For five years, the "Six Steps" promise has offered people with sight loss a simple standard of service from their public library that is common in over 200 authorities across the UK. Working in partnership with the Society of Chief Librarians and a number of independent charities, Share the Vision (a partnership of public, academic and third sector library organisations) has developed training, web-based tools and raised awareness of the needs of print disabled people as well as providing library staff with a place to seek advice and guidance.

In the absence of a government funded national library service for print disabled people, we have taken the initiative in bringing together expertise from a wide range of organisations to provide a support network which offers resources and expertise to our public libraries.

This paper seeks to examine how staff meet the challenges of dealing with a community group which may be small but which has very specific needs. It also looks at how a community whose lives can be dramatically enhanced by access to reading, information and learning can be more successfully served by better understanding of their needs through increased staff awareness. Throughout 2013-14, we have offered, in partnership with The Network, workshops designed to help frontline staff deal with the challenges of delivering public library services to blind or partially sighted people.

In the coming year, Share the Vision will be working with the Royal National Institute of Blind People to commission externally led research which will help us to craft our services for the future. With this research in hand, we will develop new training resources focusing in on the use of new technologies and make these freely available to our public library service colleagues across the UK and beyond. We will build on tools we and RNIB have already developed and provide training which is specifically aimed at libraries and library staff and which will enable us to improve access to libraries for print disabled people.


Background Ambulatory care-sensitive conditions, including asthma, can be managed with timely and effective outpatient care, thereby reducing the need for hospitalization. Objective This study assessed the relationship between market competition, continuity of care (COC), and hospital admissions in asthmatic children according to their health care provider. Methods A longitudinal design was employed with a 5-year follow-up period, between 2009 and 2013, under a Korean universal health insurance program. A total of 253 geographical regions were included in the analysis, according to data from the Korean Statistical Office. Data from 9,997 patients, aged ≤ 12 years, were included. We measured the COC over a 5-year period using the Usual Provider Continuity (UPC) index. Random intercept models were calculated to assess the temporal and multilevel relationship between market competition, COC, and hospital admission rate. Results Of the 9,997 patients, 243 (2.4%) were admitted to the hospital in 2009. In the multilevel regression analysis, as the Herfindahl–Hirschman Index increased by 1,000 points (denoting decreased competitiveness), UPC scores also increased (ß = 0.001; p < 0.0001). In multilevel logistic regression analysis, the adjusted odds ratio (OR) for hospital admissions for individuals with lower COC scores (≥ 2 ambulatory visits and a UPC index score of < 1) was 3.61 (95% CI: 2.98–4.38) relative to the reference group (≥ 2 ambulatory visits and a UPC index score of 1). Conclusions Market competition appears to reduce COC; decreased COC was associated with a higher OR for hospital admissions.


Cefprozil (BMY-28100) is a semisynthetic cephalosporin with broad-spectrum antibacterial activity and prolonged serum elimination half-life allowing for once-a-day oral administration. In vitro, cefprozil demonstrates excellent activity against Staphylococcus aureus, Streptococcus pyogenes, Haemophilus influenzae, and Moraxella catarrhalis. Cefprozil (500 mg once daily) was compared to cefaclor (250 mg three times daily) in an open, randomized, comparative trial for the treatment of acute group A beta-hemolytic streptococcal pharyngitis. Ninety-four patients were enrolled in this study; 53 patients were evaluable for clinical and bacteriological response assessment. Seventy-eight patients were evaluable for safety assessment. Three patients (all in the cefprozil treatment group) required disenrollment because of side effects, mainly nausea. Clinical and bacteriological responses were comparable for both study drugs. Leukopenia and nausea, the most common side effects observed, were more common in the cefprozil-treated group. Cefprozil appears to be an appropriate alternative to cefaclor for the treatment of acute group A beta-hemolytic streptococcal pharyngitis. However, because of the small number of patients eligible for efficacy assessment, a large type II (beta) error was expected in our study, which may have resulted in a potential failure to detect a difference between both treatment groups. A larger study would be required to determine the proper role of cefprozil in the treatment of group A beta-hemolytic streptococcal infections.


This essay discusses the memoir of Boria Sax, the son of Saville Sax, a U.S. citizen who was a Communist and Soviet spy during World War II. Saville Sax failed at most things he attempted, but he proved to be a valuable asset for Soviet espionage agencies because he was the roommate of the gifted physicist Theodore Hall, who was recruited to work for the Manhattan Project. Sax convinced Hall, who shared Sax's admiration of the Soviet Union, to supply highly sensitive information to the Soviet foreign intelligence service. The memoir offers a poignant view of the terrible impact that Saville Sax's actions had on his family as well as on the country he betrayed.


The problem of equalizing a discrete signal that has been transmitted through a channel selected at random from an ensemble of channels is considered. Using mean-square error as the performance index, the minimum number of adjustable parameters required to achieve a given level of performance is sought. For certain special cases, it is shown that, using nonrecursive sampled data filters, the optimum tap weights are given by the eigenvectors of the matrix formed from the covariances of the channel's impulse response. A numerical algorithm is developed to find the optimum equalizer structure for a wide class of channels with the restriction that the number of channels in the given ensemble is finite. Results worked out for several examples show that the optimum equalizer structure requires significantly fewer adjustable parameters than the standard transversal equalizer in order to obtain the same level of performance.


In the run up to the AV referendum in May, there has been considerable debate and commentary from both campaigns on how AV would actually operate. In this light, it is worth considering the impact of the last large-scale electoral reform in the UK: the 2007 introduction of another preferential electoral system, the single transferable vote (STV) for local government elections in Scotland. Alistair Clark looks at what this change can teach us about what may happen if the 'Yes' campaign is successful.


The problem of an inclined impact by an elastic plate on a thin liquid layer is considered. Evolution of the flow behind the plate is studied. The main input parameters are the position of the separation point of the liquid from the plate and the speed of the liquid under this point. The flow in the wake behind the plate is described by shallow water equations without gravity. Analytical formulae for the shape of the free surface behind the plate are derived. The study is focused on the possibility of the formation of jets arising from the wake perpendicular to the liquid layer. The problem is solved in two stages: before and after the formation of the first such a jet. The effects of the flow speed at the beginning of the wake, its time derivative, and the law of motion of the separation point on the formation of jets are investigated. The positions of the jets, their speeds and shapes are determined. Using the obtained results, mechanisms of the thin layer aeration behind the plate are discussed.


Purpouse: The activity of vinorelbine (VRL) as single agent in treatment-naive inoperable non small cell cancer (NSCLC) patients (pts) has been assessed in several published studies. Oral and intravenous formulation have a linearity of VRL pharmacokinetics with both routes of administration. This is a study with oral VRL in first line advanced NSCLC in elderly pts. Patients and methods: A total of 12 chemonaive elderly pts ≥ 70 years were recruited from October 2005 through to June 2006. Principal inclusion criteria included histologically confirmed advanced NSCLC, performance status ≤ 2, measurable disease, appropriate bone marrow and organ function. The dosage schedule was 60 mg/m 2 once a week for three weeks (first cycle), followed if not toxicity by 80 mg/m 2 once a week, until disease progression or development of unacceptable toxicity. Results: The mean age was 74 years (range: 71 to 79), all males, and all pts stage IV. Histology subtypes: adenocarcinoma in 5 pts, largo cell carcinoma in 1 pts and squamous cell carcinoma in 6 pts. PS (ECOG) distribution was: 3 pts with PS 1, and 9 pts with PS 2. The median weekly VRL doses was 13 (range 3-23). Out of 11 pts receiving the second cycle, 7 patients went a dose escalation to 80 mg/m 2 . The other 4 pts remained at the 60 mg/m2 dose level. There were no complete responses (CR). Two (13%) of 12 patients achieved partial response (PR). There were 6 (50%) stable disease (SD) and 4 (34%) progressive disease (PD). Respect survival, the median follow-up was 4 months (range 1-9 months). Until date, the median survival time (MST) and median progression-free survival had not been reached; and survival and progression-free survival was 66% in both. Treatment with oral VRL in elderly patients was well tolerated, and there were no toxic deaths. No grade 4 toxicities were observed, and grade 3 toxicities were infrequent, exclusively neutropenia in 2 patients and asthenia in other 2 patients. Rest of toxicities were grade 1 or 2. Conclusions: Oral VRL appears to be a reasonable alternative intravenous VRL, both in terms of activity and tolerability in advanced, elderly NSCLC patients.


A recent study by Tsukahara et al. (2016) found correlations between pupil size and measures of intelligence, with r values around .30. We attempted to replicate this association in a large dataset of US military personnel (n = 4,462). General intelligence, g, was extracted from 19 diverse tests. We first confirmed that right and left eye pupil size measures are strongly correlated (r = .97), suggesting high measurement reliability for this phenotype. However, unlike Tsukuhara et al., we could establish only small to nonexistent associations between cognitive ability and pupil size (r's -.01 to .06, r with g specifically = .05). Regression analyses, controlling for multiple covariates, revealed that the association in this large representative sample was entirely attributable to confounding with race/ethnicity. Mean pupil size (mm) was 3.56, 3.35, and 3.23 for whites, Hispanics, and blacks, respectively. Relative to whites, this corresponds to effect sizes of 0.22 and 0.34 d. It is unclear why our results differ from those reported by Tsukahara et al. (2016), but the ethnic size rank order suggests an evolutionary explanation in terms of geo-bio-climatic selection for pupil size.


Objectives: To find evidence on effects of depression, anxiety or stress on the visual functions and to evaluate visual performance in depressed patients with no other ocular anomalies and find out which component of visual system is more compromised due to depression. Method: Screening of Visual acuity, Contrast sensitivity, Color vision, Glare sensitivity and Visual field were carried on 80 patients having clinically diagnosed depression using Snellen chart, Ishihara test, Lea low contrast test, Snellen chart for Glare sensitivity and Confrontation respectively. Results: 1% of depressed patients show decrease in Visual acuity and Contrast sensitivity with higher value for glare sensitivity while 99% of depressed patients exhibit no defect in visual processing. Anxiety, Stress and Panic also do not affect visual functions. This study is unbiased to age, gender and occupation. Conclusion: Depression does not affect vision or any component of visual functions. Visual acuity and Contrast sensitivity is more likely to be affected by depression. Most cases illustrate the bi directional relationship between depression and visual anomalies.


Background Calculating a paediatric dose is complex due to a variety of parameters influencing the dose and therefore error prone, ultimately resulting in incorrect dosing, lack of efficacy and/or adverse effects. The devel-opment and implementation of a paediatric dosing cal-culator could reduce calculating errors. Objectives 1. To develop a clinical decision tool for cal-culating an individual paediatric dose, using the compre-hensive Dutch paediatric formulary as dosing reference. 2. To show a 50% reduction of calculation errors by estab-lishing an individualised paediatric dose through a paedi-atric dosing module. Methods The Paediatric Dosing Calculator consists of a calculation interface which integrates the dosing rec-ommendations of the Dutch paediatric Formulary with clinical patient variables, thus resulting in an individual recommended dose. After establishing the functional requirements and risk minimization measures the dosing calculator was developed by using a test-retest approach. The alfa version was validated by performing 2 calcula-tions for an aselect sample of 230 drugs of the formulary. Two groups of healthcare professionals were presented with 15 cases for which they were asked to calculate a dose. One group (n=37) was instructed to calculate with conventional tools i.e. a mathematical calculator and the dosing recommendations as listed in the Dutch Paediat-ric Formulary. The second group (n=36) was instructed to use the integrated paediatric dosing calculator interface. The time for the calculating tasks was limited to 2 min-utes per case as to mimic the stressful circumstances of daily practice. The% of calculating errors was compared between groups. Results Of the 460 test calculations of the first calculator version 5% contained a calculation error. After analysing, correction and re-testing an error-free beta version was launched. Using the calculator interface resulted in a 35% reduction of calculating errors compared to manual cal-culations (18,7%/(range 0%–83%) vs 28,4% (range 9%–61% ), respectively. Conclusion We successfully developed a web-based dose calculator. The use of this calculator appears to re-duce dosing errors by approximately one third. Health-care providers may benefit from using the calculator in-terface provided that they carefully enter and select the parameters required.


BACKGROUND
Locally advanced rectal cancer can be down staged by neoadjuvant therapy and the resultant tumor response can be quantified histologically. This study aimed to assess pathological response of neoadjuvant chemoradiation in patients with locally advanced rectal cancers treated in Wad Medani Teaching Hospital (WMTH) and National Cancer Institute (NCI), Wad Medani, Sudan.

PATIENTS AND METHODS
A total of 36 consecutive patients with locally advanced rectal cancer that were managed in WMTH and NCI during the period from 2006-2011 were reviewed. Preoperative pelvic radiotherapy was delivered. Total of 46 Gray were delivered concurrently with 5- fluorouracil (5-FU) on the first and last week of radiation. Total mesorectal excision of the rectal tumour either by anterior or abdominoperineal resections was planned at 6-8 weeks from completion of preoperative treatment. The pathological response to therapy was assessed by histopathology examination of the surgical specimen.

RESULTS
Initial clinical staging of patients revealed 58.3% of them were stage T3/T4N2M0 and 41.7% were stage T3N0M0. Down-staging to stage T1/T2N0M0 was found in 36.1% and stage T3N0M0 in 30.6%. No response was seen in 8.3% of cases with stage T3/T4N2M0 while complete clinical response (no residual) was seen in 25.0%. Complete histological response was observed in 13.8%. Positive lymph-nodes metastasis was confirmed in 8.3% of cases.

CONCLUSION
Neoadjuvant chemoradiation is a reasonable option for cases of rectal cancer and deserves further evaluation.


Objectives: The impact of fatigue on injury risk to the anterior cruciate ligament (ACL) in adolescent athletes is unknown. Identifying athletes who demonstrate increased risk for injury may help determine who would benefit from early neuromuscular control intervention for injury prevention. The goal of this study was to determine if fatigue increases ACL injury risk in adolescent athletes using the drop-jump test to assess dynamic valgus. Methods: Youth and adolescent competitive athletes were recruited for this video analysis study. Participants were recorded performing the standard drop-jump test assessing dynamic valgus on landing three times. They then completed a standardized fatigue protocol consisting of a timed period of high-intensity aerobic tasks. A set amount of fatigue was quantified and achieved using a maximum vertical jump, which was compared to pre-fatigue values. The drop-jump test was then repeated three additional times post-fatigue. All drop-jump recordings (six in total) were randomized by order and scored for dynamic knee valgus by three independent reviewers. A multivariable analysis was performed to assess the correlation between demographic variables and injury risk. Results: Forty-seven female patients and thirty-eight male athletes were included in the study. The average age was 15.4 years (age 14-18). Athletes were found to have significantly higher ACL injury risk post-fatigue when compared to pre-fatigue (p = .001). Thirty-five athletes were found to change from low/medium injury risk pre-fatigue to medium/high risk post fatigue. No demographic variables were found to contribute to ACL injury risk. Conclusion: In adolescent athletes, fatigue appears to increase risk of ACL injury through drop-jump testing. Age, BMI, and hip width were not found to contribute to ACL injury risk. Implementation of neuromuscular or conditioning programs for at-risk athletes may reduce injury risk.


In this paper, we investigated the potential of using a tangible interaction interface for creative activities as a preliminary step to achieve human-AI co-creation. We conducted a preliminary study to explore sand as a medium for co-creation and identify potential opportunities of AI mediating the process. We created Sand Playground, a co-creation interface that uses sand as an interaction medium. We describe details for building the interface. We selected two opportunities from the study and developed them as two modes, Artistic Mimicry and Zen Garden. We also conducted a workshop study using Sand Playground to evaluate collaboration and the characteristics of the tangible interface. We identified findings responding to drawing strategies, multisensorial experience, and performative and ephemeral quality of creation. We discuss next steps of achieving our ultimate goal: an AI-mediated interface that collaborates with users physically in real-time on sand.


This study was designed to compare the degree of cervical spine movement during laryngoscopy and tracheal intubation using the Belscope and Macintosh laryngoscope blades. Twenty ASA 1 and 2 patients scheduled for elective surgery requiring tracheal intubation were studied. Following induction of anaesthesia and muscle relaxation, a neutral cross-table lateral cervical spine X ray was taken. Laryngoscopy was then performed in each patient using both the Belscope and Macintosh blades. After visualisation of the vocal cords and tracheal intubation the cervical spine X ray was repeated. Movement of the cervical spine was evaluated by tracing bony landmarks on each film and then superimposing the neutral and intubating films. We were unable to demonstrate a difference in the amount of cervical spine movement comparing the two blades. Using the Belscope blade, intubation took longer (median 18 s) than the Macintosh blade (median 12 s, p < 0.01) and was unsuccessful in two patients despite adequate visualisation of the vocal cords.


Rattan cane ( Calamus deeratus ) mainly found in the natural wetland forests and is harvested for use in making of baskets, cords and furniture. While its natural stock levels are decreasing, rattan cane use for the production of various items continues to rise. Previous studies have revealed that the high consumption of this commercial product from its natural reserves is likely to cause a crisis to the handicraft industry due to shortage created by over-harvesting, degradation of wetland forests and the breakdown of traditional and management trade systems. A study was carried out during 1998 to 2001 to investigate the possibilities of propagating rattan cane in Uganda and to formulate guidelines for its propagation in nurseries that are engaged in raising plant seedlings. This was aimed at promoting propagation of this endangered species on peoples' farms and private forests after it was observed that some private nurseries needed information on its propagation. Experiments were done using suckers, cuttings and seeds as planting materials under different conditions. Five months after sowing the seeds, the results showed the following levels of successes: 80% for seeds with completely removed sarcotesta, 67% with partially removed sarcotesta and 43% with intact sarcotesta. Although the suckers showed some levels of survival under nursery conditions, they were susceptible to fungal infections and collar rot disease, which caused losses after about one year. The paper discusses the various media of soils, which give better results, and highlights the success of propagating rattan cane by use of seeds. It also gives recommendations on community propagation programmes.


Recent rapid expansion of the Private Rented Sector (PRS) is recognised but the extensive involvement of ex local authority stock in this new PRS is not. This paper uses existing literature to outline the commodification processes through which Right to Buy (RTB) housing enters the PRS. Other published research is used to estimate a likely range of council to PRS tenure change over 30 years of RTB in the UK. Then using detailed data matching, we present one local authority example at individual dwelling level across the whole stock to establish the true scale of this transfer from council housing to private rental. Finally, to stimulate debate about the revenue cost of this switch of rental tenures we speculate on the additional annual cost of Housing Benefit support to this ex RTB stock given that the PRS is invariably more expensive than council renting for equivalent dwellings. This may well be over £1bn per year. We conclude that UK government's plans to expand the RTB scheme will simply increase revenue costs year on year for no discernable social or housing supply benefit.


Productivity often increases in a part of an industry while remaining unchanged in the rest of the industry. In assessing the social gain from a productivity increase in a part of an industry producing a tradeable commodity it is necessary to consider the relationships between the part of the industry affected, the industry in the rest of the country concerned and the industry in the rest of the world. In this paper an attempt to assess the social benefits of serrated tussock control on the tablelands of New South Wales is critically reviewed and found wanting. An analytical framework is outlined that is conceptually appropriate to that task, and to other situations where cost per unit of output is reduced in a part of an industry. The social gains from the control of serrated tussock on the New South Wales tablelands are recalculated. A discussion is also presented of some issues in the distribution of the gains from research.


As we know that human disease diagnosis is a complicated process and requires high level of expertise.Any attempt of developing a web-based expert system dealing with human disease diagnosis has to overcome various difficulties. Detecting diseases at early stage can enable to overcome and treat them appropriately.Identifying the treatment accurately depends on the method that is used in diagnosing the diseases.Human Diseases Diagnosis Systems (HDDS) is an expert system that used to give earlier diagnosis of four major diseases,Chikungunya,Avian Influenza,H1N1 and Dengue. The idea to build the system by using expert systems is because expertise is not always available so that users can do their check up on the symptoms.So,by using this system can help them to give earlier diagnosis based on the questionnaires provided and lastly will generate the result of the disease.Besides that,user can get information of the diseases and be aware of the symptoms.This system is build by using PHP and MySQL as the database.Basic structure of rule based expert system are knowledge base,the database and the inference engine,explanation facilities and lastly is the user interface.The knowledge base for this system contains the knowledge useful for problem solving which is represented as a set of rules.The database includes a set of facts that used to match against the IF condition parts of rules that stored in the knowledge base.There are two types of inference which are forward and backward chaining.As for this system,it used forward chaining as its inference engine. This is because the reasoning is from facts to conclusion.Finally,it is hoped that this system can provide benefits to the users.


The Pediatric Anesthesia NeuroDevelopment Assessment team at Columbia University Medical Center Department of Anesthesiology convened its fourth biennial Symposium to address unresolved issues concerning potential neurotoxic effects of anesthetic agents and sedatives on young children and to assess study findings to date. Dialogue initiated at the third Symposium was continued between anesthesiologists, researchers, and a panel of expert pediatric surgeons representing general surgery and dermatology, orthopedic, and urology specialties. The panel explored the need to balance benefits of early surgery using improved technologies against potential anesthetic risks, practice changes while awaiting definitive answers, and importance of continued interprofessional dialogue.


In December 2019, Rolling Stone magazine ran a piece on the best videos of the year which began by asking, "What even counts as a music video now?" (Shaffer). Vevo, Tiktok and Instagram TV have blurred the lines. Videos can be an hour long. They can be events on YouTube Premiere. They can be virtual reality. The idea that the world of the earliest creators of pop promos was simple in comparison to today subtends this dossier. In 2015, I was awarded an Arts and Humanities Research Council (AHRC) grant to investigate the history of music videos in Britain since 1966.1 At the end of the grant, I curated a collection of the most significant of those videos into a limited-edition box set (Power). Selecting them involved very detailed discussions with our interviewees and industry consultants about just what a "music video"—known as a "promo" until the mid 1980s—is. The term "music video" arose in the 1980s. It was used in record labels to describe visual products mastered on physical videotapes for television broadcast. In fact, almost all of those products were shot on celluloid (16mm or 35mm) until digital technologies allowed HD to become the norm in the 2000s. For the purposes of this dossier, I define music videos and pop promos as a type of musical short film for mass audiences commissioned and released by record labels (usually) at the same time as the release of a synchronised audio "single"; the shorts comprise a copyrighted synchronised picture and audio track in which a percentage of the royalties accrue to the recording artist and/or record label.


Effectiveness of different regimes of a course exposure to impulse low-intensity electromagnetic field (Infita unit) was studied in 69 adolescents with essential hypertension. A ten-day course of single 9 min procedures with 30 Hz field produced better antihypertensive effects than the regime used in the adults. This treatment provided improvement in bioelectric activity of the brain, mental state, central hemodynamics.


Multiple myeloma (MM) is a hematologic malignancy characterized by proliferation of plasma cells with or without production of monoclonal immunoglobulins. Management of patients with MM begins with induction therapy, typically a proteasome inhibitor (PI) with dexamethasone and an immunomodulator (IMID), followed by autologous hematopoietic stem cell transplantation in eligible patients. Although various treatments are available, MM is considered incurable, and patients with progression after multiple treatment lines, including CD38 monoclonal antibodies, have a median overall survival of 8.6 months. Belantamab mafodotin-blmf (Blenrep) is a first-in-class antibody-drug conjugate directed against B-cell maturation antigen (BCMA) that obtained U.S. Food and Drug Administration accelerated approval in August 2020 for patients with multiply relapsed/refractory MM. This article provides information on the mechanism of action, efficacy, safety, monitoring, and current place in therapy for belantamab mafodotin-blmf.


If there were a stigma scale for chemotherapy, alkylating agents would be ranked at the top of the list. The chemical term alkylation is associated with nonselective toxicity, an association that dates back to the use of nitrogen mustards during World War I as chemical warfare agents. That this stigma persists and extends to compounds that, through selectivity, attempt to "tame" the indiscriminate destructive potential of alkylation is the subject of this review. Selective alkylation, as it is referred to herein, constitutes an extremely nascent and dynamic field in oncology. The pharmacodynamic response to this selective strategy depends on a delicate kinetic balance between specificity and the rate and extent of binding. Three representative compounds are presented: RRx-001, 3-bromopyruvate, and TH-302. The main impetus for the development of these compounds has been the avoidance of the serious complications of traditional alkylating agents; therefore, it is the thesis of this review that they should not experience stigma by association.


Abstract In St Helier, Jersey, a surface water link and storage cavern are being constructed to alleviate surcharging of the town's sewerage system during periods of high rainfall. Foul sewers will discharge a stormwater/sewage mix into a 25 000 m3 cavern for temporary storage. The cavern will be emptied by pumping to a treatment works at a regulated rate. As part of the site investigation for the work, an assessment of the levels of radon likely to be encountered during the construction and operation of the cavern was undertaken. Samples of borehole core were analysed in the laboratory to obtain values of radon emanation per unit surface area. These were then combined with design data to estimate radon concentrations in the void. The method described provides a simple and effective way of assessing radon contamination at the site investigation phase of a project, enabling protection measures to be incorporated into the design at an early stage, so minimizing the exposure of staff to potential harmful levels of radon during both construction and operation.


Many mesh parameterization algorithms have focused on minimizing distortion and utilizing texture area, but few have addressed issues related to processing a signal on the mesh surface. We present an algorithm which partitions a mesh into rectangular charts while preserving a one-to-one texel correspondence across chart boundaries. This mapping permits any computation on the mesh surface which is typically carried out on a regular grid, and prevents seams by ensuring resolution continuity along the boundary. These features are also useful for traditional texture applications such as surface painting where continuity is important. Distortion is comparable to other parameterization schemes, and the rectangular charts yield efficient packing into a texture atlas. We apply this parameterization to texture synthesis, fluid simulation, mesh processing and storage, and locating geodesics.


As far as it is known from the survey of literature this is the first study of the problem of Zn separation from NaOH solution through ion exchange. It was therefore essential to carry out a selection procedure for finding a suitable resin for the separation. Ten resins were tested from which Amberlite IRC-718 was selected. The resin was found to tolerate the high pH involving the process and give a favourable eguilibrium relationship for 0.1 and 0.2M NaOH solutions. Work concerning fixed and moving bed processes was done to determine various design parameters such as mass transfer coefficients, zone height, number and height of transfer units. The kinetics of ion exchange was studied through fixed bed operation by obtaining breakthrough data. These data were analysed through a new method and also by the methods of Michaels, and Moison and O'Hern. For some data the methods of Michaels, and Moison and O'Hern were found to be inadeguate while the new method was applicable to all the data. The kinetics of ion exchange was found to be controlled by diffusion of ions in the solution. This was also confirmed by the determination of activation energy which gave a value of 1.6 kcal/mole. Correlations for saturation time, zone height and zone velocity were established. The extraction efficiency of 99.6% was achieved using a moving bed system with bed height of 24cm and solution flow rate of 7 ml/min. The height of transfer units was found to increase with Zn and OH ions concentration, solution flow rate, and cycle time. However, HTU was unaffected by bed height increase. Correlation of HTU with Zn concentration was established.


The present study was carried out to investigate the effects of vascular endothelial growth inhibitor 174 (VEGI174) and its functional domains (V7 and V8) on epithelial‑mesenchymal transition (EMT) in renal cell carcinoma (RCC) cells in vitro. The RCC cell lines A498 and 786‑O were used in this study. Based on our preliminary study, we selected full‑length VEGI174 and its functional domains (V7 and V8) as the target genes in this study. Plasmids containing VEGI174, V7 or V8 transgenes were constructed and transfected into A498 and 786‑O cell lines. Cytological activity was tested during cell culture. Quantitative PCR and western blot analysis were performed to determine the expression levels of EMT markers (E‑cadherin, vimentin, β‑catenin and Slug). Overexpression of VEGI174, V7 or V8 did not have a significant influence on cell viability (P>0.05). The mRNA level of E‑cadherin was significantly upregulated, while that of vimentin was downregulated in A498VEGIexp, A498V7exp, A498V8exp, 786‑OVEGIexp, 786‑OV7exp and 786‑OV8exp cells compared with the cells containing the empty plasmid controls (P<0.05). The western blot results showed that changes in protein expression levels were consistent with the changes in mRNA expression. Both the mRNA and protein expression levels of β‑catenin and Slug were downregulated in the A498VEGIexp, A498V7exp, A498V8exp, 786‑OVEGIexp, 786‑OV7exp and 786‑OV8exp cells. In conclusion, overexpression of VEGI174, V7 or V8 inhibited EMT in A498 and 786‑O cells. Notably, V7 and V8 are two effective functional domains of VEGI174 that have the potential to be studied for peptide synthesis and the treatment of RCC.


For many applications it is important to provide communication services with guaranteed timeliness and fault-tolerance at an acceptable level of overhead. In this paper, we present a scheme for restoring real-time channels, each with guaranteed timeliness, from component failures in multi-hop networks. To ensure fast/guaranteed recovery, backup channels are set up a priori in addition to each primary channel. That is, a dependable real-time connection consists of a primary channel and one or more backup channels. If a primary channel fails, one of its backup channels is activated to become a new primary channel. We describe a protocol which provides an integrated solution to the failure-recovery problem (i.e., channel switching, resource re-allocation, ...). We also present a resource sharing method that significantly reduces the overhead of backup channels. The simulation results show that good coverage (in recovering from failures) can be achieved with about 30% degradation in network utilization under a reasonable failure condition. Moreover, the fault-tolerance level of each dependable connection can be controlled, independently of other connections, to reflect its criticality.


Extracellular superoxide dismutase (SOD3) is the primary extracellular enzymatic scavenger of superoxide ((.)O(2)(-)). SOD3's expression is highest in the kidney, but its distribution and biologic functions there are unknown. To investigate the function of renal SOD3, we colocalized it with erythropoietin (EPO) to proximal tubules using in situ hybridization and immunohistochemistry. We then exposed wild-type (Wt) and SOD3 knock-out (KO) mice to hypoxia and found a late hematocrit response in the KO strain. EPO mRNA expression was attenuated in KO mice during the first 6 hours of hypoxia preceded at 2 hours by less accumulation of nuclear hypoxia-inducible transcription factor 1 alpha (HIF-1 alpha) protein. Meanwhile KO mice exposed to hypoxia showed increases in renal mRNA for superoxide-producing nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (NOX4) and early significant increases in glutathione disulfide (GSSG)/glutathione (GSH), a marker of oxidative stress, compared with Wt mice. Plasma nitrite/nitrate and renal 3-nitrotyrosine (3-NTyr), indicating peroxynitrite formation, increased later in hypoxia, and renal endothelial nitric oxide synthase protein induction was similar in both strains. These data show that hypoxic activation of HIF-1 alpha and its target gene EPO in mouse kidney is regulated closely by the oxidant/antioxidant equilibrium involving SOD3, thus identifying renal SOD3 as a regulatory element in the body's innate adaptation to hypoxia.


The immunological backgrounds of canine atopy, and in particular of atopic dermatitis, are described in the present review. The significance of the history, the intradermal allergic test and the determination of allergen-specific antibodies in the diagnosis of canine atopy are discussed.


Data on primary ciliary dyskinesia (PCD) epidemiology is scarce and published studies are characterised by low numbers. In the framework of the European Union project BESTCILIA we aimed to combine all available datasets in a retrospective international PCD cohort (iPCD Cohort). We identified eligible datasets by performing a systematic review of published studies containing clinical information on PCD, and by contacting members of past and current European Respiratory Society Task Forces on PCD. We compared the contents of the datasets, clarified definitions and pooled them in a standardised format. As of April 2016 the iPCD Cohort includes data on 3013 patients from 18 countries. It includes data on diagnostic evaluations, symptoms, lung function, growth and treatments. Longitudinal data are currently available for 542 patients. The extent of clinical details per patient varies between centres. More than 50% of patients have a definite PCD diagnosis based on recent guidelines. Children aged 10–19 years are the largest age group, followed by younger children (⩽9 years) and young adults (20–29 years). This is the largest observational PCD dataset available to date. It will allow us to answer pertinent questions on clinical phenotype, disease severity, prognosis and effect of treatments, and to investigate genotype–phenotype correlations.


In this paper, we present a review of different real-time capable algorithms to detect and isolate component failures in large-scale systems in the presence of inaccurate test results. A sequence of imperfect test results (as a row vector of I's and O's) are available to the algorithms. In this case, the problem is to recover the uncorrupted test result vector and match it to one of the rows in the test dictionary, which in turn will isolate the faults. In order to recover the uncorrupted test result vector, one needs the accuracy of each test. That is, its detection and false alarm probabilities are required. In this problem, their true values are not known and, therefore, have to be estimated online. Other major aspects in this problem are the large-scale nature and the real-time capability requirement. Test dictionaries of sizes up to 1000 x 1000 are to be handled. That is, results from 1000 tests measuring the state of 1000 components are available. However, at any time, only 10-20% of the test results are available. Then, the objective becomes the real-time fault diagnosis using incomplete and inaccurate test results with online estimation of test accuracies. It should also be noted that the test accuracies can vary with time --- one needs a mechanism to update them after processing each test result vector. Using Qualtech's TEAMS-RT (system simulation and real-time diagnosis tool), we test the performances of 1) TEAMSAT's built-in diagnosis algorithm, 2) Hamming distance based diagnosis, 3) Maximum Likelihood based diagnosis, and 4) HidderMarkov Model based diagnosis.


In this paper we propose a radical departure from the dominant conceptions in IS evaluation literature by adopting Actor-network Theory (ANT) to provide a better understanding of the development and evaluation of IS proposals in practice and examine the ways in which the evaluation process shapes and ensures the selection of the best IS projects. By drawing on a field study of the IS evaluation processes in a company with a history of IS successes, we reveal the relational nature of IS project proposals and the ways they are constitutively entangled with business processes and practices. Our ANT account demonstrates a) that the view of pre-investment IS evaluation in the literature is very narrow, b) that the practice of IS evaluation produces the 'object' it evaluates, c) that this object, that is the IS project proposal document, is a focal actor (an inscription device) produced by relations in the actor-network emerging around it, and d) that reconfiguration of these relations involving the translation of actors' expertise, experiences and interests into the IS proposal documents are critical for the evaluation of IS project proposals and their chances of success.


When boundary element (BE) was coarse, the general Gauss quadrature of Helmholtz integral equation (HIE) on it was not accurate. A mesh-less refined integral algorithm (RIA) of BEM was used to overcome this problem. Then RIA coupled with FEM/CFD was applied to predict submarine propeller excited hull underwater noise. The thrust and torque excitations of propeller simulated via CFD were loaded on to submarine respectively to calculate the acoustic response, and the sound power and main peak frequencies were obtained. Results show that, thrust mainly excites submarine axial mode and high sound area appears at the two conical-type ends, and torque mainly excites circumferential mode and high sound area appears at the broadside of cylindrical section, but with rather smaller sound power and radiation efficiency than the former. So, main attention should be focused on thrust excitation when perform the sound radiation reduction of submarine that propeller excited. Keywords: Submarine, Propeller excitation, Refined integral algorithm, Vibro-acoustic, CFD/FEM.


An aromatic amino acid decarboxylase DNA fragment was generated from opium poppy (Papaver somniferum L.) genomic DNA by the PCR using primers designed from conserved amino acid sequences of other aromatic amino acid decarboxylase genes. Using this fragment as a probe, a genomic clone was isolated that encodes a new member of the opium poppy tyrosine/3,4-dihydroxyphenylalanine decarboxylase gene family (TyDC5). The predicted TyDC5 amino acid sequence shares extensive identity with other opium poppy tyrosine/3,4-dihydroxyphenylalanine decarboxylases (84%), and when expressed in Escherichia coli, it is active against tyrosine and to a lesser extent against 3,4-dihydroxyphenylalanine. Ribonuclease protection assays indicate that TyDC5 is expressed primarily in the roots of mature poppy plants. A peak of TyDC5 expression was also observed during germination, coincident with the emergence of the radicle from the seed coat. Parallel results were obtained in transgenic tobacco using a TyDC5 promoter fragment (-2060) translationally fused to the [beta]-glucuronidase reporter gene (GUS). In TyDC5::GUS tobacco, GUS activity transiently appeared in all parts of the seedling during germination, but was limited to the roots in older plants. These results indicate that TyDC5 expression is transcriptionally regulated and suggest that the TyDC5 enzyme may play an important role in providing precursors for alkaloid synthesis in the roots and germinating seedlings of opium poppy.


According to Jewish tradition God reveals himself and communicates with his people through the Torah that was given at Sinai (Exod 19–24) and by means of Israel's constant interpretation of God's word God continues to speak to them throughout the ages. However, it is only with the emergence of Rabbinic Judaism that the Torah becomes God's only way of making himself known to humans. During the first centuries of the common era, Jews seem to have believed that God could manifest himself in many different ways, and his Word (Logos) and Wisdom were by some perceived as semi-independent divine manifestations. The focus on Torah and the rejection of other manifestations of the divine is a characteristic of Rabbinic Judaism, and by some scholars considered to be one way in which the rabbis distinguished themselves from other contemporary Jewish groups such as the followers of Jesus. It thus happened that the Logos theology became a distinctly Christian notion as a consequence of its rejection by Rabbinic Judaism. However, in contrast to what is often claimed by both Jews and Christians there is nothing intrinsically "unjewish" about the idea of incarnation. The idea that God wants to diminish the distance between humans and the divine and take part in the life of humans is thoroughly biblical and Jewish.


Nuclear beams with energies of several TeV per nucleon are considered as carriers of intense fields of photons in the energy range up to 100 GeV. Cross sections for intermediate boson and Higgs production by two-photon collisions are predicted to be in the nanobarn range. Production of heavy neutral particles in peripheral collision could be easily detectable because of low background.


Arthur Conan Doyle's medical and writing careers intertwined and his work has a history of being read in the light of his medical expertise. He wrote at a time when the professionalisation and specialisation of medicine had resulted in an increasing distance between the profession and the public, yet general practitioners relied financially on maintaining good relationships with their patients and popular medical journalism proliferated. A variety of contrasting voices often disseminated narratives of medical science. These conflicting developments raised questions of authority and expertise in relation to the construction of medicine in the popular imagination: how is knowledge constructed? Who should disseminate it? How and by whom is authority conferred? How can the general population judge experts in medical science? These are questions explored more widely in Conan Doyle's writing as he examines the relationship between expertise and authority. In the early 1890s, Conan Doyle wrote for the popular, mass-market periodical The Idler: An Illustrated Magazine. His contributions to it address these questions of authority and expertise for a lay audience. First establishing the medical context of doctor/patient relationships in which these questions arose, this article undertakes a close reading of these mostly rarely studied single-issue stories and articles as a means of ascertaining how Conan Doyle and his illustrators identified the relationship between competing narratives, expertise and authority. It argues that rather than maintaining a distance between public and professional, Conan Doyle's illustrated work demonstrates to his readers that there are ways to successfully navigate the appearance of authority and recognise expertise as they confront entangled representations of advances in medical science.


Esteban Mayorga Advisor: Professor Ernesto Livon-Grosman This dissertation takes a literary and cultural studies model to explain the textual representation of these unique islands since their discovery until present day. The main argument suggests that the depiction of this crucial space for modernity in Western thought, given the rhetoric of travel and fiction writers, deploys the insular area with the intention of conceiving new forms of political displacement and identity endeavors in addition to those of the nation building project that took place in the mainland. As a result of colonial enterprises, scientific excursions, exile, tourism, journalistic pieces, expeditions, etc., travel writings of the Galápagos record the experience of reshaping this space à propos of a theory of travel and travel writing mediated by narratives that complement the formation of the state and its national imagery. The insular space functions as a vacant signifier where travelers are able to communicate their own signified upon narrating the experiences of their journeys. This phenomenon creates a profound conceptual and political division between the identity of the isles and the nation of Ecuador, and the findings of this study can be extrapolated to a historical specificity of explorations and representations that deal with narrative constructions of highly condensed spaces throughout Latin America as a whole, if one can claim they are a case study of an "unfinished" modernity. This separation created a rupture leading to fundamental variations in the manner in which local inhabitants and foreign entities interpret the insular province nowadays. The literature of the Galápagos reflects the scale of friction, migratory tendencies into the islands, and how global interests prevail in the appropriation of the space, reshaping the subjective individuality of the host culture. The first chapter examines texts of discovery written during the colonial enterprise of Spain. Given the anthropological void in the Galápagos, these initial pieces of writing emphasize the monstrosity of the landscape and the biota, but also portray a possibility to find riches. This description ignites a dichotomist infernalparadisiacal appraisal of the archipelago, and recreates it as a warped textual space which, in turn, develops an imagery that demonstrates the flexibility of the deserted island: writers set forth almost any form of representation that favors imperial interests. The second chapter analyzes travel literature written in English during the nineteenth century. These texts define the islands as a world within itself rather than as a province of Ecuador, and have a major impact on its imagery given the authority of its writers. In the midst of Latin-American independence, the nation-building project, and the quest for a cosmopolitan state, foreign texts are detached from the social and political reality of the entourage, and transmit a fallacious notion of desertedness, which allows for future occupations of transcontinental scope. These books also create a bilingual literature that preludes the migratory movement and touristic commerce that currently defines this province. The final chapter focuses on three books written by local authors and how they combat or appropriate previous insular narratives providing a native perspective. A historiographical novel, defined as a "foundational fiction" that portrays the Galápagos as a prison and pirate hideout, exhibits the violent environment of the newborn Ecuadorian Republic. This piece generates a fissure in the international community that regards the islands as paradise and still is, therefore, largely ignored. A second narrative shows how the Galápagos occupation of the United States during World War II is crucial for interpreting and understanding the archipelago during the twentieth century. It preludes current international interests that dominate policyundertakings, particularly the ones concerning tourism, environmental, and geopolitical endeavors. Finally, a quarto book exemplifies how texts have enticed and caused not only a critical political and national divorce between the nation and the insular region, but also a market-oriented global milieu triggering migration towards this zone. The discussed works include Tomás de Berlanga's "Carta a su majestad describiendo su viaje" (1535), Sarmiento de Gamboa's Historia de los incas (1572), Darwin's Voyage of the Beagle (1839), Melville's The Encantadas, or Enchanted Isles (1854), Manuel Bilbao's El pirata del Guayas (1855), Bolívar Naveda's Galápagos a la vista (1952), and Hugo Idrovo's Galápagos: huellas en el paraíso (2005). I use critical theory from Adorno, Bartkowski, Bloom, De Certeau, Deleuze, Edmond, Mignolo, Molloy, Musgrove, O'Gorman, Pratt, Sommer, Todorov, Van den Abbeele, and others to show the impact of the construction of an imaginary space that morphs incessantly and responds more to writers' interests than to the inherent qualities of the isles.


This paper seeks to contribute to an emerging debate in human geography concerning
the spatialities of the future, and aims to address a gap in work on the geography of
religion regarding the temporalities of faith. Through a focus upon religious prophecy,
the paper seeks to examine how different spaces, temporalities, identities, practices and
dispositions (both religious and secular-scientific) are generated through and generate
this religious future. The paper argues that prophecy is a particular form of making the
future, and advances the dual notions cosmic-divine time and preparatory assured
readiness in order to understand and underline this specificity. Through the example of
the prophetess Joanna Southcott (1750-1814) and an event involving a box of her
prophecies publically opened in 1927, it argues that prophetic space-times presence the
future through multiple and intersecting 'not-yets', hesitancies and assurances.


The purpose of this study was to describe and compare perceptions of the quality of on-campus and off-campus courses held by students enrolled in courses offered through the College of Agriculture Off-Campus Professional Agriculture Degree Programs @= 173) and faculty members with teaching responsibilities or with teaching experience in the same college of agriculture (N=262). Faculty and students provided a positive assessment of the overall quality of both on- and off-campus courses. They also provided a positive assessment of both on- and off-campus courses on the manufacturing-based user-based value-based and transcendent-based quality factors. Even so, both students and faculty perceived off-campus courses to be of lower quality than on-campus courses with the greatest difference on the transcendent quality factor. It was recommended that the focus for improving the quality of off-campus courses be on the manufacturing-based factor. When the production and delivery processes are handled correctly and aligned to achieve outcomes based on student needs, off-campus courses will be recognized for innate excellence (transcendent quality). If quality off-campus courses in agriculture are to be offered, special attention must be given to improving the production, quality control, and distribution systems for courses and course materials.


This paper concerns learning and prediction with probabilistic models where the domain sizes of latent variables have no a priori upper-bound. Current approaches represent prior distributions over latent variables by stochastic processes such as the Dirichlet process, and rely on Monte Carlo sampling to estimate the model from data. We propose an alternative approach that searches over the domain size of latent variables, and allows arbitrary priors over the their domain sizes. We prove error bounds for expected probabilities, where the error bounds diminish with increasing search scope. The search algorithm can be truncated at any time. We empirically demonstrate the approach for topic modelling of text documents.


Purpose. To explore the structural progression of X-linked retinoschisis (XLRS) in patients by using spectral-domain optical coherence tomography (SD-OCT). Design. Retrospective, observational study. Methods. Patients who were diagnosed with XLRS by genetic testing underwent comprehensive ophthalmological examinations from December 2014 to October 2016. Each eye was measured by SD-OCT using the same clinical protocol. A correlation between best-corrected visual acuity (VA) and SD-OCT measurements was observed. Results. Six patients demonstrated retinoschisis (12 eyes) and typical foveal cyst-like cavities (10 eyes) on SD-OCT images with a mean logMAR VA of 0.48. The median age was 7.5 years at the initial visit. Their foveal retinal thickness (516.9 μm) and choroid thickness (351.4 μm) decreased at a rate of 38.1 and 7.5 μm, respectively, at the 10.5-month follow-up visit; however, there were no significant differences (P = 0.622 and P = 0.406, resp.). There was no significant correlation between VA, the foveal retinal thickness, and subfoveal choroid thickness. Conclusions. SD-OCT images for XLRS patients during the juvenile period revealed no significant changes in the fundus structure, including the foveal retinal thickness and choroid thickness within one-year follow-up. There was a lack of correlation between VA, foveal retinal thickness, and subfoveal choroid thickness.


We present GeoNeRF, a generalizable photorealistic novel view synthesis method based on neural radiance fields. Our approach consists of two main stages: a ge-ometry reasoner and a renderer. To render a novel view, the geometry reasoner first constructs cascaded cost volumes for each nearby source view. Then, using a Transformer- based attention mechanism and the cascaded cost volumes, the renderer infers geometry and appearance, and ren-ders detailed images via classical volume rendering techniques. This architecture, in particular, allows sophis-ticated occlusion reasoning, gathering information from consistent source views. Moreover, our method can eas-ily be fine-tuned on a single scene, and renders com-petitive results with per-scene optimized neural rendering methods with a fraction of computational cost. Ex-periments show that GeoNeRF outperforms state-of-the- art generalizable neural rendering models on various syn-thetic and real datasets. Lastly, with a slight modification to the geometry reasoner, we also propose an alter-native model that adapts to RGBD images. This model di-rectly exploits the depth information often available thanks to depth sensors. The implementation code is available at https://www.idiap.ch/paper/geonerf.


The Internet has changed significantly business operation across national borders. However, existing literature about its impacts on export channels remains limited. This inductive study explored the Internet's impacts on the relations between 13 Chinese manufacturers and their export intermediaries in Canada. Findings from this study suggest that export intermediaries that provide financing and credit, intensive after-sales services, and important distribution infrastructure survive the Internet while those that offer traditional market-sensing and customer-linking services can hardly survive the Internet.


Childhood epilepsy with centrotemporal spikes, had been previously considered as benign childhood epilepsy. According to the new classification proposed by Sheffer I. and colleagues the term "benign" has been changed to "self-limited". Many studies reported that BECTS may cause transient or long lasting cognitive and behavioral disturbances. Rolandic epilepsy is the most frequent among the childhood focal epilepsy and may account for about 15–25% of all epileptic syndromes diagnosed between the ages of 5 to 15 years. The incidence range changes between 7.1–21 per 100000 in population younger than 15 years with male predominance. The age of onset in 90% of cases between 1 and 10 years with peak around 6–7 years. Seizures mainly occur during a night sleep, whereas the probability of awake seizures are less than 10%. The characteristic clinical features are: (1) focal motor seizure with unilateral orofacial tonic or clonic contractions; (2) speech arrest; (3) hypersalivation; (4) sensory symptoms represented by unilateral numbness or paresthesia of tongue, lips, gum and inner part of the check; (5) unilateral clonic jerk in leg and arm with postictal paresis; (6) generalized seizures. The EEG picture is distinctive in Rolandic epilepsy. The background activity is almost always preserved in awake state and during a sleep. The typical interictal EEG pattern is high voltage, diphasic spikes or sharp waves frequently with slow activity on central-midtemporal region. The centrotemporal spikes or rolandic spikes come from the lower rolandic region created a horizontal dipole with maximal electronegativity in the centrotemporal region and electropositivity in the frontal region usually seen unilateral or bilateral. In most cases children with RE have a good prognosis regarding both seizures and neurodevelopment. The remission of seizures usually occurs before the age of 18 years. The cognitive and behavior problem may happen in active period of disease which are reversable in most of patients.


The movie Fantastic Voyage (1966) is not an innocent science fiction fantasy but a trope that concurrently underlies the development and implementation of a particular medical imaging technique: the endoscope. Sketching the past, present and future of endoscopy, this article advances the broader argument that medical imaging techniques and media technologies are developed concurrently. The endoscopic gaze - the look from within the body - has gradually become a pervasive mode of corporeal inspection, not only in high-tech medicine, but in television and other popular media as well. But what are the implications of this ubiquitous endoscopic gaze? How may innovations in endoscopic technologies - including the latest virtual techniques - affect doctors' and patients' concepts of corporeality? And do these innovations, in turn, affect our collective appreciation of surgical intervention and its consequences? Persistent myths of transparency and non-intervention have prevailed in both the production and popul...


DOI: https://doi.org/10.53523/ijoirVol8I1ID1 Abstract One of the most important healthcare institutions in Iraq is Outpatient clinic that requires a lot of thinking to improve the way to provide services and the nature of care. Outpatient clinics are increasingly keen to meet the needs of care, and this has been recognized as a fundamental issue related to service quality. Therefore, many researchers in various fields have taken this matter as a basis for their research, as it is considered a rich material for research due to the problems these institutions contain. The most important problems faced by outpatient clinics are the waiting time and the insufficient number of clinic staff to perform the various tasks. The aim of this paper is to reduce the waiting time by building a model for the clinic environment, especially dental clinics, and trying to benefit from all the existing medical staff and exploit their experiences. Since the patient spends a long time between registration, returning to the doctor and finally the result or process that the doctor performs, building such a model might help in identifying and improving the problem. The simulation model built in this research for the clinic is based on modelling the discrete events inside the dental clinic using the Arena software. This form is used to assess the quality of services provided by dental outpatient clinics in Iraq.


Written for a symposium honoring Lyman Johnson and David Millon, this essay uses the writing of Johnson as a starting point to consider what religious thought can contribute to our understanding of corporate law. How does a religious understanding of human nature affect an analysis of how directors and officers are likely to respond to their fiduciary duties? How does a religious understanding of collective action and enterprise affect our vision of corporate purpose? If our answers to those questions change our understanding of how corporations may (or may not) pursue the public interest, how does that in turn reflect an analysis of how the state should regulate business, and in particular, how it should regulate religiously-guided businesses whose core beliefs may in some ways conflict with some legal regulations? This paper addresses those questions by drawing on three different theologians with differing perspectives: Walter Rauschenbusch, Michael Novak, and Reinhold Niebuhr. The first two of these figures resemble — but deepen — perspectives already widely developed within contemporary corporate law scholarship. The third figure, Niebuhr, is more novel, and poses some hard questions for corporate law scholars of varying perspectives.


The main aim of this paper is to provide an overview of current debates
concerning the role of the mammalian hippocampus in learning with a
particular emphasis on spatial learning. The review discusses recent debates
on (1) the role of the primate hippocampus in recognition memory and
object-in-place memory, (2) the role of the hippocampus in spatial
navigation in both rats and humans, and (3) the effects of hippocampal
damage on processing contextual information. Evidence from these lines of
research have led many current theories to posit a function for the
hippocampus that has as its organizing principle the association or binding
of stimulus representations. Based on this principle, recent theories of
hippocampal function have extended their application beyond the spatial
domain to capture features of declarative and episodic memory processes.


We report on an analysis of feedback behavior in an Active Listening Corpus as produced verbally, visually (head movement) and bimodally. The behavior is modeled in an embodied conversational agent and displayed in a conversation with a real human to human participants for perceptual evaluation. Five strategies for the timing of backchannels are compared: copying the timing of the original human listener, producing backchannels at randomly selected times, producing backchannels according to high level timing distributions relative to the interlocutor's utterance and pauses, or according to local entrainment to the interlocutors' vowels, or according to both. Human observers judge that models with global timing distributions miss less opportunities for backchanneling than random timing.


Communities of Practice are powerful way of thinking about and exploring the social discipline of learning. Rigorous models for informational and cognitive aspects of learning are well defined, but social dimensions of learning are not so well explored nor are the practices involved in establishing an appropriate learning environment. A workshop conducted by Etienne Wenger was specifically structured to model the practices to establish a social learning space and provided an opportunity for participants in the professional disciplines of health, social care, education and business to engage in social learning. The workshop enabled a telling and recording of people's own learning stories, through individual and group face-to-face encounters and further non-face-to-face communication encounters (within the workshop group and the world) through a range synchronous and asynchronous electronic media, video, wikispace1, blog and twitter. This is a powerful process by which to explore the development of professional practices in a Work Integrated Learning or Practice Based Learning context and illustrates the manner in which transitions or boundary encounters arise and are navigated as individuals explore the ˜landscape of professional practice".


This research aims to understand the source of temporal fluctuations in real estate development through simulating a cellular automata model. In this cellular automata city, investment decisions are made according to the profitability measured in a local neighbourhood. If developers think there is enough of a profit margin in a particular site, i.e. a 'niche' of investment, they will increase investment at that site. However, by increasing investment at the site, new 'niches' might be created. Therefore, the action of converging towards an equilibrium state itself paves the way towards new fluctuations. This model demonstrates the potential of using simulation to increase our understanding of real estate dynamics. The experiments suggest that locally made 'rational' decisions can lead to temporal fluctuations because of non–linearity (discrete changes/densification and local bounded information). Interestingly, the fluctuations may show the property of a temporal fractal. This requires a sufficiently sensitive process of 'niche' formation compared with a relatively large impact of additional investment. The simulation suggests that the impact should be 4 to 20 times higher than the threshold over which a niche will be formed. This condition is satisfied in most cases of real estate investment, thus suggesting a self–organised criticality in complex real estate development.


We aimed to systematically review studies that examine factors affecting depression among parents of children
with disabilities, especially, the autistic children. Besides, we emphasized the effects of gender on depression among the parents. There were at least 27 articles reviewed. The related journal articles on factor affecting depression were downloaded with cut off limit from 1997 to 2013. The articles were then analyzed and organized according to the definitions of depression and various factor affecting depression. We found there was no conclusive evidence regarding the factors affecting the depression among parents of children with autism. There was conclusive evidence from the reviewed literature regarding gender effect, yet the number of article supporting it was small. Mothers of children with autism were more affected in the depression as compared to fathers. Finally, with conclusion we then suggest for future interventional study.


With the increasing popularity of electric vehicles, there is an urgent demand to shorten the charging time, so the development of high-power charging stations with fast chargers is necessary to alleviate range anxiety for drivers. The charging station based on the neutral-point-clamped (NPC) converter can bring many merits, but it has unbalanced power problems in the bipolar dc bus. To solve this issue, comprehensive dc power balance management (PBM) in conjunction with high-power three-level dc-dc converter based fast charger is proposed in this paper. The active dc power balance management (APBM) is proposed to assist the central NPC converter in balancing power so that the additional balancing circuit is eliminated; while the passive dc power balance management (PPBM) is proposed to eliminate the fluctuating neutral-point currents and to ensure the balanced operation of fast chargers. The principles of APBM and PPBM are researched, the efficient integration between them is studied, and the overall control scheme for the fast charger is proposed. The power balance limits of APBM are explored, while the circulating currents of PPBM are analyzed. Simulation and experimental results are presented to verify the effectiveness of the proposed fast charger with PBM functions.


This study examines the discrepancy between teachers' beliefs and practices in Hong Kong kindergartens and the factors that influence this discrepancy. Three kindergartens, considered by the Hong Kong Education Bureau to be of varying quality, were chosen from different areas of Hong Kong. Questionnaires about teaching beliefs were administered to 35 teachers from these kindergartens. These quantitative data were supplemented with qualitative data gathered during individual interviews with five of the teachers and the three principals. In addition, a focus group of five early childhood education specialists commented on the videotaped observations of the classroom practices of the five interviewed teachers. The findings showed that all of the teachers endorsed the advocated teaching beliefs, but there was a discrepancy between their beliefs and practices. The most significant factors contributing to the discrepancy were teachers' professional education and their attitudes towards personal teaching introspection. Teachers were also under pressure from parents' curriculum requests, demands on the children's academic abilities and expectations for a strong link to Primary One. Enhanced early childhood education training that helps teachers to be introspective about their own teaching practices and beliefs is recommended. Government support is also required to teach parents what constitutes a high-quality learning environment for young children.


Coastal tourism has become a major facet of modern life. Further, tourism development in the coastal zone has become a constant since the end of World War II. Coastal tourism is a process involving tourists and the people and places they visit, particularly the coastal environment and its natural and cultural resources. Most coastal tourism takes place along the shore and in the water immediately adjacent to the shoreline. In India Goa, Kerala, Karnataka were emerged spontaneously as a coastal tourism destination in the 1960s, its unique selling points being its natural coastal beauty. But the history of coastal tourism is not very old in West Bengal. The coastal stretch of West Bengal with a length of about 350 kilometer comprises the two districts- Purba Medinipur and Dakshin Chabbisparagana. In West Bengal there are many popular coastal tourism destinations, but coastal tourism in West Bengal started in 1980s. Present study focuses on historical background and development of the coastal tourism destinations in West Bengal. Int. J. Soc. Sci. Manage. Vol-2, issue-3: 267-272 DOI: http://dx.doi.org/10.3126/ijssm.v2i3.12910


Micro-credentials research, which includes digital badges, is a relatively new field of study that seeks to inform the implementation, portability and sustainability of the ecology of meaningful delivery. This paper reviews literature relevant to understanding connections between universities' intent to offer micro-credentials and the environment that is needed to do so. From this integrated study, the paper distils a number of core concerns and identifies some gaps in the literature. One of its primary goals is to clear the ground for the construction of a technical model of micro-credentialing implementation that can be used by the various stakeholders involved in the design and evaluation of new micro-awards. A closely related goal is to help those participating in micro-credentialing research to locate and understand each other's contributions, as fragmentation in research related to micro-credentials makes progress in the field slow. Hence, this review draws together research in the field to identify research foci and gaps, and then also capture some work by micro-credentialing researchers that directly attempts to model the main relationships in the field. The paper ends with a summary of implications for practice, especially for the Australasian higher education context.


When behavior is directed toward activities, people, and experiences that people find most important in their lives, they are engaged in valued living. Given that valued living is associated with well-being, quality of life, and happiness, understanding ways in which value-concordant behavior can be promoted, enhanced, and maintained is of utmost importance. Two studies sought to examine the associations between mindfulness—as a dispositional trait and as developed through training—and valued living. In Study 1 dispositional mindfulness was strongly related to three aspects of valued living: the general tendency for people to understand their values and act in value-consistent ways; directing behavior toward valued activities; and clarity of, action toward, and feelings of success and satisfaction with action toward specific important values. Study 2 compared valued living scores of people participating in a Mindfulness Based Stress Reduction (MBSR) program to a control group. Mindfulness training was related to increased general valuing processes and value-relevant behavior but was not related to increased clarity of, action, or success or satisfaction with action toward specific values. The two studies also explored the mechanisms underlying the relationship between mindfulness and valued living. In Study 1, self-compassion, psychological flexibility, and self-clarity each partially mediated the relationship between dispositional mindfulness and valued living, but decentering did not. In Study 2, change in attention mediated the relationship between group (MBSR or control) and valued living, but v acceptance, self-compassion, psychological flexibility, self-clarity, and decentering did not. Lastly, both studies found that valued living mediated the relationship between mindfulness and well-being. Taken together, these findings add to the growing body of literature demonstrating the benefits of mindfulness and highlight the important influence that clearly identifying and behaving in accordance with important values has on well-being.


A parameterization for cloud processing is presented that calculates activation of aerosol particles to cloud drops, cloud drop size, and pH-dependent aqueous phase sulfur chemistry. The parameterization is implemented in the global aerosol-climate model ECHAM5-HAM. The cloud processing parameterization uses updraft speed, temperature, and aerosol size and chemical parameters simulated by ECHAM5-HAM to estimate the maximum supersaturation at the cloud base, and subsequently the cloud drop number concentration (CDNC) due to activation. In-cloud sulfate production occurs through oxidation of dissolved SO 2 by ozone and hydrogen peroxide. The model simulates realistic distributions for annually averaged CDNC although it is underestimated especially in remote marine regions. On average, CDNC is dominated by cloud droplets growing on particles from the accumulation mode, with smaller contributions from the Aitken and coarse modes. The simulations indicate that in-cloud sulfate production is a potentially important source of accumulation mode sized cloud condensation nuclei, due to chemical growth of activated Aitken particles and to enhanced coalescence of processed particles. The strength of this source depends on the distribution of produced sulfate over the activated modes. This distribution is affected by uncertainties in many parameters that play a direct role in particle activation, such as the updraft velocity, the aerosol chemical composition and the organic solubility, and the simulated CDNC is found to be relatively sensitive to these uncertainties.


No Hardy heroine has divided critical opinion more radically than Tess of the D'Urbervilles. Hardy's defiant sub-title, 'A Pure Woman Faithfully Presented', challenges the moral preconceptions of his Victorian readership, insisting that Tess's sexual violation is no bar to her moral purity. The history of the novel's rewritings reflects not only Hardy's negotiation with contemporary sexual mores, but also his own compex feelings about Tess: 'I have not been able to put on paper all that she is, or was, to me.' 'In the light of a critical practice that demands a stable and coherent consolidation of character', Penny Boumelha writes, Tess can only be read as 'complex and contradictory.' Peter Widdowson, postmodernizing Tess, has left behind him any such critical practice, and even perhaps his own modernist reading in which juxtaposed multiple registers of Tess's character fracture, in Cubist mode, the plane of vision. His up-to-the-minute Tess is one whose inconsistencies make her 'unknowable' in a way that explodes the whole notion of character as 'a humanist-realist mystification'. Instability of meaning, as Terry Eagleton remarks, is the doctrinal obsession of postmodernism.


Empirical mode decomposition (EMD) is a relatively new, data-driven adaptive technique for analyzing multicomponent signals. Although it has many interesting features and often exhibits an ability to decompose nonlinear and nonstationary signals, it lacks a strong theoretical basis which would allow a performance analysis and hence the enhancement and optimization of the method in a systematic way. In this paper, the optimization of EMD is attempted in an alternative manner. Using specially defined multicomponent signals, the optimum outputs can be known in advance and used in the optimization of the EMD-free parameters within a genetic algorithm framework. The contributions of this paper are two-fold. First, the optimization of both the interpolation points and the piecewise interpolating polynomials for the formation of the upper and lower envelopes of the signal reveal important characteristics of the method which where previously hidden. Second, basic directions for the estimates of the optimized parameters are developed, leading to significant performance improvements.


We reviewed the serial CT studies obtained between 1974 and 1986 of 31 patients with malignant glioma who survived for 2 to 11 years after surgical removal of their tumors. In all cases surgery was followed by radiation therapy to the head (6000 rad) and chemotherapy. Patients were divided into two age groups: those under age 40 (n = 13) and those over age 40 (n = 18). By 2 years all patients in the older group developed evidence of leukoencephalopathy characterized by periventricular zones of decreased attenuation. Only 58% of the younger group showed evidence of white matter changes at this point. All patients from both age groups who survived for 4 years developed leukoencephalopathy. The severity of leukoencephalopathy from 6 months after surgery and beyond was always greater in the older group. All patients developed cerebral atrophy as evidenced by sulcal dilatation and ventricular enlargement. Atrophy was progressive beginning with the first postirradiation scan, and was always more severe in the older patients. A significant difference was found in the clinical status of the two age groups as determined by the mental status score and the Karnofsky scale. Despite progressive brain changes, survivors under age 40 maintained a nearly normal mental status and Karnofsky scores until their death, whereas survivors over age 40 showed progressive clinical decline.


The Nature of Kingship c. 800-1300. The Danish Incident by Nils Hybel presents the first comprehensive history of the changeable nature of monarchial power in Danish territories from the Viking Age to the Central Middle Ages.


Abstract Irrespective of sex and age, cancer is the leading cause of mortality around the globe. Therapeutic incompliance, unwanted effects, and economic burdens imparted by cancer treatments, are primary health challenges. The heritable features in gene expression that are propagated through cell division and contribute to cellular identity without a change in DNA sequence are considered epigenetic characteristics and agents that could interfere with these features and are regarded as potential therapeutic targets. The genetic modification accounts for the recurrence and uncontrolled changes in the physiology of cancer cells. This review focuses on plant-derived flavonoids as a therapeutic tool for cancer, attributed to their ability for epigenetic regulation of cancer pathogenesis. The epigenetic mechanisms of various classes of flavonoids including flavonols, flavones, isoflavones, flavanones, flavan-3-ols, and anthocyanidins, such as cyanidin, delphinidin, and pelargonidin, are discussed. The outstanding results of preclinical studies encourage researchers to design several clinical trials on various flavonoids to ascertain their clinical strength in the treatment of different cancers. The results of such studies will define the clinical fate of these agents in future.


The text includes a possibly complete reconstruction of 27 days spent by Schulz in Paris in 1938. The reconstruction provides the basis of a theoretical commentary which compares the advantages and traps of narrativized biographical discourses on Schulz with the order of the calendar. All that is known about Schulz in Paris has been found in about a dozen documents and several dozens of references in his correspondence, which is not too bad for a biography of a "writer without archive." The documentation of other episodes of his life is much scarcer. We know when and where he stayed in Paris, sometimes even his hotel room number. However, of the 27 days spent by Schulz in Paris only about one third can be reconstructed in fragments. All the rest remains nebulous and impenetrable. Schulz often disappears into thin air and in fact we do not know what he was doing all days long. He neither talked nor wrote about it much. The opinions and remarks which he formulated, e.g., that Paris is a "riotous Babylon," were quickly picked up by his exegetes and reconstructors of his biography. The surviving documents set boundaries which – while the reconstruction of episodes is still at stake – can be crossed only by conjectures and speculation. There is nothing wrong in these risky procedures. They are not bad as such, but those who move too far from the documents letter can be easily led astray. Not that everything is legitimate – in the world without the god of biography some rules are still valid. Conjectures and speculation must not reach beyond the "material truth."


The rapid advances in wireless communications and networking have given rise to a number of emerging heterogeneous wireless and mobile networks along with novel networking paradigms, including wireless sensor networks, mobile crowdsourcing, and mobile social networking. While offering promising solutions to a wide range of new applications, their widespread adoption and large-scale deployment are often hindered by people's concerns about the security, user privacy, or both. In this dissertation, we aim to address a number of challenging security and privacy issues in heterogeneous wireless and mobile networks in an attempt to foster their widespread adoption. Our contributions are mainly fivefold. First, we introduce a novel secure and loss-resilient code dissemination scheme for wireless sensor networks deployed in hostile and harsh environments. Second, we devise a novel scheme to enable mobile users to detect any inauthentic or unsound location-based top-k query result returned by an untrusted location-based service providers. Third, we develop a novel verifiable privacypreserving aggregation scheme for people-centric mobile sensing systems. Fourth, we present a suite of privacy-preserving profile matching protocols for proximity-based mobile social networking, which can support a wide range of matching metrics with different privacy levels. Last, we present a secure combination scheme for crowdsourcing-based cooperative spectrum sensing systems that can enable robust primary user detection even when malicious cognitive radio users constitute the majority.


OBJECTIVE
To observe the impacts of electroacupuncture (EA) on oocyte quality and pregnant outcome for the patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization and embryo transfer (IVF-ET) and explore its potential mechanism.

METHODS
Sixty-six patients with PCOS and undergoing IVF-ET were divided into two groups randomly, including an observation group (34 cases) and a control group (32 cases). Ethinylestradiol and cyproterone acetate tablets and gonadotropin-releasing hormone agonist were administered for long-program superovulation in either group. In observation group, the intervention of EA was applied to Guanyuan (CV 4), Zhongji (CV 3), Sanyinjiao (SP 6), Zigong (EX-CA 1) and Taixi (KI 3) additionally. The pregnant outcome and the levels of stem cell factor (SCF) in the serum and follicular fluid on the day of egg collection were compared between two groups.

RESULTS
The score of kidney deficiency symptoms reduced remarkably after treatment in either group and the improvement in observation group was superior to that in control group (P < 0.01). The fertilization rate [(76.25 +/- 20.33)% vs (66.34 +/- 15.44)%], cleavage rate [(98.66 +/- 3.70)% vs (94.47 +/- 9.45)%] and the rate of high-quality embryos [(60.20 +/- 22.20)% vs (50.55 +/- 16.15)%] in observation group were all superior to those in control group separately (all P < 0.05). Clinical pregnancy rate (46.67%, 14/30) in observation group was higher than that (37.93%, 11/29) in control group, but without statistical difference (P > 0.05). SCF levels in the serum and follicular fluid on the day of ovary collection were higher obviously than those in control group (all P < 0.05).

CONCLUSION
Electroacupuncture plays an active role in the pregnant outcomes of PCOS patients undergoing IVF-ET and it can relieve the symptoms of kidney deficiency in terms of TCM and improve clinical pregnant rate. The results are relevant with the overall adjustment of organic endocrinal system and the local micro-environment of ovary and the improvement of oocyte quality through the up-regulation of SCF level in mechanism.


There is need for efficient energy conversion systems based on domestic fossil or biofuels. Solid Oxide Fuel Cells (SOFC's) are attractive in this case, however sealing is a critical issue in SOFC development. The purpose of this investigation is to find a procedure to seal yttria stabilized zirconia (YSZ) electrolyte to the stainless steel electrical interconnect or gas manifold. The seal is usually exposed to high temperatures in the range of 500 to 1000°C. Brazing by in-situ alloying of nickel and titanium foils was performed to braze zirconia to 444- stainless steel. Different combinations of nickel/titanium foils were used; brazing was done in vacuum at 6 x 10-6 torr at 960°C, 1010, and 1030°C for different brazing times. The braze and interfacial microstructures were characterized by optical microscopy, scanning electron microscopy (SEM), and energy dispersive spectroscopy (EDS). This paper assesses the effect of process parameters on the development and stability of the braze metal and the interactions of the filler metal with the two substrates.


A solar trigeneration system, based on photovoltaic-thermal (PV/T) collectors, photovoltaic (PV) modules and a heat pump unit for heating and cooling, is modelled to forecast the thermal and electric yields of the system. The aim of the trigeneration system is to provide enough electricity, domestic hot water (DHW), heating and cooling power to meet the typical demand of an urban single family dwelling with limited roof area and allow the household to achieve a positive net energy status. The PV/T collectors and PV modules provide the electricity while the former also powers the DHW component of the trigeneration system. The heating and cooling components rely on a vapour compression cycle heat pump unit powered by electricity. In Fong et al. (2010), solar-powered electric compression refrigeration was found to have the most energy saving potential in subtropical climates. Thus, a heat pump based cooling system is a cost effective solution for residential applications in Lisbon, Portugal. Thus, according to the dwelling's location, construction details and energy demand patterns, the model computes the system's net results by comparing the dwelling demand with the trigeneration system supply. The paper presents a breakdown of the proposed trigeneration system model and describes each component briefly. Preliminary results produced by the model are presented and analysed in order to identify possible ways of improving the overall system performance.


To the best of our knowledge, most of the few methodological studies which analyze the impact of faked interviews on survey results are based on "artificial fakes" generated by project students in a "laboratory environment". In contrast, panel data provide a unique opportunity to identify data which are actually faked by interviewers. By comparing data of two waves, unequivocal fakes are easily identifiable. However, in most surveys there is no second wave because they have a pure cross-sectional nature. In search of a method which does not need two waves of data we test an unconventional benchmark called Benford's Law, which is used by several accountants to discover frauds. Our preliminary results let us conclude that Benford´s Law might be not an efficient method for detecting faked data, but it might be a new instrument for quality control of the interviewing process The raw data of the German Socio-Economic Panel Study (SOEP) provide a rich source of faked interviews because it is built on several sub-samples. However, because interviewers know that panel respondents will be interviewed again over the course of time, clever interviewers will not fake panel interviews. In fact, in raw data of SOEP the share is about only 0,5 percent of all records. The fakes are used for an analysis of the potential impact of non detected fakes on survey results. The major result is that the faked records has no impact on the mean and the proportions. But in very rare, exceptional cases there may be a bias in estimates of correlations and regression coefficients if fakes would not be detected. One should note that – except for some fakes in the first two waves of sample E – faked data were never disseminated within the widely-used SOEP. The fakes were detected before the data were released.


Medical drama "Grey's Anatomy" features weddings as pivotal life events, with 14 unions portrayed over the program's 13 seasons on ABC. This paper is a synthetic approach combining communication, gender studies, and rigorous methodology to examine weddings in "Grey's Anatomy" through a feminist lens. We employ Butler's theory of gender performance and Rich's concept of compulsory heterosexuality to examine weddings throughout the show's extensive run. Depictions of women and weddings demonstrate dissonance between hegemonic gender performance and the potential to redefine the performance of "woman" in one's own ways. Tension exists between the program's portrayal of traditional heterosexual weddings and its progressive inclusion of a lesbian ceremony. We argue that the program's portrayal of both traditional "white" weddings and ceremonies which are more private and self-defined reflect the challenges inherent in navigating cultural expectations and personal objectives associated with performing as a "woman" in contemporary culture


Purpose: The primary aim of this study was to observe variations and trends in the implementation and conformity to guidelines and standards in the advanced practice role of radiographer reporting within United Kingdom (UK) National Health Service (NHS) trusts.
Method: A questionnaire using a 5-point Likert categorical response scale, and free text open questions was applied. The engagement process used on-line survey was sent out between July and August 2015 to NHS reporting radiographers. The inclusion criteria covered a cross section of imaging modalities including plain film, computed tomography (CT), magnetic resonance imaging (MRI), nuclear medicine (NM), fluoroscopy, and mammography.
Results: A total of 261 radiographers completed and returned the survey. Commenting on a selection of questions based on four key themes of scope of practice (a clearly defined job description (74.3%; n=168/226). Education and training support (55%; n=125/227 had no mentor allocated), resources and equipment (48%; n=102/212 did not have access to dedicated equipment); and outcome measures of performance (36%; n=77/216 regularly audited their workload).
Conclusion: The results of the data collected, identified specific trends in the sample group on defined scope of practice, and the level of organisational support. It was implicitly implied from the varied responses on equipment and resources provided to fulfil the role, that best practice guidance on resources used to fulfil the role should have a clearly defined area in future frameworks and policy to support safe working practices. The variances of responses suggest adherence to recommended best principles in reporting were not consistent within this sample group; and acknowledged factors on the parity of support, equipment, scheduled sessions, audit mechanisms and cross-cover of service provision.


Gastrectomy with lymph node dissection remains the gold standard for curative treatment of gastric cancer. Dissection of splenic hilar lymph nodes has been included as a part of D2 lymph node dissection for proximal gastric cancer. Previously, pancreatico-splenectomy has been performed for dissecting splenic hilar lymph nodes, followed by pancreas-preserving splenectomy and spleen-preserving lymphadenectomy. However, the necessity of routine splenectomy or splenic hilar lymph node dissection has been under debate due to the increased morbidity caused by splenectomy and the poor prognostic feature of splenic hilar lymph node metastasis. In contrast, the relatively high incidence of splenic hilar lymph node metastasis, survival advantage, and therapeutic value of splenic hilar lymph node dissection in some patient subgroups, as well as the effective use of novel technologies, still supports the necessity and applicability of splenic hilar lymph node dissection. In this review, we aimed to evaluate the need for splenic hilar lymph node dissection and suggest the subgroup of patients with favorable outcomes.