Abstract Both managers and the staff they supervise bring unconscious and unresolved personal issues into their relationships in the workplace. This phenomenon is called 'transference'. Transference generally interferes with the positive working relationships that are essential to achieving organizational objectives. This article provides a conceptual framework for differentiating transference from other complex emotional interactions that can occur in the workplace as well as a set of clear action steps for how the manager can respond to transference constructively. Examples of both staff and manager transference are presented to illustrate how managers can detect and then respond effectively to transference. It is noted that managers are not psychotherapists; knowledge about transference should therefore be used with caution. It is a manager's job is to help staff to succeed with their work, not to help them resolve personal problems.


The output power of single-phase PV inverter is AC and the input power is DC,so there exists fluctuations in the power transmission. Generally, the fluctuations can be removed by using coupling capacitors. However, the voltage fluctuations of coupling capacitors will result in corresponding input power fluctuations, and will affect the maximum power tracking of the system. In this paper, the power transfer process is analysised, and a theoretical derivation to voltage fluctuations of the generatrix capacitor and the impact on the input currents is designed.The corresponding correction control algorithm of subdivision control is developed according to its characteristics. The feasibility of the solution is verified by the 3KW experimental prototype.


The pavement engineering industry, having realized the significance of the impacts that it imposes on the environment through the production, construction and management of its products and assets, has been driven towards a more sustainable and circular way of operating. This has partly been through asphalt recycling, which is an area that many road authorities have prioritized. However, not all the National Road Authorities (NRAs) and/or sector stakeholders seem to be adequately familiar with the Circular Economy (CE) concept. This paper attempts to assist the transition of NRAs to a more circular way of doing business, by analyzing the current situation of CE within national/regional authorities and NRAs. To do so, a questionnaire was sent to different NRAs and an online search was conducted to identify the ways that NRAs communicate their CE practices. Findings indicate that, although the majority of the NRAs are familiar with CE as a concept, not many actions have been taken so far towards its holistic implementation. Finally, there is a significant lack of CE expertise and communication within these bodies.


The main argument of this paper is, namely, the need for greater emphasis on disclosure requirements and measures – particularly within the securities markets. This argument is justified on the basis of lessons which have been drawn from the recent Financial Crises, one of which is the inability of bank capital requirements on their own to address funding and liquidity problems. The engagement of market participants in the corporate reporting process, a process which would consequently enhance market discipline, constitutes a fundamental means whereby greater measures aimed at facilitating prudential supervision could be extended to the securities markets. Auditors, in playing a vital role in financial reporting, as tools of corporate governance, contribute to the disclosure process and towards engaging market participants in the process. This paper will however consider other means whereby transparency and disclosure of financial information within the securities markets could be enhanced, and also the need to accord greater priority to prudential supervision within the securities markets. Furthermore, the paper draws attention to the need to focus on Pillar 3 of Basel II, namely, market discipline. It illustrates how through Pillar 3, market participants like credit agencies can determine the levels of capital retained by banks – hence their potential to rectify or exacerbate pro cyclical effects resulting from Pillars 1 and 2. The challenges encountered by Pillars 1 and 2 in addressing credit risk is reflected by problems identified with pro cyclicality, which are attributed to banks' extremely sensitive internal credit risk models, and the level of capital buffers which should be retained under Pillar Two. Such issues justify the need to give greater prominence to Pillar 3. As a result of the influence and potential of market participants in determining capital levels, such market participants are able to assist regulators in managing more effectively, the impact of systemic risks which occur when lending criteria is tightened owing to Basel II's procyclical effects. Regulators are able to respond and to manage with greater efficiency, systemic risks to the financial system during periods when firms which are highly leveraged become reluctant to lend. This being particularly the case when such firms decide to cut back on lending activities, and the decisions of such firms cannot be justified in situations where such firms' credit risk models are extremely sensitive – hence the level of capital being retained is actually much higher than minimum regulatory Basel capital requirements. In elaborating on Basel II's pro cyclical effects, the gaps which exist with internal credit risk model measurements will be considered. Gaps which exist with Basel II's risk measurements, along with the increased prominence and importance of liquidity risks - as revealed by the recent financial crisis, and proposals which have been put forward to mitigate Basel II's procyclical effects will also be addressed.


Stable CO2 isotope ratio breath tests are established as a valuable tool in diagnostic and investigative medicine, with the potential to become more prominent in the future. The instrument conventionally used to measure the very small changes involved is an Isotope Ratio Mass Spectrometer however, the expense and complexity of such an instrument severely restricts the widespread and routine use of isotopic breath tests. Hence, to realise their full potential an alternative technique is required which is reliable, insensitive to environmental and component fluctuations, uncomplicated and affordable. We present a system that satisfies these criteria using broadband, non-dispersive, ground-state absorption infrared spectroscopy. Two isotopically distinct channels are created and their basal path length ratio recorded at the condition of transmitted intensity equilibrium. The change in channel path length ratios required to restore equilibrium in the 13C-enriched breath sample is directly related to the change in 13CO2 / 12CO2 concentration ratio. The system's novelty lies in this negative feedback loop balancing the signal by means of adjusting the path length of one of the channels. There is little evidence in the literature on infrared breath measurements that the possibility of interference from coincident infrared active breath trace compounds or various spectral effects that could lead to spurious results have been adequately assessed. Therefore, prior to the construction of a prototype instrument based upon this technique the question of its validity must be addressed. Furthermore, in addition to any instrument presenting a viable alternative it should also offer better reliability, long term stability and ideally be of lower cost than other emergent infrared instruments. Significant emphasis has therefore been placed upon evaluation of possible interferents, with the intention of providing an unambiguous assurance of the measurement's validity over a range of conceivable operating conditions and establishing operating tolerances that improve reliability over other infrared techniques. Also the prospect of using this technique to perform alternative isotope ratio breath tests was explored with the feasibility of using a novel filtering technique to enable measurement of 18O12O16O / 13C16O2 being investigated further. These aims were accomplished through the thorough evaluation of literature on breath trace compound's infrared spectra and by a series of theoretical computer instrument simulations, using detailed modelling of a breath sample's CO2 spectroscopy, capable of identifying, evaluating and quantifying the risks posed to a reliable measurement of 13CO2 / 12CO2 due to various spectral effects. The breath trace compound analysis revealed that 13C16O2 / 12C16O2 ratios can confidently be measured for isotopic breath tests using an instrument based on infrared absorption, the position of C02's n3 absorption band precluding any discernible risk. From the instrument simulations it has been possible to establish operating tolerances required to avoid or limit the generation of a spurious results and determine parameters necessary for the instrument's construction. Thus, we conclude that through the merits of its design and compliance to operating tolerances established the instrument described presents a viable alternative for providing highly accurate, reliable and low cost breath tests capable of being performed outside of a laboratory environment.


This report is a cost benefit analysis of a proposal for new sprinkler installation guidelines for ro-ro deck. It is a relative comparison between the present guidelines and a new proposal developed by SP
Technical Research Institute of Sweden. The results and conclusions in this report are based on; data gathered from multiple water sprinkler tests, other relevant literature, experts' judgment and computer
simulations. The conclusions based on the results are that it would most likely be profitable for the shipping companies if the proposal is adopted. Capital would be saved due to a lowered frequency of sever fire incidents and also a decrease of the expected loss of life. ©


Capacitive and inductive parasitics that exist in every electrically conducting structure are inseparably associated with the geometry. Especially in power electronic systems the geometry also is defined through thermal aspects. Investigation of the correlation between thermal optimisation of the electrically conduction structure and the influence of this reshape process on the formation of capacitive and inductive parasitics is the main task. The work aims on a combined optimisation process. Therefor PEEC (partial element equivalent circuit) method is employed to extract parasitics as lumped parameters for an adequately subdivided current path under view. Approaches for methodical application in design processes are studied.


The topography and specificity of B- and T-cell stimulatory epitopes from the 19-kDa protein of Mycobacterium tuberculosis were investigated by using overlapping synthetic peptides. Murine antisera identified two cryptic epitopes (residues 11 to 30 and 61 to 80) and one species-specific immunodominant epitope (residues 140 to 159). Immunoglobulins G1 and G2a antibody isotypes varied for the respective peptide immunogens but without relationship to the T-cell cytokine profiles which were characterized by high gamma interferon and low interleukin 5 levels. Antisera to recombinant M. tuberculosis 19-kDa protein (rGST-19) cross-reacted with homologous proteins of similar size from organisms of the Mycobacterium avium-intracellulare complex. Two-dimensional gel electrophoresis revealed differences in the number, relative mobility, and charge of isoforms of the 19-kDa protein, possibly reflecting posttranslational modifications. The immunodominant T-cell epitope from the M. tuberculosis 19-kDa protein (residues 61 to 80) and the corresponding peptide sequence from Mycobacterium avium subsp. intracellulare (residues 64 to 83), differing at five residues, were both recognized in a genetically permissive manner. Peptides 61-80 and 64-83 stimulated cross-reactive responses in BALB/c (H-2d) mice, while in the C57BL/10 (H-2b) strain, responses to peptide 61-80 were species specific. In purified protein derivative-positive healthy individuals, the M. avium subsp. intracellulare peptide stimulated stronger responses than did the M. tuberculosis peptide, whereas patients with active tuberculosis had enhanced in vitro T-cell responses to both peptides.


Background/Aim: Stroke is a well-documented public health problem in low, middle, and high-income countries. Post stroke, patients are discharged home quite early and usually need help with activities of daily living. This help is usually provided by informal carers. The purpose of this study was to establish the effect of carer education on functional abilities of patients with stroke in a low resource setting where access to rehabilitation post discharge was limited. Methods: A randomised controlled trial consisting of two groups (control and experimental) each with 100 patients and their carers was used. The carers in the control group received individualised training as was needed to help look after the person with stroke. The patient's functional abilities were measured using the Barthel Index and the Rivermead Mobility Index. Measurements were taken at discharge, 3, 6 and 12 months post discharge from hospital. Results: Patients were discharged home with low functional abilities and though they improved over time, they did not do so to satisfactory levels. Carer education alone did not result in significant improvements in patients' functional abilities. Implications and conclusion: There is a need to devise new ways of providing rehabilitation to patients post discharge from hospital e.g. strengthen domiciliary visits. Carers require more support to enable them to positively influence patient outcomes post stroke.


Background and Objective: Iguana breeders usually used red spinach as a feed for iguanas. However, several studies have indicated that red spinach contains oxalate and purine which are harmful if consumed at a certain level because they can interfere with kidney function. This study aimed to investigate the change of anatomy and histology of green iguana (Iguana iguana) kidney after feeding with red spinach. Materials and methods: Twelve iguanas were used in this study and were divided into four groups in accordance to the dose level of red spinach (100%, 75%, 50% and 25%, namely group I to IV, respectively). The red spinach was given for 30 days through the nasogastric intubation. The effect of red spinach administration was observed through the anatomy and histological changes. The results were statistically analyzed with One Way ANOVA with p<0.05 was considered significant, and Post Hoc Test. The histopathology change of the kidney was analyzed descriptively. Results: The administration of red spinach in iguanas caused some anatomy changes of the kidney; such as the enlargement of iguana's kidney. The histological findings included the enlargement of the glomerulus, capsular space constriction, hydropic degeneration, tubular dilation, necrosis, and formation of connective tissue (fibrosis), uric acid crystal sediment (gout), oxalate crystal, and lymphocyte infiltration. Among four different dose levels of red spinach, 100% of red spinach caused the highest damage to the iguana's kidney. The significant change grew as the increasing dose of red spinach that was given to the green iguanas' bodies. Conclusion:  Red spinach caused changes in anatomy structure as well as kidney histology of green iguanas. Severe damages occurred in the treatment group III, moderate damage occurredin the treatment group II, and light damage occurred in the treatment group I. Keywords: Green iguana, Red spinach, Kidney, Anatomy Change, Histology Change


Sepsis is a life-threatening condition caused by a dysregulated immune response to infection. Interestingly, sepsis mortality increases with acute kidney injury (AKI) and patients with AKI worsen with sepsis. It is interesting to note that most of the clinical trials on sepsis treatment that derived from the results of translational researches are a failure. This is, in part, because of the complexity of human sepsis in comparison with animal models. Another reason for the failure-translation might be the improper matching of the animal models to the individual patient. It is possible that the main mechanism of sepsis induction in each patient with the variety causes of sepsis might be different. Indeed, immune response to sepsis depends on genetic background, route of immune activation, and organisms. Thus, sepsis treatment classified by "mechanistic approach" to individual patient might be more proper than the classification with "sepsis severity". Specific treatment of sepsis in individual patient according to the specific immune response characteristic might be a more proper translational strategy. Indeed, the understanding in immune response pattern of sepsis and sepsis pathophysiology is necessary for "sepsis mechanistic approach". Then, we conclude most of the topics and our hypothesis regarding SA-AKI in this review.


As the assessment standards of the community structure, in this paper, it unfolds the process of modularity. Firstly, it describes the original authority definition of Newman in detail, and popularizes to all kinds of different types networks. With the discovery of overlap feature, the modularity integrates the characteristic property of belonging factor, including extensions on Newman's modularity and the non-fuzzy modularity based on node contribution. Next, some new novel definitions are represented; LC modularity proves the defects of Newman modularity and provides a better choice with density and cohesion, and local modularity shows a way to community in large scale network. And then, the comparisons of the various definitions demonstrate their advantages and disadvantages, and the academic cause is analyzed, it is that the different understanding on the community structure results in the different reference model. In the end, weighted LC modularity is proposed, and some serviceable suggestions on the independence and equity are presented, and it proves that the collective decision-making community pattern surpasses the single self-centered vertex pattern.


In this essay, I will examine Chesnutt's use of black folkloric material and vernacular forms in The Conjure Woman. Chesnutt's collection of stories responds to a tradition of Plantation fiction that often portrayed black people in stereotypical terms. Chesnutt effectively writes against the grain of that popular fiction by appropriating African American folklore as a counter-hegemonic racial narrative. The text accomplishes this through its portrayal of Uncle Julius, an ex-slave storyteller whose colorful folk tales are ostensibly deployed as a means of outwitting his white employer. However, his stories also illustrate the ways in which the characters of these folk tales utilize symbolic forms and practices such as conjuration in establishing personal agency and challenging racial proscriptions. Thus, I will argue that Chesnutt represents the act of story-telling in the collection as a symbolic expression of black agency and racial formation (Omi and Winant, 1994, p. 56). Indeed, Chesnutt's marshals black folklore as a means of exposing both the past horrors of slavery and the continuing effects of racial inequality. In doing so, these stories of racial transformation, often involving the supernatural metamorphosis of characters into animal form, (re)define blackness as positive value within the dehumanizing system of American slavery. Therefore, by evoking African American folklore as an interpretative framework for (re)constructing racial meaning, Chesnutt's literary work functions as a "racial project," Michael Omi and Howard Winant's (1994) term describing the representational strategies underlying processes of racial formation (p. 56). As "racial project," Chesnutt's fiction posits at once the social reality and the social fiction of race in America. When "The Goophered Grapevine" was first published in 1887, its author Charles W. Chesnutt was relatively unknown. The first story penned by a black author to be published in the Atlantic Monthly, "The Goophered Grapevine" would later become the opening piece in Chesnutt's collection of black vernacular tales, The Conjure Woman, published in 1899. It was his first major fictional work. Although it has often been described as a "novel," The Conjure Woman is perhaps best understood as a collection of folk tales narrated from several points of view, the most central of which is Chesnutt's ex-slave storyteller, Uncle Julius McAdoo. After its publication, Chesnutt would quickly gain a reputation as a writer of "color line fiction" and plantation stories of slavery. Ironically, the latter placed in him a category that included authors such as Joel Chandler Harris and Thomas Nelson Page, whose stories of plantation life framed the old South (and slavery itself) in romantic terms. In a 1901 letter addressed to Chesnutt, his friend and sometimes adversary, Booker T. Washington, wrote "I think you have a golden opportunity to create sympathy throughout the country for our cause through the medium of fiction" (Washington, personal communication, 1901). Washington adds in the same letter that the principle authors of Plantation fiction, Harris and Page, "have done infinite harm through their writings" (1901). Chesnutt echoed Washington's concerns, writing in response "it has been the writings of Harris and Page and others of that ilk which have furnished my chief incentive to write something upon the other side of this very vital question" (Chesnutt, personal communication, 1901). The "question" Chesnutt tacitly refers to here is the so-called "Negro question," perhaps the most important question of his day as it involved both the social uplift of black people after emancipation as well as their status as citizens after the failures of reconstruction. If Chesnutt believed himself to be "upon the other side of this vital question," he then clearly viewed mainstream literary representations of black people as part of the problem. These mainstream representations were popular precisely because they proffered a reductive view of black culture and lived experience as entirely derivative of slavery. …


Abstract : Solutions to the problem of obtaining the optimal bounded input to a servomechanism which must follow a discrete-time random process are given in the case of a first order system. If the random process is a finite Markov chain, solutions can be obtained for any servomechanism with finite state vector, with each component having only a finite range. The cost function is any function of the state and of the control, which is restricted to a finite set of values. The generalizations of these problems can be done in various directions. Keeping the assumptions of a discrete-time random process x(t) and the form of the cost functional, which both ake sense in engineering applic tions, a first extension would be o consider servom c anisms of order greater than one, in the cases of independent and of M rkov dependent random variables. As a further extension, the cost functional could include a function of the control itself, instead of depending only on the error. In the finite case, when the inputs and the servomechanism take values in finite sets only, the problem is theoretically solved by application of the minimization procedure in a product space of sufficiently high dimensions. However, this b comes rapidly numerically unworkable as the number of variabl s increases. How to reduce the dimensionality of the problem is then worth a careful investigation. (Author)


The aim of this study was to determine whether femoral neck preserving total hip arthroplasty would become less difficult and more efficient during the first 20 cases and to identify potential pitfalls during the introduction of this procedure. The difficulty and efficiency of the initial 20 procedures performed by four surgeons was prospectively determined by analysing a total of 68 video recordings using time-action analysis. This method measures the duration and efficiency of individual actions needed for a surgeon to achieve his or her goal. Afterwards, we reviewed all actions with a long duration and discussed possible causes of delay with the surgeons to identify possible pitfalls. We found a decrease of difficulty and an increase of efficiency during the first 20 cases and a more consistent execution after the initial five cases. Estimating the correct osteotomy level and stem curvature was often difficult, which resulted in a variable stem position. Radiologic analysis demonstrated a tendency for varus position and increased leg length throughout the series, even after the surgeons demonstrated technical proficiency.


Organic polymers with ability of apatite formation in body environment are expected as novel bone substitutes having not only bone-bonding ability, i.e. bioactivity, but also mechanical performance analogous to natural bone. Several metal oxides have been found to be effective for the apatite deposition in body environment. In addition, release of calcium ions from the materials significantly enhances it. In this study, we attempted to synthesize bioactive organic-inorganic hybrids from poly(vinyl alcohol) (PVA) by incorporation of titanium oxide or zirconium oxide as well as calcium salt. Ability of apatite formation on the hybrids was examined in vitro using simulated body fluid (SBF, Kokubo solution). Apatite deposition was observed to occur on the surfaces of PVA/titanium oxide hybrids in SBF, when their compositions were appropriately controlled.


In this paper we propose a new technique for Semi-Supervised Learning based on attraction forces. The main idea behind the SSL paradigm is to perform a classification task taking into account a few labeled instances and the information provided by many unlabeled instances. Essentially, the proposed technique considers each data instance as dimensionless points on a n-dimensional space and performs their dynamics accordingly to the resultant forces. The labeled points act as fixed attraction points whereas the unlabeled ones move towards them, whereby the unlabed instances are labeled through a label propagation mechanism when they approximate a defined neighborhood region around a fixed attraction point. The technique mainly takes into account two important SSL assumptions: smoothness and cluster. The results obtained from simulations performed on artificial datasets exhibit the effectiveness of the proposed method.


DMF (dimethyl fumarate) exerts anti-inflammatory and pro-metabolic effects in a variety of cell types, and a formulation (BG-12) is being evaluated for monotherapy in multiple sclerosis patients. DMF modifies glutathione (GSH) levels that can induce expression of the anti-inflammatory protein HO-1 (haem oxygenase-1). In primary astrocytes and C6 glioma cells, BG-12 dose-dependently suppressed nitrite production induced by either LI [LPS (lipopolysaccharide) at 1 μg/ml plus IFNγ (interferon γ) at 20 units/ml] or a mixture of pro-inflammatory cytokines, with greater efficacy in C6 cells. BG-12 reduced NOS2 (nitric oxide synthase 2) mRNA levels and activation of a NOS2 promoter, reduced nuclear levels of NF-κB (nuclear factor κB) p65 subunit and attenuated loss of IκBα (inhibitory κBα) in both cell types, although with greater effects in astrocytes. In astrocytes, LI decreased mRNA levels for GSHr (GSH reductase) and GCL (c-glutamylcysteine synthetase), and slightly suppressed GSHs (GSH synthetase) mRNAs. Co-treatment with BG-12 prevented those decreased and increased levels above control values. In contrast, LI reduced GSHp (GSH peroxidase) and GCL in C6 cells, and BG-12 had no effect on those levels. BG-12 increased nuclear levels of Nrf2 (nuclear factor-erythroid 2 p45 subunit-related factor 2), an inducer of GSH-related enzymes, in astrocytes but not C6 cells. In astrocytes, GSH was decreased by BG-12 at 2 h and increased at 24 h. Prior depletion of GSH using buthionine-sulfoximine increased the ability of BG-12 to reduce nitrites. In astrocytes, BG-12 increased HO-1 mRNA levels and effects on nitrite levels were blocked by an HO-1 inhibitor. These results demonstrate that BG-12 suppresses inflammatory activation in astrocytes and C6 glioma cells, but with distinct mechanisms, different dependence on GSH and different effects on transcription factor activation.


The electoral communication flows produced by leaders, parties, and the main candidates are the result of hybrid media logics and this is due to the environment in which they develop, and to the communicative strategies used. These strategies are generated by the intersection of traditional media logics (TV, radio, press) with digital media logics (Internet).
This article investigates the social media communication habits of the main Italian leaders and political parties on Twitter and Facebook. To understand how the hybrid campaign developed in the Italian context, specific indicators were identified to operationalize social media habits related to: (a) communicative strategy, based on the productivity of the account (broadcast) and on its degree of interactivity (conversational), (b) skillfulness, regarding the capability to use different features of the social media platform; and (c) engagement, related to the capacity of the account to involve the audience. Results show that a more skillful use of the platforms, combined with a conversational communication strategy, produce more engaging messages regardless the specific political actor (leader or party). Finally, the outcomes show a significant strengthening of hybrid media campaigning during the last Italian general elections on 4 March 2018.


Abstract
Real estate investment has been generally accepted as a value-adding proposition for a portfolio investor. Such an impression is not only shared by investment professionals and financial advisors but also appears to be supported by an overwhelming amount of research in the academic literature. The benefits of adding real estate as an asset class to a well-diversified portfolio are usually attributed to the respectable risk-return profile of real estate investment together with the relatively low correlation between its returns and the returns of other financial assets. By using the regime-switching technique on an extensive historical dataset, we attempt to look for the statistical evidence for such a claim. Unfortunately, the empirical support for the claim is neither strong nor universal. We find that any statistically significant improvement in risk-adjusted return is very much limited to the bullish environment of the real estate market. In general, the diversification benefit is not found to be statistically significant unless investors are relatively risk averse. We also document a regime-switching behavior of real estate returns similar to those found in other financial assets. There are two distinct states of the real estate market. The low-return (high-return) state is characterized by its high (low) volatility and its high (low) correlations with the stock market returns. We find this kind of dynamic risk characteristics to play a crucial role in dictating the diversification benefit from real estate investment.


Multiscale PCA (MSPCA) is a well-established fault-detection and isolation (FDI) technique. It utilizes wavelet analysis and PCA to extract important features from process data. This study demonstrates limitations in the conventional MSPCA fault detection algorithm, thereby proposing an enhanced MSPCA (EMSPCA) FDI algorithm that uses a new wavelet thresholding criterion. As such, it improves the projection of faults in the residual space and the threshold estimation of the fault detection statistic. When tested with a synthetic model, EMSPCA resulted in a 30% improvement in detection rate with equal false alarm rates. The EMSPCA algorithm also relies on the novel application of reconstruction-based fault isolation at multiple scales. The proposed algorithm reduces fault smearing and consequently improves fault isolation performance. The paper will further investigate the use of soft vs. hard wavelet thresholding, decimated vs. undecimated wavelet transforms, the choice of wavelet decomposition depth, and their implications on FDI performance.The FDI performance of the developed EMSPCA method was illustrated for sensor faults. This undertaking considered synthetic data, the simulated data of a continuously stirred reactor (CSTR), and experimental data from a packed-bed pilot plant. The results of these examples show the advantages of EMSPCA over existing techniques.


Compressed Path Databases (CPDs) are a leading technique for optimal pathfinding in graphs with static edge costs. In this work we investigate CPDs as admissible heuristic functions and we apply them in two distinct settings: problems where the graph is subject to dynamically changing costs, and anytime settings where deliberation time is limited. Conventional heuristics derive cost-to-go estimates by reasoning about a tentative and usually infeasible path, from the current node to the target. CPD-based heuristics derive cost-to-go estimates by computing a concrete and usually feasible path. We exploit such paths to bound the optimal solution, not just from below but also from above. We demonstrate the benefit of this approach in a range of experiments on standard gridmaps and in comparison to Landmarks, a popular alternative also developed for searching in explicit state-spaces.


This study explored the personal and professional needs of novice school counselors and the ways in which they feel mattered through qualitative methodology. Findings revealed that mattering manifested through interactions with administrators, positive student connections and student success, and collaborations with others. Factors that reduced feelings of mattering included lack of formal interaction with administrators, ineffective transition processes, and lack of an assigned, formal mentor.


Background: Anger expression refers to the manner in which an individual expressed her/his emotional experience of anger (which may include anger-in, anger-out, or anger-constant). Anger-out is the tendency to express one's anger outwardly as negative manner which may involve the use of aggressive actions. Anger-in refers to the extent to which individuals suppress anger when they are experiencing negative emotions, whereas constant means that there is no change. Aim: The aim of the present research was to study the interaction of anger expression and mental health among school students of Kashmir valley. Method: One hundred and twenty school students with equal number of males and females were selected from different districts of Kashmir valley. The Anger Expression (Ax) scale and the Youth Self-Report (YSR) inventory were the tools for data collection. Results: Group comparisons between male and female students were not significant on the measures of anger expression (i.e. anger-in, anger-out, and anger-constant) and mental health (i.e. internal, external, and neither internal nor external). Anger-in and anger-out were significantly correlated with the mental health dimensions of internal, external, and neither internalising nor externalising). Whereas, the relation between anger control with external and neither internal nor external dimensions of mental health was negative; but, it was statistically insignificant. Multiple regression analyses yielded anger-out as a significant predictor of mental health (F=12.24; p<0.001). Twenty four per cent variance (R2 change=0.24; beta value=0.44) in mental health was explained due to anger-out (t-value=5.29; p<0.001). The results are discussed in the context of history of violence in Kashmir.


Multiphase flows are frequently encountered in many important physical and industrial applications. These flows are usually characterized by very complicated structure that involves free moving surfaces inside the fluid domain and discontinuous or even singular material properties of the flow. The application range for the multiphase flow phenomena is extremely wide, ranging from processing industry to environmental problems, from biological applications to food industry and so on. Unfortunately, due to the inherent complexity of these problems, their solution proved to be a considerable challenge. Thus, in the many applications, the predictive capability and physical understanding must rely heavily on numerical models. In this thesis we develop and analyze a finite element based method for the solution of multiphase problems. This thesis consists of four papers. In paper 1 we develop our finite element based method for the elliptic interface problems. The interface jump conditions that are present due to the discontinuity of the coefficients and presence of the singular forces are derived. Using these jump conditions, we enrich the finite element spaces in order to account for the irregularities in the flow. The resulting method was applied to the interface Stokes problem, modeling a thin elastic rubber band immersed in the homogeneous fluid. In order to apply the introduced method, the interface Stokes problem was rewritten as a sequence of three Poisson problems, one for the pressure and two for the velocity components. Paper 2 is an extension of the ideas used in paper 1. Namely, third order Hermitian polynomials are used as basis functions, their modification according to the interface jump conditions is presented and analyzed, both theoretically and numerically. The rigorous error analysis of the introduced method for two-dimensional elliptic problems is presented in paper 3. The results imply that our method is second order accurate in the L2 norm. Finally, paper 4 concerns with the extension of our method to a coupled interface Stokes problem, that contains both singular forces and discontinuities in the material properties. An application to the Rayleigh-Taylor instability problem is presented.


By screening a drug library comprising FDA approved compounds, we discovered a potent interaction between the antifungal agent haloprogin and the experimental organometallic drug RAPTA-T, to synergistically induce cancer cell killing. The combination of these two small molecules, even at low doses, elicited an improved therapeutic response on tumor growth over either agent alone or the current treatment used in the clinic in the highly aggressive syngeneic B16F10 melanoma tumor model, where classical cytotoxic chemotherapeutic agents show little efficacy. The combination with the repurposed chemodrug haloprogin provides the basis for a new powerful treatment option for cutaneous melanoma. Importantly, because synergistic induction of tumor cell death is achieved with low individual drug doses, and cellular targets for RAPTA-T are different from those of classical chemotherapeutic drugs, a therapeutic strategy based on this approach could avoid toxicities and potentially resistance mechanisms, and could even inhibit metastatic progression.


An exhaustive search for shortly spaced repeats in 74 bacterial chromosomes reveals that they are much more numerous than is usually acknowledged. These repeats were divided into five classes: close repeats (CRs), tandem repeats (TRs), simple sequence repeats (SSRs), spaced interspersed direct repeats, and "others." CRs are widespread and constitute the most abundant class, particularly in coding sequences. The other classes are less frequent, but each individual element shows a higher potential for recombination, when the number of repeats and their distances are taken into account. SSRs and TRs are more frequent in pathogens, as expected given their role in contingency loci, but are also widespread in the other bacteria. The analysis of CRs shows that they have an important role in the evolution of genomes, namely by generating duplications and deletions. Several cases compatible with a significant role of small CRs in the formation of large repeats were detected. Also, gene deletion in Buchnera correlates with repeat density, suggesting that CRs may lead to sequence deletion in general and genome reductive evolution of obligatory intracellular bacteria in particular. The assembly of these results indicates that shortly spaced repeats are key players in the dynamics of genome evolution.


The key element to a successfully business continuance is the implementation of Total Quality Management but however if not properly implemented or used it can lead to a failure. The theory behind Total Quality Management is sound so the problems that can be generated from the usage and implementation must come from another important source. This source is the leadership and employees of that particular organization. The leadership or management of an
organization and the employees can greatly impact the final outcome of a Total Quality Management implementation. Just how Total Quality Management can give impact on organizational leadership and employees on their job satisfaction is a topic that is often not considered well until a Total Quality Management project and issues begin to arise. From the literature, five antecedents of employee job satisfaction are identified. The variables measured
are "employee participation", "teamwork, "recognition and rewards", "organizational culture" and "education and training". This research seeks to investigate the employees' perception on the Total Quality Management factors and its impact on job satisfaction in a manufacturing facility. A total of 120 questionnaires were distributed, 98 questionnaires were returned and useable
representing 82 percent response rate. The Pearson correlations test results showed that "educational and training" is the top influential factors in determining employees' job satisfaction. On the other hand, "employee participation" is the second significantly that influenced job satisfaction followed by "teamwork and "organizational culture". Lastly, "recognition and rewards" suggests that employees need to be monitored in order to have a better
job. The findings could prescribe potential implications for top management to review their TQM programs. Managers must, therefore, consider these factors in all TQM initiatives.


Delay-sensitivity of real-time applications stipulates resilience against errors and losses in multimedia content. Such resilience is particularly important for bandwidth-constrained and error-prone wireless networks. Recent wireless studies have highlighted that significant improvements in bandwidth utilization and multimedia quality can be achieved if the decision to retain or drop "corrupted" packets is made at the application layer instead of medium access, network or transport layers. Such a strategy, however, necessitates that the maximum number of (good and bad) packets are relayed to the application layer while minimizing any modifications (if any) to the widely-deployed UDP/IP protocol stack. Previous studies have proposed that, while ignoring corruptions in packet payload, only packets with errors in the headers should be dropped. We introduce a receiver-based scheme which uses the history of a multimedia session to correct packet header errors, thereby improving the throughput of real-time applications over wireless local area networks (LANs). The proposed scheme is truly receiver-based and, therefore, does not require any modifications to the source or any intermediate network node. Only minor modifications are required to the protocol stack of the multimedia receiver. Specifically, the proposed scheme generates statistics based on the history of "critical" protocol header fields for active multimedia sessions. These statistics are in turn employed to (a) correct errors in the critical fields and (b) determine if the relevant packets belong to the receiver's session of interest.


This article argues that the democratic peace theorists have overlooked the defining development that underlies that peace of the nineteenth and twentieth centuries: the industrial-technological revolution. Not only did that revolution make democracy on a country scale possible; it also made all the countries that experienced the revolution—democratic and nondemocratic—far less belligerent in comparison with preindustrial times. The democratic peace did not exist among premodern democratic and republican city-states, not because they were not democratic or liberal enough but because they were premodern. Other factors that have emanated from the modern transformation and may generate greater aversion to war apply mostly to liberal democratic countries while being only variably connected to their regime. Such factors include the staggering rise in the standard of living; the decrease in hardship, pain, and death; the dominance of metropolitan life and the service economy; the spread of the consumer and entertainment society; sexual promiscuity; women's franchise; and the shrinking ratio of young males in the population.


The evaluation of the hydraulic performance of geotextiles from field experiments is not an easy task as it takes a long time before conclusions can be drawn. Laboratory research is the only possibility to evaluate the performance of various geotextiles in a relatively short period. Permeameters with upward flow are used to achieve that purpose. As the flow of water through a soil is not a static process, an increasing hydraulic gradient is applied. Tests normally last three weeks. They allow the prediction of the risk of particle passage as well as the risk of blocking and clogging. However, results cannot be expressed as a gradient ratio only. The gradient ratio just gives an overall picture of the behavior of soil and envelope. To evaluate the hydraulic performance of the envelope, a comparison must be made between the evolution of the hydraulic gradient in the soil and the hydraulic gradient across the geotextile. Permeameter tests designed to evaluate the performance of geotextiles require careful preparation and accurate execution. Not only soil types but also soil conditions may influence the final results. The experience with permeameter research is described and results are presented.


Lewis acid-mediated highly regioselective S N2-type ringopening of 2-arylN-tosylazetidines with alcohols to afford various 1,3-amino ethers in excellent yields with good enantiomeric excess is described. Similar S N2-type ringopening of chiral 2-phenylN-tosylaziridine with various alcohols produces the corresponding nonracemic 1,2-amino ethers in excellent yields and good ee. The mechanism of the ring-opening of aziridines and azetidines Via an SN2 pathway is supported by the formation of nonracemic amino ethers.


Mammography is one of the screening methods used to detect breast cancer, which is established based on the protocols within a health system. However, many developing countries are unable to avail of this method. Although, other screening methods can be used in rural areas with portable equipment and well-trained radiology technologists. Our investigation aims to determinate the frequency of mammography in radiology departments as a basis for education of radiological technologists. Materials and methods: We performed a retrospective analysis of the frequency of mammography and mastectomies in the last three years at the Bitola clinical hospital in Macedonia. Results: Upon examining the procedures of 2,373 patients over the last three years, results indicate a high number of diagnosed and treated breast cancer patients. Radiological technologists are involved in the process of diagnosing and treating the disease and also can learn from other medical experts. Discussion: The radiation dose in modern mammography is not as high as in an MRI, and with precise protocols mammography can be used as a screening method in almost every hospital. Conclusion: University-educated radiological technologists can perform some diagnostic methods in rural areas without the supervision of a doctor. Education of these staff could have a huge economic benefit for society, particularly in rural areas in which, an easy access to a full-service hospital is not available.


Aim: The assessment of the survival rate according to axillary lymph nodes status in patients diagnosed with breast cancer. Material and methods: The study group included 206 women, treated in the 4th Obstetrics and Gynecology Clinic during 2002-2005. All patients were treated surgically with lymph nodes dissection. The analyzed variables included clinical and morphological features of both primary tumor and axillary lymph nodes. We have evaluated 5 years survival in relation to positivity and number of dissected lymph nodes. In order to determine the prognostic value of evaluated variables we have used Kaplan Meir method. Results: 77.7% of all patients were aged between 40 and 49 years old and 62.6% of them presented stage II tumors. Invasive ductal carcinoma was the most frequent histologic type (79.12%) and 71.2% of tumors were moderated of poorly differentiated, lymph nodes invasion being presented in 93 cases. Survival was significantly influenced by lymph node sta-tus (p = 0.0001), number of involved nodes (p = 0.0001), number of dissected nodes in pN0 patients (p = 0.0001) and application of adjuvant systemic therapy in pN0 patients (p = 0.0001). Conclusions: The pathological examination of axillary nodes in breast cancer patients offers a valuable information regarding survival. The absence of lymph node metastases of 10 lymph nodes dissection or more, and the application of adjuvant systemic therapy favorably influence the survival.


Background Malaria control efforts are stifled by the emergence and dispersal of parasite strains resistant to available anti-malarials. Amino acid changes in specific positions of proteins encoded by Plasmodium falciparum genes pfcrt, dhps, dhfr, and pfmdr1 are used as molecular markers of resistance to antimalarials such as chloroquine, sulphadoxine-pyrimethamine, as well as artemisinin derivatives. However, a challenge to the detection of single nucleotide polymorphisms (SNPs) in codons responsible for these amino acid changes, in several samples, is the scarcity of automated computational pipelines for molecular biologists to; rapidly analyze ABI (Applied Biosystems) Sanger sequencing data spanning the codons of interest in order to characterize these codons and detect these molecular markers of drug resistance. The pipeline described here is an attempt to address this need. Method This pipeline is a combination of existing tools, notably SAMtools and Burrows Wheeler Aligner (BWA), as well as custom Python and BASH scripts. It is designed to run on the UNIX shell, a command line interpreter. To characterize the codons associated with anti-malarial drug resistance (ADR) in a particular gene using this pipeline, the following options are required; a path to reference coding sequence of the gene in FASTA format, gene symbol (pfcrt, pfmdr1, dhps or dhfr), and a path to the directory of ABI sequencing trace files for the samples. With these inputs, the pipeline performs base calling and trimming, sequence alignment, and alignment parsing. Results The output of the pipeline is a CSV (Comma-separated values) file of sample names, codons and their corresponding encoded amino acids. The data generated can be readily analyzed using widely available statistical or spreadsheet software, to determine the frequency of molecular markers of resistance to anti-malarials such as chloroquine, sulphadoxine-pyrimethamine and artemisinin derivatives. Conclusions ADRes is a quick and effective pipeline for detecting common molecular markers of anti-malarial drug resistance, and could be a useful tool for surveillance. The code, description, and instructions for using this pipeline are publicly available at http://setfelix.github.io/ADRes.


Developing an understanding of the potential consequences for children of disorganised attachment is thought to be significant to practitioners This articles reviews the literature on the theory of mental health outcomes for children who display disorganised attachment behaviours. The complex relationships between biochemical, neurological and behavioural systems in relation to attachment are discussed. A connection in the literature between some children with disorganised attachment who receive a diagnosis of conditions such as attention deficit disorder, attention deficit hyperactive disorder, oppositional defiant disorder and conduct disorder, and later progression into adult diagnosis of personality, anxiety and major depressive disorders was found. Disorganised attachments are considered to lead to a higher risk of developing dissociative symptoms and psychopathology in later life.


This thesis develops a technique for the identification,dassification and quantification of instream flow environments. These features have been traditionally referred to as 'habitats' by lotic ecologists, in this research they are termed 'hydraulic biotopes'. The hydraulic biotope is the lowest of six nested levels of a hierarchical geomorpho[ogi2al model. This model has been developed as a tool to assist river managers, researchers and conservationists to categorise or classify rivers with respect to their geomorphic characteristics. Each level of the model provides data at a different level of resolution. This ranges from the broad scale catchment data to the site specific 'habitat' or hydraulic biotope data. Although this thesis is primarily concerned with the development of the hydraulic biotope, the interaction of all catchment variables needs to be recognised. Detailed analysis of hydraulic biotope data in the Buffalo River are presented within the broader hierarchical model. Consultation with lotic ecologists, together with a review of ecological literature, emphasised the need for a standardised terminology for the classification of ecologically significant instream flow environments. At present a fairly haphazard 'habitat' classification tends to be carried out by most researchers, this often leads to confusion in the identification and naming of differenf hydraulic biotopes ('habitats'). This confusion is exaggerated by the sharing of terminology between lotic ecology and fluvial geomorphology, usually for the categorisation of different types of features. A review of the ecological literature emphasises the importance of flow hydraulics within a river to describe the distribution of biota. The hydraulic variables considered to be most significant inClude velocity and depth. As river morphology directly determines the prevailing distribution of depth, velocity and substratum, it is obvious that there are important links to be made between fluvial geomorphology and lotic ecology. This thesis explores the potential of the hydraulic biotope as a tool to help develop those links. This thesis presents a standardised classification matrix for the identification of hydraulic biotopes. The matrix is simply based on water surface characteristics together with channel bed substratum. The validity of this matrix is tested by statistical analysis of hydraulic variables quantifying flow conditions within the various hydraulic biotope classes. Data is presented from four different river systems, each representing a different sedimentological environment. Where possible the influence of discharge has been considered. Results from more than 3000 data points show that hydraulic biotopes have distinct hydraulic characteristics in terms of velocity-depth ratio, Froude number, Reynolds number, 'roughness' Reynolds number and shear velocity. These hydraulic indices represent flow conditions both as an average within the water column, and near the bed. Statistical analysis shows that the hydraulic characteristics of the various hydraulic biotope classes are relatively consistent both within different fluvial environments and at different stages of flow. Unlike the morphological unit in which the hydraulic biotope is nested, in stream flow environments are shown to be temporally dynamic. Using the classification matrix as a tool for identification, -~ hydraulic biotopes identified at one discharge are shown to be transformed from one class to another as a response to change in stage. The pattern of transformation is shown to be consistent within different sedimentological environments. An examination of the associations between hydraulic biotopes and morphological units demonstrates that, although some hydraulic biotopes are common to all morphological units (backwater pools, pools and runs), some features have specific associations. In this study rapids were found to be prevalent in bedrock pavement, bedrock pool and plane bed morphology, while cascades, chutes and riffles were common to plane bed, step and riffle morphology. Results from this research indicate that the hydraulic biotope, within the hierarchical geomorphological model, has the potential to aid the prediction of channel adjustment and associated 'habitat' (hydraulic biotope) transformation in response to changes in flow and sediment yield. These are likely to become increasingly important issues as South Africa strives to maintain a balance between the development of water resources to meet the needs of the rapidly expanding population, whilst at the same time maintaining the fluvial environment for sustainable use.


A genetic search algorithm in conjunction with density functional theory calculations was used to determine the lowest-energy minima of the pure B22 cluster and thereby to evaluate the capacity of its isomers to form endohedrally doped cages with two transition metal atoms M (M = Sc and Ti). An important charge transfer from metal atoms M to the boron cage takes place, stabilizing the endohedral compounds, as predicted with the genetic algorithm implemented. High-level coupled-cluster theory CCSD(T) calculations were carried out to confirm that the structures found are the lowest-energy isomers. For a deeper understanding of the doping effects and related charge transfer, the best structural motif of the B22 isomers was also determined when the bare cages are in anionic states, such as B222- and B224-. It was found that B22 has an appropriate size, geometric shape and electronic state to host the chosen metal atoms and, consequently, to form stable endohedrally doped compounds Ti@B22 (C2v, 4-Ti) and Sc@B22 (C2v, 5-Sc). The chemical bonding was analyzed in order to understand the molecular orbitals that these novel systems form. The cage aromaticity was evaluated by means of the nuclear independent chemical shift (NICS(0)iso) indices, the isochemical shielding surface (ICSSzz), the anisotropy of the current induced density (ACID) maps, and the magnetic ring current Gauge-Including Magnetically Induced Current (GIMIC) method, indicating that aromaticity plays a crucial role in the stabilization of endohedrally doped boron clusters. Finally, the thermodynamic stability of the latter, using parameters derived from density functional theory (DFT), was evaluated. Ab initio molecular dynamics (AIMD) simulations were performed to elucidate the stability, at high temperature, of the most stable endohedrally doped boron clusters 4-Ti and 5-Sc.


Polyethylene terephthalate (PET) is one of the major electret materials which has been studied and widely used in charge storage applications for a long time. The homo-charge and hetero-charge formation responsible for the electret effect of PET can be explained by the dipolar polarization, space charge separation and charge injection respectively as a result of contact poling or corona charging. These processes are also verifiable from studies of surface charges and thermally stimulated depolarization current (TSDC) of the PET films. Now consider a stack of PET films charged under the same condition as a single film. It would be intuitively expected that the electret effects of the individual films of the stack should be different due to their different positions in the stack. However, in a recent study on charged PET stacks, it was found that the electret effects of the individual films are quite similar. The surface charges of the individual films are about the same and they sum to make same total as a single charged PET film. On the other hand, the TSDC thermograms of individual films show similar characteristics in the thermal relaxation processes where homo- and hetero- charge effects are still observed. From the TSDC results, especially for the film in the middle of a triple layer sandwich, it shows clearly dipolar polarization and charge injection related peaks. These findings agree with the results of surface charge studies of the individual films.


: The blood flow was studied in occlusive disorders of major extracranial blood arteries. Doppler ultrasound was used to quantify the blood flow and velocity in 120 patients. Four stenosis degrees were singled out. In the 1st one, internal carotid artery (ICA) was narrowed by 50%, and blood flow and velocity were reduced by more than 35% as related to normal levels. In 2nd degree stenosis. ICA blood flow decreased below the 65% level and ante- and retrograde blood flow was detected in orbital artery. In 3rd grade stenosis (over 75% ICA occlusion) the retrograde flow in the orbital arteries was recorded and ICA blood flow was considerably reduced. ICA occlusion featured no blood flow in ICA and orbitals, or high retrograde orbital blood flow (p less than 0.001). Reliable criteria were developed for detection of vertebral and ICA stenosis.


The metabolism and biliary excretion of [14C]phenytoin (DPH) was examined in female control rats and in rats pretreated with estradiol-17 beta (E2) (1 mg/day s.c.) for 7 days. In the isolated perfused liver, the half-time of [14C]DPH in the perfusate was not altered by E2 treatment, nor was the rate of appearance and disappearance of 5-[14C]phenyl-5-para-hydroxyphenylhydantoin (HPPH), the major metabolite of DPH. Cumulative secretion of the glucuronide 4- and 6-fold, respectively, in E2-treated rats. Following administration of [14C]DPH (1 mg/kg i.v.) in vivo, the concentration of [14C]HPPH-glucuronide was significantly increased in the blood in E2-treated rats, although there was no significant decrease in the bile concentration or excretion rate of this metabolite. Bile flow averaged 50 and 35 microliters/min/kg in control and E2-treated rats, respectively. Following administration of [14C]HPPH (60 mg/kg i.v.) in vivo, the rate of disappearance of [14C]HPPH from the blood was increased in E2-treated rats. The concentration in bile (micromoles per milliliter) and biliary excretion rate (micromoles per minute per kilogram) of [14C]HPPH-glucuronide were significantly increased in E2-treated rats relative to controls. Maximal bile/blood concentration ratios of [14C]HPPH-glucuronide were 725 and 200 in control and E2-treated rats, respectively, indicating a decreased ability of the liver to concentrate the glucuronide conjugate in the bile following estrogen treatment.


Increasing availability of devices with processing and communication capabilities, such as PDAs and mobile phones, has led to a desire to use various combinations of these devices for new and as yet unrealised operations. Not only are mobile devices expected to offer facilities like e-mail and Web browsing, but also more demanding operations such as displaying video. Attaining these operations within a stationary environment with good workstations is non-trivial; however, many other factors are associated with attaining these tasks in a highly active ad-hoc environment. In particular, a means of discovering available devices and enabling manipulation of them within a highly active environment is required. This paper examines the currently available architectures for the detection and manipulation of devices leading to a describing of the novel approach taken by MARE (Mobile Agent Runtime Environment).


This paper is mainly devoted to identify an evolutionary approach based on search strategy, namely multiobjective evolutionary algorithm for indoor positioning (MEIP). Each subproblem is optimized by information from its several neighboring subproblems, which makes MEIP lower computational complexity at each generation and be capable of determining the user position with high accuracy. Experimental results have demonstrated that MEIP is able to achieve accuracy significantly better than the current WLAN location determination systems. It has been shown that MEIP using objective normalization can deal with disparately scaled objectives, and MEIP with an advanced decomposition method can generate a set of very evenly distributed solutions for n-objective test instances. The ability of MEIP to track a large number of users and to be used with large areas, the scalability and sensitivity of MEIP have also been experimentally investigated in this paper.


Objective: To determine whether ritodrine‐stimulated production of prostaglandin (PG) F2α by pregnant uterine tissues can be blocked by the concurrent administration of ketorolac, a PG synthesis inhibitor. Methods: We infused saline, ritodrine, ketorolac, or a combination of ritodrine and ketorolac into chronically catheterized pregnant sheep. Concentrations of PGF2α in uterine venous plasma were measured by radioimmunoassay at 0, 1, 2, 3, 4, and 24 hours during the infusions. Results: Ritodrine significantly increased uterine venous PGF2α; mean percent increases at 4 hours were 330% and 380%, and at 24 hours 370%, compared with controls. During concurrent ritodrine and ketorolac infusion, there was no increase in uterine venous PGF2α at any time. Conclusions: Ketorolac completely blocks ritodrine‐stimulated production of PGF2α in pregnant uterine tissues. We conclude that ritodrine stimulates PG production through mobilization of arachidonic acid, and this can be effectively blocked with a PG synthesis inhibitor. This finding may have important clinical applications in the treatment of preterm labor.


Abstract This paper extends Brock and Durlauf's (2001a, 2001b) binary choice complete network (or group interaction) model with homogeneous rational expectations to a general network model with heterogeneous rational expectations. In our model, individuals will form expectations regarding peers' behaviors taking into account their characteristics. Endogenous, contextual, and correlated effects are all identifiable. Conditions for unique equilibrium are established. For a complete network with heterogeneous rational expectations, multiple equilibria can be characterized by an aggregate scalar index. The empirical results on adolescents' smoking behaviors show significant endogenous and contextual effects, even after controlling for school-grade random effects and school fixed effects.


HER2+ breast cancer (BC) is a highly aggressive subtype, affecting ~20% of BC patients. Current treatments include adjuvant or neoadjuvant chemotherapy plus anti-HER2 agents such as trastuzumab, a monoclonal antibody directed against HER2. Despite improvement in disease free survival, most patients eventually succumb to metastatic disease, which is largely incurable. Consequently, there is an urgent need to identify novel drugs that can efficiently kill HER2+ BC and/or potentiate the effect of existing anti-HER2 therapies. We performed a lenti-viral shRNA kinome screen on non-adherent mouse Her2/Neu tumorspheres and identified TBK1, a non-canonical IκB kinase (IKK), as the most potent target [1]. TBK1 knock-down, or treatment with TBK1-II, a drug that efficiently inhibits TBK1 and its close relative IKKe (IKBKE), suppressed growth of human HER2+ BC cells and induced cellular senescence. Senescence was associated with inhibition of phosphorylated/active p65-NFkB and induction of the cell cycle inhibitor, p16ink4a. In addition, TBK1-II cooperated with lapatinib, a EGFR/HER2 inhibitor, to accelerate apoptosis in vitro and suppress tumor growth in a xenograft model of HER2+ BC. Thus, TBK1/IKKe inhibitors may improve treatment of HER2+ BC in cooperation with anti-HER2 therapy.


When reliable prior bounds on the acceptable errors between the data and corresponding model outputs are available, bounded-error estimation techniques make it possible to characterize the set of all acceptable parameter vectors in a guaranteed way, even when the model is nonlinear and the number of data points small. However, when the data may contain outliers, i.e., data points for which these bounds should be violated, this set may turn out to be empty, or at least unrealistically small. The outlier minimal number estimator (OMNE) has been designed to deal with such a situation, by minimizing the number of data points considered as outliers. OMNE has been shown in previous papers to be remarkably robust, even to a majority of outliers. Up to now, it was implemented by random scanning, so its results could not be guaranteed. In this paper, a new algorithm based on set inversion via interval analysis provides a guaranteed OMNE, which is applied to the initial localization of an actual robot in a partially known two-dimensional (2-D) environment. The difficult problems of associating range data to landmarks of the environment and of detecting potential outliers are solved as byproducts of the procedure.


Physical Education (PE) is one of the most gendered school subjects, and is historically based on a binary which normalises a difference between young men and young women. As young people develop through adolescence, their social lives are characterised by interconnected social fields, including schooling, sport and media. This study sought to explore how young people negotiate their gendered identities within, and across, these interconnected fields using a Bourdieusian analysis. I used a mixed-methods approach of collective case studies to answer three research questions:
1. What role does sport play in the ways young people negotiate their gendered identity?
2. What role do schooling and media messages play in reproducing gender norms for young people?
3. How does social class influence how young people understand sport and their gendered identity?

My methods combined a content and narrative analysis of media messages produced by four online sports media outlets during Rio 2016 Olympic Games with case studies in three demographically different schools in North East England. In each school, Year 11 students completed a questionnaire about their participation in sport and physical activity, coupled with their views of masculinity and femininity. Following this, interviews with 70 young people (33 males, 37 females) were conducted which focused on how young people negotiate their gendered identities within different social fields.

Using Bourdieusian concepts of habitus, field and capital, this study has shown that these young people are strongly influenced by rigid and stereotypical representations of masculinity and femininity which are often conflated with binary notions of biological sex. The internalisation of these norms within one's gendered habitus has meant that many young people expressed a sense of being "trapped" by these rigid notions of "acceptable" gendered behaviours, and consequently reproduce an ideology of difference between masculinity and femininity. Sport is internalised as "natural" within young men's habitus, where participation and excellence in the "right" sport can lead to the accrual of social status and popularity. In contrast, the "sporty" female is othered, and little capital can be accrued for female participation in sport. Instead, young women are pressured to presenting an image of a "healthy" female appearance (one which is often unattainable as both skinny and curvy) through a symbolic attention to the body. Many young women go to the gym, but do not engage in vigorous exercise when they are there.

Within this thesis, I refer to young people playing the game of gender, whereby there are "rules", tactics, referees and winners/losers. The expectations of the game differ depending on whether the individual is male or female, and also on one's classed position. This metaphor demonstrates an awareness that young people can be simultaneously affected by both structure and agency. By using tactics and strategy to manipulate one's own gendered identity, young people can show agency. However, the rewarding of stereotypical and binary representations of masculinity and femininity through capital often means that many young people feel pressure to reproduce normative behaviours which do not challenge the status quo of the doxa.

This PhD paints a negative image of how schooling and PE reinforce gender norms which prevent many young people experimenting and exploring their own gendered identities. However, through challenging young people's reflexivity during the interview process, I found that many young people can reflect on their behaviours, bringing the often-non-conscious habitus into consciousness. This suggests that to challenge taken-for-granted norms of the habitus, pedagogy and research must encourage this reflexivity and force young people to think about gender in ways they have not done before.


decapentaplegic (dpp) encodes a Drosophila transforming growth factor‐β homologue that functions as a morphogen in the developing embryo and in adult appendage formation. In the wing imaginal disc, a Dpp gradient governs patterning along the anteroposterior axis by inducing regional expression of diverse genes in a concentration‐dependent manner. Recent studies show that responses to graded Dpp activity also require an input from a complementary and opposing gradient of Brinker (Brk), a transcriptional repressor protein encoded by a Dpp target gene. Here we show that Brk harbours a functional and transferable repression domain, through which it recruits the corepressors Groucho and CtBP. By analysing transcriptional outcomes arising from the genetic removal of these corepressors, and by ectopically expressing Brk variants in the embryo, we demonstrate that these corepressors are alternatively used by Brk for repressing some Dpp‐responsive genes, whereas for repressing other distinct target genes they are not required. Our results show that Brk utilizes multiple means to repress its endogenous target genes, allowing repression of a multitude of complex Dpp target promoters.


Laser Surgery and Medicine: Principles and Practice is a compilation of articles from the journal Lasers in Surgery and Medicine. The dermatology chapter by Ronald Wheeland is 22 pages long. It describes the range of lasers available and their clinical uses, including cutaneous surgery and the treatment of tattoos and vascular and pigmented lesions. A short section addresses new laser applications in dermatology. Cutaneous resurfacing is not covered, perhaps because the explosion of interest in this area is a relatively recent occurrence. The remainder of the 447 pages are devoted to lasers in other areas of medicine. This book will be of interest to those who require a comprehensive overview of the use of lasers in specialties other than dermatology. Ambulatory phlebectomy is an outpatient procedure in which diseased venous segments are removed through a series of micropunctures or microincisions with a surgical hook and local anesthesia. During the past


Many service industry firms strive hard to fill free capacity in order to cover their costs for a fixed capital stock. This paper presents a time series model where the capacity constraint is an integral part. The integer-valued autoregressive model builds on a simple idea of how daily time series arise for hotels and other similar establishments. Measures that follow naturally from the time series model are the occupancy probability and the duration of stay for the visitor. Empirically, we study the effects of price changes and a large festival, on these measures.


The approximation of the overall aerosol extinction coefficient is conventionally achieved through integrating the single particle extinction efficiency over the whole size distribution, which requires much computational time. In this work, a new approximation scheme with higher efficiency than the conventional scheme is proposed, in which the combination of polynomials for fitting Mie's solution and the method of moments produces the overall extinction coefficient of evolving nanoparticles. The closure of arbitrary moments is achieved by implementing the Taylor-series expansion method of moments. The new approximation scheme was verified by comparing it to a more exact referenced scheme for two different typical aerosol modes, namely the nucleation mode and the accumulation mode. This study verifies that the new scheme is a reliable method for approximating the overall extinction coefficient during aerosol evolution with acceptable efficiency and accuracy; thus, it is suitable for use in some atmospheric aerosol models.


Eighty-five samples of commercially available Japanese green teas were assayed for caffeine and the following eight catechins; epicatechin (EC), epigallocatechin (EGC), epicatechin gallate (ECg), epigallocatechin gallate (EGCg), catechin (C), gallocatechin (GC), catechin gallate (Cg), and gallocatechin gallate (GCg). The tea samples were derived from the following types of tea ; Gyokuro, Matcha, Sencha, Bancha, Hojicha, Kamairisei tamaryokucha, and Mushisei tamaryokucha. The total catechin content ranged from 9 to 18 except Hojicha and the caffeine content ranged from 2 to 4 % of dry tea leaf. Four major catechins, EC, EGC, ECg, and EGCg, and caffeine were found in nearly all of tea, although some of the Hojicha samples did not have quantititative levels of EC. In addition, four catechins, C, GC, Cg and GCg, were detected in some samples. Gyokuro and Matcha, both of which are produced from leaves grown under a sunshade, contained more caffeine and less catechins compared to the other types of teas. In general, the higher grade teas contained more caffeine and the lower grade teas contained more catechins. More than half of total catechins contented in the teas was EGCg. The combined contents of EGC and EGCg comprised approximately 80 % of total catechin content regardless of the tea type. The level of the free type catechins, EC and EGC, was less than half of the contents of ester type catechins, ECg and EGCg, in Sencha and the tamaryokuchas and less than one-third of ester type catechins in Gyokuro and Matcha. The level of catechins was much lower in Hojicha tea than in the other six types and the catechins composition was also different ; probably due in part to the roasting of the tea during processing.


We argue that neoclassical value theory suffers from a more basic and serious logical indeterminacy, which is inherent in the axiom of price-taking behavior, and which renders price dynamics indeterminate before inquiring as to its stability. If everyone in the economy takes price as given, whence come these prices? Who is giving these prices? Jevons avoided the indeterminacy by assuming that people must have complete information on supply and demand, and the consequent equilibrium prices—'perfect competition.' Walras in effect imported an external agent who found the prices by trial-and-error-correction (the Walrasian Auctioneer). Paradoxically, both approaches had the potential better to serve central planning, than a market economy. A theory based on price taking agents required some agency for giving prices. Indeed, the fit with socialism was rigorously established by influential neoclassical authors starting from Wieser (1893, ch. VI) and Pareto (1897, 364-371; 1909, 362-364), and, more formally during the Socialist Calculation Debate, by Barone ([1908] 1935), Lerner (1934), and Lange (1936, 1937). The paradox is hidden in the idea of 'perfect competition' a passive treatment of individuals who are not even interacting, let alone interacting in a rivalrous manner. 'Perfect competition' is the negation of any real competition, as Hayek (1948) emphasized.


PURPOSE
To determine the maximum-tolerated dose (MTD), dose-limiting toxicities, and potential antitumor activity of weekly paclitaxel with concurrent radiation (RT) for locally advanced pancreatic and gastric cancer.

PATIENTS AND METHODS
Thirty-four patients with locally advanced adenocarcinoma of the pancreas or stomach were studied. The initial dose of paclitaxel was 30 mg/m2 by 3-hour intravenous (I.V.) infusion repeated every week for 6 weeks with 50 Gy RT. Doses were escalated at 10-mg/m2 increments in successive cohorts of three new patients until dose-limiting toxicity was observed.

RESULTS
The dose-limiting toxicities at 60 mg/m2/wk were abdominal pain within the RT field, nausea, and anorexia. Of 23 patients with assessable disease, 11 (seven with gastric, four with pancreatic cancer) had objective responses for an overall response rate of 48%.

CONCLUSION
Concurrent paclitaxel with upper abdominal RT is well tolerated at dosages that have substantial activity. A phase II trial of neoadjuvant paclitaxel and RT at the MTD of 50 mg/m2/wk is underway.


The mammalian gut microbiota is considered pivotal to host fitness, yet the determinants of community composition remain poorly understood. Laboratory studies show that environmental factors, particularly diet, are important, while comparative work emphasises host genetics. Here, we compare the influence of host genetics and the environment on the microbiota of sympatric small mammal species (mice, voles, shrews) across multiple habitats. While sharing a habitat caused some microbiota convergence, the influence of species identity dominated. In all three host genera examined, an individual's microbiota was more similar to conspecifics living elsewhere than to heterospecifics at the same site. Our results suggest this species-specificity arises in part through host-microbe codiversification. Stomach contents analysis suggested that diet also shapes the microbiota, but where diet is itself influenced by species identity. In this way, we can reconcile the importance of both diet and genetics, while showing that species identity is the strongest predictor of microbiota composition.


Although various techniques and materials have been used for making cranioplasty implants, personalized cranioplasty implants are high in cost because of expensive materials and production technology, long design and manufacturing time, and intensive labor use. This research was a part of our research project in ASEAN countries to investigate feasible technical solutions of minimizing the implant cost based on available production technologies in the region. The use of 3-axis CNC (Computer Numerical Control) milling techniques for making molds to fabricate PMMA implants was successfully investigated. With the development of a design support program bridging between Computer Aided Design (CAD) and Medical Image Processing (MIP) system, the time for geometrical modeling of implants and molds was reduced to half a day. The machining time to complete a mold was about 5 to 6 hours; and it took maximal 2 hours to fabricate an implant with self-curing PMMA and 3 and half hours for fabricating an implant with heat-curing PMMA. The cost of implants is acceptable for the ASEAN region.


This article analyzes the Supreme Court appeal in Ernest & Young LLP v. Morris, argued in October 2017. The Court will decide if the provisions of National Labor Relations Act invalidate class action waivers in employment arbitration clauses, requiring that employees arbitrate their grievances on an individual, rather than a collective basis.
The Court's consideration of the Ernst & Young appeal continues the Court's recent attention to arbitration clauses and class action waivers. In particular, the Court will for the first time take up the controversial question of class action waivers included in employment contracts that contain arbitration clauses. The controversy centers primarily on a question of statutory construction of the NLRA in relation to the Arbitration Act.
Although the Court has upheld the primacy of the Arbitration Act in cases involving allegedly conflicting statutes, the purported clash of the Arbitration Act with the NLRA may present the Court with a closer call. The Court may focus on the NLRA's statutory language repeatedly referring to the protection of collective worker rights under the law. The Court might well rely on this statutory language to find Congressional intent to override the Arbitration Act. On the contrary, if the Court resorts to a requirement of express Congressional intent to supersede the Arbitration Act, the plaintiffs' appeal may fail to gain support.
If enforced, contractual arbitration clauses force employees to arbitrate their grievances with their employers and to forego litigation in court. The addition of class action waivers in arbitration clauses deprives employees of the ability to pursue class action litigation either in judicial forums or in arbitration.
The Court's ruling in Ernst & Young is important because of the prevalence of arbitration clauses embedded in employment contracts. Employers nationwide now routinely include arbitration provisions in their employment contracts. The Court's initial arbitration jurisprudence centered on arbitration provisions in consumer product contracts and warranties. Until now, the Court has not considered the enforceability and legality of arbitration clauses in employment contracts. The Court's decision potentially will affect millions of workers.
In the consumer arena, the Court's arbitration jurisprudence generally has not been sympathetic to plaintiffs' attempts to invalidate and render arbitration clauses unenforceable. Instead, the Court has defaulted to the policy favoring arbitration and the enforceability of arbitration clauses as a matter of contract law. Moreover, the Court has consistently deflected various challenges to class action waivers contained in arbitration clauses.
Recognizing the magnitude of the Court's decision relating to employer-employee rights, an array of amicus briefs have been filed in support of the contending parties. Unsurprisingly, the business community and assorted defense organizations have supplied briefs in furtherance of Ernst & Young's position on the primacy of the Arbitration Act over the NLRA. Countering this, a usual collection of liberal groups, labor organizations, and civil rights advocates have joined to urge the Court to uphold the Ninth Circuit's decision rendering Ernst & Young's arbitration provision unenforceable.


South Australia (SA) has a reputation as clean and green and natural. SA takes biosecurity very seriously, and natural barriers of desert facilitate keeping out fruit fly, cane toads and other unwanted intruders. There is a battle raging in South Australia for the integrity of its agricultural sector. SA is a world leader in organic agriculture. It accounts for 20% of the world's certified organic agriculture hectares - SA is Australia's leading state for organics. It capital, Adelaide, hosts the world's largest organics certifier (NASAA). There are no genetically modified crops grown in SA. There has been a GMO (genetically modified organisms) Moratorium in SA for the past two decades (beginning in 2003). While Australia is a giant in organics (accounting for 51% of world certified organic hectares), it is a minnow in the world of GMOs (accounting for 0.4% of the world's GMO hectares). Despite the natural advantages of SA for producing clean and green and natural food, the incumbent government appears 'hell bent' on dismantling the successful and popular SA GMO Moratorium. Most Australians (90%) do not regard GMOs as "safe", and they may be right. But, whether they are right or wrong, or just right to be cautious, in the market place consumers will vote with their dollars. Globally, consumers avoid purchasing GMOs. The SA GMO Moratorium is in place due to an Act of Parliament. There are two ways to dismantle it, by Regulation or by an Act of Parliament. Regulations can be interposed to subvert the intention of the Act. This can be regarded as shoddy governance since there is no mandatory Parliamentary oversight nor debate (Gazetted Regulations are only debated if there is a disallowance motion tabled). Alternatively, an Act can be changed by Parliament. The incumbent Liberal (i.e. conservative) government of SA, led by Steven Marshall, appears to have a very tenuous grasp on the concept of 'democracy'. There is no mandate to dismantle the SA GMO Moratorium, but that is what they are trying for. There was a review of the GMO Moratorium and the majority (78%) of submissions supported the continuance of the Moratorium.


Interference is one of the major degrading factors of mobile ad hoc networks (MANET). Since, MANET transmits over the single wireless channel; packets of the same flow interfere with each other greatly. This mutual interference causes the bottleneck over the network. Further, predicting interference accurately around a transmitter or receiver is a complicated task. As a solution to these problems, in this paper, we propose an interference reduction technique for MANET using mathematical prediction filters. The technique used Hidden Markov Model (HMM) for predicting the interference of the nodes. Initial transmission power is set by comparing received signal power with minimum and maximum values. During data transmission, RTS and CTS messages are exchanged using initial transmission power level and they include interference value of the source and destination respectively. The source then uses the interference value of the destination to transmit data packet. On the other hand, the destination uses the interference value of the source for transmitting the acknowledgement (ACK) packet to the source. Thus, this interference calculation at both ends reduces the interference. By simulation, we show that our technique reduces the interference considerably.


The diagnosis of SLE is associated with an enlarging assortment of autoantibodies. The presence or absence of particular antibodies influences the confidence with which this diagnosis is made. It is the presence of autoantibodies and the deposit of immunoglobulin that has led to the general conclusion that lupus is an autoimmune disease.


Increasing over-the-top video consumption endangers the sustainability of content delivery over the Internet. Internet Service Providers (ISP) face difficulties in competing on value-added services with content providers and Content Delivery Network (CDN) operators. In this respect, we propose a new model for the collaboration between content delivery stakeholders, so that CDN operators can deploy their software in ISP infrastructures leveraging on Network Function Virtualization (NFV). As the ISP network topology and utilization is deemed confidential, we use a high-level Service Level Agreement (SLA) for the negotiation of both computing resources and connectivity, allowing the ISP to optimize server selection, while providing at the same time sufficient flexibility to the CDN operators for content delivery. Furthermore, we present a linear programming formulation for the VNF Service Chain Embedding and an heuristic to increase problem tractability with a small cost overhead. Finally, we validate the efficiency of the proposed service chain model for virtual CDN management.


A 65-year-old woman underwent elective hip replacement surgery and postoperatively developed significant anterograde amnesia, without other significant neurological deficits. Magnetic resonance imaging (MRI) revealed an area of infarction in the anterior fornix and genu of the corpus callosum. Neuropsychological testing revealed extremely poor learning performance and immediate memory, as well as delayed memory, consistent with anterograde amnesia. This case illustrates the relationship between the anterior fornix and memory function and the role of hypoperfusion brain injury in ischemic strokes. Keywords: Anterograde amnesia, brain fornix, ischaemic stroke, postoperative period


Parasitic worm infections are a major health issue around the world, which causes numerous physiological
damages in the patient's infected organ(s).The aim of this review was to investigate the anthelmintic properties of various
medicinal plants.In this systematic review, all randomized controlled trials (RCTs), quasi-experimental and experimental
studies that examining the anthelmintic effects were retrieved from databases including Institute for Scientific Information
(ISI) and PubMed from 1988-2019 by interesting keywords.In vitro and in vivo studies have demonstrated that many
medicinal plants, including their compounds and derivatives, have anthelmintic properties through various mechanisms of
action (MOA). Examples of MOAs include paralysis of the helminths' central nervous system, tegumental (outer body
covering) destruction, interference with enzyme functioning, increased autophagy and apoptosis and reduction in cell
viability and count. These actions lead to reduction in the helminth ability to reproduce, decrease in eggs count, inhibition
of energy generation, damage to digestive tissues, lipid and ion accumulation, and change in and binding to different
regulatory proteins and disruption of the helminth motor activity. These MOA can also be used for the treatment of parasitic
worms. Medicinal plants and their compounds have been the primary sources of new therapeutics, and are comparably more
cost-effective than synthetic drugs and provide effective methods to combat parasitic worms that have entered into the
human body. Therapists must take into account the effective dose of these compounds in treating the patients and also
consider their overall health status including comorbidities. There is an urgent need to conduct clinical trials using certain
approaches, such as clinical interventional trials, to identify the effectiveness of herbal medicines in treating human host
and zoonotic helminthic infections.


Elmore delay has been widely used to estimate interconnect delays in the performance-driven synthesis and layout of very-large-scaleintegration (VLSI) routing topologies. For typical RLC interconnections, however, Elmore delay can deviate significantly from SPICE-computed delay, since it is independent of inductance of the interconnect and rise time of the input signal. Here, we develop an analytical delay model based on first and second moments to incorporate inductance effects into the delay estimate for interconnection lines under step input. Delay estimates using our analytical model are within 15% of SPICE-computed delay across a wide range of interconnect parameter values. We also extend our delay model for estimation of source-sink delays in arbitrary interconnect trees. We observe significant improvement in the accuracy of delay estimates for interconnect trees when compared to the Elmore model, yet our estimates are as easy to compute as Elmore delay. Evaluation of our analytical models is several orders of magnitude faster than simulation using SPICE. We also illustrate the application of our model in controlling response undershoot/overshoot and reducing interconnect delay through constraints on the moments.


During the past decade, model order reduction (MOR) has been successfully applied to reduce the computational complexity of elliptic and parabolic systems of partial differential equations (PDEs). However, MOR of hyperbolic equations remains a challenge. Symmetries and conservation laws, which are a distinctive feature of such systems, are often destroyed by conventional MOR techniques, resulting in a perturbed and often unstable reduced system. The goal of this thesis is to study and develop model order reduction techniques that can preserve nonlinear invariants, symmetries, and conservation laws and to understand the stability properties of these methods compared to conventional techniques. Hamiltonian systems, as systems that are driven by symmetries, are studied intensively from the point of view of MOR. Furthermore, a conservative model reduction of fluid flow is presented. It is illustrated that conserving invariants, conservation laws, and symmetries not only result in a physically meaningful reduced system, but also result in an accurate and robust reduced system with enhanced stability.


Thirty‐eight patients with a mean age of 53.2 years (19 to 75 years of age), who were receiving doxorubicin (D) for malignant disease, were studied in order to determine the relationship between functional and morphologic myocardial changes at different dose levels. Serial patient evaluations included physical examination, chest x‐ray, electrocardiogram (ECG), endomyocardial biopsy (EMB), and rest‐exercise gated nuclear angiography (GNA), at doses of D ranging from 144 to 954 mg/m2 (mean, 426 mg/m2). Physical examination, chest x‐ray, and ECG proved to be insensitive predictors of D cardiotoxicity. Correlation of GNA and EMB in 31 patient evaluations, exclusive of known heart disease, did not reveal any false‐positive angiograms, and all abnormal GNAs were associated with abnormal biopsies. Use of stress GNA uncovered six abnormal ventricles which could have been missed with a rest GNA alone. It has been suggested that: (1) GNA is a reliable monitor of D therapy; (2) an exercise study should be performed when the rest ejection fraction is normal, but is unnecessary when the rest EF is abnormal; (3) all patients with a resting ejection fraction of less than 45%, exclusive of other cardiac disease, should have D discontinued; and (4) endomyocardial biopsy is useful in assessing D cardiotoxicity in patients with other possible causes of an abnormal GNA.