In striated muscle the transition from the active to the resting state requires a reduction in the cytosolic concentration of ionized calcium (Ca2+), achieved by a rapid sequestration into the sarcoplasmic reticulum and the return of some Ca2+ to the extracellular phase. Morphologically the sarcoplasmic reticulum (SR) is heterogeneous. Specialized regions occur whenever the limiting membranes of the SR approach those of the plasmalemma. These specializations include a narrowed lumen, relative to that found in non-specialized parts of the SR, the presence of electron-dense 'feet' extending into the junctional gap separating the facing membranes of the plasmalemma and the SR, and the occurrence of intraluminal densities. These specializations can assume a variety of configurations, some of which appear to be species specific. The accumulation of Ca2+ by the SR, is a rapid process and the required energy is derived from the hydrolysis of ATP via a Ca2+-activated ATPase in the limiting membranes of the SR. Impaired relaxation in heart muscle can result either from an inadequate supply of ATP, Ca2+-overload, failure of the Ca2+-activated ATPase enzyme, leakage of Ca2+ from the SR, or the failure of the cell to return Ca2+ back into the extracellular phase. Evidence will be presented to show that the rise in resting tension that is caused by an inadequate supply of oxygen involves a mobilization of Ca2+ from the internal stores, and insufficient ATP to drive the ATPase enzyme in the SR, rather than a malfunction of the enzyme. Likewise ouabain-induced contractures have been found to be associated with diminished tissue stores of ATP, the rise in tissue Ca2+ occurring as a late phenomenon.


Simple Summary Spodoptera exigua (Hübner) is a common agricultural pest that can harm hundreds of crops. Carbohydrates and proteins are the two key nutrients affecting the development of insect populations. To study the development of the S. exigua population under different carbohydrate and protein nutrition conditions, we constructed a life table of S. exigua under different nutrient conditions: high nitrogen, medium nitrogen–medium sugar, and high sugar. The results showed that there was no significant difference in net reproductive rate among the three nutritional conditions. S. exigua on medium nitrogen–medium sugar diets had the shortest generation time and significantly higher intrinsic rate of increase, finite rate of increase, fecundity, and predicted population at 100 days. These results suggested that an appropriate protein:carbohydrate ratio was beneficial to the rapid development of Spodoptera exigua on farmland. These findings are important for scientifically predicting the population dynamics of S. exigua and constructing a system for controlling the insect population. Abstract Spodoptera exigua (Hübner) is a common agricultural pest that can harm hundreds of crops. Nutrition conditions can significantly affect the development of insects, especially carbohydrates (C) and proteins (P), which are the two most critical nutrients. To study the development of the S. exigua population under different carbohydrate and protein nutrition conditions, we constructed a life table of both sexes of an S. exigua population under three artificial diets: high nitrogen (P:C = 7:1), medium nitrogen, medium sugar (P:C = 1:1), and high sugar (P:C = 1:7). The results showed that the generation time of S. exigua was 26.38 ± 0.54 d under the medium nitrogen–medium sugar diet, which was the shortest among the three nutrition conditions. The intrinsic rate of increase (0.18 ± 0.01), finite rate of increase (1.20 ± 0.01), fecundity (605.42 ± 36.33 eggs/female), and predicted population at 100 days (8,840,000) were significantly higher under the medium nitrogen–medium sugar condition. There was no significant difference in the net reproductive rate among the three conditions. These results suggested that an appropriate protein:carbohydrate ratio is beneficial to the rapid development of S. exigua on farmland. These findings are important for scientifically predicting the population dynamics of S. exigua from the perspective of nutritional ecology, understanding its catastrophic mechanism, and constructing a prevention and control system.


Although the great genital diversity of the barklouse genus Trichadenotecnum has been described in previous studies, the specific function of the genital structures during the copulation process has received less investigative attention. We reconstructed 3D‐models of each structure of the male and female genitalia of Trichadenotecnum incognitum in copula and those of uncopulated male and female of Trichadenotecnum pseudomedium. By comparing the changes in male and female genital structures and related muscles in copulated and uncopulated states, the function of each genital structure can be described. During the copulation, we found that the female subgenital plate was hooked into the male body by the distal process on the male paraproct and was fixed by the male epiproct, hypandrium and phallosome. In addition, sexual coevolution was suggested by tightly contacting structures, that is, thorny male hypandrium and thickened membrane around the female spermapore plate. These results not only give us a new understanding copulation process of Trichadenotecnum, but also explain the reasons why genital structures are so divers in the genus.


The connection between different tissues is vital for the development and function of any organs and systems. In the musculoskeletal system, the attachment of elastic tendons to stiff bones poses a mechanical challenge that is solved by the formation of a transitional tissue, which allows the transfer of muscle forces to the skeleton without tearing. Here, we show that tendon-to-bone attachment cells are bi-fated, activating a mixture of chondrocyte and tenocyte transcriptomes, which is regulated by sharing regulatory elements with these cells and by Krüppel-like factors transcription factors (KLF). To uncover the molecular identity of attachment cells, we first applied high-throughput RNA sequencing to murine humeral attachment cells. The results, which were validated by in situ hybridization and single-molecule in situ hybridization, reveal that attachment cells express hundreds of chondrogenic and tenogenic genes. In search for the underlying mechanism allowing these cells to express these genes, we performed ATAC sequencing and found that attachment cells share a significant fraction of accessible intergenic chromatin areas with either tenocytes or chondrocytes. Epigenomic analysis further revealed transcriptional enhancer signatures for the majority of these regions. We then examined a subset of these regions using transgenic mouse enhancer reporter. Results verified the shared activity of some of these enhancers, supporting the possibility that the transcriptome of attachment cells is regulated by enhancers with shared activities in tenocytes or chondrocytes. Finally, integrative chromatin and motif analyses, as well as the transcriptome data, indicated that KLFs are regulators of attachment cells. Indeed, blocking the expression of Klf2 and Klf4 in the developing limb mesenchyme led to abnormal differentiation of attachment cells, establishing these factors as key regulators of the fate of these cells. In summary, our findings show how the molecular identity of bi-fated attachment cells enables the formation of the unique transitional tissue that connect tendon to bone. More broadly, we show how mixing the transcriptomes of two cell types through shared enhancers and a dedicated set of transcription factors can lead to the formation of a new cell fate that connects them.


Though the adhesion between substrate and sprayed coating seems to be mainly due to the anchoring effect, quantitative examinations have not been sufficient. In this paper, the surface condition of a roughened substrate is quantitatively evaluated using a surface roughness tester, and the adhesive relationship is clarified. Substrate used was S45C(JIS standard) carbon steel, and the roughening methods were blasting and endless belt polishing with alumina grit, in various roughening conditions. A pure copper coating was formed using the powder flame spraying method on roughened substrate. The drawing adhesion strength test method was used to evaluate the adhesive properties. The adhesive strength is reduced, though the surface roughness of the substrate increases, as the size of the grid particles for roughening increase. The alumina grits remained on the substrate after roughening, and they were removed by ultrasonic cleaning. Though there is no relation between the adhesive strength and the ratio of the increase in the surface area of substrate due to the roughening treatment, it is recognized that the adhesive strength also increases when the roughness gradient of the substrate increases.


Child abuse occurs when an adult demonstrates dominance over a child by mistreating that child physical, mentally, emotionally, or through neglect. This tragic issue is pervasive in the United States today and the number of children being abused continues to rise. Children who have been abused are affected in many different ways, and the effects can be both devastating and long lasting, depending on the child. Teachers are some of the only adult figures and role models that children have in their life. Since teachers see most children between six and eight hours each day, they can and should play a major role in detecting and reporting child abuse. If the child discloses abuse to a teacher, the teacher has a legal responsibility to report that abuse. If not, depending on the type of abuse a child is a victim of, there could be any number of signs or symptoms present for a teacher to detect and report. Teachers must follow certain guidelines when reporting child abuse. Once the abuse has been reported, a teacher should help with the follow-up and recuperation of the child. None of those steps can be completed, however, if teachers are uneducated about child abuse. There is a gap in teacher education programs when it comes to child abuse. If future teachers are educated, they are more likely to report child abuse and more children are likely to be rescued from the abusive


The syntheses, solid state, spectroscopic and potentiometric solution characterizations of VO(acac-NH2)2 (acac-NH2
= acetylacetamido) and VO(acac-NMe2)2 (acac-NMe2
=
N,N-dimethylacetylacetamido) have been investigated. In VO(acac-NMe2)2 the vanadium ion exhibits a distorted square pyramidal coordination environment. Crystals of VO(acac-NMe2)2 are monoclinic and structural studies were carried out. EPR and UV-visible spectroscopic and potentiometric methods were used to characterize the speciation, complex stability and structures in both aqueous and organic solutions. VO(acac-NH2)2 and VO(acac-NMe2)2 each form two species in solution: a 1 ∶ 2 and a 1 ∶ 1 metal ∶ ligand complex. The complexes formed from VO(acac-NH2)2
are slightly more stable than those of VO(acac-NMe2)2; however, VO(acac)2 forms more stable complexes. In non-coordinating solvents the 1 ∶ 2 complexes maintain a five-coordinate vanadium atom, whereas in coordinating solvents such as water and pyridine the complexes become six-coordinate. Based on the similarity of the EPR parameters of VO(acac-NH2)2 with those of the VO(acac)2 complex, it is likely these species contain the coordinating solvent added trans to the VO bond. These new VO(acac)2 derivatives are improved with respect to water solubility. Although the solution stability is not as good as that of VO(acac)2, it is higher than that of VO(acac-R)2 (R = CH3 or C2H5). Thus, should the stability of the 1 ∶ 1 complex be important for the compound's efficacy, both of these
new complexes would be predicted to be less effective than VO(acac)2 but more effective than VO(acac-Et)2 (acac-Et = 3-ethylacetylacetonate) in lowering glucose levels in streptozotocin-induced diabetic rats.


This paper focuses on the compatibility between forest management and soil conservation with reference to chesnut (Castanea sativa Mill.), holm oak (Quercus ilex L.) and especially Manna Ash (Fraxinus ornus L.) mixed hop Hornbeam (Ostrya carpinifolia Scop.) coppices stands, located on slopes of Campania and characterized by intensely pedogenised pyroclastic coverage, but unstable when facing intense rainy events. Based on the Corine Land Cover system (2012), we divided the areas into the three physiognomic types; thus, the proportion of surfaces falling under the pyroclastic coverage, which are the more instable, were obtained by overlapping the land systems and soil map produced by the Campania region (2014). For each type of coppice, we examined all the different structural conditions (traditional coppices, coppices past traditional rotation age and coppice in conversion to high forest) and underlined the most important critical issues due to clearcutting, We summarized the different types of silvicultural interventions to improve the forest management sustainability, especially in those areas which are vulnerable to hydrogeological instability. We also stressed that forest planning is the essential tool for sustainable management of coppices, together with the catchment area and the fire-fighting planning.


Associations between herd management practices and both bacterial counts (BC) and coliform counts (CC) from 254 and 242 dairy herds in Flanders (Belgium), respectively, were studied. Data were analyzed using multivariable, multilevel linear regression analysis, allowing variance components analyses. Both BC and CC fluctuated throughout the year, although the milk quality parameters followed an opposite pattern. Bacterial count values decreased with each increase of the cleaning frequency of the cubicles (once per week, once per day, twice per day, or more than twice per day) between January and March. Herds with a conventional milking parlor had substantially lower BC than herds where the cows were milked using an automatic milking system. Lower BC were observed when the milking parlor was equipped with an automatic cluster removal system, when premilking teat disinfection was applied, when the dry cows were supplemented with a mix of minerals and vitamins, and when the teats were prepared either first wet and dried or via an automatic milking system. Milking cows with a high-pipeline milking parlor setup or with an automatic milking system was associated with substantially higher CC values. Herds where prepartum heifers were often treated with antimicrobials before calving had a lower CC than farms where heifers were either not or only rarely treated. Most variation in BC and CC resided at the herd level rather than at the observation level, indicating that management is important in the control of both BC and CC. Still, only a small proportion of the total variance was explained by factors capturing information related to the milking, herd health, and dry cow management, which suggests that the bacteriological milk quality and, in particular, CC is primarily driven by other factors than the ones included in this study.


Introduction: The thoracic outlet is bounded by the clavicle, first rib, and muscles of the scalene triangle. When a compression within the outlet occurs, it presents as thoracic outlet syndrome (TOS). TOS typically develops from the combination of developmental abnormalities, injuries, and physical activities that cause compression of the brachial plexus neurovasculature. This classically manifests as sensory and motor symptoms involving lower trunk (C8-T1) dermatomes and myotomes. The upper trunk and associated peripheral nerves, including musculocutaneous, are typically spared. Case Description: A 22 y.o. male with a history of ulnar collateral ligament reconstruction and right elbow ulnar decompression a year prior presented for follow up with persistent shoulder soreness. He was collegiate pitcher and after 18 months post op, he started to experience vague anterior shoulder/upper arm pain and numbness down the arm. He had some difficulty localizing the symptoms. He was clinically diagnosed with TOS and initial recommendations included physical therapy, changing pitching biomechanics, pitch count limits and an interval throwing program. Clinical course: His symptoms progressed however and he developed worsening paresthesias. He was now able to endorse both medial and lateral forearm symptoms, and later some weakness in the biceps with weightlifting. Electromyography testing was consistent with brachial plexopathy (TOS) but also showed a superimposed musculocutaneous neuropathy. He was treated more aggressively with activity modification and therapy, along with education and counseling regarding TOS and musculocutaneous neuropathy. His musculocutaneous neuropathy symptoms improved, but TOS symptoms continued. At last follow-up he returned to pitching but was considering consultation with a TOS surgeon. Conclusions: When diagnosed, TOS typically should involve sensory changes in the medial arm and motor changes of C8-T1 innervated muscles. Isolated musculocutaneous neuropathy can cause vague shoulder and arm symptoms and may be difficult to diagnose clinically in absence of biceps weakness. This case highlights the rarity of musculocutaneous neuropathy superimposed on TOS and the importance of dermatome and myotome clinical correlations as it relates to the brachial plexus.


Objective: Infective endocarditis (IE) caused by Staphylococcus species (spp.) is believed to be associated with higher morbidity and mortality rates. We hypothesize that Staphylococcus spp. are more virulent compared with other commonly causative bacteria of IE with regard to short-term and long-term mortality. Background: It remains unclear if patients suffering from IE due to Staphylococcus spp. should be referred for surgical treatment earlier than other IE patients to avoid septic embolism and to optimize perioperative outcomes. Materials and Methods: The database of the CAMPAIGN registry, comprising 4917 consecutive patients undergoing heart valve surgery, was retrospectively analyzed. Patients were divided into 2 groups with regard to the identified microorganisms: Staphylococcus group and the non-Staphylococcus group. The non-Staphylococcus group was subdivided for further analyses: Streptococcus group, Enterococcus group, and all other bacteria groups. Results: The respective mortality rates at 30 days (18.7% vs 11.8%; P<0.001), 1 year (24.7% vs 17.7%; P<0.001), and 5 years (32.2% vs 24.5%; P<0.001) were significantly higher in Staphylococcus patients (n=1260) compared with the non-Staphylococcus group (n=1787). Multivariate regression identified left ventricular ejection fraction <30% (P<0.001), chronic obstructive pulmonary disease (P=0.045), renal insufficiency (P=0.002), Staphylococcus spp. (P=0.032), and Streptococcus spp. (P=0.013) as independent risk factors for 30-day mortality. Independent risk factors for 1-year mortality were identified as: age (P<0.001), female sex (P=0.018), diabetes (P=0.018), preoperative stroke (P=0.039), chronic obstructive pulmonary disease (P=0.001), preoperative dialysis (P<0.001), and valve vegetations (P=0.004). Conclusions: Staphylococcus endocarditis is associated with an almost twice as high 30-day mortality and significantly inferior long-term outcome compared with IE by other commonly causative bacteria. Patients with Staphylococcus infection are more often female and critically ill, with >50% of these patients suffering from clinically relevant septic embolism. Early diagnosis and referral to a specialized center for surgical treatment are strongly recommended to reduce the incidence of preoperative deterioration and stroke due to septic embolism.


Populations of some dabbling ducks have declined sharply in recent decades and information is needed to understand reasons for this. During 1982-85, we studied duck nesting for 1-4 years in 17 1.6 by 16.0-km, high-density duck areas in the Prairie Pothole Region (PPR) of Canada, 9 in parkland and 8 in prairie. We estimated nest-initiation dates, habitat preferences, nest success, and nest fates for mallards (Anas platyrhynchos), gadwalls (A. strepera), blue-winged teals (A. discors), northern shovelers (A. clypeata), and northern pintails (A. acuta). We also examined the relation of mallard production to geographic and temporal variation in wetlands, breeding populations, nesting effort, and hatch rate. Average periods of nest initiation were similar for mallards and northern pintails, and nearly twice as long as those of gadwalls, blue-winged teals, and northern shovelers. Median date of nest initiation was related to presence of wet wetlands (contained visible standing water), spring precipitation, and May temperature. Length of initiation period was related to presence of wet wetlands and precipitation in May, June temperature, and nest success; it was negatively related overall to drought that prevailed over much of Prairie Canada during the study, especially in 1984. Mallards, gadwalls, and northern pintails nested most often in brush in native grassland, blue-winged teals in road rights-of-way, and northern shovelers in hayfields and small ( < 2 ha) untilled tracts of upland habitat (hereafter called Odd area). Among 8 habitat classes that composed all suitable nesting habitat of each study area, nest success estimates averaged 25% in Woodland, 19% in Brush, 18% in Hayland, 16% in Wetland, 15% in Grass, 11% in Odd area, 8% in Right-of-way, and 2% in Cropland. We detected no significant difference in nest success among species: mallard (11%), gadwall (14%), blue-winged teal (15%), northern shoveler (12%), and northern pintail (7%). Annual nest success (pooled by study area and averaged [unweighted] over all study areas) was 17% in 1982, 15% in 1983, 7% in 1984, and 14% in 1985. We estimated that predators destroyed 72% of mallard, gadwall, blue-winged teal, and northern shoveler nests and 65% of northern pintail nests. In prairie, average nest success decreased about 4 percentage points for every 10 percentage points increase in Cropland, suggesting that under conditions of 1982-85, local populations of these species probably were not stable when Cropland exceeded about 56% of available habitat. We found recent remains of 573 dead ducks during 1983-85; most were females (Anas spp.) apparently killed by predators. In some years, mallards and northern pintails were more numerous among dead ducks than we expected. More females than males were found dead among mallards and northern shovelers, suggesting higher vulnerability of females. Of factors we examined, nest-success rate appeared to be the most influential factor in determining mallard production. Nest success varied both geographically and annually. WILDL. MONOGR. 128, 1-57


The granular material behaviour is determined by the local contact behaviour between particles and the spatial arrangement of particles. Investigation of particle-scale mechanism provides fundamental insights into global granular material behaviour. A multi-scale investigation has been carried out to study granular material behaviour under general stress paths using discrete element method (DEM). The commercial software Particle Flow Code in Three Dimensions (PFC3D) is employed for numerical simulations and the linear contact model is used to describe local contact behaviour. General loading paths were achieved by implementing a boundary control programme with independent control of both the magnitudes of three principal stresses and their principal directions.
The intermediate principal stress ratio , where are the major, intermediate and minor principal stresses, and material anisotropy both had significant effect on granular material strength. The true triaxial simulation results indicated that the peak stress ratio was mainly contributed by the micro-scale contact force anisotropy. A smaller stress ratio was observed at greater a b value due to smaller degree of contact force anisotropy. Fabric anisotropy was another contributor to the material stress state. A lower peak stress ratio was obtained at a larger tilting major principal stress direction from the vertical deposition direction since smaller fabric anisotropy degree developed at larger . However, the material initial anisotropy had negligible effect on the critical stress ratio owing to the same contact force anisotropy and fabric anisotropy achieved.

In true triaxial simulations, the intermediate strain increment rate ratio was generally larger than the stress ratio b since the particle-scale tangential force ratio was observed to be smaller than b value. The non-coaxial deformation observed in monotonic loading with various loading direction can be explained due to the non-coincidence between the principal fabric direction and the principal stress direction. And the degree of non-coaxiality decreased against shearing as the principal fabric direction approached loading direction gradually.

The granular material response to rotational shear showed significant volumetric contraction and deformation non-coaxiality. The material internal structure rotated continuously along the principal stress rotation. The principal fabric direction did not exactly follow the rotation of principal stress direction. The fabric reorganisation mechanism accompanied by irrecoverable plastic deformation, leading to non-coaxial deformation behaviour.

During rotational shear, the ultimate void ratio was determined by the stress ratio and b value but independent of initial void ratios. Under otherwise identical conditions, the greater internal structure anisotropy was observed at the higher stress ratio and at a greater b value, resulting in smaller ultimate void ratio (larger volumetric contraction). The general degree of deformation non-coaxiality decreased with increasing stress ratio and b value for rotational shear. The difference between the major principal stress direction and the major principal fabric direction was smaller at higher stress ratio and greater b value.

It was interesting to note that the sample could fail during rotational shear, resulting in significant deviatoric strain developed in the first few cycles. The sample failed at a stress ratio , which was lower than the peak stress ratio obtained in monotonic loading but higher than the critical stress ratio . This indicated importance of considering stress rotation in geotechnical design and the material strength should be chosen based on the critical stress ratio rather than the peak value.

The multi-scale investigation of granular material explains the strength characteristics from the micromechanical point of view. Observations on the fabric evolution have been made under various loading conditions. This may be useful information for the development of an advanced constitutive model.


Scholarship on international norms has recently begun to explore how domestic-level structures and processes affect compliance. This literature has identified the domestic legitimacy of an international norm as an important variable in accounting for the effects of norms on state behavior. But scholars have devoted insufficient attention to measuring the legitimacy or salience of international norms in the domestic arena and to identifying the pathways that lead to domestic salience. We offer insights that could lead to more systematic studies of the domestic impact of international norms. First, we propose a framework to measure the domestic salience of an international norm. Second, we identify four pathways by which an international norm can enter the national arena and one factor that conditions its impact on domestic political processes. The paper concludes by suggesting directions for future empirical research.


The story of western literature is the story of two Wests, the one immediately and deeply persuasive, the second more complex in its intentions and effects. This anthology, gathered and introduced by distinguished western scholar Thomas J. Lyon, offers a panoramic literary range of the American west, from the romance of the mythic Wild West to the present-day creative explosion of the real, diverse west. The regional expanse of this authoritative and adventuresome selection of short stories, essays, plays, and novel excerpts stretches from the Great Plains, Texas and the Southwest, the Rocky Mountains and the Great Basin interior, to California and the Northwest. Including selections from Pedro Font, Meriweather Lewis, Willa Cather, James Fenimore Cooper, Owen Wister, Zane Grey, John Muir, Tillie Olsen, Rick Bass, Amy Tan, Sarah Winnemucca, and N. Scott Momaday, among others, the volume is organized in five main sections: Discovery and Exploration, Pioneering and Settlement, The Mythic West, Modernism and the Realistic West, Recent and Contemporary Currents, and The Native West. From the projective "Great Frontier" of dime-store novels to the real west brought to light by sixteenth century explorers, mid-nineteenth century realists and naturalists, and todays environmentalists and ethnic writers, The Literary West offers students a comprehensive overview of the vital field of Western American literature.


OBJECTIVE
The aim of the present study was to develop an instrument to measure "internalized racism" called appropriated racial oppression for people of Color.

METHOD
Generated items were reviewed by experts in the areas of multicultural psychology and scale construction. A total sample of 656 adults was collected in 2 phases: The first phase consisted of 341 adults (Age: M = 35, SD = 12.05). Of these, 99 were Black, 70 multiracial, 61 Asian, 61 Latino, 37 Native American, 10 identified as "other," and 3 participants did not answer. Most were female (n = 256), and heterosexual (n = 277). In the second phase, there were 315 adults (Age: M = 35; SD = 12.05). Eighty were Black, 68 Multiracial, 56 Asian, 54 Latino, 40 Native American, 16 were other and 1 participant did not answer. Two-thirds were female (n = 216) and heterosexual (n = 251).

RESULTS
The 341 adult participants' responses were used to run exploratory factor analysis that revealed a 32-item, 4-factor structure for the construct of appropriated racial oppression. The 315 adult participants' data were used in a confirmatory factor analysis that resulted in a 4-factor, 24-item model fit. To test for both predictive and criterion-related validity, a path analysis was conducted. Results of the path analysis demonstrated significant relationships between appropriated racial oppression and anxiety and depression.

CONCLUSION
It has been found that there is preliminary evidence for the validity of the newly developed Appropriated Racial Oppression Scale. Moreover, results of this study provide critical information in assisting clinicians treating individuals with appropriated racial oppression.


A mixed-fidelity simulation environment for humanin-the-loop study of Distributed Air / Ground – Traffic Management (DAG-TM) concepts has been developed at NASA's Ames Research Center. The simulation environment facilitates large-scale experiments supporting high numbers of pilot, air traffic controller, and air traffic manager participants. Decision Support Tools (DST) for flight crews and air traffic service providers are accessible at the respective operator stations. Many operator positions can be augmented or autonomously run with agent support. We present samplings of results from studies conducted using this environment, and outline our goals in terms of improving and refining the simulation. We review the overall simulation architecture, and the key upgrades, including:


We have studied eight men with moderate hypertension to determine the atrial natriuretic peptide (alpha-hANP) response to acute volume expansion. Rapid infusion of 1,000 ml 0.9% saline (10-20 min) caused an increase in central venous pressure (4.7 +/- 1.6 cmH2O) while blood pressure and pulse pressure (arterial baroreceptor load) did not change. Stroke volume and heart rate were not affected by the volume load but plasma renin activity (PRA) was significantly suppressed (from 0.83 +/- 0.14 to 0.68 +/- 0.34 microgram AI I/ml-h; p less than 0.01). A significant hemodilution was also observed. Renal sodium excretion was significantly increased. Arterial alpha-hANP increased significantly from 21.1 +/- 6.1 to 30.5 +/- 4.0 pmol/l (p less than 0.02) during volume expansion. There was a significant correlation between corrected plasma volume increase (urine volume subtracted from the infused volume) and alpha-hANP plasma elevation (r = 0.78; p less than 0.05). There was also a significant negative correlation between changes alpha-hANP and PRA (r = -0.78, p less than 0.05). We conclude that only moderate volume loading in human hypertensives is a mechanism for increase in plasma alpha-hANP levels. The significant negative correlation between changes in alpha-hANP and PRA suggests that alpha-hANP may be the humoral factor at least partly responsible for suppression of renin in hypertensive man. Since increased fluid volume also affects sympathetic renal efferents as well as vasopressin secretion, our observed relationship between volume load and renin may well be related also to such mechanisms.


This research has purpose to explain, (1) Ledhek grave history in Dukuh Punthuk Unggul Tunggulrejo Village, Jumantono Sub-district, Karanganyar Regency, (2) explain myth form at Ledhek grave in Dukuh Punthuk Unggul Tunggulrejo Village, Jumantono Sub-district, Karanganyar Regency, (3) also last explain the benefits of Myth in pasarean Ledhek in Dukuh Punthuk Unggul Tunggulrejo Village Jumantono District Karanganyar District. This research includes the type of qualitative research. The way used to collect data is by using participant observation, interviews, and documentation. The tool used to collect data is the researchers themselves and use other tools such as, digital camera to take pictures, voice recorder to record sound, as well as notebooks. The way is analyzed by way of inductive data analysis. The data is validated by means of triangulation. Triangulation used in this study triangulation source also triangulation method. The results of this study indicate that (1) the history of the grave ledhek according to the story that there is a woman whose job ledhek who has two girlfriends, then the three of them fight each other in the middle of the field near Punthuk Unggul hamlet, then a woman died. Then found by residents punthuk Unggul then treated also buried in Punthuk Unggul ranch. (2) the grave of the ledhek is populated by the community as a place of request, the public should not use anything from green silk, if it will have the event must send the conditions to the grave, can make the soil fertile, should not talk about the ugly about ledhek as well the last people believe that the spirit of mbok mas ledhek is attached to the body of Mrs. Sredek. (3) the benefits of such myths for Punthuk Unggul community are: a) Preserving the ancestral heritage, b) Life advice for Punthuk Unggul community, c) Cultural tour for the surrounding community, d) brings together the people of Punthuk Unggul dukuh.


The basic aim of this paper is recognition of a character from a thresholded picture file, and converting it to text for further applications. The program first accepts a picture of raster type as input and removes the background noise from the picture. An iterative method of thresholding is presented which performs this operation. The picture is then passed through a number of pre-processing steps before recognition of characters. Character recognition using perceptual distance functions was first tried out. Because of the computational complexity involved in this method, a new method of character recognition using 2-dimensional discrete correlation is proposed in this paper. A comparison between the two methods is presented


In conversational speech, the acoustic signal provides cues that help listeners disambiguate difficult parses. For automatically parsing a spoken utterance, we introduce a model that integrates transcribed text and acoustic-prosodic features using a convolutional neural network over energy and pitch trajectories coupled with an attention-based recurrent neural network that accepts text and word-based prosodic features. We find that different types of acoustic-prosodic features are individually helpful, and together improve parse F1 scores significantly over a strong text-only baseline. For this study with known sentence boundaries, error analysis shows that the main benefit of acoustic-prosodic features is in sentences with disfluencies and that attachment errors are most improved.


Background In contrast to the considerable literature on the prognostic value of right ventricular metrics at baseline and follow-up in PAH, the prognostic value of right atrial size and function has been less well studied. The aim of this study was to compare the prognostic value of right atrial length, area and volume measurements in treatment naive patients with PAH and the impact of treatment. Methods Patients with PAH who underwent MRI at baseline and follow up on a 1.5 T MRI scanner were identified. Maximum and minimum right atrial length, area and volume were measured on two and four chamber images. Survival analysis, using univariate and multivariate Cox proportional hazards regression analysis was performed. Results 154 patients were identified, of whom 18 died. Change in minimal right atrial volume predicted mortality (p=0.028). Change in maximal right atrial volume, stroke volume and ejection fraction did not predict mortality, p=0.228, p=0.229 and p=0.915 respectively. Other than change in minimum two chamber right atrial area predicting mortality (p=0.049), individual changes in length and area measurements in the 4 chamber images were not prognostic. Right atrial length and area measures were highly reproducible intraclass correlation coefficient 0.910 to 0.984. Conclusion Change in minimal right atrial volume predicts mortality and maybe of value in the serial evaluation of patients on PAH therapy.


Near-infrared spectroscopy was used to measure oxy-hemoglobin concentration ([HbO2]), deoxy-hemoglobin concentration ([Hb]), total hemoglobin concentration ([HbT]), oxygen saturation of hemoglobin (SO2), cerebral blood flow (CBF), and cerebral blood volume (CBV). The purpose of this study was to find how these parameters changed when adults were excited, scared or waked by sensory stimulations. The tests were made on 18 healthy adult volunteers. High- and low-level of each variable with mean flows for all 18 subjects in the sleeping state are showed as 70plusmn10 and 19plusmn2 muM/1 for [HbO2], 18plusmn2 and 11plusmn2 muM/1 for [Hb], 88plusmn8 and 30plusmn2 muM/1 for [HbT], 77plusmn4% and 55plusmn5% for SO2, 37plusmn2 and 13plusmn3 mlldr100g-1ldr min-1 for CBF, 2.3plusmn0.5 and 1.5plusmn0.13 ml/100g for CBV. Analysis of changes in these variables when adults waked from the sleep state or excited or scared in the wake state are given to prove brain activity has a close relationship with cerebral local oxygen metabolism and hemodynamic variables. This noninvasive technique may be a powerful tool for brain functional research.


A Long-term Study of Variation in Respiratory Function in Normal Subjects. By JANET COULSEN, R. E. WALLER, and P. J. LAWTHER (MRC Air Pollution Research Unit, London): Reductions in respiratory function have been observed in some members of the Air Pollution Research Unit after experimental exposure to pollutants in the laboratory and after exercise out of doors at times of high pollution. In view of this it was of interest to determine whether smaller day-to-day changes in pollution or weather could be related to changes in simple lung function tests, and in November, 1960, a study was begun in which daily lung function measurements were made on several members of the unit. There is little evidence from this that environmental factors affect these subjects; however, the results provide useful information on the random variations which occur in apparently normal people and some show well-defined trends over the period, although these differ from one individual to another. Some weekly cycles have been detected and a subsidiary experiment with the Wright peak flow meter on two of the subjects has shown well-defined diurnal variations. An Epidemiological Study of the Paterson-Kelly Syndrome. By P. C. ELWOOD (MRC Epidemiological Research Unit, Cardiff).


Objectives Congenital muscular torticollis, a common disorder that refers to the shortening of the sternocleidomastoid in infants, is sensitive to correction through physical therapy when treated early. If physical therapy is unsuccessful, surgery is required. In this study, we developed a support vector regression model for congenital muscular torticollis to investigate the prognosis of the physical therapy treatent in infants. Methods Fifty-nine infants with congenital muscular torticollis received physical therapy until the degree of neck tilt was less than 5°. After treatment, the mass diameter was reevaluated. Based on the data, a support vector regression model was applied to predict the prognoses. Results 10-, 20-, and 50-fold cross-tabulation analyses for the proposed model were conducted based on support vector regression and conventional multi-regression method based on least squares. The proposed methodbased on support vector regression was robust and enabled the effective analysis of even a small amount of data containing outliers. Conclusions The developed support vector regression model is an effective prognostic tool for infants with congenital muscular torticollis who receive physical therapy.


A pair of correlated photons generated from parametric down conversion was sent to two independent Michelson interferometers. Second order interference were studied by means of a coincidence measurement between the outputs of two interferometers. The reported experiment and analysis studied this second order interference phenomena from the point of view of Einsteln-Podolsky-Roeen paradox. The experiment was done in two steps. The first step of the experiment used 50 psec and 3 nsec coincidence time window simultaneously. The 50 psec window was able to distinguish a 1.5 cm optical path difference in the interferometers. The interference visibility was measured to be 38% and 21% for 50 psec time window and 22% and 7% for 3 nsec time window, when the optical path difference of the interferometers were 2 cm and 4 cm, respectively. By comparing the visibilities between these two windows, the experiment showed the non-classical effect which resulted from an E.P.R. state. The second step of the experiment used a 20 psec coincidence time window, which was able to distinguish a 6 mm optical path difference in the interferometers. The interference visibilities were measured to be 59% for an optical path difference of 7 mm. This is the first observation of visibility greater than 50% for a two interferometer E.P.R. experiment which demonstrates nonclassical correlation of sp_ce-time variables.


Tin-doped indium oxide (ITO) layers show severe corrosion in alkaline solutions when they are in electrical contact with Al. This corrosion process is investigated by etching experiments, electrochemical measurements, and analytical techniques. It is shown that Al maintains ITO at a cathodic potential where it is reduced. Al itself is oxidized and dissolves as AlO 2 - . The products of the ITO corrosion are most probably SnO 3 2- , which dissolves in the solution, and In metal, which forms grains at the surface. This causes a gray opaque appearance and a disconnection between the ITO and Al


: Introduction: Family size is an important population, socio-economic and reproductive health issue. Number of children preferred in a society generally influences the population of society and population growth rate. Education of both the parents play a significant role in determining the family size. The study aims towards finding the effect of education of parents on the family size, so that using local data, attention can be drawn on this major demographic determinant to improve the quality of life of people. The study was conducted in Khyber Teaching Hospital MTI Peshawar. The duration of our study was from July 2020 to August 2020.Our sample was of 100 married couples. Methodology: After taking informed consent from the respondents, data was collected through a preformed questionnaire having two separate sections. Section 1 included the demographic details of the respondents while section 2 was based on a total of 14 close ended questions regarding the number of children, educational status, family values and their personal awareness about contraceptives and education. Results: According to our research study conducted on a 100 people, in which age distribution of male respondents showed that 29% of them are in the age of 40-49 years (period of reproductive potential).63% of them were qualified up to graduate and post-graduate level. Age distribution of female respondents showed that most of them were between ages of 30-39 years (period of high reproductive potential).66% of them were qualified up to graduate and post graduate level. Chi-square valued showed that association between the education level of parents and number of children with the p-value of <0.001 for males and <0.005 for females.63% of highly educated families have less children while less educated have more children showing a negative relation between parent education and family size. Conclusions: Level of education has direct relationship with the use of contraceptives and inverse relationship with the number of children. Education process helps parents by raising awareness and decision making about the use of contraceptives and ultimately family size.


Data races complicate programming language semantics, and a data race is often a bug. Existing techniques detect data races and define their semantics by detecting conflicts between synchronization-free regions (SFRs). However, such techniques either modify hardware or slow programs dramatically, preventing always-on use today. This paper describes Valor, a sound, precise, software-only region conflict detection analysis that achieves high performance by eliminating the costly analysis on each read operation that prior approaches require. Valor instead logs a region's reads and lazily detects conflicts for logged reads when the region ends. As a comparison, we have also developed FastRCD, a conflict detector that leverages the epoch optimization strategy of the FastTrack data race detector. We evaluate Valor, FastRCD, and FastTrack, showing that Valor dramatically outperforms FastRCD and FastTrack. Valor is the first region conflict detector to provide strong semantic guarantees for racy program executions with under 2X slowdown. Overall, Valor advances the state of the art in always-on support for strong behavioral guarantees for data races.


Since the official standardization of explicit congestion notification (ECN) in 2001, the differentiated service (DS) bits 6 and 7 in packets are now classified for purposes of shaping and prioritization. These classifications are used to mark packet streams for controlling traffic flow in an intelligent satellite system (ISS). Using a forward link connection between a transmitting ground terminal to a geostationary satellite (GEO) acting as a relay, to a receiving hub back on the earth; a traffic shaping software which evaluates the ECN type or classification is used to control traffic flow and the results are observed.


In this paper fuzzy analysis for economically fabricating a holographic optical element (HOE) in photoresist is conducted. We find that the grating profile has a close relationship with diffraction efficiency, and that the process parameters influence the grating profile significantly. Thus, using the fuzzy control in these relations, it becomes possible to predict the diffraction efficiency and to solve many problems in the grating fabrication process. From the modulation mechanism in these complex holograms we believe we have extracted the necessary and intrinsic qualities, and our model of fuzzy set analysis produces good general agreement with the experimentally measured diffraction efficiency. The new concepts of the "linear equivalent" which we established to simplify a HOE from a honeycomb structure to a linear one will be helpful for processing various types of HOEs.


We report a case of spontaneous pneumomediastinum with unusual clinical presentation. The most common symptoms of spontaneous mediastinum are chest pain and shortness of breath. Our patient presented with neck swelling and change in voice, an unusual presentation for spontaneous pneumothorax. A 30-year-old previously healthy man presented with complaints of neck swelling and hoarseness of voice beginning after an intense coughing spell. He had no other complaints. He denied any trauma to the chest, nausea, vomiting, recent air travel, scuba diving or recreational drug use. His vital signs were stable with an O2 saturation of 97 percent on room air. Chest examination was remarkable for palpable crepitus over lower neck as well as bilateral upper and mid anterior chest. Chest radiograph as well as chest computed tomography (CT) demonstarted a massive pneumomediastinum with free air dissecting throughout the soft tissues of the neck. The patient was admitted for observation. Neck swelling and hoarseness of voice resolved in less than 24 hours with conservative management of cough. He was discharged without incident. Spontaneous pneumomediastinum is an uncommon, self-limiting condition in which air is present in the mediastinum with no obvious precipitating factor. Cough, inhaled drugs, physical exercise, labor, and diabetic ketoacidosis have been reported to trigger spontaneous pneumomediastinum. Our patient developed the condition after an intense coughing spell following smoking cessation. CT scan is considered gold standard for the diagnosis. Spontaneous pneumomediastinum is characterized by spontaneous recovery and can be treated with short period of observation and symptomatic management.


In cooperative man-machine interaction, it is necessary but not sufficient for a system to respond truthfully and informatively to a user's question. In particular, if the system has reason to believe that its planned response might mislead the user, then it must block that conclusion by modifying its response. This paper focusses on identifying and avoiding potentially misleading responses by acknowledging types of "informing behavior" usually expected of an expert. We attempt to give a formal account of several types of assertions that should be included in response to questions concerning the achievement of some goal (in addition to the simple answer), lest the questioner otherwise be misled.


The article is devoted to the main approaches to the concept of femininity in psychology. The concept of "femininity" in various areas of psychological thought was analyzed. A modern understanding of the phenomenon of femininity was described. Conceptual approaches to the concept of "femininity" are discussed. The role of mass media in shaping the image of femininity is emphasized. Representations of the female image in world culture are revealed. Female archetypes of the "emotional cold" syndrome are described in Russian folk tales. Criteria for the structure of the concept of femininity in psychology are highlighted. Many different approaches to understanding femininity are analyzed. For example, the evolutionary-biological and psychoanalytic paradigms justify femininity by Innate anatomical and physiological factors. In the theory of cognitive development, a person, in the process of self-knowledge and self-actualization, introduces himself to representatives of a certain sex. Proponents of the theory of femininity refer to the latter the following characteristics: care, benevolence in relationships, high emotional sensitivity, compliance, developed intuition, credulity, ability to negotiate with the interlocutor, the ability to compromise, the direction to maintain psychological and emotional intimacy, inconsistency, emotional speech, talkativeness, smooth movements, openness, flexibility in relationships, attentiveness to socially accepted norms, naivety, vulnerability, low self-control, taking into account the opinions of others about themselves, unstable self-esteem, demonstrativeness, tendency to self-embellish, frivolity, superficiality in judgments, impulsiveness in decision-making. A systematic holistic approach provides a model of criteria for femininity, which is convenient to represent in the form of a pyramid. It will be based on physical manifestations of femininity, inside - psychological, and at the top - spiritual. Each of these criteria is important, but it is necessary to invent an individual optimal manifestation of the physical, psychological and spiritual criteria of femininity. The media identifies three fragmentary inharmonious images of femininity (a single careerist, an unhappy housewife mother, and a sexual consumer of material goods).


flict in the modern woman (a rather omnibus category, incidentally) is not a flouting of biology but an incessant wavering between traditional sex roles and new, indeterminately defined, &dquo;masculinized&dquo; roles. In any event, the degree of acceptance or rejection of this thesis will probably depend, not so much on its demonstrability, as on the extent to which modern thought, confused over the unfulfilled promises of liberalistic doctrines, is seeking other faiths. The book is written with quiet good humor and a number of shrewd insights. Questioning the value of modern sex literature, the authors point out the feelings of inadequacy often resulting from the popular insistence on the husband's insuring physical response from his wife and the frustration over his failure to do so. In


Human CMV (HCMV) uses members of the hematopoietic system including neutrophils for dissemination throughout the body. HCMV encodes a viral chemokine, vCXCL-1, that is postulated to attract neutrophils for dissemination within the host. The gene encoding vCXCL-1, UL146 , is one of the most variable genes in the HCMV genome. Why HCMV has evolved this hypervariability and how this affects the virus' dissemination and pathogenesis is unknown. Because the vCXCL-1 hypervariability maps to important binding and activation domains, we hypothesized that vCXCL-1s differentially activate neutrophils, which could contribute to HCMV dissemination, pathogenesis, or both. To test whether these viral chemokines affect neutrophil function, we generated vCXCL-1 proteins from 11 different clades from clinical isolates from infants infected congenitally with HCMV. All vCXCL-1s were able to induce calcium flux at a concentration of 100 nM and integrin expression on human peripheral blood neutrophils, despite differences in affinity for the CXCR1 and CXCR2 receptors. In fact, their affinity for CXCR1 or CXCR2 did not correlate directly with chemotaxis, G protein-dependent and independent ( b -arrestin-2) activation, or secondary chemokine (CCL22) expression. Our data suggest that vCXCL-1 polymorphisms affect the binding affinity, receptor usage, and differential peripheral blood neutrophil activation that could contribute to HCMV dissemination and pathogenesis. The Journal of Immunology , 2015, 195: 000–000.


Notary is one of professions lawful services to public, which has responsibilities related with authentic attesting instruments, such as, letters,certificates, or documents made by him/her in written form concerning various lawful actions Departing from the circumstances as preventive measures of prevention needs to be premature given information about the notarial deed (deed authentic) as evidence in the event of civil law in order to later villagers in any transaction in a very large amount in order to carry out the agreement in front notary officials. The fact that occurs in the community, some of them are less aware of the importance of a document as evidence that an agreement between the parties is done with a sense of mutual trust and made ??orally, but there are also some people who understand the importance of making a document as evidence that the deal is made in writing, that it will be presented as a means of evidence.


The problem of developing information literacy in modern society is urgent because the ability to use information resources is one of the ways to carry out effective professional activity. The aim of our study is to analyse the development of information literacy of foreign language teachers in the PRC. The following research methods have been used for this purpose: comparative pedagogical analysis and empirical data analysis. The obtained survey results were processed using qualimetric techniques. The results of the survey allowed determining a need to develop information literacy in Chinese foreign language teachers. For deeper analysis, observation of teachers was conducted during classes, which allowed determining areas of work with them on understanding the component of pedagogical competence as an individual professional element and the value attitude towards information resources. The main conclusions of the study provide for identification of the ways to develop information literacy in Chinese foreign language teachers. At the same time, possibilities of using modern interactive methods for information literacy in Chinese foreign language teachers were identified. Promising areas of further research may be the study of the use of interactive methods in combination with collaborative technologies to develop information literacy in Chinese foreign language teachers.


We make use of the powerful formalism of quantum parameter estimation to assess the characteristic rates of a continuous spontaneous localization (CSL) model affecting the motion of a massive mechanical system. We show that a study performed in non-equilibrium conditions unveils the advantages provided by the use of genuinely quantum resources—such as quantum correlations—in estimating the CSL-induced diffusion rate. In stationary conditions, instead, the gap between quantum performance and a classical scheme disappears. Our investigation contributes to the ongoing effort aimed at identifying suitable conditions for the experimental assessment of collapse models.


Based on a high-quality dataset of 713 daily precipitation series, changes in daily precipitation events during 1960–2013 were observed in China's ten largest river basins. Specifically, the amount of precipitation in four categories defined by fixed thresholds and their proportion on total precipitation were analyzed on annual and seasonal time scales. Results showed annual precipitation increased by 1.10 mm/10yr in China, but with obvious spatial differences. Regionally, annual precipitation increased significantly in northwestern rivers, upstream areas of the Yangtze River, the Yellow River, southwestern rivers (due to increase in light and moderate precipitation); and in southeastern rivers, downstream areas of the Yangtze River, and the Pearl River (due to increase in heavy and extreme precipitation). Annual precipitation decreased significantly in the mid-Yangtze River and upstream Pearl River (due to decrease in light, moderate, and heavy precipitation). Seasonally, precipitation decreased only in autumn; this was attributable to a decrease in light and moderate precipitation. Results show that the distribution of precipitation intensity over China has shifted to intense categories since the 1960s, there has been an increase in moderate precipitation in Northwestern and Northern China, and an increase in extreme precipitation in Southeastern China. This shift was detected in all seasons, especially in summer. Precipitation extremes were investigated in the categories of extreme precipitation and results show that the risk of flood has been exacerbated over the past half-century in the Huaihe River, the mid- and lower Yangtze River, the Pearl River, and southeastern rivers.


Majorana zero modes have received widespread attention due to their potential to support topologically protected quantum computing. Emerging as zero-energy states in one-dimensional semiconductors with induced superconductivity, Zeeman coupling, and spin-orbit interaction, Majorana modes have been primarily investigated in individual InSb or InAs nanowires, including recently realized epitaxial hybrid nanowires. Tests of non-Abelian statistics of Majoranas involve braiding or interferometric measurement, requiring branched geometries, which are challenging to realizing using nanowire growth. Scaling to large networks using arrays of assembled nanowire also appears difficult. Here we explore signatures of Majorana zero modes in devices made from a two-dimensional heterostructure using top-down lithography and gating. Scalable top-down fabrication readily allows complex geometries and large networks, paving the way toward applications of Majorana devices.


In the present study we characterize allelic variation of polymorphic OLA-DQA1 and OLA-DQA2 genes in sheep. To achieve this, PCR primers were designed to independently amplify the second exons of OLA-DQA1 and OLA-DQA2 genes. Single strand conformation polymorphism (SSCP) gel analyses reveals that there are at least 12 distinct OLA-DQA2 sequences, 10 of which have been characterized by sequencing. Six distinct OLA-DQA1 alleles have been sequenced in sheep and we can detect at least seven DQA1 alleles, including a null allele, by SSCP analysis. The second exon of the OLA-DQA2 gene is more polymorphic than the equivalent region of the OLA-DQA1 gene. Thirty-two per cent of nucleotide and 49% of amino acid sites showed variation at the DQA2 locus, compared to 20% of nucleotide and 33% of amino acid sites for DQA1. Phylogenetic analysis of DQA sequences from a number of species show that sheep DQA1 sequences group together and are more similar to bovine DQA1 sequences than to sheep DQA2 alleles. The majority of OLA-DQA2 sequences are on the same main branch of the phylogenetic tree as bovine DQA2 sequences. However, three sheep DQA2 sequences have a tendency to group with putative bovine DQA3 sequences rather than to other ovine DQA2 alleles. A variety of SSCP gel conditions were tried in order to develop a typing system for the OLA-DQA2 gene. We describe a set of PCR and SSCP conditions which distinguish between all known OLA-DQA2 alleles.


We contribute to the Responsible Research and Innovation (RRI) literature in two ways: (i) we consider how societal aspects are taken into account in research and innovation activities in four fundamentally different futures, as opposed to analysing current practices; and (ii) put the emphasis on the framework conditions, as opposed to focussing on RRI principles and instruments. In the Kingdom of RRI citizens participate directly in decision-making processes; Fortress Europe depicts a libertarian system; Failed Democracy is a populist regime; while Benevolent Green Eurocrats describes a technocratically coordinated strong state. The RRI concept is ignored, manipulated, or rather selectively applied in the latter three scenarios. The scenarios offer novel insights into the nature and repercussions of possible policy problems. We discuss issues related to efficacy and efficiency of policy-making; legitimacy of research and innovation activities; societal involvement; equity; and freedom of research in each scenario. We also posit that there is room for safeguarding meaningful interactions between the societal and professional actors in an innovation system even in the harshest framework conditions. JEL codes: F50, F52, H10, H11, O20, O25, O30, O31, O32, O33, O38, P11, P18, Q54, Q55, Q56


ABSTRACT This article analyses the content of 483 reports of sexual violence, including rape, sexual assault, child sexual abuse and various forms of sexual harassment, made to a digital reporting tool (DRT) developed by a rape crisis centre in Melbourne, Australia. These written digital reports were made in a confidential and informal capacity, with all de-identified reports distributed to relevant policing jurisdictions to support intelligence gathering. Based on an analysis of the de-identified reports, this article suggests the DRT functioned as an important gateway in connecting survivors with appropriate therapeutic support when disclosing sexual violence and had a demonstrable capacity to provide the police with information for intelligence gathering. There was also scope for survivors to make formal reports should they wish to do so. However, further research with police, sexual violence support services and survivors is needed to develop a full understanding of the potential of informal sexual violence reporting options.


Tripartite partnerships between water utilities, local government and civil society are often seen as a good way to deliver services to informal urban communities and slums. However, while these 'partnerships' can be seen as benign relationships, they often fail because the incentives and interests of the partners are not well aligned. In this report, the authors argue that the development of robust documentation (in forms which consitute a 'contractual' agreement) can enhance the performance of such partnerships. Aspects of the partnership which should be included in such documentation include roles and responsibilities, financing, objectives and indicators of success and dispute-resolution mechanisms. The report provides practical guidance and examples of good practice to guide the reader through a process of developing such documentation.


The effects of a coupling agent on the behavior of flax fiber-reinforced composites have been investigated by testing the specimens under both quasi-static (QS) indentation and high-velocity impact loading. The specimens are manufactured embedding a commercial flax fiber fabric in a polypropylene (PP) matrix, neat and premodified with a maleic anhydride-grafted PP, the latter acting as a coupling agent to enhance the interfacial adhesion. QS compressive tests were performed using a dynamometer testing machine equipped with a high-density polyethylene indenter having the same geometry of the projectile employed in the impact tests. The impact tests were conducted setting three different impact velocities. Digital image correlation maps of out-of-plane displacement were employed to compare the specimens with and without the coupling agent. The QS testing results indicate that the coupling agent has an enhancing influence on the bending stiffness of tested flax composites. The testing results show that the coupling agent improves the mechanical behavior by decreasing the out-of-plane displacement under impact loading. This approach gives rise to new materials potentially useful for applications where impact performance is desired while also providing an opportunity for the incorporation of natural fibers to produce a lightweight composite.


Abstract : Strong, effective, economic assistance programs are a crucial part of U.S. foreign policy. They are a primary instrument for advancing U.S. national interests, enhancing global stability, expanding economic opportunities, and promoting American democratic values. From 2004 through 2010, the United States donated more than $16 billion in economic assistance to countries in the Western Hemisphere. Some ask why the United States spends so much money abroad on humanitarian programs and infrastructure investments in developing states. To address this question, this thesis looks at Colombia and Mexico, both of which are of crucial strategic importance to the United States. Under Plan Colombia (2000 2006), U.S. economic assistance and staunch political will enabled Colombia to improve from 14th (2005) to 57th (2013) on the Failed State Index scale. As a result, Colombia has also emerged as a stronger U.S. partner in the Western Hemisphere. The Colombian experience was historically specific, but lessons can be extracted for Mexico, even though its history and relationship with Washington is very different. In particular, the recent Merida Initiative ( Plan Mexico ; 2008 present) can benefit immensely from being carefully evaluated in light of the earlier success of Plan Colombia.


The presence of palytoxin or palytoxin-like compounds in fish extracts has been presented in this study. The hemolytic assay with sheep erythrocytes demonstrated the occurrence of hemolytic factors in fish extracts of Hawaiian reef fish from Barber's Point, Oahu. The rabbit anti-palytoxin inhibition assay with fish extracts and sheep erythrocytes demonstrated that palytoxin or its congener contributed to the lysis of sheep erythrocytes. From these results, it was concluded that sheep erythrocyte hemolysis was caused by palytoxin or palytoxin-like factors present in the fish extracts. Moderate correlation (R2) between mouse toxicity and sheep erythrocyte hemolysis was shown with 50 microg (R2 = 0.48) and 100 microg (R2 = 0.45) extracts. An inverse correlation of R2 = 0.64 was shown between hemolysis and MIA endpoint.


This new volume collects the best articles on this topic from the first 50 issues of the 'Journal for the Study of the New Testament'. Here the reader will find ground-breaking studies that introduce new critical questions and move into fresh areas of enquiry, surveys of the state of play in these particular fields of New Testament study, and articles that engage with each other in specific debates. This volume will make an excellent textbook for students.


Aims: The primary objective of this review was to determine whether tranexamic acid (TXA) reduces transfusion rates in patients undergoing surgery for hip fractures. The secondary objective was to assess the effects of TXA on mortality and thromboembolic events in the same cohort. Methods: A systematic review of electronic databases was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We included randomized controlled trials comparing perioperative TXA in patients treated surgically for hip/proximal femoral fractures against placebo. The primary outcome was the proportion of patients requiring blood transfusion. Secondary outcomes were blood loss, mortality, and complications. Meta-analysis was performed using inverse variance and random effects model. Results: The pooled data from 10 studies involving 842 patients showed that the proportion of patients requiring blood transfusion was significantly less in the TXA group (risk ratio (RR) 0.72, 95% confidence interval (CI) 0.59–0.88). There was no difference between TXA and control groups when comparing mortality (RR 1.17, 95% CI 0.65–2.10), deep venous thrombosis (RR 1.14, 95% CI 0.43–3.06), pulmonary embolism (RR 0.53, CI 0.09–3.02), acute coronary syndrome (RR 1.52, CI 0.18–12.98), cerebrovascular events (RR 0.78, CI 0.16–3.68), or wound complications (RR 1.61, CI 0.51–5.13). Conclusion: There is evidence that TXA reduces the proportion of patients requiring blood transfusions when undergoing hip fracture surgery. However, the small sample size and low event rates for adverse effects preclude any definitive conclusions from being established regarding adverse effects. Future trials should be powered to further assess potential complications and determine the ideal dosage and regime.


The volcanic plains that fill the Caloris basin, the largest recognized impact basin on Mercury, are deformed by many graben and wrinkle ridges, among which the multitude of radial graben of Pantheon Fossae allow us to resolve variations in the depth extent of associated faulting. Displacement profiles and displacement‐to‐length scaling both indicate that faults near the basin center are confined to a ~ 4‐km‐thick mechanical layer, whereas faults far from the center penetrate more deeply. The fault scaling also indicates that the graben formed in mechanically strong material, which we identify with dry basalt‐like plains. These plains were also affected by changes in long‐wavelength topography, including undulations with wavelengths of up to 1300 km and amplitudes of 2.5 to 3 km. Geographic correlation of the depth extent of faulting with topographic variations allows a first‐order interpretation of the subsurface structure and mechanical stratigraphy in the basin. Further, crosscutting and superposition relationships among plains, faults, craters, and topography indicate that development of long‐wavelength topographic variations followed plains emplacement, faulting, and much of the cratering within the Caloris basin. As several examples of these topographic undulations are also found outside the basin, our results on the scale, structural style, and relative timing of the topographic changes have regional applicability and may be the surface expression of global‐scale interior processes on Mercury.


Immune cells drive chronic inflammation underlying obesity-related T2DM. We previously reported a cholesterol metabolism pathway as the top coordinated transcriptional module in human monocytes associated with both obesity and T2DM (FDR <0.05) . To investigate whether this pathway is a modifiable link between obesity and T2DM, we randomly assigned 112 adults with obesity and prediabetes aged 40-70 years, 71% woman, 29% African American, to a weight loss intervention using Medifast meal replacement (N=63) or a weight stable control group (N=49) for 4 months. The outcome was a composite measure as the average of standard scores of cholesterol metabolism gene transcripts in monocytes. The intervention achieved 10% weight loss. The control group remained weight stable. Compared with the weight stable group, the weight loss group experienced reductions in both the composite measure and HbA1c (Table) . Changes in the composite measure and HbA1c were correlated (r=0.24, p=0.01) . For individual gene transcripts of this pathway, weight loss reversed obesity-associated upregulation in cholesterol synthesis (FDFT1 and SQLE) , fatty acid synthesis (SCD and FADS1) , and cholesterol uptake (LDLR and MYLIP) (p values <0.05) .
 In conclusion, weight loss induces beneficial changes in the cholesterol metabolism pathway in monocytes, a potential therapeutic target for obesity-related T2DM.

 J.Ding: Research Support; Medifast, Inc. K.Lohman: None. S.B.Kritchevsky: None. J.S.Parks: None. I.Hoeschele: None. B.J.Nicklas: None. J.Demons: None. Y.Liu: None.

 National Institutes of Health (R01DK103531)


Tomato plants ( Lycopersicon esculentum ) synthesize the glycoalkaloids dehydrotomatine and alpha-tomatine, possibly as a defense against bacteria, fungi, viruses, and insects. Six green and three red tomato extracts were investigated for their ability to induce cell death in human cancer and normal cells using a microculture tetrazolium (MTT) assay. Compared to untreated controls, the high-tomatine green tomato extracts strongly inhibited the following human cancer cell lines: breast (MCF-7), colon (HT-29), gastric (AGS), and hepatoma (liver) (HepG2), as well as normal human liver cells (Chang). There was little inhibition of the cells by the three low-tomatine red tomato extracts. Cell death induced by the pure glycoalkaloids dehydrotomatine and alpha-tomatine isolated from green tomatoes and characterized by HPLC, GC, and GC-MS, as well as their respective aglycones tomatidenol and tomatidine, was also evaluated. alpha-Tomatine was highly effective in inhibiting all of the cell lines. Dehydrotomatine, tomatidenol, and tomatidine had little, if any, effect on cell inhibition. The results show that the susceptibility to destruction varies with the nature of the alkaloid and plant extract and the type of cancer cell. These findings extend related observations on the anticarcinogenic potential of glycoalkaloids and suggest that consumers may benefit by eating not only high-lycopene red tomatoes but also green tomatoes containing glycoalkaloids. Possible mechanisms of the anticarcinogenic and other beneficial effects and the significance of the cited observations for breeding improved tomatoes and for the human diet are discussed.


Let $p$ be a prime and ${\mathfrak P}_p$ the set of positive integers which are prime to $p$. Recently, Wang and Cai proved that for every positive integer $r$ and prime $p>2$ $$ \sum_{\substack{i+j+k=p^r\\ i,j,k\in{\mathfrak P}_p}} \frac1{ijk} \equiv
-2p^{r-1} B_{p-3} \pmod{p^r}, $$ where $B_{p-3}$ is the $(p-3)$-rd Bernoulli number. In this paper we prove the following analogous result: Let $n=2$ or $4$. Then for every positive integer $r\ge n/2$ and prime $p>4$ $$ \sum_{\substack{i_1+\cdots+i_n=p^r\\ i_1,\dots,i_n\in{\mathfrak P}_p}} \frac1{i_1i_2\cdots i_n} \equiv
-\frac{n!}{n+1} p^{r} B_{p-n-1} \pmod{p^{r+1}}. $$ Moreover, by using integer relation detecting tool PSLQ we can show that generalizations with larger integers $n$ should involving finite multiple zeta values generated by Bernoulli numbers.


Several methods for routine cytological examination of the cerebrospinal fluid (C.S.F.) have been published. In 1904 Fuchs and Rosenthal introduced a methodfor counting the number ofcellsper 3 2c.mm. with differentiation between mononuclear and polynuclear cells. This method, however, yields but little cytological information, especially if the C.S.F. is poor in cells. Various procedures for concentrating, fixing, and staining have been tried in an attempt to obtain cellular preparations allowing a detailed morphological study in the same way as in blood films. However, all of these techniques have proved unsatisfactory in one respect or another with the result that the Fuchs-Rosenthal method is still the one most widely used. There is thus need of a better method for routine clinical use. Such a method should be technically simple, rapid, gentle, and give a high cell yield. After concentration of the sample it should be possible to identify the cells, which should be a representative sample of the cell population, i.e., allow a reliable differential cell count. A method satisfying these requirements and suitable for routine use is described below.


Formal manipulations of double series are useful in getting some other identities from given ones and evaluating certain summations, involving double series. The main object of this note is to summarize rather useful double series manipulations scattered in the literature and give their generalized formulas, for convenience and easier reference in their future use. An application of such manipulations to an evaluation for Eu- ler sums (in itself, interesting), among other things, will also be presented to show usefulness of such manipulative techniques.


Educating tomorrow's doctors in injury prevention Those of us who teach undergraduate medical students are well aware of the innate resistance of most embryonic doctors to anything that seems " irrelevant " to clinical practice. Overcoming this resistance has long preoccupied public health teachers throughout the world yet few have managed to come up with a sure fire method. The result has been a continuation of the relative neglect of preventive medicine training in many parts of the world, especially in the older established, traditional medical schools. Is it possible that this is one reason for the scandalous indiVer-ence of most medical practitioners and researchers to injury prevention? In the UK, the General Medical Council (GMC), which has a statutory responsibility for medical education, acknowledged the lowly status of public health and in 1993 called for a major realignment of the undergraduate medical curriculum. 1 In its report Tomorrow's Doctors, the GMC's Education Committee proposed a greatly increased role for public health in the curriculum in a manner consistent with the underlying aim of interdisciplinary integration in teaching. This has presented British public health educators with a golden opportunity to raise the profile of the subject, although it remains unclear how many have seized it. In Glasgow, we have been experimenting with an innovative attempt to integrate the teaching of two disciplines—public health and paediatrics—within the eight week clinical attachment of senior medical students to the Royal Hospital for Sick Children, Yorkhill. This comprises a " clinical epidemiology ward round " that involves the illustration of the application of public health (especially epidemiological) principles and knowledge to clinical paediatric practice. 2 The response of the students has been a mixture of bemusement and approval but our evaluation concluded that the experiment had succeeded. We are currently exploring ways of extending the idea into other clinical areas. Injury prevention should be an ideal candidate for this type of integrated educational approach. Rather than presenting and constantly reiterating its somewhat dry theoretical basis, we could consider incorporating strong preventive elements into teaching being delivered in appropriate clinical settings. Among these are accident and emergency departments, fracture clinics, neuro-surgical units, burns treatment centres, and intensive care wards. One potential obstacle is a mismatch between the orientation of the teacher and the location of the teaching. An orthopaedic surgeon, for example, may have little interest in prevention while a public health physician may not …


A synthesis of substituted quinolines has been achieved by the Doebner reaction which is a three component coupling of arylaldehyde, p-amino-acetophenone and phenyl pyruvic acid. The products of 2,3-diary-6-acetyl-quinoline-4-carboxylic acids were obtained by Claisen Schmidt condensation reaction with aldehydes in the presence of sodium hydroxide in order to give the corresponding α,β-unsaturated carbonyls. The substituted α,β-unsaturated carbonyls were condensed with urea, thiourea, hydrazine, phenyl hydrazine, semicarbazide hydrochloride and ethanolamine to synthesized 2-pyrimidinone, 2-pyrimidinethion, pyrazoline-1-phenyl, pyrazoline, pyrazoline-1-carboxamide and 1,4-oxazepines derivatives, respectively, with good yields. The purity and identities of products were elucidated through thin layer chromatography (TLC), melting point and spectroscopic data (IR, 1H NMR, 13C NMR and LC-Mass).


In schizophrenia, social cognitive impairment is considered one of the greatest obstacles to social participation. Although numerous measures have been developed to assess social cognition, only a limited number of them have become available in Japan. We are therefore planning this evaluation study for social cognition measures in Japan (ESCoM) to confirm their psychometric characteristics and to promote research focused on social cognition. Participants in the cross-sectional observational study will be 140 patients with schizophrenia recruited from three Japanese facilities and 70 healthy individuals. In our primary analysis, we will calculate several psychometric indicators with a focus on whether they can independently predict social functioning. In secondary analyses, we will assess the reliability and validity of the Japanese translations of each measure and conduct an exploratory investigation of patient background, psychiatric symptoms, defeatist performance belief, and gut microbiota as determinants of social cognition. The protocol for this study is registered in UMIN-CTR, unique ID UMIN000043777.


Through their inherent skin losses, conductive planes around sufficiently thin dielectric layers may provide good suppression of plane resonances in printed-circuit-board power distribution networks. When combined with thin conductive layers, a resistor-like flat self-impedance and low-pass transfer-impedance profiles can be created. A lossy transmission-line grid model is used to simulate power-ground plane pairs with thin dielectric and thin conductive layers. Some of the modeling errors of the analytical planeimpedance expressions and lossy transmission-line grid plane models are compared. Simulated and measured impedances are compared on test structures with plane separation of 40 and 8 microns (1.6, and 0.3 mils).


Emplacement of a tracer mixture containing 13C-labeled green algae on the sea floor of the continental slope offshore of Cape Hatteras, North Carolina, elicited a rapid response over 1.5 d from the dense benthic community. Certain deposit-feeding annelids (e.g. Scalibregma injlatum and Aricidea quadrilobata) became heavily labeled with 13C as a result of ingestion of the algae. 13C-labeled organic matter was transported to a depth of at least 4-5 cm into the seabed during the 1.5-d period, presumably as a consequence of a feedingassociated activity. Nonlocal transport produced subsurface peaks in organic 13C at 2-3 cm. Dissolved inorganic 13C, produced by the oxidation of the labeled algae, penetrated to lo-cm depth. The transport of highly reactive organic matter from the sediment surface at initial velocities 1.3 cm d- l is expected to be an important control of subsurface benthic processes in slope environments characterized by abundant macrofaunal populations. Anaerobic processes, which are enhanced on the Cape Hatteras slope relative to adjacent areas, may be promoted by the rapid injection of reactive material into subsurface sediments. The transport, in turn, is a consequence of the dense infaunal populations that are supported by the rapid deposition of organic carbon in this region.


A novel dilatometer has been used to measure the evolution of specific volume at different cooling rates and at elevated pressures under quiescent conditions and under shear for a series of commercial iPP homopolymers and polypropylene-ethylene random copolymers. Signifi- cant influences of cooling rates, pressures, and shear flow on the transition temperature Ttr related to molecular weight and polydispersity and of course the temperature at which shearing was applied could be found for the iPP homopolymers. In the copolymers, the composition defined by the ethylene content determined the position of the transition temperature Ttr.


Background: Chronic colitis, regardless of type, is defined histologically by chronic inflammation, mainly plasmacytosis, in the lamina propria. Specific diagnosis of chronic colitides in biopsies can be challenging for practicing pathologists. The present research was undertaken to study complete clinico-pathology of chronic colitis, pathological pattern and spectrum of colitis, also study correlation of colonoscopy and histopathology of these lesions.Method:This study was a retrospective and prospective analysis of 187 cases ofhistopathologicallyproven colitis on colonic biopsies over a period of 5 years from June 2015 to May 2020. Results:Majority of specimen were rectal biopsies (57.22%) followed by mapping biopsies (34.22%). Of 85 cases where both colonoscopy and histopathology diagnosis was available, 61 (71.76%) colonoscopy diagnosis were consistent with histopathology. Among 187 cases, 107 were inflammatory bowel disease (57.22%), they were further sub classified as ulcerative colitis (UC) (96.26%), Crohn's (0.93%) and indeterminate colitis (2.8%). Cases of UC had features of basal plasmacytosis (97.19%), crypt distortion (93.45%), crypt loss (70.09%) and goblet cell depletion.48cases diagnosed as non-specific colitis. Infectious colitis comprised 8.56% of total colitis cases. It included tuberculosis 4 (2.14%), CMV colitis 2(1.07%) and 5.35% cases of acute self-limiting colitis. 5(2.67%) cases were diagnosed as lymphocytic colitis and 2 cases showed focal active colitis. Also, found single case of eosinophilic colitis and radiation proctitis each.Conclusion:Good clinico-pathological correlation helps to reduce number of cases diagnosed as non-specific colitis. To improve the detection rate of microscopic colitis, it is important to take multiple biopsies from normal looking colon on colonoscopy.


Barrett's esophagus is one of the most serious complications of gastroesophageal reflux disease also known as GERD. Late diagnosis and treatment cause a high risk of developing adenocarcinoma of the esophagus with the background of Barrett's esophagus. Today, this condition is one of the most controversial diseases of the gastrointestinal tract (GIT), requiring a careful approach to diagnosis and treatment by a group of specialists, including an endoscopist, gastroenterologist and pathologist. This article is a review of the literature on the history and current aspects of the diagnosis and treatment of Barrett's esophagus.


Background The epidemiology of mental health disorders has important theoretical and practical implications for health care service and planning. The recent increase in big data storage and subsequent development of analytical tools suggest that mining search databases may yield important trends on mental health, which can be used to support existing population health studies. Objective This study aimed to map depression search intent in the United States based on internet-based mental health queries. Methods Weekly data on mental health searches were extracted from Google Trends for an 11-year period (2010-2021) and separated by US state for the following terms: "feeling sad," "depressed," "depression," "empty," "insomnia," "fatigue," "guilty," "feeling guilty," and "suicide." Multivariable regression models were created based on geographic and environmental factors and normalized to the following control terms: "sports," "news," "google," "youtube," "facebook," and "netflix." Heat maps of population depression were generated based on search intent. Results Depression search intent grew 67% from January 2010 to March 2021. Depression search intent showed significant seasonal patterns with peak intensity during winter (adjusted P<.001) and early spring months (adjusted P<.001), relative to summer months. Geographic location correlated with depression search intent with states in the Northeast (adjusted P=.01) having higher search intent than states in the South. Conclusions The trends extrapolated from Google Trends successfully correlate with known risk factors for depression, such as seasonality and increasing latitude. These findings suggest that Google Trends may be a valid novel epidemiological tool to map depression prevalence in the United States.


The research thrust of this grant has been directed into two areas. The principal effort has been spent in an investigation of the synthesis, mechanical behavior and internal structure of ferritic nanocrystalline material. A second effort involves a study of the high temperature behavior of several ferritic steels. In particular, we are investigating the precursors and earliest stages of fatigue crack initiation, especially how initiation is affected by hold times and by environment.


Abstract. Current data are an important input data for electrical
prospecting data postprocessing. The existing current recorder is
inadequate for continuous recording, precision, bandwidth, dynamic range,
and input range. A new full waveform current recorder that is ideal for
measuring current signal for electrical prospecting applications is
presented. The new measurement principle enables the fabrication of a
high-precision current sensor with an autonomous data logger as well as
continuous measurement capabilities for full waveforms that are comparable
to recent developments for electrical prospecting applications. The full
waveform current recorder is capable of measuring current with bandwidth
from direct current (DC) to 10 kHz, with a power spectrum density noise floor of
10 µA/rt(Hz) at 10 Hz. The current recorder has a dynamic range that is higher
than 97 dB over a range of 100 A at peak, with time synchronisation error as
low as ±0.1 µs. These features make new current recorder a
promising technology for high-precision measurement with long-duration,
autonomous data logging for field electrical prospecting applications.


B o n c h i a l a s t h m a i s a c o m p l e x a n d h e t e r o g e n e o u s s y n d r o m e characterised by episodic intrathoracic airways obstruction, airway hyperr e s p o n s i v e n e s s a n d a i r w a y s inflammation resulting in episodic occurrence of dyspnoea and wheezing, which varies widely over time either s p o n t a n e o u s l y o r i n r e s p o n s e t o treatment. Multifactorial stimuli are responsible for airway hyperreactivity leading to obstruction which varies widely over time either spontaneously or in response to treatment. There is marked heterogeneity in the clinical course and in the response to standard treatment. The symptoms of bronchial asthma are controlled in majority of patients by the administration of bronchodilators and corticosteroids. However the symptoms persist and frequently exacerbate in some patients.


Background: High-quality data is essential for guiding clinical decision-making, quality improvement initiatives, national and local policy recommendations, and outcomes measurement and reporting. In Kenya, EHRs have been implemented in several disease- and goal-specific care modules, but their post-implementation usage remains low and precludes scale-up. Maintenance costs, attitudinal-behavioral limitations, and workflow interference have limited EHR implementation in other LMIC. While continued investigation will likely refine future EHR functionality, creative solutions are needed in the meantime to supplement these efforts. The aim of this study is to describe the creation and implementation of clinical forms for the secondary development of a prospective database in a multidisciplinary breast clinic.
Methods: We developed clinical forms and corresponding RedCAP instruments, through the following steps: (1) multidisciplinary needs assessment and plan; (2) collaborative drafting of forms; (3) iterative clinical piloting and revision; (4) harmonization of forms with RedCAP instruments; and (5) administrative approval for clinical use.
Results: The needs assessment identified challenges related to documentation of clinical encounters. Five clinical forms were created and edited over a period of 6 months, corresponding to ten RedCAP instruments with 469 fields. These tools capture data with potential for use as quality improvement metrics, including ECOG status, clinical and pathologic staging, barriers to care, disease status and progression, treatments and other interventions, among others.
Conclusion: We hypothesize that insight gained from EHR implementation in LMIC can be applied on a small scale to generate high-quality data and facilitate care in the absence of widespread EHR usage. These tools will be used both to develop a prospective database and to retroactively migrate legacy data for outcomes analysis of the multidisciplinary breast clinic at Moi Teaching and Referral Hospital in Eldoret, Kenya. Following administrative approval, a formative evaluation will be conducted during the clinical implementation phase in a hybrid effectiveness-implementation trial.


In advanced chronic obstructive pulmonary diseases, functional residual capacity (FRC) can be markedly increased by dynamic mechanisms involving expiratory flow limitation. We studied respiratory mechanics in a seated ventilator-dependent patient with such changes. Relaxed expiration was flow-limited; pressures of 9 to 27 cm H2O (varying with lung volume) could be applied to the airway opening (Pao) without decreasing expiratory flow rate. The FRC was at least 2 L above relaxation volume. Inspiratory total resistance was 16 cm H2O/L/s. Compliance of the lung was 0.16, chest wall was 0.04, and respiratory system was 0.032 L/cm H2O. More importantly, recoil pressures at end inspiration and end expiration, respectively, were 6.5 and 1.5 cm H2O for the lung, 33 and 11 cm H2O for chest wall, and 38 and 12 cm H2O for the respiratory system. Thus the chest wall recoiled inward at all times, pleural pressure was always substantially positive (11 to 33 cm H2O), expiratory flow was maximal, and jugular veins were always full and nonpulsating. Inspiratory work was about 0.27 kg-m per breath (7 times normal), most of it elastic work done on the chest wall.


H OMENET IS AN EMPIRICAL FIELD TRIAL OF residential Internet use whose goal is to increase our knowledge about the use and impact of residential electronic services. It uses longitudinal data collection techniques to study families' online behavior over time. This article is an early attempt to describe how ordinary citizens use the Internet and explore their motivations for doing so. The HomeNet Field Trial of Residential Internet Services R o b e r t K r a u t , W i l l i a m S c h e r l i s , T r i d a s M u k h o p a d h y a y , J a n e M a n n i n g , a n d S a r a K i e s l e r


Work volition refers to the perceived ability of an individual to choose work under constraints. As they age, older workers often face declines in cognitive functioning and adaptability, as well as age discrimination in organizations. Our goal was to examine the relation between the mentioned constraints and work volition for aging workers, and whether general self-efficacy moderated the associations between constraints and work volition. A total of 350 working Chinese (aged over 45 years) in Hong Kong were recruited. Structural equation modeling (SEM) result showed that perceived age discrimination and cognitive constraint (planning and organization) were salient correlations of work volition. Multi-sample SEM analysis verified that general self-efficacy moderated the association between the cognitive constraints as well as perceived age discrimination in the workplace and work volition. Limitations and recommendations, including assessment of work volition, strengthening of general self-efficacy, and elimination of age discrimination, were discussed.