), ultraviolet-induced visible luminescence (UVL), infrared-reflected (IRR), infrared-reflected false colour (IRRFC), ultraviolet-reflected (UVR) and ultraviolet-reflected false colour (UVRFC) images that provided preliminary indications of the colourants used and their spatial distribution. This proved to be an important aid in planning more targeted and effective sampling strategies and facilitated comparisons between objects. Visible-induced visible luminescence (VIVL) and multiband-reflected (MBR) imaging were also explored for the first time with application to textiles, demonstrating their potential in mapping red and blue colourants respectively. The physical properties observed from all of these images were then related to the more detailed information provided by complementary non-invasive techniques, such as fibre optic reflectance spectroscopy (FORS), and micro-invasive approaches, such as high-performance liquid chromatography mass spectrometry (HPLC-MS). Guidelines towards the interpretation of complex MSI images and a discussion of the potential and limitations of relating multispectral data to chemical properties are presented. An important result of this work is the delineation of a protocol, which combines optical microscopy (OM), MSI, FORS and HPLC-MS and shows a high degree of potential, not only for the investigation of Late Antique textiles but for textiles in museum and historic collections generally.


ABSTRACT.
 Twelve new diatom species are described from remote locations in the western United States: Cymbella blinnii sp. nov., Cymbopleura maggieae sp. nov., Encyonema drakei sp. nov., E. pentoniae sp. nov., E. willeyorum sp. nov., Frustulia esandalliae sp. nov., Gomphonema darwinii sp. nov., G. evolutionensis sp. nov., Muelleria agnellus sp. nov., M. spauldingiae sp. nov., M. tetonensis sp. nov., and Navicula harmoniae sp. nov. Descriptions are supported by LM images showing size diminution in the type populations and by SEM images. Type populations of the new species are from California (3 species), Colorado (3), Montana (2), Oregon (2), Washington (1), and Wyoming (1). All of the type materials for these new species were collected by unpaid citizen volunteers. This paper reviews other new species and significant new distribution records produced by volunteer collections. It also discusses the process of engaging citizen volunteers in diatom collection and the value of citizen collections in building diatom herbaria, in cataloging diatom biodiversity, and in expanding our knowledge of diatom biogeography, especially in remote regions with difficult access.


Gender is crucial to individual identity and, in all societies, to the roles individuals will play and the experiences they will have. The position of men and women in any society is a social construct, not a natural state. Each society and every social group has a culture that defines the roles and rules of masculinity and femininity; by conforming to these definitions an individual becomes a "legitimate" man or woman. The goal of this book is to examine these roles and rules and thus understand the variety and limitations of the female experience in colonial Latin America. One overarching limitation in both Spanish and Portuguese America was the existence of a patriarchal social organization. In the New World as in the Old, a clear sexual hierarchy placed women below men. By law and by tradition, men held the lion's share of power in government, religion, and society. Furthermore, a man, particularly a father, was supreme within his family. Legally, all those living within the household were required to obey him. In this society women were defined first and foremost by their sex and only secondarily by their race or social class. In many colonial documents the lack of attention to women's race and class suggests that these attributes were malleable. Sex was not. Indeed it can be argued that sex was the most important factor in determining a person's status in society.


Probably the highlight of the Brown Swiss World Conference in Switzerland was watching the best Brown Swiss cows and heifers in Europe compete for the title of Miss Bruna 2012.


In this article, we report on a study of two South African primary school teacher education cohorts undertaken to investigate and understand their readiness to succeed in higher education and to plan support accordingly. Using the methodology of portraiture, we generated data from a combination of student questionnaires and examination results. Qualitative content analysis enabled the construction of six personas and three main themes. The portraits helped with an understanding of the complexity of the themes, in particular with how an identification of both the malleable and non-malleable elements affecting students' lives could inform and shape interventions for successful transition into university. More specifically, the dominance of particular characteristics in the personas provided information about which student groups required the most psychosocial and academic support and where it was required. The portraits also helped us to gauge the value of existing firstyear initiatives, such as the educational excursion, for promoting student enculturation and in overcoming their initial anxieties and preconceptions. We argue for more nuanced information about students to inform a multipronged approach to student support that may extend much longer than teacher educators anticipate.


Shortly after the monograph's introduction, the author reminds us that it has been 30 years since his first comprehensive work appeared on the physiology of hemostasis. This present work serves as his modern version and is intended as a practical guide for every physician who encounters bleeding problems. Easily read and well written, the book is divided into several major sections. It begins with a chapter devoted to the historical development of the modern theory of hemostasis and a section on methods. Some readers will find the methods provincial, and the references to the prothrombin consumption test redundant, but these have served the author throughout the years and he naturally stresses them. There are major oversights in the methods section that detract from its value, eg, no discussion of clottingfactor assays and tests for fibrin-split products. Interest notably increases when one begins the section where specific diseases are discussed. I


Reproductive biology of spiny eel Macrognathus pancalus Hamilton, 1822 was studied from the waterbodies of upper Assam, India. Sexual dimorphism was easily distinguished based on their body shape and colouration. Among the 467 fish samples examined, 312 males and 155 females were identified and the Male:Female (M:F) ratio ranged from 1:0.08 in November to 1:2.17 in June with overall sex ratio of 1:0.5. Five maturity stages were identified in a year and percentage distribution of each stage was calculated. The gonadosomatic index (GSI) ranged from 0.42 to 8.08 for females and from 0.33 to 1.25 for males. The length at 50% of the fishes attained maturity (Lm50) was 9-12 cm in males and at 12-15 cm in females, indicating males matures at moderately smaller size than their female counterparts. Ova diameter ranged from 0.3 to 1.3 mm; absolute fecundity ranged from 765.48 to 1691.96 and relative fecundity from 57.9 to 152.17. M. pancalus spawned once in a year with peak spawning between June and August.


Graph embedding techniques attempt to construct a high locality projection in such a way that projected same class samples should be close to each other. However, estimation of population data locality could be severely biased due to limited number of training samples. This biased estimation could trigger overfitting problem, leading to poor generalization. In this paper, we propose three new dimensionality reduction techniques. Projection features are regularized by utilizing a local Laplacian matrix to better approach true data locality for higher locality preserving. These techniques are developed based on the manipulation of locality regularization. The difference between them would be the adoption of different local Laplacian matrices. In view of this, a common name is given, which is Locality Regularization Graph Embedding (denoted as LRGE). The robustness of these techniques is tested on CMU PIE and FERET databases. Experimental results validate the effectiveness of these techniques in face verification


AbstractTraumatic cleft earlobe is the most common secondary deformity of the ear. Numerous techniques have been introduced to repair traumatic cleft earlobe and break the linear scar. However, most of the techniques require elevation of additional flaps from normal surrounding tissue and sacrifice healthy tissue from small earlobes. The authors used epithelialized scar tissue from the cleft margin to elevate 2 triangular flaps. The flaps were turned 90 degrees to fit into the fish-mouth incision at the margin of the cleft earlobe. With this method, tissue from the cleft margin is saved to elongate and break the linear scar of the earlobe. Twelve cases of secondary cleft earlobe were repaired with this technique. After a follow-up of at least 3 months, there was no scar contracture or notching of the earlobe lower border.Level of Evidence: Level IV, therapeutic


including psychologists, social workers, welfare officers, parsons, teachers, marriage guidance coun sellors, hypnotists and evangelists have entered the field. They are backed by even greater numbers of enthusiastic amateurs whose need for a person in distress overcomes any inhibitions their lack of training and experience should create. The public must like that sort of thing or it would not flourish. What we as psychiatrists should be very wary of is that we do not select one group from among them and by association give them an air of medical respectability. I would go further. I would seriously questionthepractice oftakingpartintheir training, for once †̃¿ trained' one has precious little control over them. Psychiatry has been ridden for years with the practice of the cult, but as doctors we are flexible enough to surrender or modify a useless model for a more useful one. If all psychiatrists had no medical qualifications and were committed entirely to, say, a dynamic model, how would recent psychopharma cological advances have been incorporated? We have problems enough in psychiatry without creating new ones. I would not forbid meddling, neither can I aid, abet or even condone it.


Based on the approach of 'arena of development' controversies over bioenergy in the shaping of a Danish climate strategy are analyzed as a contribution to a sustainable transition perspective on bioenergy in industrialized societies with substantial agricultural production. Bioenergy plays a prominent role in several Danish climate and energy plans, alongside with wind and solar energy, and energy savings. There are major controversies about targets for bioenergy with respect to acceptable types, sources and amounts of biomass. Strong path dependency is identified. Energy companies in Denmark convert coal fired power plants to biomass in order to sustain the role of these power plants. Their increasing use of imported wood pellets is criticized for increasing greenhouse gas emissions because of fast logging of years of forest growth. A Danish biotech company is developing enzymes for processing of biomass for biofuels. The alignment with the private car regime is strong, because biofuel enables continuation of fuel-driven vehicles as dominating transportation mode. Danish farmers see manure as important source for biogas while arguing for reduction of climate impact and nuisances from digested manure. Such biogas is questioned by some NGOs who fear manure-based biogas is used as argument for increased animal husbandry. The bioenergy controversies concern also methodologies for environmental assessments, including for indirect land use changes (ILUC), and reliability of certification schemes. The mapping of controversies identifies issues that probably need to be taken into account in shaping of Danish bioenergy strategies if these strategies should gain substantial legitimacy among environmental NGOs.