Tuberculosis may affect many of the endocrine glands including the hypothalamus, pituitary, thyroid with adrenal gland being the commonest. We describe a patient presented with recurrent spontaneous hypoglycemia, hypotension, fever, weight loss and cough. Along with this clinical picture, high ACTH in the face of low cortisol was compatible with diagnosis of Addison's disease. Rapid ACTH stimulation test affirmed the diagnosis. Disseminated TB affecting adrenal glands was supported by CXR, USG, CT Abdomen and FNAC. Adrenal Crisis was led by add-on bacterial pneumonia. Patient made good recovery with treatment for adrenal crisis and subsequently with standard antitubercular regimen and steroid replacement therapy. Tuberculosis, although uncommon but potentially devastating cause of adrenal failure, merits consideration when fever, weight loss, gastrointestinal symptoms, hyponatremia, hyperkalemia are observed in patients with features of active tuberculosis or past history of tuberculosis.


Introduction The non-absorbable antibiotic rifaximin has been used to treat hepatic encephalopathy (HE) since the 1980s. Interest in its use increased following a recent Phase III study showing that treatment with rifaximin over 6-months resulted in a relative reduction in the risk of breakthrough HE of 58% compared to placebo (Bass et al, 2010). The aim of this study was to evaluate the efficacy and safety of rifaximin for the treatment of all types of HE in patients with cirrhosis against a variety of comparative regimens. Methods A language unrestricted search for papers published between January 1983 and September 2011 was undertaken utilising 11 databases. All HE treatment trials were scrutinised and randomised trials identified. Raw data were obtained from six trials. Data were extracted on (1) the numbers of patients showing improvement overall; (2) the means (±1SD) for mental state, asterixis, number connection tests (NCT), EEG and blood ammonia; and (3) adverse events. Fixed effect model meta-analyses were applied, subdivided by population type. Random effects analyses were used when statistically significant heterogeneity of results occurred. Overall relative proportions were calculated for binary outcomes and standardised mean differences (SMD) for quantitative outcomes. Results 17 trials were identified comparing rifaximin to non-absorbable disaccharides (9 trials), other antibiotics (6 trials) or "no treatment" (2 trials) in patients with either "acute" (4 trials), "chronic" (8 trials), or "minimal" (3 trials) HE or else for the "prevention of HE recurrence" (2 trials). Most trials were of adequate quality; the total sample size was 1037 patients, but data were not extractable for all outcomes. The relative proportion of patients experiencing clinical improvement with rifaximin, compared to all control regimen, was 1.26 (95% CI 1.05 to 1.52, p=0.014). Broadly consistent benefits were shown for individual outcome variables for example, asterixis (SMD −0.32, 95% CI −0.62 to −0.02, p=0.038, 5 trials); EEG (SMD −0.49, 95% CI −0.92 to −0.07, p=0.023, 2 trials) and blood ammonia (SMD=−0.25, 95% CI −0.48 to −0.02, p=0.034, 8 trials), although not for mental status (SMD −0.19, 95% CI −0.47 to 0.10, p=0.20, 5 trials) or NCTs (SMD 0.05, 95% CI −0.19 to 0.28, p=0.8, 7 trials). SMDs were stronger in the eight trials in chronic hepatic encephalopathy (asterixis −0.34; EEG −0.56; blood ammonia −0.26; mental state −0.45; NCTs 0.36). No significant differences were observed in side-effects between rifaximin and control regimens. Conclusion Rifaximin is an efficacious and safe treatment for HE when compared to a variety of other treatments regimens; the benefits are most marked in patients with chronic HE. Competing interests None declared.


Purpose: To report a case of hypertensive choroidopathy with detailed chorioretinal images obtained using swept source optical coherence tomography. Methods: We report the case of a 36-year-old pregnant woman who presented with extensive bilateral exudative retinal detachments (visual acuity of hands movement bilaterally), high blood pressure, and severe alteration of the laboratory test results resulting in the diagnosis of HELLP syndrome. The baby was delivered by emergency cesarean section and the patient was hospitalized in the intensive care unit. Results: Two weeks later, exudative retinal detachments improved substantially and bilateral Elschnig spots were present in the posterior fundus. Swept source optical coherence tomography revealed serous retinal detachment, multiple pigmentary epithelial detachments (PEDs), a thickened subfoveal choroid (437 and 466 &mgr;m), and fibrinous material between the neurosensory retina and retinal pigment epithelium in the B-scans of both eyes. En face swept source optical coherence tomography allowed a more precise evaluation of the multiple and confluent PEDs. Six weeks later, despite some focal areas of thickened retinal pigment epithelium, the serous retinal detachment, PEDs, and fibrinous material resolved bilaterally and visual acuity and choroidal thickness returned to normal range (361 and 366 &mgr;m). En face swept source optical coherence tomography revealed a dramatic improvement of PEDs in terms of extension and distribution. Conclusion: Swept source optical coherence tomography detected serous retinal detachment, PEDs, increased subfoveal choroidal thickness, and fibrinous material under the neurosensory retina in the acute phase of hypertensive choroidopathy. En face OCT is useful for monitoring the evolution of confluent PEDs in hypertensive choroidopathy.


To compensate for changes in ambient temperature, thermal flow sensors are usually heated to a constant temperature above ambient temperature. This operating mode, however, requires an extra ambient-temperature sensor. Using a simple model, it is shown that for a two-dimensional thermal flow sensor, similar compensation may be obtained by using a constant beating power, thus eliminating the need for an ambient-temperature sensor. The flow sensor's interface circuitry consists of two thermal sigma-delta modulators that heat the sensor with constant power and dynamically cancel the flow-induced temperature gradient. The modulator's bit-stream outputs are then a digital representation of the heat distribution in the sensor. Wind tunnel tests confirm the validity of the sensor model used and show that both flow speed and direction may be accurately determined from the bit-streams, with errors less than /spl plusmn/5% and /spl plusmn/3/spl deg/, respectively, for flow speeds between 1 and 25 m/s.


This report presents a summary of the results of an ex-ante socioeconomic assessment of the potential impacts of the improved cucurbits germplasm in Indonesia and South Africa. The cucurbits technology was developed by Cornell University through support from the USAID-funded Agricultural Biotechnology Support Project (ABSP). The objectives of these assessments were to: a) investigate the current status of the cucurbits subsector in Indonesia and South Africa; b) evaluate and quantify potential/projected benefits and costs of the cucurbits technology to seed companies, producers, and consumers in Indonesia and South Africa; and c) identify key issues that ABSP researchers, the ABSP management team, and USAID need to take into account in the development and transfer of technology to developing countries in order to fully reap the potential benefits and minimize costs. This study provides several key insights with respect to the characteristics of the cucurbit subsector in Indonesia and South Africa, the performance of Cornell's disease-resistant germplasm in recent in-country field trials, the potential farm- and market-level economic impact of this germplasm, institutional lessons, and opportunities to increase the impact of Cornell's collaboration with seed firms in these countries. Preliminary field tests of the Cornell materials demonstrate that their sources of resistance appear to be valuable in the growing environments of Indonesia and South Africa. Analysis of the farm-level benefits of disease-resistant cucurbits show that adopting farmers in both countries would likely pay higher input costs, but would enjoy higher net revenues. Using assumed adoption rates-based upon subsector analysis of each cucurbit-the farm-level benefits are aggregated to the market level using a standard economic surplus model. These aggregate benefits are then compared in a benefit-cost framework with past and (assumed) future investment costs borne by ABSP and private sector seed companies in the development of these varieties. Under the baseline scenario, the internal rate of return to ABSP's investment in Indonesia and South Africa is 46.5% and the net present value (discounted net social gains) is US$47.3 million. The collaborating seed companies in Indonesia and South Africa could potentially increase their gross revenues by US$4.5 million, as a result of incorporating disease-resistance into their future cucurbit varieties. Sensitivity analysis demonstrates that when using 50% of the baseline adoption rates and 50% of the baseline farm-level expected yield gain from disease-resistant cucurbit varieties, the rate of return is still favorable at 27.1% and the net present value is US$6.9 million. With respect to poverty alleviation, the distribution of benefits and labor generation in Indonesia is ideal, as cucumber is produced by small-scale farmers throughout the country and consumed by all Indonesians. Although melon is produced by small-scale yet higher-resource farmers, it is consumed primarily by higher-income Indonesians. By contrast, the distribution of benefits in South Africa is less than ideal, as zucchini, cucumber, and melon are produced by large-scale (white) farmers and consumed by high-income whites. While these crops do generate labor for black women, they are not traditionally grown by small-scale (black) farmers. Furthermore, the constraints that small-scale (black) farmers face in producing these high-value crops cannot be alleviated solely through varietal improvement. An exception to this is butternut, which is grown by both white and black farmers and is consumed by all South Africans. Keys to increasing future ABSP impact in cucurbits include: performing socioeconomic assessment of cucurbit subsectors in target countries to help set collaborative breeding priorities; encouraging Cornell to collaborate with several firms in each country (in order to avoid monopoly pricing of new technologies), and, in South Africa, working with cucurbits that small-scale farmers traditionally produce and consume-primarily pumpkins.


The aim of this paper is to give a method for the estimation of total parasite burden of the patient and the rate of infection in a malaria's intra-host model by using control theory tools. More precisely, we use an auxiliary system, called {\it observer} or {\it estimator}, whose solutions tend exponentially to those of the original model. This observer uses only the available measurable data, namely, the values of peripheral infected erythrocytes. It provides estimates of the {\it sequestered infected erythrocytes,} that cannot be measured by clinical methods. Therefore this method allows to estimate the total parasite burden within a malaria patient. Moreover, our constructed observer does not use the uncertain infection rate parameter $\beta$. In fact, we derive a simple method to estimate this parameter $\beta$. We apply this estimation method using real data that have been collected when malaria was used as therapy for neurosyphilis by the US Public Health Service.


In this paper, we propose a robust space-time block coded (STBC)-based transmit diversity scheme with low decoding complexity against spatially transmit-correlated fading channels compared with the conventional STBC orthogonal frequency-division multiplexing (STBC-OFDM) schemes. The proposed scheme is comprised of Alamouti code for spatial diversity and a simple mapping process with subcarrier selection for frequency diversity. Proceeding from a detailed analysis of the rank and determinant of the channel correlation matrix, we present a proper subcarrier selection scheme satisfying the conditions for robustness against spatial transmit correlation. Furthermore, when the receiver employs a low-complexity decoder such as a zero-forcing decoder, the proposed scheme shows improved performance compared with the existing space-frequency coded OFDM schemes


Cloud computing has come out to be an interesting and beneficial way of changing the whole computing world. In this paper, we deal with the various methodologies adopted to handle all the processes and jobs concurrently executing and waiting into the web application and web server housed into the same system or different systems. Also, these different methods will be compared taking into account the same number of jobs, but varied environmental conditions and hence, the result would be formulated. Various issues like virtual resources, queuing strategies, resource managers etc. has been discussed here apart from the main coverage points. All these aspects will be closely studied, observed and proved with proper explanations.


Halide is a programming language designed to make it
easier to write high-performance image processing code. Halide
separates the scientific problem of how to write the image
processing algorithm to get the required result from the
engineering problem of how to schedule the different parts of this
algorithm to get a fast solution. This allows Halide's users to
test out different schedules for a single image processing
algorithm to get the fastest program. Unfortunately, the amount of
possible schedules is staggeringly large, and there is no
deterministic way to find the fastest schedules. This leads to a
lot of man-hours spent trying to find good Halide schedules. As
Halide grows in popularity and the platforms on which it runs
diversify, the need for Halide schedules will increase. As the need
for good Halide schedules increases, so will the need for good
schedule designers. However, given the elusiveness of highly
performant schedules, machine generated schedules will become
highly preferred to human trial and error. HalideTuner solves this
problem by automating the entire process. The automation of the the
schedule generation and tuning is done by a machine learning
framework called Opentuner. Before Opentuner can operate, defining
how to iterate through the search space needs to be codified. In
this paper we present HalideTuner a codification of how Opentuner
can manipulate Halide schedules to improve them in the process of
clever trial and error. HalideTuner serves as the foundation for
generating and tuning Halide schedules.


Since the electrical conduction in the COG assembly using a non-conductive adhesive takes place through the connection of the bump and the electrodes, the contact resistance can be applied to the evaluation of the design quality as well as the overall reliability of the particular assembly. It should be further noted that as reported in the literature (e.g., see Liu, 1996; Kristiansen et al, 1998; Nicewarner, 1999; Timsit, 1999), the contact resistance between the bump and the electrode on the substrate strongly depends on the contact stress and the contact area. A higher reliability of the packaging somewhat relies on better contact stability as well as larger bonding stresses.
 In order to explore the physical contact behaviors of a non-conductive adhesive type of COG assemblies, the contact pressure during manufacturing process sequences and during the temperature variation are extensively investigated using a three-dimensional nonlinear finite element model. The so-called death-birth simulation technique is applied to model the manufacturing process sequences. The typical COG assemblies associated with two types of micro-bumps that are made of different materials: metal and composite are considered as the test vehicle. The contact stress between the electrode and the bump is extensively compared at each manufacturing sequence as well as at elevated temperature in order to investigate the corresponding mechanical interaction. Furthermore, the adhesion stresses of the adhesive are also evaluated to further investigate the possibilities of cracking or delamination within the adhesive and in its interfaces with the die and with the substrate. At last, a parametric finite element model is performed over number of geometry/material design parameters to investigate their impact on the contact/adhesion stresses so as to attain a better reliability design.


We extend the notions of conditioned and controlled invariant spaces to linear dynamical systems over the max-plus or tropical semiring. We establish a duality theorem relating both notions, which we use to construct dynamic observers. These are useful in situations in which some of the system coefficients may vary within certain intervals. The results are illustrated by an application to a manufacturing system.


Based on our analysis of the behavior of standard UNIX communication software, we propose a new communication mechanism which reduces the software overhead. This mechanism is optimized to be used in business applications, such as those of online transaction processing and database management. These applications are currently designed to operate in multiple concurrent processes, thus requiring multiprocessing environments with virtual addressing. The proposed communication mechanism, named DLA (dynamic link allocation), supports direct data transfer communication between processors without any intermediate data copying operations. The DLA mechanism adopts a synchronous non-blocking interface which can be used directly by user processes. Since the DLA mechanism provides address translation for each communication port, the sender may directly specify the virtual address of the receiver's buffer area. With the DLA mechanism, sender and receiver CPU usages are reduced to one-third of those for TCP/IP communication, while attaining 30% higher throughput.


Microsporidia are intracellular parasites considered to be ubiquitous in the environment. Yet the true extent of their diversity in soils, sand, and compost remains unclear. We examined microsporidian diversity found in the common urban environments of soil, sand, and compost. We retrieved 22 novel microsporidian sequences and only four from described species. Their distribution was generally restricted to a single site and sample type. Surprisingly, one novel microsporidian showed a wide distribution, and high prevalence, as it was detected in five different compost samples and in soil samples collected over 200 km apart. These results suggest that the majority of Microsporidia appear to have a narrow distribution. Our phylogenetic analysis indicated that the Microsporidia detected in this study include representatives from four of the five major microsporidian groups. Furthermore, the addition of our new sequences calls into question the cohesiveness of microsporidian clade II. These results highlight the importance of increasing our knowledge of microsporidian diversity to better understand the phylogenetic relationships and evolutionary history of this important group of emerging parasites.


Little appears to be known about the value of urban green spaces (tree canopy cover and grassy areas) in a Mediterranean climate, or in relation to multifamily buildings. This study starts addressing this gap by quantifying the impact of urban green spaces on the value of 1197 multifamily buildings sold in 2003/04 in Los Angeles, California. To assess the robustness of the results, a spatial Durbin model is contrasted with a geographically weighted regression model and an extensive sensitivity analysis is conducted. It is found that increases in grassy areas either on the parcels of multifamily buildings or in their vicinity (200 metres outward from each parcel boundary) would typically not enhance their value and neither would more parcel tree canopy cover (TCC); by contrast, most multifamily properties would benefit from an increase in vicinity TCC. These results have implications for tree planting programmes that rely heavily on private property owners.


A novel laboratory synthesis of cadiolides was studied. Cadiolides are secondary metabolites from marine ascidians and tunicates, and they were found to have potent activity against Gram positive bacteria like Methycillin Resistant Staphylococcus Aureus (MRSA). Previous laboratory synthesis of Cadiolide B has been accomplished by 6 steps and with a 42% overall yield. However, this approach was unable to provide Cadiolide C. In this research, a synthetic approach towards Cadiolide B was planned with cheaper and more readily-available reagents, which could in principle also be adapted to construct Cadiolides A, C, D, and E. The new approach involves a key intra-molecular 5-exo-trig-cyclization step on a betaketo-ester of a dibenzylmethanol derivative. This research focused on to synthesis of the beta-keto-ester, but unexpected challenges were encountered along the way. The original approach involving acylated Meldrum's acid will be modified to a Claisen condensation. The synthesis of the dibenzylmethanol intermediate also needs to be optimized, and a Claisen condensation approach to this intermediate is also currently in progress.


The frequently studied conventional distribution channel has largely overlooked the role of the retail buyer who is employed by the retailer to procure products from the manufacturer. In many economies and industries, the presence of the buyer opens the door for the manufacturer to distort buying decisions by offering the buyer a kickback. In this paper, we introduce the retail buyer in the conventional channel and explore her role when kickbacks are feasible. We examine a context where the buyer may be responsible for ordering the right quantity from the manufacturer to match uncertain demand. A knowledgeable buyer can always help improve the channel efficiency when the channel is clean of any kickbacks. However, when kickbacks are possible, we show that, ironically, the manufacturer may not be the one who benefits. Instead, the retailer or buyer may be made better off. While kickbacks can incentivize the buyer to act against the retailer's interest, the retailer can strategically take advantage of the kickback so as to lower its cost of employing the buyer, effectively shifting the cost to the manufacturer. In fact, the retailer may even tacitly encourage kickbacks and not do all it can to eliminate kickbacks from taking place even if doing so adds no additional cost. Surprisingly, the presence of kickbacks can improve channel efficiency and be a win-win for the retailer and the manufacturer.


Movement related potentials (MRPs) are used as features in many brain-computer interfaces (BCIs) based on electroencephalogram (EEG). MRP feature extraction is challenging since EEG is noisy and varies between subjects. Previous studies used spatial and spatio-temporal filtering methods to deal with these problems. However, they did not optimize temporal information or may have been susceptible to overfitting when training data are limited and the feature space is of high dimension. Furthermore, most of these studies manually select data windows and low-pass frequencies. We propose an adaptive spatio-temporal (AST) filtering method to model MRPs more accurately in lower dimensional space. AST automatically optimizes all parameters by employing a Gaussian kernel to construct a low-pass time-frequency filter and a linear ridge regression (LRR) algorithm to compute a spatial filter. Optimal parameters are simultaneously sought by minimizing leave-one-out cross-validation error through gradient descent. Using four BCI datasets from 12 individuals, we compare the performances of AST filter to two popular methods: the discriminant spatial pattern filter and regularized spatio-temporal filter. The results demonstrate that our AST filter can make more accurate predictions and is computationally feasible.


Previously we provided evidence that the anticipation observed in bipolar (BP) disorder may be explained by expanded CAG/CTG triplet repeats. Data were generated with the repeat expansion detection (RED) method in a BP case-control sample showing a significant association of BP disorder with expanded CAG/CTG repeats (RED products of 120 bp). In this study we demonstrated that 86% of the RED expansions could be accounted for by the ERDA1 and CTG18.1 CAG/CTG repeats located respectively on chromosomes 17 and 18. Further, significantly different allele distributions were observed for ERDA1, with a larger proportion of BP patients (34.7%) carrying one or two expanded ERDA1 alleles (CAG/CTG repeats >40) than controls (19.2%) (P = 0.032). Also, a negative correlation was observed for ERDA1 between CAG/CTG length and age at onset in affected offspring of eight BP families. Although interesting, these data should be interpreted with caution since the ERDA1 association did not remain significant after correcting for multiple testing. Also, no linkage was observed between BP disorder and expanded ERDA1 alleles in the families.


Metaphors are common transfer devices that map concrete experiences onto abstract target concepts. We investigated whether a specific gustatory sensation (sweet taste) affects social judgments (here, of harmful acts) via indirect activation of an idiomatic metaphor ("Revenge is sweet"). After reading about a harmful act motivated (vs. not motivated) by revenge, participants judged the avenger and her action more leniently when they had a sweet (vs. neutral) taste in their mouths (Experiment 1). In Experiment 2, we disentangled the activation of target concept and judgment by priming participants with revenge before they read about a harmful act. Only after being primed with the concept revenge, but not after being primed with the similar concept schadenfreude, a concurrent sweet (vs. fresh) taste led to more lenient judgments. We discuss the role of idiomatic (vs. conceptual) metaphors in effects of concurrent bodily experience on social judgments. [144 words]


Tension pneumopericardium is a rare disease that is very difficult to diagnose. A 3-year old child was run over by a minibus. Computed tomography showed bilateral pneumothorax, multiple rib fractures on both sides, and a hepatic laceration. The massive blunt thoracic trauma caused entrapped air in the pericardium, and a tension pneumoprecordium developed abruptly. We report this unique case of tension pneumopericardium in a child, and the subsequent emergency surgery and damage control measures.


Reduced spectral response in adjacent spectral bins is very desirable for detectors since it provides the capability to detect narrowband signals in the presence of unknown interference and colored noise. Recently, a new method of detecting narrowband signals which uses a close approximation to the matched filter is proposed by Raja Kumar. The impulse response of this filter turns out to be longer than that of the matched filter. In order to support this extra length of filter response, it is proposed that the signal be extrapolated by prediction before the filtering operation. In this paper, the characteristics of this detector are mathematically analyzed and the performance of the detector in the presence of additive white Gaussian noise (AWGN) is studied. The detection method uses predicted signals that are obtained typically from short time data. Hence, in this paper, a method of analyzing the statistics of predicted signals from short time data is presented, and it is applied for the performance analysis of the present detector. The accuracy of the present detection analysis is demonstrated through theoretical and simulation studies. Also the analysis and performance study is extended to fluctuating targets, and it is shown that the proposed method yields near-optimum performance for Swerling's Case-1 and Case-3 targets while giving the excellent advantage of low out-of-bin response


Aspergillus sp. N2 and Penicillium sp. N3 are chromate-resistant filamentous fungi that were isolated from Cr(VI) contaminated soil based on their ability to decrease hexavalent chromium levels in the growth medium. After 120 h of growth in a medium containing 50 ppm Cr(VI) at near neutral pH, Aspergillus sp. N2 reduced the Cr(VI) concentration by about 75%. Penicillium sp. N3 was able to reduce the Cr(VI) concentration by only 35%. However, Penicillium sp. N3 reduced the Cr(VI) concentration in the medium by 93% under acidic conditions. Interestingly, the presence of Cu(II) enhanced the Cr(VI) reducing ability of Aspergillus sp. N2 and Penicillium sp. N3 at near neutral pH. Aspergillus sp. N2 and Penicillium sp. N3 reduced the Cr(VI) concentration in the growth medium to a virtually undetectable level within 120 h. For both Aspergillus sp. N2 and Penicillium sp. N3, mycelial seed cultures were more efficient at Cr(VI) reduction than conidium seed cultures. The mechanisms of Cr(VI) reduction in Aspergillus sp. N2 and Penicillium sp. N3 were enzymatic reduction and sorption to mycelia. Enzymatic activity contributed significantly to Cr(VI) reduction. Aspergillus sp. N2 and Penicillium sp. N3 reduced the levels of Cr(VI) in polluted soil samples, suggesting that these strains might be useful for cleaning up chromium-contaminated sites.


Healthy living in the community is affected by many factors. Vital among these factors, is the presence of the barangay health (BHW) worker who inspires and motivates people to live a healthy lifestyle. With competence, commitment and having relevant tools as BHW can provide quality health care services to their constituents. As such, the study determined the level of competence of BHWs. The descriptivecorrelational method was used with questionnaire as the primary data gathering tool. Quota sampling method was used in determining the respondents. Data analysis included percentage technique, weighted mean, Spearman rank method, Kendall's Coefficient of Concordance and Kruskal-Wallis test. Findings revealed that BHWs are competent. The personal, political and environmental factors affect the level of competence of the BHWs. Continuous attendance to seminars and trainings and the use of the BHW intervention bundle is highly encouraged to enhance their performance.


the size of the bleb produced in the skin, provided that a constant relationship was known to exist between the volume of liquid injected intracutaneously and the diameter of the bleb produced by it; and in fact it is much easier to observe and measure the latter than the former. Accordingly experiments have been made to correlate the volume of intracutaneous injections and the "size of the bleb produced. It has been found that a relationship exists between the two so close as to permit an intracutaneous injection to be measured by observation of the size of the bleb produced by it with sufficient accuracy for clinical purposes. The findings were as follows: (i) an intracutaneous injection of 0·025 cubic centimetre produces a bleb about 5 millimetres in diameter; (Ii) a bleb 5 millimetres in diameter is produced by an intracutaneous injection of about 0'025 cubic centimetre; (iii) an intracutaneous injection of 0'1 cubic centimetre produces a bleb about 10 millimetres in diameter; and (iv) a bleb 10 millimetres in diameter is produced by an intracutaneous injection of about 0·1 cubic centimetre. The clinician applying the Mantoux test should have by him when making the injection the millimetre scale and pair of dividers used for measuring the size of the reaction.


Introduction: Bronchiectasis is recognized to be an important respiratory condition with a significant burden of disease. The prevalence of this condition is still not well defined however, particularly in inpatient populations with their high utilization of health services. Aims and objectives: To define the prevalence of bronchiectasis in an inpatient respiratory service. Methods: We performed a retrospective study over 6 months to assess the prevalence and clinical features of bronchiectasis in a respiratory inpatient unit. Results: Patients were excluded if they had a diagnosis of cystic fibrosis and 439 patients were identified of whom 285 had a CT scan. The results of the CT scans were reviewed and bronchiectasis was reported to be present in 75 patients (26% of the patients who had had CTs). The subjects with bronchiectasis had a high incidence of potentially pathogenic airway microorganisms resistant to first-line antibiotics (45%). The majority of patients who had bronchiectasis present on CT scans did not have this documented in the medical file (58/75 or 77%). Conclusions: In this study we found that bronchiectasis was common in inpatients in a respiratory unit and this was associated with a high prevalence of resistant airway pathogens and was generally not recognized by the treating medical team.


Although the common bile duct is now accessed using a coelioscopic approach by an increasing number of surgical equipes, the problems related to the diagnostic iter of lithiasis of the common bile duct and the need to obtain a correct preoperative diagnosis, in order to select the most appropriate form of therapy, are of growing topical importance. Following a revision of the literature, the authors focus their attention on those studies which seem to be most interesting and important in relation to the criteria for suspected lithiasis of the common bile duct, studied in single, multivariable and preoperative analyses, namely without taking account of perioperative analyses, namely without taking account of perioperative criteria. These studies reveal the most statistically significant criteria for predicting lithiasis of the common bile duct. Although the application of these studies is not practicable, they undoubtedly arouse considerable interest. The authors have selected the simple criteria whose rigorous application may result in the selection of patients with 0 criteria, with a 1% risk of non-suspected lithiasis of the common bile duct. Perioperative cholangiography (POC) and echoendoscopy are closely correlated to these criteria. The authors outline their diagnostic iter within the framework of a prospective study they carrying out.


Programmed algorithms for test generation and test evaluation are described. The D-notation is introduced and a test generator (DALG) for combinational logic is presented. The sequential case is then examined. "Real life" constraints related to LSI testing are discussed. Two heuristic test generators satisfying these constraints are introduced. The iterative test generator (ITG) generates tests by transforming the given sequential circuit into an iterative combinational circuit. The macroblock test generator (MTG) uses the same approach but makes use of complex primitives (latches, triggers, etc.) to represent the circuit to be tested. Both the ITG and the MTG are not always guaranteed to generate good tests for each examined failure, and are used in connection with a test evaluator (simulator). Basic features of this evaluator are discussed.


This article explores research issues and methods of textbook research. Drawing on literatures and the author's own work in the area of mathematics textbook research, it conceptualizes textbooks as an intermediate variable in the context of education and hence defines textbook research as disciplined inquiry into issues about textbooks and the relationships between textbooks and other factors in education. Furthermore, it argues that to further advance the field of textbook research, researchers need to expand research issues from descriptive issues focusing on what textbooks are to correlational and especially causal issues including why the textbooks are and how textbooks function in the context of education, and for this purpose, researchers must go beyond textbook analysis, comparison and use to employ more empirically-based and particularly experimental method and view more rigorously textbook research as scientific research


Conventional spline procedures have proven to be effective and useful for estimating smooth functions. However, these procedures find piecewise and inhomogeneous smooth functions difficult to handle. Conventional spline procedures often yield an overly-smooth curve in regions where the true function or its derivative are discontinuous. To fully realize the potential of the spline methodology, this article proposes a function estimation procedure that uses adaptive free-knot splines and allows for multiple knots to be replaced at the same location and between design points. The article also proposes an associated algorithm for implementation in non-parametric regression. The proposed knot selection scheme uses a data-adaptive model selection criterion and an evolutionary algorithm that incorporates certain key features of simulated annealing. The evolutionary algorithm accurately locates the optimal knots, while the data-driven penalty guards against selection errors when searching through a large candidate knot space. The algorithm stochastically yields the globally optimal knots. The simulations suggest that the procedure performs competitively well against alternative methods and has a substantial advantage in relation to nonsmooth and piecewise smooth functions.


Introduction Part I: The Consumer and the Civil Law "They say it isn't mine" "It's a good little bus" "It doesn't work" "It will cost GBP1,000 to make them safe" "Do I have to pay?" "What are my remedies?" "They say that I have signed away my rights" "These small print terms seem very unfair" "How do I enforce my rights without going to court?" "What happens if I go to court?" Part II: The Consumer and the Criminal Law Introduction "The description misled me" "The price was wrong" "The goods aren't safe" Crime and compensation Part III: Administrative Control Fair Trading Part IV: Special Protection in Credit Transactions The background to Consumer Credit "What agreements are caught by the Act?" Control of business activities "I can't remember what I signed" "Can I get out of the agreement?" "The goods are defective" "I have lost my credit card" "I can't afford to pay" "I want to see my credit file" Proposals for reform The European Union dimension.


This is a descriptive, exploratory and retrospective study, with a quantitative approach, performed in a low-income community in São Paulo, with the purpose to identify whether the maintenance of exclusive breastfeeding (EBF) in the first six months is influenced by the following variables: early contact in the first hour after birth, permanence in joint lodging, type of delivery and type of hospital. Data were collected from 75 medical records and analyzed with the methodology of generalized estimate equations. The results showed that the variables joint lodging, type of hospital and type of delivery interfered in the maintenance of EBF; however, that was not the case with early contact. It was concluded that the EBF indexes were higher in cases where the mother and the baby remained together after the birth, in baby-friendly hospitals and after normal deliveries. It was also observed that the care received by the mother during the process of delivery and birth influences breastfeeding directly.


In recent years, a remarkable progress has been accomplished to develop biodegradable, recyclable and environmentally friendly composites which reduce or eliminate the need for non–degradable materials like synthetic polymers and plastics. Due to many advantages of using natural resources, natural fibers have been used recently as a method of providing added strength and ductility to reinforced polymer composites. This is mainly due to their availability, renewability, low density, cost effectiveness as well as satisfactory mechanical properties, which makes them an attractive ecological alternative to glass, carbon and man–made fibers used for the manufacturing of composites. In this study, a full factorial design of experiments technique has been utilized to study tensile strength and flexural strength of chopped date palm fronds reinforced polypropylene (CDPF/PP) composites. Both tensile and flexural strengths of fabricated composites were experimentally characterized according to ASTM standards. Then, nonlinear regression models were developed to predict the mechanical behavior over the target range of fabrication parameters. Chopped date palm fronds reinforced polypropylene composites with fiber contents (20, 40, and 60 v. %), alkali treatment (5, 10, and 15 wt.%) and treatment time (4, 6, and 8 h) have been considered. Subsequently, the response surface methodology approach was used for identifying the optimal combination of these parameters. Then, the machinability of developed bio-composite based on the optimal search in the mechanical properties analysis is utilized under conventional drilling. Specifically, machining of natural fiber reinforced composites causes delamination which is one of the major problems associated with the hole accuracy. Further investigation on optimal manufacturing input parameters is underway. The delamination of drilled chopped date palm fronds polypropylene composites are analyzed and characterized under controlled drilling parameters which includes drill bit diameter (d) spindle speed (s), feed rate (f). The results demonstrated that the drill size significantly influences the delamination among the cutting parameters. The optimal setting of the input variables shows that a combination of moderate values for drill diameter (6.6 mm), low feed rate (143 mm/min) and low spindle speed (1000 rpm) lead to minimum value of delamination. It was also observed that the induced delamination was minimal and so it can be concluded that chopped date palm reinforced polypropylene bio-composites are promising NFRC for industrial applications.


During the COVID-19 pandemic, good knowledge and attitude towards handwashing are essential. Education through various media is found in public places, television, social media and others. However, a specific approach is needed for children of school age as a vulnerable population, since the prevalence of COVID-19 is relatively high in this group. Storytelling is a method to deliver health education and develop cognitive (knowledge), affective (feelings), social and conative aspects in children. This study aimed to determine the effectiveness of storytelling in improving handwashing knowledge and attitudes among school-age children. This research used a quantitative approach with a pre-experimental one-group pretest-posttest design, and it was conducted in April-May 2021. A total of 40 respondents participated. Data were collected using a self-filled questionnaire related to handwashing knowledge and attitude with good reliability (Cronbach's alpha > 0.881 [knowledge] and > 0925 [attitude]). Data were analyzed using SPSS Version 23 for univariate and bivariate formulas. Storytelling had a significant impact on knowledge and attitudes in the school-age children (p < 0.001).
Keywords: storytelling, hand puppets, knowledge, attitude, school-age children


Training models continually to detect and classify objects, from new classes and new domains, remains an open problem. In this work, we conduct a thorough analysis of why and how object detection models forget catastrophically. We focus on distillation-based approaches in two-stage networks; the most-common strategy employed in contemporary continual object detection work.Distillation aims to transfer the knowledge of a model trained on previous tasks -- the teacher -- to a new model -- the student -- while it learns the new task. We show that this works well for the region proposal network, but that wrong, yet overly confident teacher predictions prevent student models from effective learning of the classification head. Our analysis provides a foundation that allows us to propose improvements for existing techniques by detecting incorrect teacher predictions, based on current ground-truth labels, and by employing an adaptive Huber loss as opposed to the mean squared error for the distillation loss in the classification heads. We evidence that our strategy works not only in a class incremental setting, but also in domain incremental settings, which constitute a realistic context, likely to be the setting of representative real-world problems.


Introduction: Yoga is becoming increasingly popular and widely available form of physical activity. It is believed that yoga practice has a beneficial effect on the practitioner's body even with a small amount of exercise. There are also studies confirming the usefulness of yoga practice in the fight against obesity, which is a serious health problem of the 21st century. The aim of the study: Analysis of body composition of people who regularly practicing yoga, analysis of the relationship between body composition and anthropometric parameters, as well as a comparative analysis with people not related to yoga practice. Material and methods: The study ultimately included 42 women who were divided into two groups. The group of yoga practitioners (G1) consisted of 21 women aged 24-59. Out of 46 tested women who did not practice yoga, 21 women were selected due to age and height as close as possible to women from group 1. Group of non participants in yoga (G2) consisted of 21 women aged 23-62. The body composition was performed using TANITA BC 420 SMA analyzer, which uses BIA method. Anthropometric measurements were made using the SECA 201 measuring tape. Results: Statistically significant differences (p <0.05) between women practicing yoga, and women not related to yoga occurred in body weight, BMI, waist circumference, hip circumference, fat mass, muscle mass, lean body mass and total body water. Women who practice yoga had lower BMI, waist circumference and hip circumference than women in second group. Interestingly, only 10% of women practicing yoga expressed their intention to reduce weight, in non yoga practitioners it was 81% of women. Conclusions: The results show that people practicing yoga are characterized by normal body weight and waist circumference, and they have lower body fat content and BMI index compared to nonpractitioners. In addition, it can be stated that regular yoga practice contributes to a better body perception.


BACKGROUND
Stent thrombosis is potentially lethal complication with huge economic burden. The role of insufficient response to antiplatelet therapy is still unclear reason for its occurrence.

CASE REPORT
We presented 54-year-old man with recurrent stent thrombosis on the 4th, 9th and 12th day after the primary percutaneous coronary intervention in spite of double antiaggregation therapy (aspirin+clopidogrel). All possible procedural causes were excluded and reimplantation of intracoronary stent was insufficient to resolve the problem, so four platelet tests were performed: flow cytometry, Platelet Function Analyzer-100 test, aggregometry, and determination of gene polymorphism for P2Y12 receptor (directly involved in the mechanism of thienopyridine), and GPIIbIIIa receptor (final receptor in aggregation). The patient was the carrier of the major haplotype H1H1 for P2Y12 receptor and minor A1A2 for GPIIbIIIa receptor. The results of all the performed tests showed insufficient antiplatelet effect of aspirin and sufficient response to thienopyridin (not to clopidogrel, but to ticlopidine).

CONCLUSION
Performance of platelet function tests is necessary in the case of major adverse cardiac events especially stent thrombosis, after implantation of intracoronary stent.


The discipline of time-dependent fracture mechanics has traditionally focused on the creep crack growth behavior of high-temperature materials that display creep-ductile behavior, such as stainless steels and chromium-molybdenum steels. Elevated temperature aluminum alloys, however, have been developed that exhibit creep-brittle behavior; in this case, the creep crack growth rate correlates with the stress intensity factor, K. The fracture characteristics of aluminum alloy 2519-T87 were studied at 135 C, and the creep and creep crack growth behavior were characterized utilizing experimental and numerical methods. The strain to failure for creep deformation specimens was limited to only 1.2 to 2.0%. Creep crack growth tests revealed a unique correlation between the creep crack growth rate and K, a result consistent with creep-brittle behavior. No experimental correlation was found between the creep crack growth rate and the C{sub t} parameter. Microscopy of fracture surfaces revealed distinct regions of intergranular and transgranular fracture, and the transition between the fracture regions was found to occur at a critical K-level. Experimental results also appeared to show that initiation of crack growth (incubation) is controlled by the accumulation of a critical amount of damage ahead of the crack tip and that a correlation exists between the incubation timemore » and K. Total time to failure is viewed as a summation of the incubation period and the crack growth period, and the design importance of incubation time is discussed.« less


This study was performed to investigate the thermal and mechanical properties of foamed concrete when supplementary cementitious materials (SCMs) are utilized. Sustainable foamed concrete of 1800 kg/m dry density was prepared by incorporating Palm Oil Fuel Ash (POFA) ranging from 30 % to 35 % and Eggshell Powder (ESP) from 5 % to 15 % as SCMs. It was found that the combined utilization of POFA and ESP in the foamed concrete produced favorable results by reducing the thermal conductivity up to 42.68 % compared to the control sample, thus enhanced thermal insulating property of foamed concrete. This study confirmed that recycling and reusing of POFA and ESP are possible in foamed concrete which could be used for non-structural applications where thermal insulating is required.


The development of the educational institution industry continues to increase, which demands an effective marketing strategy to face the increasingly tight competition in the education service business. This research is a qualitative research methodology with a descriptive approach that aims to determine the marketing strategy of Baitul Qur'an educational institutions. The analysis tool used is the analysis of the company's environment (EFE, IFE, and IE Matrix) with the SWOT method (Strength, Weakness, Opportunity, Threat). The results of the Baitul Qur'an Islamic Boarding School evaluation based on Internal and External analysis obtained from the SWOT analysis resulted in an alternative strategy of S-O (Strength-Opportunity). Then, the results of the SWOT analysis are reprocessed using the QSPM (quantitative strategic planning matrix) method to obtain priority strategies from various alternative strategies as well as a decision to choose a strategy. The priority strategy in this study is to optimize the use of digital marketing and other marketing technologies to support the development of Islamic boarding schools in a wider area (6,87). Keywords: Marketing Strategy; Educational Institution; SWOT; QSPM


This paper compares relative performance evaluation via tournaments to absolute performance evaluation via piece rates when agents are heterogeneous ex post, to make the point that agent heterogeneity compromises the insurance function of tournaments. In particular, we show that the more heterogeneous agents are the less insurance can be offered through tournaments and the less dominant tournaments are over piece rates. Thus, absolute performance piece rates should be preferred when agents are highly heterogeneous. However, even with heterogeneous agents, tournaments become more desirable when the number of agents or the uncertainty about the common shock increases sufficiently.


Key notions such as 'theory' and 'testing' are highly disputed in the literature on entrepreneurship and business venturing, as a result of an intellectual stasis. Thus, the lack of agreement on core ideas and notions undermines any progress toward developing a coherent body of knowledge on entrepreneurship. To go beyond this stasis, we draw on the discourse regarding design science that has been emerging in the past few decades, informed by Simon's seminal "The Sciences of the Artificial". First, we provide a map of the 'design science' territory, by distinguishing a broad range of research outputs (i.e. values, constructs, models, principles, instantiations) as well as a discovery-validation cycle of research activities. We then illustrate how entrepreneurship research at the interface of science and design serves to connect ideas and findings (from disparate literatures and practices) that otherwise would remain unconnected. A key method at this interface is mechanism-based review and synthesis. In this respect, the notion of social/generative mechanisms is central to rigorous descriptive-explanatory work as well as to impactful creative-practical work.


Ageratum leaf curl Sichuan virus (ALCScV) is a novel monopartite begomovirus, which was identified from Ageratum conyzoides plants in Sichuan Province, China. In this study, we showed that ALCScV can induce typical dwarf and downward leaf-curling symptoms in Ageratum conyzoides, Helianthus annuus, and Nicotiana benthamiana plants and that the noncognate betasatellite can enhance disease symptoms and increase viral accumulation. Expression of the ALCScV-encoded V2, C1, and C4 proteins through a Potato virus X (PVX) vector caused severe symptoms in N. benthamiana. Further study revealed no symptoms in N. benthamiana plants inoculated with infectious ALCScV clones lacking the C4 protein and that the relative viral DNA accumulation levels significantly decreased when compared with ALCScV-inoculated plants. Thus, our mutational analyses demonstrated that C4 is a pathogenicity determinant that plays key roles in symptom formation and virus accumulation. Furthermore, we also demonstrated that the second glycine of C4 was critical for ALCScV pathogenicity.


OBJECTIVE
To evaluate the resident doctors' competency in professionalism and communication skills in south China.

METHODS
We conducted this cross-sectional study in 8 hospitals, in 4 provinces of southern China from October to December 2007. The evaluation included 148 resident doctors. A 360-degree instrument from Education Outcomes Service Group (EOS group) of the Arizona Medical Education Consortium was developed and used by the attending physicians, residents, and their peers, nurses, patients, and office staff in this study. All data were entered into a computerized database and analyzed using the Statistical Package for Social Sciences version 13.0( SPSS Inc., Chicago, IL, USA) for Windows®.

RESULTS
Our results indicated that the instruments are internally consistent (Cronbach's alpha >0.90). The principal components analysis with varimax rotation for the attending-, resident self-evaluation, nurse-, patient-, office staff- and resident peer-rated questionnaires explained 70.68%, 76.13%, 77.02%, 76.37%, 75.51%, and 72.05% of the total variance. Significant differences (p<0.05) were found among different evaluators.

CONCLUSION
The 360-degree instrument appears to be reliable in evaluating a residents' competency in professionalism and communication skills. Information from the assessment may provide feedback to residents.


The properties of small clusters can be investigated by various methods. For very small clusters having 3 or 4 atoms, the spectroscopic techniques are suitable and results are presented on Na3 for which the dynamical Jahn-Teller effect, the ground state structure and predissociated states have been observed. For larger clusters, various other methods can be used and some of them are detailed in the paper. General trends in the cluster properties are given for selected examples of atomic clusters studied in the literature. Rare gas clusters are dominated by the van der Waals bonding. Alkaline clusters are well interpreted by a very simple shell model. In divalent metal clusters, a transition from a van der Waals to metallic structure is expected and has been observed in mercury clusters. Finally, the more complicated case of semi-metal clusters is also discussed. Results are presented on antimony and bismuth clusters.


Indigenous coastal farming communities need to address future climate change impacts, yet many communities are slow to respond, due to lack of adequate information, economic pressures, the abstract nature of climate change science and poor communication between what science knows and what indigenous farming communities need to know. Art and design can address these issues by synthesizing broad scientific principles with local place-specific culture and their visual language can effectively communicate short and long-term benefits to local communities. Art and design are thus both generative research methods and media for representation. This research uses art and design to provide a bridge between the Māori culture of a local farming community in coastal New Zealand and climate change science. It provides a framework of strategies for new farm practices. Underpinned by the qualitative awareness of thresholds and an open-ended toolbox of land-based strategies, the role of the framework is to catalyze adaptation. The framework is responsive to both the Māori worldview and scientific knowledge, and has the potential to provide a model for other coastal communities.


The coir industry was chosen for study because of its social and economic importance to the area. The industry employs vast numbers of the disempowered social sections, mostly of the "lower castes" and "outcastes", an overwhelming majority of them women. The economic development of any country demands industrialization. Though this is realized in our country, it is high time we thought about balanced regional development, an important component of industrialization. Rural development forms a key component in a nation's progress towards economic freedom and equality. In the scenario, any study on a performing sector like Coir would be of immense help from a broader perspective. The coir making activity with a strong presence in the study area is making valuable contributions in the socio economic.


It is popular to claim that radio has always had pictures – the ones listeners created in their own minds – and this is often seen as one of the medium's greatest strengths. The process of visualization of radio in the digital age has most often focused on how producers can fill the screen of the various devices through which we receive radio today. This article focuses on the other ways in which radio is visualized online, in a process that deploys transmedia storytelling techniques. It looks at specific examples and explores the way in which these transmedia techniques build relationships with the audience, strengthen brands and create opportunities for broadcasters to tell stories in ways never before possible.


The paper is concerned with media coverage of the on-going refugee crisis in Afghanistan. It begins by looking at how the terrorist attacks on the World Trade Center of 11 September 2001 had the result of stimulating renewed media interest in Afghan refugees. Paying special regard to the role of visual images in the reporting of disasters, the paper reviews the narrative strategies adopted by television news. It considers the factors that have instigated media response by examining some general issues arising from the media coverage of disasters. While the central focus of the study is BBC Television News Special Reports on the Afghan refugee crisis, selective comparisons are made with other television broadcast channels, Sky News and Euronews. Based on the Afghan case study, I propose three main constituent factors contributing to the likelihood of effective media coverage of a refugee crisis. Firstly, in order to attract Western press coverage it is necessary for the crisis to be of such a magnitude that it cannot be ignored; or else it is necessary for it to be perceived as having some obvious connection with Western concerns. Secondly, the story will gain airtime if the nature of the crisis is such that it produces dramatic imagery – pictures with impact. Finally, if the style of the media coverage is sufficiently innovative it will stimulate interest in the viewers. The paper concludes with a critical review of media examples that break away from conventional news formulae.


Heat shock proteins (HSP70) play an important role in many biological processes. However, as typical in Sorghum bicolor, the systematic identification of the HSP70 gene is very limited, and the role of the Hsp70 gene in the evolution of Sorghum bicolor has not been described systematically a lot. To overcome the gap, Insilco analysis of HSP70 gene family was conducted.The investigation was utilizing the bioinformatics method to analyze the HSP70 gene family and it has been identified that 30 HSP70 genes from the genome sequence of Sorghum bicolor. A comprehensive analysis of these 30 identified genes undertaking the analysis of gene structure, phylogeny, and physicochemical properties, subcellular localization, and promoter region analysis. The gene structure visualization analyses revealed that 22 genes contains both 5' and 3' UTRS and one 5' and one 3' gene and 6 genes without UTR. The highest number of introns was recorded as 12 and those genes have shown that without in any intron. In the promoter region analysis, ten protein motifs are identified and characterized and 2219 cis-acting elements are identified. Among those, the promoter enhancer elements share the highest number (1411) and light-responsive elements share the next value (335). The physicochemical properties analysis revealed that 23 families have an acidic nature while four families are basic and the rests are neutral. In general, the different analyses performed disclosed their structural organization, subcellular localization, physicochemical properties, cis-acting elements, phylogenetic, and understress conditions. This study provides further information for the functional characterization of HSP70 and helps to understand the mechanisms of abiotic stress tolerance under diverse stress conditions in Sorghum bicolor.


The scaled gradient projection (SGP) method is a first-order optimization method applicable to the constrained minimization of smooth functions and exploiting a scaling matrix multiplying the gradient and a variable steplength parameter to improve the convergence of the scheme. For a general nonconvex function, the limit points of the sequence generated by SGP have been proved to be stationary, while in the convex case and with some restrictions on the choice of the scaling matrix the sequence itself converges to a constrained minimum point. In this paper we extend these convergence results by showing that the SGP sequence converges to a limit point provided that the objective function satisfies the Kurdyka-Łojasiewicz property at each point of its domain and its gradient is Lipschitz continuous.


Social work scholarship concerned with mixed-race and queer identities is growing and ever-changing, yet often treats race and sexuality as separate experiences independent from context and environment. In addition, in studies of mixed-race people, the legacy of the Black-White/US-based multiracial paradigm and the history of such research using race as the only or primary analytic has left a dearth of studies that seek to understand mixed-race experiences within geographical, transnational and intersectional contexts. In this paper, we extend previous work focused on situational and contextual multiracial identities through an interview-based study of a sample of 12 queer and mixed-race individuals. We employ a narrative analysis to explore how emergent themes of geography and migration are salient to self-making processes of participants. Findings include: (1) diverse geographic and migration histories among participants; (2) interviewees' use of discursive strategies that draw upon experiences of geography and migration within the narrative structure; and (3) the critical role of geography and migration in expanding and changing participants' identity discourses and in shaping individuals' identity and sense of community. Ultimately, this work serves as a call for on-going attention to how geography and migration, as well as intersectional and transnational perspectives, add depth and texture to studies of queer-mixed people while also offering specificity to social work's broader commitment to context and environment.


This report analyses changes in public current and capital healthcare expenditure (HCE) (2004 to 2017), and its components, along with trends in HSE staffing and pay expenditure (2007 to 2017). This report adopts an inclusive approach to the measurement of HCE and HCE is defined in gross terms which includes any income receipts used to fund public care. Healthcare expenditure trends are adjusted to account for population growth and ageing, and price effects, over the period of analysis. Nominal public current HCE increased by 74.2 per cent between 2004 and 2017, equating to a 4.4 per cent annual average increase. However, with adjustment for demographic and price effects, public current HCE increased by a more modest 0.2 per cent on an annual average basis. Furthermore, the introduction of the Employment Control Framework (in 2009) reduced HSE staffing levels and pay expenditure but was associated with substantial increases in agency pay and HSE superannuation expenditure. Overall, discussion and assessment of HCE would benefit from placing trends into the context of changing prices and demographics. The long-term effects of measures, such as incentivised early retirement schemes, aimed at short-term cost-saving need to be considered as they may, in fact, lead to increased expenditure over time. Insights from this analysis of historic Irish healthcare expenditure trends may prove useful to policymakers' approach to ongoing financing of the Irish healthcare system in the COVID-19 healthcare crisis. Corresponding author: email@example.com a Centre for Health Policy and Management, Trinity College, Dublin b Economic and Social Research Institute, Dublin ESRI working papers represent un-refereed work-in-progress by researchers who are solely responsible for the content and any views expressed therein. Any comments on these papers will be welcome and should be sent to the author(s) by email. Papers may be downloaded for personal use only. Working Paper No. 660


Summary Hydrochemical aspects of the Triassic Sandstone aquifer of the Birmingham area are discussed to show the effect of aquifer structure upon the quality and nature of ground-waters. The presence of faulting and its effects upon ground-water flow and quality are demonstrated by reference to major ion chemistry. Carbon isotope data show that old groundwater exists in an unconfined outcrop area, its distribution being controlled by a structural low in the base of the Triassic. Radiocarbon ages of 20 samples show that low levels of chloride (<20 mg/l) are indicative of old ground-waters.


This document presents a validation of the global burned area product (L3JRC) in Colombia, using the method of the confusion matrix where Landsat images are used as a proxy for fieldwork. The product L3JRC is a burned area map based on remote sensing SPOT-VEGETATION data and generated by Tansey et al. in 2007. Determination of burned area using satellite data is possible because of the difference in reflectance before and after a fire. A pattern toward larger omission errors was found in the validation process, although commission errors also were present. Disregarding the type of error, it was shown that the product L3JRC underestimates 40% of the burned area of the country. With this accuracy of assessment, it was concluded that the annual average burned area in Colombia during the annual study period was 14,807 km 2 , taking into account omission values burned area may exceed 21.000 km 2 . Orinoquia region has more than (90%), of the total burned area of the country, where Vichada, Meta, Arauca, and Casanare were the most affected Colombian departments.


In this paper, a dual-mode compact microstrip antenna based on the fundamental backward wave supported by a composite right/left-handed (CRLH) metamaterial transmission line (TL) is demonstrated. The physical size and operational frequencies of the antenna are determined by the CRLH metamaterial's unit-cell. This antenna is capable of monopolar radiation at one resonant frequency and patch-like radiation at another resonant frequency. Numerical and experimental results of a three unit-cell CRLH-based antenna are used to verify the authors' claims.


In 2008, several publications have highlighted the role of climate change and globalization on the epidemiology of infectious diseases. Studies have shown the extension towards Europe of diseases such as Crimea-Congo fever (Kosovo, Turkey and Bulgaria), leismaniosis (Cyprus) and chikungunya virus infection (Italy). The article also contains comments on Plasmodium knowlesi, a newly identified cause of severe malaria in humans, as well as an update on human transmission of the H5NI avian influenza virus. It also mentions new data on Bell's palsy as well as two vaccines (varicella-zoster and pneumococcus), and provides a list of recent guidelines for the treatment of common infectious diseases.


The scaling of CMOS technology has progressed rapidly for three decades, contributing to the superior performance and dramatically reduced cost per function for modern integrated circuits. As the CMOS dimension, in particular, the channel length approaches the nanometer regime (< 100nm), however, static power dissipation increases precipitously due to increasing leakage currents arising from quantum mechanical tunneling and electron thermal energy. To extend CMOS scaling to 10 nm while still gaining significant performance benefit, alternative device structures or materials are being studied extensively. This work considers the device design and technology requirements of scaling bulk MOSFET to the ultimate limit of 10 nm. For control of short channel effects, the 2-D scale length theory provides a guideline for CMOS device design. A scale length of less than 7 nm is required for 10-nm MOSFET with acceptable short channel effect. High-K dielectric is needed to replace silicon dioxide so that an effective oxide thickness of 0.4 nm can be obtained without inducing detrimental gate tunneling leakage. High body doping level of above 10¹⁹ cm⁻³ is required to control the depletion width to 5 nm. Metal gate would be needed to replace polysilicon gate to avoid poly-depletion effect. Counterdoping in the surface channel layer is necessary in order to lower the threshold voltage to 0.2 - 0.3 V. Also studied in this work are optimum gate-to-source/drain overlap length and the effect of source/drain lateral gradient on circuit performance. An inverse source/drain lateral gradient smaller than 3 nm /decade is needed to avoid excessive source/drain series resistance. Regions where the source/drain doping level drops below 7\\times10¹⁹ cm⁻³ should not be left un-gated. In order to manage the increasing active power due to the increasing integration level, the scaling limit of power supply voltage is studied based on noise margin considerations. Mixed-mode simulation of a three-way NAND gate is used to study the minimum noise margin condition with the threshold roll-off taken into account. It is shown that a minimum supply voltage of 0.5 V is required for high performance CMOS circuits


Abstract. The present study introduces an application of the non-modal analysis to multigrid operators with explicit Runge-Kutta smoothers in the context of Flux Reconstruction discretizations of the linear convection-diffusion equation. A dissipation curve is obtained that reflects upon the convergence properties of the multigrid operator. The number of smoothing steps, the type of cycle (V/W) and the combination of pand h-multigrid are taken into account in order to find those configurations which yield faster convergence rates. The analysis is carried out for polynomial orders up to P = 6, in 1D and 2D for varying degrees of convection (Péclet number), as well as for high aspect ratio cells. The non-modal analysis can support existing evidence on the behaviour of multigrid schemes. W-cycles, a higher number of coarse-level sweeps or the combined use of hp-multigrid are shown to increase the error dissipation, while higher degrees of convection and/or high aspect-ratio cells both decrease the error dissipation rate.


ABSTRACT To the Editor. —Triplett and associates1 have made important observations about the relationship of lupus anticoagulants, phospholipid antibodies, and clinical disorders.However, they stated that 8% of their patients had a history of spontaneous abortion. Although eight of the 100 patients had a history of recurrent abortions, there were only 50 women in the study. It would be more appropriate to state that eight (16%) of 50 women had a history of recurrent abortion. The 95% confidence intervals for this observation are 7.17% to 29.11%. Recurrent spontaneous abortion, the loss of three or more pregnancies before 20 weeks' gestation, occurs in an estimated 0.4% to 0.8% of women. Spontaneous abortion is clinically recognized in 15% to 20% of pregnancies.2 The association of phospholipid antibodies and recurrent spontaneous abortion should be emphasized. The causative role, if any exists, remains to be elucidated.


Julie Dash's film Daughters of the Dust offers a starting point for an exploration of the construction of African American communal memories. Self-consciousness about such memory making can illuminate the historically generated roles of gender, regionalism, and urbanrural differences in both popular and scholarly understandings of African American culture.

This is not just an issue for African American studies, however. A number of key dilemmas in contemporary anthropology are implicated. Most prominent is the rebellion against Enlightenment-based notions of vision and rationality, which explores the senses, the magical, the uncanny, the haunted, and the subjective.


The 1950s, 1960s, and 1970s saw the transition of mechanical circulatory support (MCS) from the necessary extension of cardiopulmonary bypass to the development of durable devices. Within the last 20 years, enhanced pumps as well as surgical and medical experience have allowed MCS to become a routine part of the armamentarium for treating heart failure patients. Most recently, within the last 10 years, there has been a dramatic shift from the use of large, pulsatile left ventricular assist devices (LVADs) to smaller continuous flow devices. In this chapter, the current state of MCS for treating advanced heart failure as well as the detail of the surgically related issues with LVADs are reviewed.


This study was conducted to determine genotypic variation among sorghum cultivars grown under similar ecological conditions for seed vigor, salt (NaCl) and drought stresses. A seedling survival test was also performed in a pod experiment to investigate genotypic differences in terms of sorghum drought tolerance. In seven sorghum cultivars, seed vigor was determined using electrical conductivity and accelerated ageing tests. Also, germination rate and seedling growth of these cultivars were evaluated under salt and drought stress induced by PEG 6000 at water potentials of 0.0 (distilled water), -1.8, -3.6, -7.2 and -10.8 bar. The results showed that there was a significant difference in seed vigor of sorghum cultivars grown at same ecological conditions. Akdari produced more vigorous seeds than the other cultivars. The significant relationship between accelerated ageing and laboratory emergence (r= 0.967**), and between electrical conductivity and germination percentage (r= -0.873**) were determined. The suitable tests for germination and emergence potential in sorghum were electrical conductivity and accelerated ageing, respectively. Increasing NaCl and PEG levels inhibited germination and seedling growth. Germination, root length and shoot length were higher, whereas mean germination time was lower, in NaCl solution compared to in PEG solution at the same water potential. In salt, drought and seedling survival tests, Aldari showed the better performance than the others. It could be concluded that seed vigor is not a reliable indicator of germination performance under salt and drought stress conditions and that genetic differences may play an important role in stress tolerance.


Stories have been broadly applied to traditional marketing, attempting to arouse consumers' affection to present empathy on the characters and plots in the stories and change consumer attitudes to achieve the marketing objective. Stories are easily memorized and would appear consonance. Planned storytelling marketing could create affection and infinite business opportunities as well as infinite value of brand to implant in consumers' mind. From the aspect of storytelling marketing, this study intends to discuss ecotourists' reaction to stories and understand the effect of emotional appeal to ecotourists by delivering external information to ecotourists. General people are distributed and collected the questionnaire on-site. Total 300 copies of questionnaire are distributed, and 282 valid copies are retrieved, with the retrieval rate 94%. The research results show significant effects of type of storytelling marketing on brand image, purchase intention, and perceived quality. According to the results to propose suggestions, it provides indicative reference for ecotourism businesses applying storytelling marketing to promote brand image and enhance consumers' perceived quality and purchase intention.


Diffuse hemangiomatosis is associated with hemangiomas of internal organs; the liver is the most frequent affected extracutaneal organ. The clinical evolution includes systemic manifestations and bleeding. Steroids and chemotherapeutic agents such as vincristine and cyclophosphamide are used for treatment. Thalidomide, due its antiangiogenic effect, could be a therapeutic option. We report the case of a 19 year old girl with diffuse hemangiomatosis with cutaneous, hepatic and digestive tract involvement. A literature revision and update is made of this topic.


This article explores the potential of blockchain technology in enabling a new system of value that will better support the dynamics of social sharing. Our study begins with a discussion of the evolution of value perceptions in the history of economic thought. Starting with a view on value as a coordination mechanism that de fi nes meaningful action within a certain context, we associate the price system with the establishment of capitalism and the industrial economy. We then discuss its relevance to the information economy, exhibited as the techno-economic context of the sharing economy, and identify new modalities of value creation that better re fl ect the social relations of sharing. Through the illustrative case of Backfeed, a new system of value is envisioned, comprising three layers: (a) production of value; (b) record of value; and (c) actualisation of value. In this framework, we discuss the solutions featured by Backfeed and describe a conceptual economic model of blockchain-based decentralised cooperation. We conclude with a tentative scenario for blockchain technology that can enable the creation of commons-oriented ecosystems in a sharing economy.


The central objective of this research is to demonstrate the relevance of the basic health indicators as instruments of control of public health management, because connecting elements of policy implementation, able to reflect the health status of the population served, given their nature epidemiological. The proposal is to apply the "Habermasian" thought the responsible act for the evaluation of the results of public management in local reality, regarding the reduction of risks and health hazards. The results of public management in a given space of time, can be described by means of social indicators, built with this purpose, which have been the subject of frequent studies leading to the development of control tools able to reflect, monitor and / or control the consequences of decision making, both for analysis / evaluation and / or verification of results in the world of life, as to the correct paths when the route plans and goals, as well as the search for means of accountability. Keywords : health status indicators; public policy; health law; public administration; control measures.


This paper presents a detailed comparative framework for assessing the usefulness of unsupervised word representations for identifying so-called implicit discourse relations. Specifically, we compare standard one-hot word pair representations against low-dimensional ones based on Brown clusters and word embeddings. We also consider various word vector combination schemes for deriving discourse segment representations from word vectors, and compare representations based either on all words or limited to head words. Our main finding is that denser representations systematically outperform sparser ones and give state-of-the-art performance or above without the need for additional hand-crafted features.


As fixed-parameter control can not satisfy control requirements when helicopter is aviating in large scale flight envelop, this paper proposes a new control law design to adjust parameters on-line. Firstly a parameter-mapping approach is developed to design flight control parameters at certain flight conditions according to the desired system performance. Then parameters obtained at given conditions are used to train Radial Basis Function Neural Network (RBFNN). Thus RBFNN can generalize the given flight conditions information and output appropriate control parameters which will meet control requirements for any current flight condition within the given flight envelop. Simulation results indicate this control law design is feasible and effective.


Deep brain stimulation (DBS) of the ventral capsule/ventral striatum (VC/VS) is a novel therapy for neuropsychiatric disorders. Hypomania is a known complication of VC/VS DBS, but who is at risk is less understood. Factors such as family history, combined with details of DBS programming, might quantify that risk. The authors performed an iterative modeling procedure on a VC/VS DBS patient registry to identify key predictors. Hypomania was less common for men and for patients stimulated on the ventral right contact. It was more common with right monopolar stimulation. These findings may help to establish decision rules to reduce complications of VC/VS DBS.


Background Quality of health care and client satisfaction are key elements in improving the performance of health systems. A community-based assessment was conducted to determine the level of client satisfaction and the perception of the quality of services received by citizens of Lagos State. Methodology A descriptive cross-sectional study using both quantitative and qualitative methods, was conducted in four local government areas of Lagos state selected by multi-stage sampling techniques. The survey instruments included an interviewer- administered, pre-tested questionnaire and a 10-itemed focus group discussion guide. The survey obtained information about quality of the facilities and services. The outcome variables were client satisfaction and service quality. Results Two thousand respondents were recruited with a mean age of 37.6±10.21 years. Almost all respondents (98%) rated the health facilities to be clean, 96% felt they received effective treatment from their providers. Six out of ten respondents rated the waiting time to be short and 60% felt that most drugs were available. Eight-five percent opined that the quality of care received was good and 95% were satisfied with the services received. There was a significant correlation between quality of care and client satisfaction (r=0.145, p=0.001). Service factors such as perceived effectiveness of treatment received, confidence in health providers and use of higher level of health care were predictive of client satisfaction and good service quality. Conclusion Most clients were satisfied with health services and felt that service quality was good.


The Formation Flying Test-Bed (FFTB) at NASA Goddard Space Flight Center (GSFC) provides a hardware-in-the-loop test environment for formation navigation and control. The facility is evolving as a modular, hybrid, dynamic simulation facility for end-tc-end guidance, navigation, and control (GN&C) design and analysis of formation flying spacecraft. The core capabilities of the FFTB, as a platform for testing critical hardware and software algorithms in-the-loop, are reviewed with a focus on many recent improvements. Two significant upgrades to the FFTB are a message-oriented middleware (MOM) architecture, and a software crosslink for inter-spacecraft ranging. The MOM architecture provides a common messaging bus for software agents, easing integration, arid supporting the GSFC Mission Services Evolution Center (GMSEC) architecture via software bridge. Additionally, the FFTB's hardware capabilities are expanding. Recently, two Low-Power Transceivers (LPTs) with ranging capability have been introduced into the FFTB. The LPT crosslinks will be connected to a modified Crosslink Channel Simulator (CCS), which applies realistic space-environment effects to the Radio Frequency (RF) signals produced by the LPTs.


T he dilemmas, policies, and outcomes of privatization in transition economies have fueled a growth industry in the analysis of corporate governance systems. The reasons for the interest in ownership and governance in transition are clear. Under socialism, dominant state ownership was complemented by tight bureaucratic control over large industrial firms-the "commanding heights" of the economy (Kornai 1992). After communism collapsed, questions immediately arose about what forms of ownership and control should follow and how the new system should be arranged. The discussions of these issues have displayed a remarkable evolution in the 10odd years since transition began. In the early transition years, the "Washington consensus" favoring rapid liberalization and privatization was dominant, while more recently a "new consensus" (Washington or not) has apparently emerged that advocates gradualism and cautious privatization.' Both viewpoints have had substantial effects on policymaking in the transition economies and on the advice provided by international organizations. But neither has ever been universally accepted, nor has the debate between them been informed by an amount of scientific analysis that would justify firm conclusions.


Negative interactions between sharks and humans are rare on a global scale. More humans are killed by toasters, cows or vending machines than are killed by sharks, and heart disease kills about a million times as many people as sharks do. However, inaccurate and inflammatory media coverage (Muter et al., 2013; Neff & Hueter, 2013) makes the problem seem worse than it really is, and that results in elected officials who want to do something about the issue. Many commonly used 'shark control' strategies involve killing sharks with the goal of reducing the probability of a swimmer encountering a shark. As nearly 25% of sharks and their relatives are considered threatened with extinction by the International Union for the Conservation of Nature Red List (Dulvy et al., 2014), this strategy is unpopular with environmentalists. Additionally, many large species of sharks migrate vast distances (i.e. tiger sharks were observed to move thousands of kilometers from their capture location; Hammerschlag et al., 2012), and shark culls have been shown to be of limited effectiveness in terms of reducing local populations of these species (Simpfendorfer, Goodreid & McAuley, 2001). The cull in Hawaii did not reduce the incidence of shark bites (Wetherbee, Lowe & Crow, 1994). Electromagnetic barriers that repel sharks without harming them have shown some early promise (O'Connell et al., 2011); however, the technology is new and not widely tested. Different species of sharks have been shown to vary widely in their responses to electromagnetic fields (Godin et al., 2013), and some of the species responsible for the most shark bites have yet to be tested. A new strategy is sorely needed, a strategy that can actually reduce the rate of shark bites without harming the populations of threatened species. The technique pioneered in Recife, Brazil may just be the new strategy we have been looking for (Hazin & Afonso, 2014). The technique itself is brilliant in its simplicity – instead of using advanced (and relatively untested) technology to attempt to repel sharks or nondiscriminatory nets that kill other threatened sea life as bycatch, the team simply caught sharks and moved them to where they would not pose a threat to swimmers. The use of baited drumlines with large hooks (instead of nets) results in low bycatch. Giving the drumlines a relatively short soak time results in low capture mortality (Hazin and Afonso report approximately 100% survival of protected species). As it does not result in killing the sharks, environmentalists will not object. As it successfully reduces shark bites (Hazin and Afonso reported a 97% decrease), it should appease politicians and the media eager to 'do something' about the perceived threat of sharks. Huxley once said 'how extremely stupid not to have thought of that' of Darwin's theory of evolution by natural selection, and many in the shark research world feel similarly of the strategy presented in Hazin & Afonso (2014). It is important to consider the potential limitations, though, despite the exciting preliminary results. While drumlines are inexpensive and can be deployed on a large scale, a short soak time requires a crewed boat frequently checking the lines. A single boat and crew could manage a relatively small area such as that used in this study, but this expense will rapidly increase as this method is scaled up to larger geographic areas. Additionally, if the area we are removing sharks from represents an important habitat for them (a migration corridor, mating aggregation area or nursery), they will likely keep coming back. If this strategy works in other regions, though, this has the potential to be a revolution in shark control.


In this work, we investigated graphene hypersurface (HSF) for the manipulation of THz waves. The graphene HSF structure is consists of a periodic array of graphene unit cells deposited on silicon substrate and terminated by a metallic ground plane. The performance of the proposed HSF is numerically analyzed. Electromagnetic parameters of HSF such as permeability, permittivity, and impedance are studied. The proposed graphene HSF has active control over absorption, reflection, and transmission of THz waves. The graphene HSF provides perfect absorption, zero reflection and zero transmission at resonance. Moreover, the graphene HSF structure has the advantage of anomalous reflection and frequency reconfiguration. Incident waves can be reflected in the desired direction, depending on the phase gradient of the HSF and the perfect absorption is maintained at all reconfigurable frequencies upon reconfiguration. The results reveal the effectiveness of the graphene HSF for the manipulation of THz waves.


Therefore this study will concentrate on finding out how children who have experienced violence actually perform academically. The participants will be drawn from among fourth and fifth graders in a Jamaican primary school in an urban area. It is hope that this study will provide some insight for school administrators and stakeholders of the various strategies to which they can employ in correcting violence at school and changing the low academic performance of children who are exposed to violence in their communities.


Background: Cardiovascular disease (CVD) is the leading cause of death among American Indians and Alaska Natives. Over the past 50 years, the prevalence of CVD has been rising among American Indians and Alaska Natives. The objective of this statement is to summarize population-level risk factors and management techniques tailored for the American Indian and Alaska Native populations. Methods: PubMed/MEDLINE, the Centers for Disease Control and Prevention, and the annual Heart Disease and Stroke Statistics report from the American Heart Association were used to identify risk factors and interventions specific to American Indians and Alaska Natives. Results: Diabetes mellitus is a major contributor to disproportionately higher rates of coronary heart disease among American Indians and Alaska Natives compared with other racial and ethnic groups. Additional risk factors for CVD include low-density lipoprotein cholesterol levels, hypertension, renal disease, age, and sex. Smoking and exposure to toxic metals are risk factors for some subpopulations. A quarter of American Indians live below the federal poverty line, and thus, low socioeconomic status is an important social determinant of cardiovascular health. Community-based interventions have reduced CVD risk in American Indians and Alaska Natives. Underreporting of American Indian and Alaska Native race could underestimate the extent of CVD in this population. Conclusions: Prevention and treatment of CVD in American Indians and Alaska Natives should focus on control of risk factors and community-based interventions that address social determinants of health, particularly among individuals with diabetes mellitus. Accurate reporting of race/ethnicity is encouraged to address race-specific risk factors.


A primary magnetization about 2.1 Ga old is well preserved in the Kenora–Kabetogama dyke swarm in Minnesota and Ontario. Its direction, the mean for 12 dykes, incorporating results from 30 paleomagnetic sites, is 115.9°, −55.6°, yielding a paleomagnetic pole position of latitude 42.7°S, longitude 4.2°E (dm = 7.3°, dp = 5.2°).The primary nature of the magnetization can be demonstrated using geochemistry to correlate individual dykes over distances that can exceed 300 km. Whereas the remanence direction varies between dykes, it remains constant along a dyke, sufficient proof that it was formed during initial cooling of the intrusion.A weak, longitudinal increase in hydrous alteration, MgO content, and degree of magnetic overprinting is observed as the swarm is followed to the south and may reflect increasing proximity to a Precambrian continental margin that underwent rifting, sedimentation, and deformation during the time interval 2.2–1.6 Ga BP. Although the cause of the longitudinal changes in terms of ma...


Author(s): Littlehale, Scott | Abstract: Previous research into the costs of publicly subsidized new housing developments has found that nonprofit developers and program requirements to pay construction workers prevailing wages significantly raise project costs. An extended ordinary least squares (OLS) model is specified that aims to better capture the influence of project-specific variable costs and geographically correlated fixed costs. The model is tested with data from a 2014 State of California-sponsored affordable housing cost study. The OLS models' estimates indicate that prevailing wages are associated with between 5 to 7% higher project costs. The cost effect associated with a developer's tax exempt status is half as large as estimated in prior studies and is not consistently a statistically significant driver of costs. The model revisions help to identify other more important sources of cost variation, including large business cycle effects, fair market rents, average county construction wages, local government impact fees, and above-average architecture and engineering costs.