Volunteers are crucial to the survival of non-profit organisations, who therefore have a fundamental interest in sustaining voluntary engagement over time. A central variable regarding sustained voluntary engagement is volunteers' organisational commitment, which has so far been a neglected research issue. The study at hand therefore explicitly focuses on hospice volunteers' commitment. Starting from the assumption that variables at the experience stage of volunteerism may be relevant in predicting volunteer commitment, questionnaire data on volunteers' motives, motive fulfilment and role identity were collected in a sample of hospice volunteers (N = 276). Results of multiple regression analyses show positive relationships between altruistic motive fulfilment and a volunteer role identity on the one hand and volunteer commitment on the other. Observed interaction effects imply that altruistic motive fulfilment is of importance both at the initial phase of volunteering and for long-term volunteers. Moreover, interaction effects provide evidence that the fulfilment of egoistic motives is of particular importance amongst volunteers to whom egoistic motives are central. Thus, the fulfilment of altruistic motives and facilitating the development of a volunteer role identity should be permanent concerns in building a committed workforce. Egoistic motive fulfilment in contrast is of special relevance, when egoistic motives for volunteering are strong. Copyright © 2014 John Wiley & Sons, Ltd.


ABSTRACT This short note clarifies how the Stackelberg leader's competitive advantage after the follower's entry affects the leader's optimal market entry decision and Stackelberg strategic interactions under uncertainty. Although the Stackelberg leader's first investment threshold remains constant and coincides with the monopolist's investment trigger, his second (third) investment threshold, which defines the exit (entry) of the first (second) investment interval, increases with an increased competitive advantage. With an increased competitive advantage, the probability of sequential investment equilibrium (simultaneous investment equilibrium) increases (decreases) irrespective of the level of volatility. Moreover, for a given level of competitive advantage, an increase in the volatility tends to decrease (increase) the probability of simultaneous investment equilibrium (sequential investment equilibrium). For a richer set of results, endogenous firm roles are examined and analyzed as well. The leader's preemptive threshold is negatively affected by his competitive advantage.


A series of conformationally restricted, cyclic octapeptides containing a conformationally stable tetrapeptide sequence related to somatostatin, -Tyr-D-Trp-Lys-Thr-, as a template, were designed and synthesized with the goal of developing highly potent and selective mu opioid antagonists with minimal or no somatostatin-like activity. Three distinct structures of the peptide became targets of chemical modifications and constraints; the N- and C-terminal amino acids and the cyclic 20-membered ring moiety. Based on the conformational analysis of active and inactive analogues of the parent peptide D-Phe1-Cys2-Tyr3-D-Trp4-Lys5-Thr6-Pen7+ ++-Thr8-NH2, CTP (Kazmierski, W.; Hruby, V. J. Tetrahedron 1988, 44, 697-710), we designed analogues to include the tetrahydroisoquinolinecarboxylate (Tic) moiety as the N-terminal amino acid instead of D-Phe, since Tic can exist only as a gauche (-) or a gauche (+) conformer. In this series, the following peptides were synthesized and pharmacologically evaluated: D-Tic-Cys-Tyr-D-Trp-Lys-Thr-Pen-Thr-NH2 (TCTP), D-Tic-Cys-Tyr-D-Trp-Orn-Thr-Pen-Thr-NH2 (TCTOP), and D-Tic-Cys-Tyr-D-Trp-Arg-Thr-Pen-Thr-NH2 (TCTAP). In rat brain membrane opioid radioligand binding assays, all three peptides displayed high affinity for mu opioid receptors (IC50 = 1.2, 1.4, 1.2 nM, respectively), and exceptional mu vs delta opioid receptor selectivity: 7770, 11,396, and 1060, respectively. TCTOP and TCTAP also possess exceptional mu vs somatostatin receptor selectivity: 14,574 and 28,613, respectively. In the peripheral in vitro GPI bioassay, TCTP, TCTOP, and TCTAP were highly effective antagonists of the potent mu opioid receptor agonist PL017, with pA2 = 8.69 for TCTAP, 8.10 for TCTP, and 7.38 for TCTOP. Our results show that a 10-fold higher affinity and selectivity for mu opioid receptors (in both central and peripheral studies) over delta and somatostatin receptor was gained as a result of the D-Tic1 substitution. These three peptides, TCTP, TCTOP, and TCTAP, are the most potent and selective mu opioid antagonists known. CTP has been shown to possess prolonged biological action, much longer than that of naloxone. This renders these analogues potentially useful ligands for investigating the physiological functions of the mu opioid receptor. Analogues of TCTP in which the 20-membered disulfide ring was contracted by deletion of D-Trp4, and/or Lys5, and/or Thr6 led to compounds with greatly reduced potency at the mu opioid receptor.(ABSTRACT TRUNCATED AT 400 WORDS)


Background: Depression and anxiety are common among inflammatory bowel disease (IBD) patients. Not only do they worsen quality of life, but also worsen the prognosis of the IBD. Yet, there are no widely accepted guidelines for screening for depression or anxiety in this population. The Hospital Anxiety and Depression Scale (HADS) is a self-administered questionnaire designed to measure anxiety and depression in the physically ill. The purpose of this study was to establish the utility of the HADS as a screening tool in IBD patients. Methods: Seventy-nine IBD patients (age 29.86 ± 8.36, 51.9% female, 77.2% Crohn's disease) were recruited consecutively at the day treatment unit, Gastroenterology Department, Sheba Medical Center. They were asked to complete the HADS, the Beck Depression Inventory (BDI), and the State-Trait Anxiety Inventory (STAI). The scores of the HADS depression and anxiety subscales were correlated with the BDI and STAI scores, and the rates of above-threshold scores were calculated and compared between the three questionnaires and findings from previous studies. Results: The two HADS subscales significantly correlated with and the BDI (rs = .69, p < 0.001) and STAI state and trait anxiety (rs = .853, p < 0.001; rs = .744, p < 0.001, respectively). The usual HADS cut-off scores yielded adequate rate of anxiety but lower than expected depression rates. Conclusions: Our findings suggest the HADS as a valid screening tool for anxiety and depression in IBD patients. We recommend administering it routinely in gastrointestinal (GI) follow-ups using a lower cut-off score for depression than anxiety (greater than 7 vs greater than 11, respectively).


This study was conducted for designing and explaining the convergence-based financial services marketing model in Tehran Stock Exchange. This study was mixed (qualitative-quantitative), and in the qualitative phase, a group of experts in the field of financial services marketing and senior managers of asset management companies were selected and unstructured interview was done for modelling based on ground theory. In the quantitative phase, customers of asset management companies were considered as the statistical population and 500 statistical samples were selected and questioned by questionnaires and 26 hypotheses derived from the initial model were tested. All hypotheses were confirmed but the effect of risk-taking and history of financial services providers on convergence of trends and indexes were rejected. There was also no relationship between history and requirements. Also, conditions and economic fluctuations governing the society and history of financial services providers did not have a significant effect on adherence to requirements of stock exchange.
Finally, the results led to the design of convergence-based financial services marketing model in Tehran Stock Exchange (based on the structure of the paradigm model). Comparing the model of the present study with previous models in the field of financial services marketing, an important and innovative point is the attention of asset manager companies to convergence in the financial markets, which was identified as one of the effective strategies for promoting perceived value and customer loyalty and its effect was also proved. Paying attention to the concept of convergence and contagion between markets and paying attention to parallel markets to get more returns is a significant factor in attracting financial services customers.


The understanding of the context in which the software applications are developed is highly influenced by events. In fact, any organizational process is intended to be triggered by an event and sometimes is related to certain eventual-type results. Managing and modeling events is one of the most important tasks of the analyst during the software development process, since the behavior of the future software application is revealed by the event interaction. In the traditional way of teaching software engineering, events are commonly taught by means of lectures and "toy" practical projects. However, events are commonly misunderstood in this way of teaching, since they are often mistaken for operations. Also, the way in which an event interacts with each other is not completely understood by the students. Games are student-centered strategies for teaching software engineering concepts. Following a similar strategy to other software engineering games, we propose in this paper the event interaction game as a way to explain the meaning of the events and their interaction for understanding their influence on the software development process. This game is intended to surpass the problems generated by the traditional way of teaching events. The game was played by four heterogeneous groups of students belonging to different courses and universities, and the results are almost the same for such groups, leading to promising results in the understanding of events.


Increased vascular permeability is a characteristic of Hantavirus illness, for which there is now no treatment. We employed the domain search method to investigate the Hantavirus protein in this present work. The results indicated that the membrane glycoprotein E protein (containing Gn-Gc) of Hantavirus had lipid phosphatase and C2-like domains. The E protein was a tensin phosphatase-like (PTEN) enzyme that could shuttle in the cytoplasm and cell membrane. In an acidic endosomal environment, Gn dissociates, exposing Gc's autophosphorylation region to complete autophosphorylation and activating the C2 domain. The C2 domain facilitates Gc's conformational transition, which is followed by Gc binding to the endosomal membrane. After being inserted into the endosomal membrane, the phosphatase domain of Gc phosphorylates PI(3,4,5)P3 on the endosomal membrane. Then converted PI(3,4,5)P3 to PI(4,5)P2 . PI(4,5)P2 bound to the N-terminal of Gc, completely anchoring the tetramer-shaped Gc to the endosomal membrane and forming a fusion hole. Then analogous to PTEN, phosphorylation of PI(3,4,5)P3 directly induced the disintegration of Gc tetramer. The enlargement of the fusion pore speeded up the fusion of the viral and endosomal membranes. Through the fusion hole, the virus's intracellular material was swiftly discharged into the cytoplasm. The C2 domain promoted the PKC signaling route during Hantavirus membrane fusion, whereas the phosphatase inhibited the PI3K signaling pathway. E protein's PTEN-like action impaired lipid metabolism and endothelial cell remodeling, increasing blood vessel permeability and resulting in renal and cardiac syndromes. Additionally, E protein inhibited the immune system and Akt-mediated eNOS activation, resulting in a cascade of consequences.


Biological systems are getting more relevance than chemical control of plant pathogens as they are not only eco‐friendly and economic in approach but are also involved in improving the soil consistency and maintenance of natural soil flora. Plant growth promoting rhizosphere microorganisms were isolated from three different tree rhizospheres using selective culture media. Five microorganisms were selected from each rhizosphere soil based on their efficiency and screened for their ability to promote plant growth as a consortium. Each of the developed consortium has a phosphate solubilizer, nitrogen fixer, growth hormone producer, heterotrophic member and an antagonist. The plant growth promoting ability of the microbial members present in the consortium was observed by estimating the IAA production level and also by the nitrogenase activity of the nitrogen fixers. The biocontrol potentiality of the consortium and the antagonist present in the consortium were checked by both dual plate assay and cross‐streaking technique. Consortial treatments effected very good growth promotion in Lycopersicon esculentum Mill and the treated plants also developed resistance against wilt pathogen, Fusarium oxysporum f. sp. lycopersici though the effect was well pronounced with consortium developed from Santalum album. (© 2009 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)


Abstract : In this paper we describe plans and initial progress in baseline investigations of fatigue on team performance in complex and operationally relevant task environments. Preliminary data collection used a PC-based analogue of command and control simulations. The platform was developed based on cognitive and functional analysis of C3 mission, tactics, team-member roles, and role interdependencies. Tactical scenarios were developed to capture core team coordination, decision-making and problem-solving task demands. Issues regarding measures and scenario development are identified and discussed. Preliminary findings, indicating increased resistance to fatigue effects over time, are presented. Lessons learned are noted, along with plans for subsequent research.


(1825–1911)

As one grows older, there comes with sad recurrence the painful duty of recording the life's work of senior comrades who have dropped from the ranks. The death of John Robert Mortimer has deprived us of a striking personality long familiar to all scientific workers in East Yorkshire. He joined our roll in 1878 and remained a member for 30 years, contributing fourteen papers to our Proceedings—two on geological subjects, and the others, archaeological. The titles of these papers will be found in the full list of his writings, appended to the sketch of his career published by Mr. T. Sheppard in The Naturalist, No. 652, May, 1911.

Mortimer was born in 1825 at the Wold village of Fimber, and attained his manhood there, receiving his schooling at the adjacent village of Fridaythorpe. After establishing himself in business as a corn merchant (later as a maltster also), he changed his residence to the neighbouring town of Driffield, where the rest of his life was spent, and where he died on August 19th, 1911, at the ripe age of 86 years. In 1869 he married the fourth daughter of the Rev. T. Mitchell, Vicar of Sancton and Holme-on-the-Wolds. He survived his wife by six years, and leaves a family of three sons and two daughters.

Mortimer had a deep affection for his native place and its surroundings, and his scientific interests were local, in the best sense of the word. Everything that pertained to the past history of …


Background: Chimeric transcripts are frequent genetic abnormalities in hematological malignancies that often contribute to leukemogenesis and play crucial roles for risk stratification, MRD monitoring and targeted therapy. However, current standard techniques for detection of gene fusions (chromosome banding analysis (CBA) and fluorescence in situ hydridization (FISH)) are only able to predict known and/or non-cryptic gene fusions. RNA sequencing (RNAseq) has successfully been applied for determination of genomic gene fusions.
 Aim: Comprehensive analysis of fusion genes in AML (acute myeloid leukemia) and MDS (myelodysplastic syndrome) patients and evaluation of the beneficial use of RNAseq in detecting recurrent and novel fusions.
 Methods: RNAseq was performed for 579 AML and 630 MDS patients for the detection of recurrent and novel fusion transcripts. WGS (whole genome sequencing) and cytogenetics (CBA, FISH) were applied for validation of the respective transcripts. 151 bp paired-end reads were produced on a NovaSeq 6000 system (Illumina, San Diego, CA) with a yield between 35 and 125 million paired reads per sample. Reciprocal fusion transcripts were counted as one fusion event. All reported p-values are two-sided and were considered significant at p<0.05.
 Results: After stringent filtering and validation by WGS and/or cytogenetics, for AML, 279 fusion events (corresponding to 147 unique gene fusions) were detected in 208 cases (36% of patients). 213/279 (76%) were confirmed by WGS and cytogenetics, 54/279 cases (19%) by WGS only and 12/279 (4%) cases by cytogenetics only. As a proof of principle, entity-defining rearrangements were detected most frequently: RUNX1-RUNX1T1 (n=42), CBFB-MYH11 (n=39) and PML-RARA (n=39). Other recurrent fusions included KMT2A-MLLT3 (n=6), KMT2A-MLLT10 (n=3) and DEK-NUP214 (n=4) (Fig 1A). However, in addition a high number (130/279, 47%) of so far unreported gene fusions were detected, including 49/130 inter-chromosomal and 81/130 intra-chromosomal fusions. These comprised 92/130 cases for which both fusion partners have not been reported before and 38/130 cases with a novel partner of a gene previously reported in hematological malignancies, including novel partners for NUP98 (XRN1), ETV6 (FAAP100, ARNTL2, SMCO2), RUNX1 (THOC6, EIF3E, OPHN1, TMEM50B), RARA (CCDC33), CBFB (TTC3, HMGB1) and KMT2A (NCBP1, ARHGEF12) (Fig 1B) (all validated by WGS and/or cytogenetics (see above)). Most of the novel fusions were detected only once, however two of them were observed in two patients each (NRIP2-ITFG2, CTDSP1-CFLAR). Moreover, cases with novel fusions were characterized by a very high frequency of TP53 mutations (59% vs. 1% in cases with known fusions and 9% in cases with no detected fusions, p<0.001), whereas FLT3-ITD and NPM1 mutations were rather rare (NPM1: 8% (novel) vs. 0% (known) vs. 35% (no fusion); FLT3-ITD: 3% (novel) vs. 14% (known) vs. 24% (no fusion). Consequently, a large number of cases with novel fusions depicted a complex karyotype (62% (novel) vs. 1% (known) vs. 9% (no fusion)). Regarding age, patients with known fusions were significantly younger than patients with novel fusions or without detected fusions (median age: 54 years (known) vs. 72 (novel) vs. 70 (no fusion), p<0.001).
 For MDS, 30 fusions (29 unique transcripts) were observed in 28/630 cases (4% of all patients). 4/30 (13%) of detected gene fusions were inter-chromosomal, while the majority (26/30, 87%) was intra-chromosomal. 27/30 (90%) fusions were validated by WGS, 9/30 (30%) by CBA, comprising 6/30 (20%) cases that were validated by both methods. Only one of the detected fusions was detected in >1 patient (n=2) and was described previously (MECOM-NRIP1), all others (n=28) are so far unreported. Of these, 23/28 comprise both so far undescribed fusion partners, whereas for 5/28 fusions one partner was previously reported to function in hematological neoplasms (e.g. MYB-PEX7, RABEP1-NUP88).
 Conclusions: (1) A large number of novel fusions were detected by RNAseq and validated by WGS and cytogenetics, especially in AML. (2) These novel fusions correlate with a very high frequency of TP53 mutations, their pathogenic role has to be evaluated further. (3) This data may provide the basis for identifying potential new actionable targets (e.g. for personalized vaccine or adoptive cell-based therapy development) and developing markers for patient sensitive MRD monitoring.

 Stengel: MLL Munich Leukemia Laboratory: Employment. Walter:MLL Munich Leukemia Laboratory: Employment. Meggendorfer:MLL Munich Leukemia Laboratory: Employment. Kern:MLL Munich Leukemia Laboratory: Employment, Equity Ownership. Haferlach:MLL Munich Leukemia Laboratory: Employment, Equity Ownership. Haferlach:MLL Munich Leukemia Laboratory: Employment, Equity Ownership.


I . Rats were given diets containing different fats (200 g/kg) from weaning to 8 months of age. The fats were sunflower-seed oil (SFO), lard (L) and an equal mixture of sunflower-seed oil and lard (mixed-fat diet; MF). A control group was given the basal diet unsupplemented with fat. Energy intake and bodyweight of individual animals were recorded weekly. 2. Three animals from each dietary group were killed after 5 , 13, 17 and 29 weeks on the experimental diets. At slaughter epididymal fat pads were excised, weighed and the number and size of fat cells in the pad was determined. 3. There were no significant differences between the energy intake in the whole experimental feeding period for rats given the different fat diets. However, when energy intakes were examined on a monthly basis animals given MF had a significantly higher energy intake in the first z months of feeding than those animals given SFO. In the third month of feeding (when animals were over 12 weeks old) the group given L had a significantly higher intake than the group given SFO. 4. Body-weight, epididymal-fat-pad weight, cell size and cell number did not differ significantly between the ' fat-fed' animals at any individual slaughter period. Analysis of pooled values from the four slaughter periods revealed that animals given M F had significantly more fat cells than those given SFO. 5. We conclude that the nature of the dietary fat has no effect on the cellularity of developing adipose tissue but that the number of fat cells formed is sensitive to energy intake before IZ weeks of age in the rat.


Summary Subject and purpose of work: The purpose of the study is to determine the variables determining the level of synthetic measure of economic efficiency in listed companies of the industry sector as part of their enterprise life cycle. Materials and methods: The article uses data from annual unitary financial statements of industrial enterprises according to the classification of the Warsaw Stock Exchange and data describing the macroeconomic situation of the state economy. The research period covered the years 1999-2012. In order to examine which factors determine the level of economic efficiency at each stage of the life cycle of enterprises, estimation of econometric models was carried out. Results: In the models obtained for companies in the growth and maturity stage, statistically significant determinants were obtained only in the field of internal factors. In the models estimated for companies in the stages of launch, shake-out and decline, statistically significant conditions were identified, both in terms of external factors and in the area of internal factors. Conclusions: A comprehensive assessment of the conditions for the level of economic efficiency of enterprises should take into account both factors dependent on the enterprise (microeconomic) as well as those determined by the environment (macroeconomic) and beyond its control. It is therefore necessary for managers of enterprises to have extensive and up-to-date knowledge of factors and conditions that are significant in shaping the level of economic efficiency.


Background. It is still a matter of debate whether the evaluation of end-tidal carbon dioxide (ETCO2) using a capnography device allows the evaluation of non-invasive monitoring of arterial carbon dioxide pressure (PaCO2). The aim of this study was to compare the value of ETCO2 by direct mainstream and PaCO2 based on arterial gas analysis (ABG) before and after cardiopulmonary bypass pump in children with congenital heart defects. Methods. Twenty nine children who were candidates for elective cardiac surgery and were admitted to the Children's Medical Center were enrolled. Before and after cardiopulmonary bypass pump, ETCO2 was evaluated based on mainstream technique and PaCO2 based on arterial gas analysis. Results. The mean difference between ETCO2 and PaCO2 values before cardiopulmonary bypass pump was 3/68 ± 5/32 mm Hg, which considering that the difference of less than 5 mm Hg is clinically negligible, indicates an acceptable agreement between them. However, the mean difference between the two indices after cardiopulmonary bypass pump was 7/0 ± 6/85 mm Hg that accordingly, the difference between the two measured values after cardiopulmonary bypass will be clinically significant. Conclusion. Preoperative ETCO2 evaluation can provide a close prediction of PaCO2 levels, but after pumping, direct arterial sampling should be taken to accurately measure PaCO2 levels in non-cyanotic patients undergoing heart surgery. Practical Implications. When confronting with a child with non-cyanotic heart defect undergoing surgery, we suggest relying on capnography as a mirror of arterial blood pressure of carbon dioxide. However, capnography may not be as reliable during early post-bypass period in this group of patients and repeated arterial blood samples may be necessary.


The mechanism by which vincristine enhances the uptake of methotrexate in leukemic L1210 mouse cells has been investigated. Methotrexate uptake after 30 min at 37 degrees C increased 44% relative to untreated controls in cells suspended in a 4-(2-hydroxyethyl)-1-piperazineethanesulfonic acid/bicarbonate-buffered saline medium containing 20 microM vincristine. This stimulation was half-maximal at a vincristine concentration of 4 microM. An enhancement of methotrexate uptake by vincristine was also observed in the presence of glucose but a reversal could be achieved by prior treatment of the cells with taxol, a drug which prevents microtubule disassembly by vincristine. When the effect of vincristine was determined on the individual influx and efflux components for methotrexate, the increased uptake of methotrexate correlated with the inhibition of the unidirectional efflux route for methotrexate that is sensitive to bromosulfophthalein. Inhibition of this route was half-maximal at 3 microM vincristine and it exceeded 90% at high concentrations of the inhibitor. Transport via the bidirectional exchange carrier for methotrexate was not affected by vincristine, while the unidirectional efflux route sensitive to probenecid was inhibited by vincristine but only at concentrations 10-fold higher than required to inhibit the bromosulfophthalein-sensitive route. Vincristine did not increase methotrexate uptake in CCRF-CEM lymphoblasts, a human cell line which contains much lower levels of bromosulfophthalein-sensitive efflux route for methotrexate. Concentrations of vincristine which inhibited the bromosulfophthalein-sensitive efflux route of L1210 cells by 80-90% had little or no effect on the intracellular pH or on intracellular levels of ATP, GTP, cyclic AMP, K+, or oxidized glutathione. A significant increase was observed in the cellular uptake of tetraphenylphosphonium ions, suggesting that vincristine causes a hyperpolarization of the plasma membrane.


Background: There is evidence that iron may play a role in the pathology of Alzheimer's disease (AD). There may be genetic factors that contribute to iron deposition resulting in tissue damage thus exacerbating AD. Methods: We have genotyped 269 healthy elderly controls, 191 cases with definite or probable AD, and 69 with mild cognitive impairment (MCI) from the OPTIMA cohort. Results: We have examined the interaction between the C2 variant of the transferrin (TF) gene and the C282Y allele of the haemochromatosis (HFE) gene as risk factors for developing AD. Our results showed that each of the two variants was associated with an increased risk of AD only in the presence of the other. Neither allele alone had any effect. Carriers of both variants were at 5 times greater risk of AD compared with all others. The interaction was significant by logistic regression (p = 0.014) and by synergy factor analysis (p = 0.015, synergy factor = 5.1). Further, carriers of these two alleles plus apolipoprotein E ε4 (APOE4) were at still higher risk of AD: of the 14 tri-carriers of the three variants, identified in this study, 12 had AD and two MCI. Conclusion: We suggest that the combination of TF C2 and HFE C282Y may lead to an excess of redox-active iron and the induction of oxidative stress in neurones, which is exacerbated in carriers of APOE4. Since 4% of Northern Europeans carry the two iron-related variants and since iron overload is a treatable condition, these results merit replication.


In the heated debate about health care reform, there has been little serious discussion about how to fix the extraordinarily expensive and inefficient delivery system that makes meaningful expansion of coverage difficult. The public debate has degenerated into polemics, while the real issue of providing better health care is lost in the fray. The know-how and capability to create a far more rational and cost-effective system is within our grasp, and there has never been a more important time for the medical profession to take the lead in advocating for reform. Academic physicians are highly respected by the public and politicians; our views are valued, and we must engage more actively to support better approaches to health care. To improve care, I believe that practice must shift from a reactive, sporadic, disease event–oriented approach to one that promotes health, prevents disease, and intervenes early and effectively when it occurs. To do this, we must combine three key elements: (a) a personalized strategic approach to care with meaningful patient engagement, (b) a delivery system designed to support and coordinate care over time, and (c) a rational reimbursement system.

The current approach unfortunately contains none of these elements, but the resources to do so are available. We are experiencing a revolution in our ability to predict disease, track its progress, and intervene coherently. These new capacities, stemming in part from genomics, systems biology, and advanced medical technologies, can improve care by making it personalized, predictive, preventive, and cost-effective. Capabilities are being improved to define each individual's risk for developing chronic diseases as well as to detect the onset and provide the best personalized treatment when needed. We already have the know-how to create strategic solutions to improving health and minimizing disease (1). Such approaches, called prospective care, personalized medicine, integrative care, or patient-centered care, provide individuals with an assessment of their health risks and the education and support needed to create their strategic health plan. This is facilitated by an ongoing relationship with a health system that provides a primary point of contact; i.e., primary care physician and/or health care coach and coordinated care over time. These capabilities can be far more cost-effective, as they heighten the involvement and compliance of the individual and organize care over time. In contrast, the system today focuses on poorly coordinated and expensive treatment of episodes of late-stage chronic disease, many of which are preventable.

As a physician with 40 years' experience in virtually all aspects of medicine, I believe that our profession has an obligation to provide a strong voice in the health care debate. My belief is that the needed outcomes for a rational approach to care include:

Accessibility. Health is among our greatest resources and a basic value. Access and insurance to support health and minimize and treat disease should be available for all Americans.

Education. Educating the public about the importance of health and one's ability to influence it should be a major societal focus. Why not advocate a broad "going healthy" movement similar to the "going green" initiative to focus our nation on improving health as a national goal and a shared responsibility? Businesses, schools, communities, consumer groups, social and religious organizations, public health groups, and the government could develop collaborations focusing on improving our nation's health.

Approach to care. Strategic health planning based on a patient's risks for preventable diseases along with appropriate tracking and early personalized intervention are crucial. Chronic diseases develop over time, so there are abundant opportunities for personalization, prevention, and minimization of disease progression. The basic medical work-up should move from its current "find it and fix it" mind-set to one that is also proactive and preventive.

Delivery systems. Health providers should be organized to give the patient ongoing and coherent care at the level needed, from health promotion to treatment of disease events.

Biomedical research and continuous improvement. Prediction, prevention, and personalization are hallmarks of rational health care. These capabilities require constant advancement, and thus support is needed for robust biomedical research and translation. Regulatory processes should be created to allow rapid adoption of validated discoveries.

Reimbursement. Strategies to pay for prevention, continuity of care, and better outcomes are essential. Our current system rewards interventions for disease events and thus encourages the care we have today. Reimbursement for prevention, early intervention, and effective long-term management is missing. Of all the impediments to reform, changes in reimbursement may be the most difficult to overcome, as there is so much money at stake. Nonetheless, reimbursing providers for better clinical outcomes will have the greatest leverage in fostering better models of care.

Creating and validating better care models. While the concepts of personalized, prospective care are sound and indications of effectiveness apparent, we must develop more working models and learn from those that work the best. To stimulate competition and ingenuity, demonstration projects funded by the government and private insurers should be established. Outcomes could be monitored and overseen by credible, nonbiased entities such as the Institute of Medicine.

I believe that as a nation, we must affirm our commitment to a reasonable and practical level of health care as an individual's right. Health care must be directed toward enhancing patient involvement to improve their health along with systems to support this. Personalized, predictive, preventive, and coordinated strategies can replace the current approach, which wastefully focuses on disease events. I consider our health care system to be the best in the world in dealing with disease events, yet sorely inadequate in preventing and minimizing disease — we can and we must do better. Resolving this dilemma is at the crux of meaningful health care reform, and, as physicians, we must provide a voice of reason in this debate.


The effectiveness and promotional claims of a particularly influential spermicidal suppository with purported foaming action (Encare Oval) were refuted and challenged. The results of a West German survey showed that amount of information on contraception and method used were closely related; unfortunately then adolescents being less informed choose spermicidal over-the-counter agents and 60-70% choose Encare Oval. Encare contains nonoxynol a surface active substance which exerts spermicidal activity by lowering the tension of the sperm cell surface leading to loss of motility because of osmotic imbalance. The manufacturer claims that following deep intravaginal application Encare melts at body temperature and creats a so-called "barrier function." It is claimed that this foam from the suppository distributes the spermicide more effectively. Since few studies (none prospective) have addressed these claims Pro Familia centers were solicited for retrospective data on usage and contraceptive failure of Encare. Related to the computed number of all counseled visitors i.e. including nonpregnant women 3eeking advice and provided a 15% overall Encare user rate in the general fertile female population the number of pregnancies occurring under Encare (marked as PO in W. Germany) use was calculated in a range from 12.5-19.1% meaning that every 6th-8th woman using the product will conceive; this rate is 5-6 times higher than with oral contraceptives and the manufacturer claims that the product is as safe and reliable as the pill. In addition failures due to improper insertion were high; but of equal importance was the fact that the foaming action claimed was proven nonexistant 15 minutes after application.


The lacustrine Esmeralda Formation (Miocene) of Nevada was studied with the purpose of determining the depositional environment of petroliferous laminated rocks that are interbedded with volcaniclastic sands and localized carbonate units. Fine-grained petroliferous shales make up a 40-m section at the inferred depositional center of the basin and interfinger laterally with volcaniclastic mudstones, sandstones, and breccias. The areal extent and geometric shape of this unit were determined by detailed geologic mapping and measurement of stratigraphic sections. This unit and other units of the Esmeralda Formation have undergone extensive folding and faulting which produced possible reservoir structures. The depositional environment is interpreted as beginning as a freshwater lake that evolved through time into a saline lake environment. This basin received volcaniclastic sediments from surrounding volcanic highs. Influx of these sediments slowed during periods of carbonate deposition. Unusual stromatolites and large tufa mounds with pseudomorphs of evaporite minerals are associated with dolostone and limestone layers. This study provides a depositional and structural context for evaluating the petroleum potential of the Esmeralda Formation in Stewart Valley, as well as an aid in understanding similar Tertiary deposits in the Basin and Range province of Nevada. End_of_Article - Last_Page 613------------


This paper uses the narrative method to critically analyze theoretical approaches and concepts related to the development of rural areas and discusses the identified research gap that allows for the search for new concepts and methodologies for determining the economic potential of rural areas. In the study, various statistical methods, including the new global envelope method and permutation tests, were used to calculate the economic potential of the global model and individual sub-models of the rural areas´ potential. The achieved results suggest that the sub-model calculation is more complex and time consuming than the calculation of the global model. The comparison has also shown that the degree of relevance of the individual sub-models is lower due to the application of four sub-test statistics compared to the one test used in the global model. The selected process thus complicates the identification of false-positive significant variables. Based on the results, it can be stated that the significant variables identified in each sub-model affect the economic potential of a given sub-model, and thus the overall economic potential of the municipality, when compared to the variables identified in the global model.


We explicitly compute the limiting transient distribution of the search-cost in the move-to-front Markov chain when the number of objects tends to infinity, for general families of deterministic or random request rates. Our techniques are based on a "law of large numbers for random partitions," a scaling limit that allows us to exactly compute limiting expectation of empirical functionals of the request probabilities of objects. In particular, we show that the limiting search-cost can be split at an explicit deterministic threshold into one random variable in equilibrium, and a second one related to the initial ordering of the list. Our results ensure the stability of the limiting search-cost under general perturbations of the request probabilities. We provide the description of the limiting transient behavior in several examples where only the stationary regime is known, and discuss the range of validity of our scaling limit.


Quantitative microbiologic examinations of fluid taken from gingival sulci were carried out with patients suffering from chronic lymphatic leukemia (CLL), i.e. with disturbed immune response, and with healthy subjects. The pathogen count in each case was correlated with the gingival index, the plaque index, the amount of fluid in the gingival sulcus, and the pocket depth. Patients with chronic lymphatic leukemia with gingiva clinically free of inflammation showed one to 20 times more bacterial flora in fluid from the gingival sulcus than fluid from healthy control subjects. The quantitative values tend to equalize only if imflammation is severe. If the pathogen count is considered a function of the amount of plaque or pocket depth, markedly more microorganisms/mm3 of sulcus fluid were found with CLL patients than in the control group. It therefore may be concluded that immunologic reactions contribute decisively to the causation and maintenance of gingivitis with all of its consequences and that these reactions play an important role in the destruction of pathogens found in the region of the gingival pocket.


Outlaws in their various images have been important parts of history. In Australia, the longest lasting image of outlaws is the bushranger. Despite its popularity, there is a range of depictions of bushrangers and these are not necessarily similar. Interpretation of the bushrangers in colonial time differs from contemporary imagining. This papers aims at unfolding the various interpretations of the bushrangers in different periods in many types of artifact. Information was collected and interpreted by library research. The artifact analysis will be seen through a postmodernism theory by Michel Foucault and Roland Barthes. Since the phenomenon of bushranger stemmed from the colonial period, this study will commence from the period up to contemporary period. It can be concluded that a study of the different periods finds out that knowledge of the bushrangers does not make up a linear history, but rather a discontinuity in the historical narratives.


T he limiting factor for growing plant in salt affected soil is available water (AW) . The present work was carried out to portioning the correlation between some soil physical and chemical properties in some selected salt affected soil differed in texture and estimate the percentage of contribution in soil AW directly and/ or indirectly effect by using path analysis. Results show that r values of coarse particles was increased with decreasing the coarse particles in soil (change the soil texture from course to fine is associated with decrease in coarse particles and increase in fine one). Direct effect of fine particles on AW found to be higher than that of the other studied soil properties. Also, fine particles has higher indirect effect through the studied soil parameters which means that fine particles (silt + clay) play an important role than whole soil properties under investigation. According to OM effect on soil AW under the studied soils, significant correlations were found under the coarse textured soils (sand and loamy sand), while highly significant correlations were attained under clay loam and clay soils. According to the indirect effect of CEC on soil AW, the maximum 3 values were 11.4 % (coarse particles), 12.4 % (OM), 15.5 % (CaCO ) and 23.4 % (fine particles) under sand, loamy sand, clay loam and clay soils, respectively. W hile the lowest value of the indirect effect on AW through CEC were 6.5 % (EC), 4.9 % (coarse particles), 4.2% (coarse particles), 4.2% (coarse particles) and 6.8 % (coarse particles) under sand, loamy sand, clay loam and clay soils. Data points that SAR and ESP contribute on soil ability to retain water through direct effect was increased with increasing fine particles but values of SAR is more than those of ESP by 2.7, 2.6, 1.7 and 1.5 times for sand, loamy sand, clay loam and clay soils. W hereas, the maximum and minimum values of direct SAR and ESP on a vailable water were 23.5, 15.8 % and 12.8, 4.7 % under sand and clay soil, respectively.


Study Design. A retrospective, multicenter clinical review was conducted. Objective. To examine our experience using somatosensory evoked potential (SSEP) monitoring during anterior cervical discectomy and fusion (ACDF) to determine if monitoring of the spinal cord with SSEPs was helpful in identifying reversible causes of neurologic impairment while performing the procedure. Summary of Background Data. Recent studies have strongly supported the use of SSEP monitoring during complicated and upper-cervical spine surgery. Methods. The complete medical records of 163 patients who underwent ACDF, and who were monitored with SSEPs during the procedure between 1995 and 2002 were retrospectively reviewed. A single observer who was uninvolved with patient care abstracted these medical records. Demographic data, length of symptoms, workers' compensation status, primary diagnosis, preoperative neurologic status, number of levels fused, bone graft type, implants used, SSEP findings, postoperative neurologic status, complications, and recovery from complications were recorded. Final neurologic status was determined through phone contact with patients or outpatient charts of patients who could not be contacted personally. Results. There were 3 false positive (1.8%) intraoperative SSEP findings in which SSEP changes intraoperatively did not reflect a neurologic deterioration after surgery. There was 1 false negative (0.6%) in which a new neurologic deficit occurred after surgery, despite no change in SSEP amplitudes during the operation. There were 2 true negatives (1.2%) in which SSEP monitoring showed a preexisting neurologic deficit, which did not change during the operation. Conclusion. In no instance were positive SSEP findings clinically useful in alerting the surgeon to potential intraoperative complications. Intraoperative SSEP monitoring is not helpful to the surgeon when performing routine ACDF. Additionally, ACDF is a safe procedure with a low rate of neurologic complications.


Although respiratory heat loss with cooling of the tracheobronchial mucosa is responsible for the airway obstruction that develops after inhalation of subfreezing air in asthmatics, the mechanism by which airway cooling results in bronchoconstriction is not known. In order to test whether release of endogenous opiate peptides might play a role in mediating this response, asthmatic subjects were studied before and after isocapnic hyperventilation of subfreezing air after the administration of placebo or naloxone, given in a double-blind fashion. Five asthmatic subjects were tested with low-dose (0.8 mg) and 5 with high-dose (10 mg) naloxone given intravenously. Pretreatment with naloxone at either dose did not attenuate the decrease in FVC, FEV1, or FEF25--75 after cold air in comparison with placebo pretreatment. A slightly greater decrease in FEV1 and FEF25--75 after low-dose naloxone than placebo pretreatment can be partially explained by a difference in the temperature achieved during cold air inhalation. We conclude that endogenous opiate peptides are not involved in mediating the bronchoconstrictor response to cold air inhalation in asthmatics.


Objectives To develop waist circumference (WC) centile curves for UK South Asian children, to make comparisons with published centiles for British, indigenous Indian and Pakistani children, as well as to make anthropometric comparisons with their UK white peers. Design Cross-sectional study. Setting School-aged children from London boroughs (main measures: 2004–2007). Participants 1562 (652 boys, 910 girls) UK South Asian and 1120 (588 boys, 532 girls) UK white children aged 4.0–13.9 years. Interventions WC, height, weight and body mass index (BMI). Main outcome measures The outcome measures were smoothed WC centile curves, constructed using the LMS (L = skewness, M = median, S = coefficient of variation) method. SD scores (SDS) were generated using UK90 and British (WC) growth references. Results WC increased with age for both sexes, rising more steeply at the upper centiles after the age of 6 years. Overall, UK South Asian children, similar to indigenous South Asian populations, had higher WC values than the British WC references. However, compared with their UK white peers, UK South Asian children had significantly (p<0.001) lower mean WC (UK white SDS=0.74 and SDS=0.64 vs UK South Asian SDS=0.32 and SDS=0.21 for boys and girls, respectively). Obesity prevalence was greater using WC than BMI for both ethnicities. At the 90th centile, for UK South Asian children, prevalence was 21.5% vs 24.4% for boys and 17% vs 24.5% for girls based on BMI and WC, respectively. Conclusions These curves represent the first WC centiles for UK South Asian children up to the age of 14 years. With a continued rise in childhood obesity, they provide a useful historical control for future comparisons.


As a manner of introduction, the editor of the book under review gives the background to Islam Hadhari or Civilisational Islam, essentially a comprehensive blueprint for progress postulated by the then Prime Minister of Malaysia, Dato' Seri (now Tun) Abdullah Ahmad Badawi in the 2004 National Front Manifesto.
In "Civilizational Dialogue and the Islamic World", Seyyed Hossein Nasr traces the Greek, Sanskrit, and Latin Christian origins of the word 'civilisation'. He speaks of the "Presiding Idea", or "heavenly-given dispensation" that underlies all traditional civilisations, and attributes the decline of Islamic civilisation from the eighteenth century onward partly to colonisation and partly to the (erroneous) efforts of the Muslims themselves to uncritically emulate the West. Islamic civilisation, he concludes, is still best suited for inter-civilisational dialogue, occupying as it does the globe's "middle belt".


Based on the research question ''what is Medellin's urban planning public policy?'', the article presents the special urban regulatory hierarchy as part of the reference that has given and keeps giving rise to the mentioned public policy. For this purpose, first, the public policy figure that contains the definitions of the policy reference and decisional flow categories is outlined. These categories are the proposals in Pierre Muller's analysis model and the basis for legitimizing the public nature of a policy and differentiating it from the State or government policy. Furthermore, the article addresses the components that form the special urban regulatory hierarchy, beginning with the ones developed by the Constitutional Court in its jurisprudence. Then, it addresses the ones proposed by the doctrine, whose scheme is considered to be modified based on the derogation of article 7, Act 388, 1997, which is the current composition of the urban administrative function from the dispersion of territorial competences conferred by law, and the anachronistic role of the metropolitan areas in the urban field.


Increasing of load demand causes the greater electrical power needed. When the transformer operation in overload conditions and hottest-spot temperature, it will accelerate the aging and failure in oil insulation of transformer. Application of distributed generation (DG) can provide the additional electrical power supply to the loads (household). So that, it can relieve the workload power transformer and reduce the acceleration of aging in oil insulation of transformer. This research will analysed the effect of loading capacity with DG injection using a PV generator on the condition of oil insulation on 150 / 20kV of electricity distribution system using ETAP software. Tests of this research are carried out on 24 hours of loading conditions on the distribution system. The calculation of isolation oil temperature was carried out using a mathematical formula according to the IEEE, and oil insulation would be tested with a breakdown voltage (BDV) test.


In his inaugural presidential address to the 1984 annual meeting of the American Medical Association, Boyle exhorts physicians to rededicate themselves to their traditional ethic of providing high quality care, rather than succumb to a business-oriented ethic of rationing medical care for purposes of cost control. He also urges physicians and their professional organizations to take a more active role in monitoring the conduct and competence of their colleagues, and recommends that medical schools include a mandatory ethics course in the curriculum.


The purpose of this paper is to compare the practices of continuous improvement that are applied in medium and large manufacturing and service companies in two Latin American countries. At the same time, benefits and barriers experienced by these companies with regard to sustainability of continuous improvement are explored.,In order to generate a comparative study between two Latin American countries, interviews were conducted with managers linked to continuous improvement in medium and large companies in the State of Puebla and the Metropolitan District of Quito, which are important areas in Mexico and Ecuador, respectively. Data were collected by means of document analysis, semi-structured interviews, and direct observation.,Companies in both countries identify the use of various techniques and/or tools for continuous improvement. The results of the empirical evidence show how the impact of the application of the techniques has been beneficial in economic and human terms. Thus, the exploratory study has permitted the identification of the drivers and inhibitors in the maintenance of continuous improvement.,The research is based on only two areas of the Latin American countries: Mexico and Ecuador. Their results can therefore not be generalized. The approach is applied in a specific environment, namely, the State of Puebla and the Metropolitan District of Quito. This study incorporates the perception of managers, directors, and/or supervisors involved in continuous improvement processes.,This paper seeks to provide analytical input. The study is of great interest to researchers, managers, consultants, and professionals linked to projects of continuous improvement who wish to incorporate continuous improvement practices which are sustainable over time. A new managerial behavior is the basis of continuous improvement, where the training and development of the human resource increases the commitment to achieve organizational changes.,This research makes an empirical contribution to the literature through the understanding of practices of continuous improvement in a Latin American context, highlighting the factors that improve or impede the process of continuous improvement. Particularly in Mexico and Ecuador, the empirical evidence on this subject is still scarce despite the existence of theoretical academic literature.


This paper proposes a novel explicit rate allocation algorithm called Fast Rate Allocation Congestion Avoidance (FRACA) algorithm supporting non‐zero minimum cell rate (MCR). The non‐zero MCR guarantee strategy for ABR service in ATM networks focused in this paper is MCR plus equal share (The ATM Forum Traffic Management Specification, version 4.0. April 1996). The main goals for designing the algorithm are the fast convergence according to the max–min fairness criteria, fairness among all sessions, maximum network utilization while the switch queue length is properly controlled. At the same time, it should work well under a wide range of network conditions without the need for adjusting the algorithm parameters. The performance of the proposed algorithm is evaluated and compared with the Generic Weighted Fairness (GWF) ERICA + (J Comput Comm 2000; 149). Simulation results show that the proposed algorithm achieves the design goals in the evaluated scenarios. Copyright © 2004 John Wiley & Sons, Ltd.


LIDAR (Light Detection and Ranging) is one of the most effective remote sensing systems, which could provide three dimensional information of earth surface with high accuracy and speed. Now the building boundary extraction is the key approach for 3D modeling of building and city mapping. In this paper, a new algorithm named Alpha Shapes is developed to extract the building boundary. Compared with other algorithms, Alpha Shapes algorithm works effectively in inner and outer boundaries extraction from point clouds data with convex and concave polygon shape. Moreover, it can keep fine features of buildings adaptively and filter the footprints of non-building. The experiments prove that the Alpha Shapes algorithm is very suitable and effective for the building boundary extraction based on LIDAR data.


Aim: To study the anthropometry of subaxial cervical vertebrae and discuss its implications in cervical spine surgery in the Indian population. Materials and Methods: The study was conducted on 50 typical (C3-C6) cervical vertebrae using computerised tomography. Analysis: Mean and standard deviation of the parameters taken into account were analysed. The comparison of dimensions of the right andleft sides were performed using Student's t-test. Results: The morphometric analysis of the cervical vertebrae showed that in comparison with other population, the mean height and transverse diameters of the vertebral body were larger but anteroposterior diameter was less, making the vertebral bodies in Indians transversely larger. Conclusion: The present study would help during surgery of the cervical spine. The data would also be help in the designing of better implants.


Growing up with disfigurement and functional limitations resulting from childhood burns can be challenging. Initial stages of care involve painful surgeries/dressing changes, strenuous physical & occupational therapy, pressure garments and time away from family/school activities. Few studies have examined the voiced issues faced by youth while maturing with burns. This study's purpose was to determine if experiences in the post-injury phase differed between currently burn-injured youth vs. young adults burned as children.

 A prior study asked Child Burn Survivors (CBS -10–16 yrs.) and Young Adults (YAs -17-25yrs.) to answer the statement: "The hardest thing about being burned is…" The most common issues included: People Staring, Getting Unwanted Questions, Being Bullied, Remembering When I Was Burned, Having Additional Surgeries and My Scars. The current study asked participants to rate items on a 4-point scale from (1) Not at all to (4) Really a lot. The YAs were asked to consider issues they encountered maturing with burns.

 Child Survivors (CBS, n=147) mean age 13.4 years, male (n=46%) female (n=54%), and YA Survivors (YA, n = 81) male(n=39%) female (n=61%) mean age =19.1 yrs., and were predominately racial/ethnic minorities (CBS=67%; YA = 58%). No differences existed for age burned (CBS=6 yrs. vs. YA = 6.4 yrs.) hidden & visible scars (CBS=55% vs. YA=68%) and TBSA ≥ 50% (CBS=19% vs. YA =20%). Top mean scores for CBS's included: Remembering the Burn (2.05) & Getting Unwanted Questions (2.0). The YA group's top mean scores included Being Bullied (2.10) & People Staring (2.0). The CBS group reported that Getting Unwanted Questions was more problematic than the YA Group (p =003). YAs shared that Being Bullied was their biggest problem vs. CVS, significantly more so (p=.01).

 Bullying appears to be less of a problem for current child burn survivors than those previously burned. The difference may be due to a recent emphasis placed on anti-bullying in US schools. Findings highlight an ongoing need to address the psycho/social issues related to burns. Teaching interventions like the Phoenix Society's Rehearse Your Response can help youth address unwanted questions and staring. Providing children an opportunity to process the injury event may also improve their ability to cope with burn stressors.

 This research has clinical implications as issues shared by participants can be addressed by burn healthcare providers and therapists. Results endorse the delivery of supportive strategies which complement surgical/medical treatment and should help improve their social interactions/quality of life.


Some educators are working towards changing the content of the mathematics curriculum and the ways in which it is taught in order to best prepare students for the 'real world' by moving from a focus on arithmetic and computational skills toward a curriculum that develops students' abilities to think, reason, and communicate mathematically (Petocz and Reid 2005; Burton 2004). The goal is to help students construct their conceptual understanding of mathematics, not just memorise facts and rules. Likewise, the teaching of mathematics is changing in order to meet these new goals. Instead of teaching by demonstration, a blend of instructional methodologies is recommended that include individual and group work and direct instruction. The aim is to provide frequent opportunities for students to explore and solve problems, individually and with others, and to develop their mathematical skills in the context of this exploration (Stacey, Kendal and Pierce 2002). Lecturers are facilitators of learning, guiding students' explorations, asking questions that extend their thinking, and encouraging students to communicate their thinking. One of the catalysts for change is the widespread and increasing use of computer algebra systems by professional mathematicians and in teaching and learning mathematics.


AIMS AND OBJECTIVES
This study examines the utilisation of healthcare resources by critically ill older patients over one year following an intensive care unit stay.

BACKGROUND
Information on healthcare resource utilisation following intensive care unit treatment is essential during times of limited financial resources.

DESIGN
Prospective longitudinal nonrandomised study.

METHODS
Healthcare resource utilisation by critically ill older patients (≥65 years) was recorded during one year following treatment in a medical-surgical intensive care unit. Age-matched community-based participants served as comparison group. Data were collected at one-week following intensive care unit discharge/study recruitment and after 6 and 12 months. Recorded were length of stay, (re)admission to hospital or intensive care unit, general practitioner and medical specialist visits, rehabilitation program participation, medication use, discharge destination, home health care service use and level of dependence for activities of daily living.

RESULTS
One hundred and forty-five critically ill older patients and 146 age-matched participants were recruited into the study. Overall, critically ill older patients utilised more healthcare resources. After 6 and 12 months, they visited general practitioners six times more frequently, twice as many older patients took medications and only the intensive care unit group patients participated in rehabilitation programs (n = 99, 76%). The older patients were less likely to be hospitalised, very few transferred to nursing homes (n = 3, 2%), and only 7 (6%) continued to use home healthcare services 12 months following the intensive care unit stay.

CONCLUSIONS
Critically ill older patients utilise more healthcare resources following an intensive care unit stay, however, most are able to live at home with no or minimal assistance after one year.

RELEVANCE TO CLINICAL PRACTICE
Adequate healthcare resources, such as facilitated access to medical follow-up care, rehabilitation programs and home healthcare services, must be easily accessible for older patients following hospital discharge. Nurses need to be aware of the healthcare services available and advise patients accordingly.


Despite the many significant advances made in robotics research, few works have focused on the tight integration of task planning and motion control. Most integration works involve the task planner providing discrete commands to the low-level controller, which performs kinematics and control computations to command the motor and joint actuators. This paper presents a framework of the integrated planning and control for mobile robot navigation. Unlike existing integrated approaches, it produces a sequence of checkpoints instead of a complete path at the planning level. At the motion control level, a neural network is trained to perform motor control that moves the robot from one checkpoint to the next. This method allows for a tight integration between high-level planning and low-level control, which permits real-time performance and easy modification of motion path while the robot is enroute to the goal position.


Android is the operating system of this modern world. Today, every tech-savvy people across the world are giving first preference to Android devices for their personal and official use. Because of the growing use of Android devices attackers are turning their attention toward android application. Because of this alarming increase in Android malware attacks there is a need to develop a defence mechanism against such attacks that must be fruitful and cost-effective. State-of-the-art malware detection techniques perform static, dynamic or hybrid analysis. Static analysis involves examining the source code malware samples without executing them. However, dynamic analysis monitors the run time behaviour of application during the actual execution of the app. Static analysis is a straightforward way to analyze the malware samples regarding the Android platform. In this research, we perform hybrid analysis using four different categories of Android application features such as permissions, intents, and network features. We extract permissions and intent from a manifest file while Network-based features extracted from java files. Our results show that the greatest precision of 0.99 can achieve by performing feature selection using Info Gain Method. Through, feature selection and results achieved by those selected features we come to know that permission are the most relevant features among all other three feature categories. We have observed that performing Ensemble method is best among all four machine learning classifiers. We have seen that network features (IP addresses, Email addresses, URL) are the relevant and effective feature for malware detection in the proposed framework.


This article examines consumers? borrowing behavior and debt levels in the wake of Hurricane Harvey. We find that high levels of flooding from Harvey were associated with modest increases in auto loan balances, but moderate decreases in mortgage balances. In general, the storm did not hurt consumers? credit access according to the limited measures we investigate. These results are influenced by a number of factors, including federal disaster assistance, insurance payouts, and creditors permitting temporary postponements in loan payments, with such delays not being reported to credit bureaus.


The diffusion path of Li in γ-InSe is determined by means of total energy calculations. Neglecting relaxation effects we find that the most favourable diffusion path lies between the layers and has an activation energy and attempt frequency of 0.24 eV and 2.91 THz, respectively. The binding energy per Li is 2.53 eV.


The exchange bias effect, especially the angular dependence of the exchange bias field and the coercivity of the epitaxial ${\mathrm{Ni}}_{81}{\mathrm{Fe}}_{19}/{\mathrm{Fe}}_{50}{\mathrm{Mn}}_{50}$ bilayer system is investigated. In order to prepare a well defined layer sequence large emphasis is laid on the structural characterization of each layer. Low-energy electron diffraction and scanning tunneling microscopy are employed after each deposition step and the height-height-correlation function is analyzed to quantify the interface quality. Successively the angular dependence of the longitudinal and transverse magnetic component is investigated by magneto-optic Kerr effect magnetometry. In order to fully analyze the magnetization reversal behavior a special gray scale representation of the data is chosen. Theoretical results based on a modified Stoner-Wohlfarth model, which includes unidirectional and fourfold anisotropy contributions, are presented and compared to the experimental results. Although a homogeneous rotation of the magnetization is assumed the agreement between theory and experiment is surprisingly good. Only in a narrow angular range, where an ongoing rotation of the magnetization is predicted by the Stoner-Wohlfarth theory, discrepancies arise. The angular dependence of the possible orientations of the magnetization are summarized in a phase diagram.


Driving north from Denver to Fort Collins, the road skirts the eastern edge of the Front Range of the Southern Rocky Mountains, primarily on lower Tertiary and then upper Cretaceous sedimentary formation of the Denver Basin. To the east lie the Great Plains. The basement rocks exposed in the Front Range are buried by up to 12,000 feet locally along the front. The ranges are comprised of Proterozoic crystalline rocks ranging in age from the 1800Ma Idaho Springs metasediments and metavolcanics, the 1700MaSilverplume granite and the 1400Ma Log Cabin and Sherman granites of the Sherman Batholith.

North from Fort Collins toward Laramie the route traverses hogbacks of uplifted Permian Pennsylvanian through lower Cretaceous sedimentary beds, locally traveling down the strike valleys. Road cuts provide excellent exposures of the Jurassic Morrison. Formation, and the Cretaceous Dakota and Ingleside Formations. Quarries developed in these formations produce sandstone for building materials and glass sand, limestone for agricultural and construction use and shales for cement manufacture. The oldest sedimentary rocks of the Permian-Pennsylvanian Fountain Formation unconformably overlie the paleo-erosion surface of the Proterozoic crystalline rocks. This route also follows the old Overland Trail stagecoach route.

In the Livermore area a large open plain named the Livermore Embayment is formed by a graben. The bounding faults, seen on the south, west and north, place the sedimentary units up against the Proterozoic rocks.

North of Livermore, the route enters the 1400Ma Sherman Batholith. The principal rock types are the coarse grained pink hornblende granite termed the Sherman Granite. The Sherman exhibits widely spaced joints and rounded weathering surfaces. The tightly jointed blocky white granite is termed the Log Cabin Granite.

The route bisects the Virginia Dale Ring Complex, a striking circular feature on aerial photographs mapped by D.H. Eggler (1967). The core is largely Sherman Batholith, while more mafic metamorphic units are common locally in the outer rings. The route follows a long curved valley formed in one of the outer rings.

The State Line Kimberlite District consists of Devonian age kimberlite intrusions into the Proterozoic crystalline rocks. Kimberlite emplacement is not restricted or controlled by any specific structural or age unit. M.E. McCallum of Colorado State University identified the first kimberlite in 1965, at the Sloan Ranch in the southern portion of the District. In collaboration with Eggler, several other occurrences were then identified. McCallum and Eggler continue their kimberlite, mantle and diamond


Empirical results on the appraisal of anxiety-provoking situations are integrated with general findings on perceptual and cognitive growth. It was hypothesized that younger teenagers would appraise relations between anxiety-provoking situations on the basis of manifest and perceptually salient characteristics of the situations more so than would older teenagers, whereas the latter group would view relations predominantly on the basis of latent, anticipatory qualities. The hypothesis was tested with a similarity rating method designed to enable subjects to rate similarity between situations both from manifest and latent situation characteristics. The results supported the hypothesis. Implications of results for stability of cross-situational behavior was discussed.


Proteins are involved in practically every single biological process. The many enzymes involved in their synthesis, cleavage, and posttranslational modification (PTM) carry out highly specific tasks with no usage of protecting groups. Yet, the chemists' strategy of protection/deprotection potentially can be highly useful, for example, when a specific biochemical reaction catalyzed by a broad‐specificity enzyme needs to be inhibited, during infection of cells by enveloped viruses, in the invasion and spread of cancer cells, and upon mechanistic investigation of signal‐transduction pathways. Doing so requires highly specific binding of peptide substrates in aqueous solution with biologically competitive affinities. Recent development of peptide‐imprinted cross‐linked micelles allows such protection and affords previously impossible ways of manipulating peptides and proteins in enzymatic transformations.


— in this article is considered a problem of predicting discrete values of power c onsumption of electric energy. Since the volume of the consumption charts database must be sufficiently large to allow prediction to be reliable, it is advis-able to apply modern mathematical approaches to processing these graphs, in particular, artificial neural networks. So it is solved by using one of the methods of artificial neural networks - the restricted Bolt zmann machine. Restricted Boltzmann machine is a stochastic artificial neural network, the training of which is carried out "without a teacher" according to the algorithm of the reverse error propagation. Compared to other structures of neural networks, a restricted Boltzmann machine enables more efficient training algorithms than is possible for a general class of neural networks, in particular, the "contrast divergence" algorithm. This algorithm performs Gibbs sampling, which is used in the gradient descent procedure to calculate the refined weighting coefficients. In this method forecasting is carried out by adjusting the weight functions of the layers of the neural network in such a way so if optimized weighting is used, we minimize the Kulbock -Leibler distance between the distribution of input data and model approximation . In each phase of network training, weighting coefficients are calculated and modified based on their current mathematical values using the appropriate mathematical functions such as, one step of the Gibbs sample (updating the weights of all hidden and visible neurons). Accordingly, the weighed sum of the values of the output signals of the neurons, which goes on to the activation block, also changes. Depending o n the function embedded in the activation block, an output signal is generated. Consequently, the result of each phase of the training is the change in the weighting factors and parameters of the activation function. As a result, after training, the system is able to effectively predict the time dependencies of the power consumption of electr ical energy, which is important when developing a power management system for industrial and household objects . After studying such a system on the current database of graphs of daily electricity consumption, it will be able to make predictions within the specified error. Application of the proposed approach is effective in developing a system for managing the consumption of both large and small industrial and domestic o bjects, in particular Micro Grid.


Increased fracture rates and problems connected with missing bones as a result of accidents or various illnesses cause serious socio-health issues. Tissue engineering strives to provide a technique for promoting the healing or restoration of injured tissue as closely as feasible to the original tissue. The construction of scaffolds made from recombinant proteins is one of the most important alternatives proposed by this specialisation. Silk in bone tissue engineering has been extensively studied and the current study summarises the literature on such materials and their fabrication.


Sadness, even when intense enough to interfere with functioning, can be seen in a variety of conditions. Affective syndromes developing in the course of treatment with antihypertensive medications, sadness that accompanies various forms of cancer, and periods of sadness observed during the clinical course of schizophrenia might all have different contributory causes, prognoses, and optimal treatments. In that light, intoxication with brain depressants, especially alcohol, can cause clinically relevant changes in mood, with prolonged intoxication likely to induce depressive symptoms that resemble those seen in major depressive disorder. However, as is true of all complex clinical pictures developing in the course of a pre‐existing physiological or psychiatric condition, the depressive symptomatology associated with heavy consumption of alcohol might not have the same causes as independent major depressive disorder, and the symptoms often disappear with abstinence. This paper reports studies documenting the phenomenon of depression in alcoholism, presents an approach for distinguishing between alcohol‐related depressions and independent major depressive disorders, and explores the clinical and research implications of the relationship between alcohol and depression.


Percutaneous aspiration biopsy of solid adrenal masses was performed without complication in 14 patients. CT guidance of 20-22 gauge needles was used in all but one of the biopsies. Diagnostic cytologic material was recovered in 13 (93%) of the 14 cases. The diagnoses were primary and metastatic neoplasms (10 cases), benign adenomas (two cases), and a mycotic abscess. Twelve additional aspirations were performed of surgically resected or autopsy specimens in six normal adrenals, one adenoma, three adrenal cortical carcinomas, a pheochromocytoma, and a sarcoma arising in the adrenal stoma. Percutaneous aspiration of solid adrenal masses is recommended as a safe, reliable alternative to open surgical biopsy for both benign and malignant adrenal disease.


Crystal structures of two examples of an important class of ionic liquids, 1,3-dimethylimidazolium and 1,2,3-triethylimidazolium bis(trifluoromethanesulfonyl)imide have been characterized by single crystal X-ray diffraction. The anion in the 1,3-dimethylimidazolium example (mp 22 degrees C), adopts an unusual cis-geometry constrained by bifurcated cation-anion C-H. . .O hydrogen-bonds from the imidazolium cation to the anion resulting in the formation of fluorous layers within the solid-state structure. In contrast, in the 1,2,3-triethylimidazolium salt (mp 57 degrees C), the ions are discretely packed with only weak C-H. . .O contacts between the ions close to the van der Waals separation distances, and with the anion adopting the twisted conformation observed for all other examples from the limited set of organic bis(trifluoromethanesulfonyl)imide crystal structures. The structures are discussed in terms of the favorable physical properties that bis(trifluoromethanesulfonyl)imide anions impart in ionic liquids.


Aiming at sensor scheduling in collaborative target tracking in wireless sensor network, a sensor algorithm based on prediction of sensors' nodes is proposed in this paper. The construction and reconstruction of sensors nodes for target tracking are solved with actual prediction of targets location on next time. The extended kalman filter is used to predict the trajectories of target. The accuracy of target tracking is insured by cooperation in nodes.


In crystal engineering and pharmaceutical chemistry, cocrystals have a wide range of applications. Ethenzamide (EA) is found to form cocrystal with 2-nitrobenzoic acid (NBA). Geometry properties like stability energy, charge distribution, bond length, electronic properties and thermodynamic characteristics have been analyzed. The C-H…O hydrogen bond involves C-H of EA and oxygen of NBA. Configuration with the angle, N3-C4-C5-C6 gives the lowest energy conformation. Partition coefficient value suggests that EA-NBA has pharmaceutics behavior. RMSD values show the simulation's relative stability and the complexes, remained stable throughout.


Aims. This study investigated the association of autoantibodies binding to oxidized low-density lipoproteins (oxLDL) in diabetic retinopathy (DR). Methods. Plasma from 229 types 1 and 2 patients with DR including diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) was analysed with ELISA-based assay to determine IgA, IgG, and IgM autoantibody levels binding to oxLDL. The controls were 106 diabetic patients without retinopathy (NoDR) and 139 nondiabetic controls (C). Results. PDR group had significantly higher IgA autoantibody levels than DME or NoDR: mean 94.9 (SD 54.7) for PDR, 75.5 (41.8) for DME (p = 0.001), and 76.1 (48.2) for NoDR (p = 0.008). There were no differences in IgG, IgM, or IgA that would be specific for DR or for DME. Type 2 diabetic patients had higher levels of IgA autoantibodies than type 1 diabetic patients (86.0 and 65.5, resp., p = 0.004) and the highest levels in IgA were found in type 2 diabetic patients with PDR (119.1, p > 0.001). Conclusions. IgA autoantibodies were increased in PDR, especially in type 2 diabetes. The high levels of IgA in PDR, and especially in type 2 PDR patients, reflect the inflammatory process and enlighten the role of oxLDL and its autoantibodies in PDR.


Introduction: Twenty-five percent of acute pancreatitis develops severe acute pancreatitis (SAP). SAP patients have prolonged hospitalization and require a substantial amount of manpower and hospital resources. The aim of this study was to give an insight into the burden of acute pancreatitis at a tertiary level military hospital and to share the experience of managing pancreatic necrosis with the application of the step-up approach.
Methods: A prospective descriptive study of consecutive patients was conducted at Shree Birendra Army Hospital from 2017 June to 2017 November. Patients with a diagnosis of acute pancreatitis admitted were stratified according to severity as per Revised Atlanta classification 2012. Patients with acute necrotizing pancreatitis were enrolled for the step-up approach. Patient's demography, baseline investigations, radiology, prognostic scoring scales and type of intervention were analyzed. The burden of severe acute pancreatitis at our center and the early experience of the step-up approach at our centre within the study period were studied.
Results: Out of 35 five patients with acute pancreatitis, 7 (20%) subsequently developed severe acute pancreatitis. Among them, five patients subsequently developed necrotizing pancreatitis who were managed according to the step-up approach. Out of them, three patients subsequently underwent operative intervention in the form of minimally invasive procedures like percutaneous drain placement, laparoscopic necrosectomy, video-assisted retroperitoneal debridement, and open necrosectomy.
Conclusion: Acute pancreatitis is a common presentation at our centre. The step-up approach in the management of acute necrotizing pancreatitis is a safe and feasible approach.


The work falls into two distinct parts : firstly a preface that discusses the varying French influence at different periods of time from the Middle Ages onwards and what reactions it provoked ; secondly a corpus of "literary" texts in printed or manuscript form as we have found them, i.e. without any emendations. The material has been chronologically arranged according to the authors' respective years of birth and each section contains some biographical information about him or her when such has been available. All in all, 471 writers have been included in the corpus, 64 of whom are identified as women. 17 remain unknown.


A case report of successful application of peripheral veno-arterial extracorporeal membrane oxygenation in a patient with chronic type B aortic dissection and myocardial stunning to bridge to recovery was presented. Good outcomes from the application of peripheral veno-arterial extracorporeal membrane oxygenation in aortic dissection have rarely been reported, and the considerations of starting veno-arterial extracorporeal membrane oxygenation in this situation were seldom discussed. The orthodox that peripheral veno-arterial extracorporeal membrane oxygenation is an absolute contraindication for initiation of peripheral veno-arterial extracorporeal membrane oxygenation should be challenged. With proper planning and real-time transesophageal echocardiography–guided cannulation, peripheral veno-arterial extracorporeal membrane oxygenation is possibly beneficial. The considerations and echocardiography-guided techniques would be discussed in this report.


Glucocorticoid therapy is the most common cause of secondary osteoporosis and the leading iatrogenic cause of the disease. Often, the presenting manifestation is fracture, which occurs in 30% to 50% of patients receiving long-term glucocorticoid therapy. Glucocorticoid-induced osteoporosis predominantly affects regions of the skeleton that have abundant cancellous bone such as lumbar spine and proximal femur. Progress has been made in clarifying the pathophysiological mechanisms that result in glucocorticoid-induced osteoporosis. Although the options for prevention and treatment of glucocorticoid-induced osteoporosis continue to expand, provider compliance with preventive measures remains suboptimal.


Objective:In this 2.5-year study of simian immunodeficiency virus (SIVsm) infection in rhesus monkeys, quinolinic acid (QUIN) levels and virus isolation determinations were made in serial cerebrospinal fluid (CSF) and blood samples to evaluate the relationship between these parameters over the course of infection. Methods:Eight rhesus monkeys were inoculated in the saphenous vein with SIVsm. Four animals were maintained as uninoculated controls. CSF and blood samples were obtained every 1–4 weeks over the course of study. SIV isolation was determined in H9 cells for the CSF and in primary rhesus lymphocyte co-cultures for peripheral blood mononuclear cells (PBMC). QUIN was quantitated in CSF and serum by electron-capture negative chemical ionization gas chromatography mass spectrometry. Results:All SIV-inoculated animals became CSF and PBMC isolation-positive by 1–3 weeks post-inoculation. Control animals remained SIV-negative. One SIV-positive animal was humanely euthanized at 2 weeks post-inoculation. The three SIV-inoculated animals that were CSF isolation-negative after the fifth week post-inoculation maintained CSF QUIN values <100nM, remained CSF and PBMC isolation-negative, and clinically healthy in the chronic course of disease. In contrast, the four SIV-inoculated animals that were CSF isolation-positive 6–8 weeks post-inoculation had CSF QUIN levels as high as 153–565 nM during the second month post-inoculation and remained CSF virus isolation-negative, persistently PBMC isolation-positive, and experienced clinical symptoms of SIV in the chronic course of disease. Three of these four animals have succumbed to SIV infection. Discussion:Initial QUIN responses and viral isolation status in the first month post-inoculation were consistent among SIV-inoculated animals with CSF and serum QUIN values significantly higher than those of controls. A divergence within the SIV-inoculated group of animals became apparent within the second month of primary SIV infection and was maintained throughout the course of infection. Persistent PBMC viral isolation and marked elevations of QUIN were linked to symptomatic disease and a poor prognosis for survival. Predominantly negative PBMC viral isolation and slight, but significant, elevations of QUIN were linked to asymptomatic disease with a favorable prognosis for survival.


Novel molybdenum dithiolene compounds having neighboring amide groups as models for molybdoenzymes, (NEt(4))(2)[Mo(IV)O{1,2-S(2)-3,6-(RCONH)(2)C(6)H(2)}(2)] (R = CH(3), CF(3), t-Bu, Ph(3)C), were designed and synthesized. The contributions of the NH...S hydrogen bond to the electrochemical properties of the metal ion and the reactivity of the O-atom-transfer reaction were investigated by a comparison with [Mo(IV)O(1,2-S(2)C(6)H(4))(2)](2)(-). The MoOS(4) core of [Mo(IV)O{1,2-S(2)-3,6-(CH(3)CONH)(2)C(6)H(2)}(2)](2)(-) shows no significant geometrical difference from that of [Mo(IV)O(1,2-S(2)C(6)H(4))(2)](2)(-) in the crystal. The hydrogen bonds positively shifted the Mo(IV/V) redox potential and accelerated the reduction of Me(3)NO.


Call centre work has been associated with involving high workload, being under performance monitoring, having low autonomy, doing repetitive tasks and requiring a minimal level of skills, and the work is also being performed in an open-plan work environment. The aim of the study was to determine whether certain factors within the work environment of call centres play a role on the emotional and physical well-being of call centre agents. The study also aimed to investigate whether there was a significant relationship between these factors and well-being. The study employed a quantitative research paradigm, and data were gathered by means of a structured questionnaire administered to a sample of call centre agents (n = 275) from four companies located in the Cape Metropole, South Africa. The main findings showed that factors in the work environment, such as a lack of skills variety, low autonomy, task identity, lack of social support, job demand, performance monitoring, temperature and air quality as well as workstation layout, contribute negatively to emotional (burnout and stress) and physical (optical and auditory health problems) well-being. The findings yielded statistically significant relations between these factors and emotional and physical wellbeing. One of the recommendations of the study is that call centre organisations should have supportive human resource policies in place that offer training and development, present promotion opportunities and promote supervisor support.


Lumbar disc herniation (LDH) is a disabling problem. This retrospective case control study was done to evaluate the possible relevance of physical work load with Lumbar Disc Herniation. We have performed this study in the Spinal Surgery Unit of Department of Orthopaedic Surgery at BSMMU, Dhaka from July 2007 to June 2010 where 200 cases with Lumbar Disc Herniation and 200 control subjects matched by age, gender and area of residence were taken and analyzed. Chi-square test was computed for sex, area of residence, type of physical work and effort at work, whereas Odds ratio was computed for physical work load, stress at work and daily working period. The highest odds ratio (OR) was with the physical work load (OR: 03.48, CI: 01.84-06.59), hard work (OR: 03.14, CI: 01.74-05.65) and working period of >8 hours (OR: 01.34, CI: 0.75-02.38). Odds ratio for heavy load carrying at work was 03.48 and less job satisfaction or stress at work was 02.45. There was a statistically significant positive association between cumulative exposure of physical work load and lumbar disc herniation indicating an increased occurrence of herniation in heavy physical work load and occupation requiring harder efforts.


There are numerous chromophores present throughout the strata of human skin, which present many challenges and opportunities to probe molecular events. Fluorescence spectroscopy is principally employed to identify important biochemical components of the skin including endogenous tryptophan, tyrosine, pepsin‐digestible collagen cross‐links, collagenase‐digestible collagen cross‐links, NADH, etc. Over the last 15 years, many advances in instrument technology have been introduced allowing for much faster data acquisition with spectrofluorometers. As a result, a series of spectrofluorescence emission scans can be generated for a range of excitation wavelengths, or vice versa (excitation scans for a range of emission wavelengths), quickly to generate excitation–emission matrices. In this work, we constructed an endogenous fingerprint of fluorescent compounds present in skin, hair and nail tissues by employing a range of excitation wavelengths from 270 to 450 nm with a resolution of 2 nm. As a result, we generated surface plots of fluorescence emission as a function of excitation and emission wavelengths. From these data, we identified the predominant fluorescent chromophores in each tissue. We examined several sources of skin including in vivo human and ex vivo pig, sheep, goat and cow skin. We also analysed various types of mature hair characterized by the degree of melanin content. These analyses provided us with a fundamental understanding of the effects of melanin distribution in hair fibres and aided with the identification of fluorophores present in hair.


This research extends on historical background and mythic structure of Yarasanism through a survey of principal concepts of their beliefs. History of Tanbur and its usages are investigated through introducing three major Mughams with a special focus on Haqqni Mugham. This research study was conducted via descriptive -analytical method and library method. This study also identifies some features and symbols of Tanbour as music instrument and its correlation with Yarsan beliefs including individuals, numbers, legends, etc. This research also addresses a relation between Tanbour and Yarsan identity. The results show that Tanbour preserved language, literature (poetry), and music. Keywords: Tanbour, Yarasan Music, Yarsanism, Mysticism, Poetry


Research suggests that worksite health promotion (WHP) programmes, and specifically health risk assessment (HRA) surveys and health education workshops, can be effective in enhancing employees' health. However, 50–75% of employees choose not to participate when offered the opportunity to do so. The reasons for nonparticipation and the characteristics of nonparticipants have largely been overlooked. Building on premises of Conservation of Resources (COR) theory, we hypothesize that nonparticipation results from lack or loss of resources, or from the perceived low value of resources. These barriers to participation are expected to be related to employees' characteristics and beliefs (termed implicit barriers) and reflected in employees' self-reported reasons for nonparticipation (termed explicit barriers). We surveyed a large random sample of participants and nonparticipants in a WHP programme (n = 1926 employees), which included two steps: a HRA survey and a health education workshop. Participants completed an anonymous web-based questionnaire. Implicit and explicit barriers that reflect resource availability (e.g., age, health status) and valuation (e.g., low value of making a lifestyle change) were identified. The magnitude and nature of these barriers differed between the HRA survey and the workshop. We discuss how future research on WHP programmes can build on these findings and propose practical implications for reducing nonparticipation.


The agricultural system experienced a strong abandonment of agroforestry in the 20th century, with agroforestry today taking place only on a few million ha in Europe. One of the aims of the AgroFE (Agroforestry Training in Europe) and the Agrof-MM (Agroforestry – Training – Mediterranean and Mountain Erasmus+) European projects is to build a knowledge databank to assist educational development and to provide experts and farmers with agroforestry knowledge. The KDB (Knowledge DataBank) is based on different professional vocabulary, metadata and thesaurus systems to build the content structure and help the users in their searches. A new tool will improve the knowledge management of agroforestry. The Agrof-MM project is creating an agroforestry thesaurus. The paper describes the knowledge databank system prototype for Agroforestry training and education. The knowledge databank is a component of the project training system. It aims to gather and share a set of documents and resources that partners, learners and public users can access in different forms: mono document objects and composite materials.


Due to the elimination of the magnetic core on the stator, the design of coils is more flexible and more sensitive to the number of rotor poles for ironless stator axial flux permanent magnet (AFPM) machine. The slot-pole combination is a vital aspect of optimization design for the improvement of torque and power density. This article is mainly aimed at investigating the influence of slot-pole combination on the comprehensive performance of ironless stator AFPM machine with non-overlapping concentrated windings. Firstly, the space utilization of coils and winding factor of non-overlapping concentrated winding are deduced in formula form to compare the output capacity. And the copper mass and utilization are analyzed with different numbers of slots and stator diameter. Then, field utilization ratio is defined and derived to analyze magnetic flux leakage of Halbach-array PM dual-rotor for different numbers of poles. The performance comparison of the optimized prototypes is carried out using three-dimensional finite element analysis (3-D FEA). The back-EMF, torque and winding loss are also highlighted. Finally, a 50 kW prototype with 12-slot and 10-pole is designed and manufactured for experimental validations. This paper provides a valuable reference to select the basic configuration for the ironless stator AFPM machine application.