OBJECTIVE
To determine whether a multidisciplinary mobility promotion quality-improvement (QI) project would increase patient mobility and reduce hospital length of stay (LOS).

PATIENTS AND METHODS
Implemented using a structured QI model, the project took place between March 1, 2013 and March 1, 2014 on 2 general medicine units in a large academic medical center. There were 3352 patients admitted during the QI project period. The Johns Hopkins Highest Level of Mobility (JH-HLM) scale, an 8-point ordinal scale ranging from bed rest (score = 1) to ambulating ≥250 feet (score = 8), was used to quantify mobility. Changes in JH-HLM scores were compared for the first 4 months of the project (ramp-up phase) versus 4 months after project completion (post-QI phase) using generalized estimating equations. We compared the relative change in median LOS for the project months versus 12 months prior among the QI units, using multivariable linear regression analysis adjusting for 7 demographic and clinically relevant variables.

RESULTS
Comparing the ramp-up versus post-QI phases, patients reaching JH-HLM's ambulation status increased from 43% to 70% (P < 0.001), and patients with improved JH-HLM mobility scores between admission and discharge increased from 32% to 45% (P < 0.001). For all patients, the QI project was associated with an adjusted median LOS reduction of 0.40 (95% confidence interval [CI]: -0.57 to -0.21, P < 0.001) days compared to 12 months prior. A subgroup of patients expected to have a longer LOS (expected LOS >7 days), were associated with a significantly greater adjusted median reduction in LOS of 1.11 (95% CI: -1.53 to -0.65, P < 0.001) days. Increased mobility was not associated with an increase in injurious falls compared to 12 months prior on the QI units (P = 0.73).

CONCLUSIONS AND RELEVANCE
Active prevention of a decline in physical function that commonly occurs during hospitalization may be achieved with a structured QI approach. In an adult medicine population, our QI project was associated with improved mobility, and this may have contributed to a reduction in LOS, particularly for more complex patients with longer expected hospital stay. Journal of Hospital Medicine 2016. © 2016 Society of Hospital Medicine.


Two novel bacterial strains were isolated from sandy soil from Cox's Bazar, Bangladesh. Strains 5-10-10(T) and 5-38-42(T) were Gram-positive, aerobic, non-motile actinomycetes that form branched substrate and aerial mycelium. On the basis of 16S rRNA gene sequence similarity studies, the novel strains were shown to belong to the genus Nonomuraea, being most closely related to Nonomuraea fastidiosa. Chemotaxonomic data supported the assignment of the novel strains as members of the genus Nonomuraea. Strain 5-10-10(T) contained MK-9(H(4)) and strain 5-38-42(T) contained MK-9(H(6)) and MK-9(H(4)) as the major menaquinones. Major polar lipids were phosphatidylethanolamine and hydroxyphosphatidylethanolamine. The major cellular fatty acid for strain 5-10-10(T) was iso-C(16 : 0) (26.4 %); C(16 : 0) (17.4 %) was the major cellular fatty acid for strain 5-38-42(T). The results of DNA-DNA hybridization and physiological tests enabled strains 5-10-10(T) and 5-38-42(T) to be differentiated genotypically and phenotypically from each other and from the closely related species, N. fastidiosa. On the basis of these results, strains 5-10-10(T) and 5-38-42(T) represent two novel species of the genus Nonomuraea. Following an evaluation of morphological, physiological and chemotaxonomic characteristics, 16S rRNA gene sequence comparisons and DNA-DNA hybridization experiments, the new isolates are proposed as two novel species, Nonomuraea bangladeshensis sp. nov. [type strain, 5-10-10(T) (=MTCC 8089(T)=JCM 13930(T))] and Nonomuraea coxensis sp. nov. [type strain, 5-38-42(T) (=MTCC 8090(T)=JCM 13931(T))].


The goal of this thesis was to investigate the influence of YWHAE on the chondrogenic potential of chondrogenic progenitor cells (CPC). If it would be possible to enhance their chondrogenic potential, CPCs would be a possible option as cell therapy to treat osteoarthritis. First, we tried to generate a homozygous YWHAE knockout in CPCs by using the CRISPR/Cas9 method. Due to not definitely known processes, possibly regulation in the CPCs or apoptosis, no CPCs with a homozygous knockout could be cultivated. It was possible however to generate a heterozygous YWHAE Knockout in CPCs, which leads to reduction of the YWHAE protein level to about 25 %. If these manipulated CPCs are cultivated in alginate culture, they produce significantly more SOX9 and less RUN2 than not manipulated CPCs. This leads to the conclusion that YWHAE has a negative impact on the synthesis of the chondrogenic factor SOX9 and a positive impact on the synthesis of the factor RUNX2. Despite this promising impact on the regulation factors CPCs with a heterozygous YWHAE knockout do not produce an increasing number of COL2. There was no reduction of the osteogenic factor COL1. The ACAN-mRNA level, tested by qPCR, does show a significantly reduction, which is also not a promising result. Furthermore, histologic images of alginate cultures do not show visible changes of the chondrogenic markers. It seems that a direct reduction of YWHAE is not a promising option to enhance the chondrogenic potential of CPCs.
Further investigations are necessary to determine the additional effects of YWHAE on CPCs, which could influence the ECM synthesis. The exact interaction between SOX9, RUNX2 and YWHAE should be the goal of new studies. With more knowledge it could be possible to block the connection between YWHAE and these two factors exclusively and not to manipulate the other effects YWHAE has on CPCs. Another important field of investigation could be to the interaction between the regulators SOX9 and RUNX2 with COL2 to find out why no influence has been detected. If it would be possible to enhance the chondrogenic potential of CPCs by manipulation of YWHAE or another factor, more studies besides measuring of chondrogenic markers would be necessary to determine the possible use of manipulated CPCs as a therapeutic option.


Background: De Quervain's disease is ste¬nosing tenosynovitis of the abductor pollicis longus and the extensor pollicis brevis within the first extensor retinaculum compartment of the wrist. The patient usually present with clinical symptoms like pain and a painful range of motions of the thumb which occur either due to increased friction force or due to increase in contain within the compartment during the gliding of the adductor pollicis longus (APL) and the extensor pollicis brevis (EPB) first extensor compartment. Following conservative trials of rest, moist heat, NSAID, and local steroid injections, surgical release of the first compartment are effective treatment modalities for De Quervain's disease, but these even leads to failure of treatment as there may be variation on the anatomy of first extensor compartment of wrist. We had done this study to find out anatomical variation in first extensor compartment during treatment of De Quervains tenosynovitis. Method: Anatomical Variations like presence or absence of septum between APL and EPB, number of tendon slip of APL and EPB in the first extensor compartment were studied in 16 patients of dequervains tenosynovitis who underwent open surgical release as the treatment. Result: 7/16 (43.75%) of patient has partial or complete Sub compartment in the fibro-osseous tunnel and 4/16 (25%) patient has extra Abductor Pollicis Longus (APL) tendon sheath in first extensor compartment. Conclusion: We found significant increase in variation of anatomy in first extensor compartment of De Quervains tenosynovitis patient which will be for the surgeon during the surgical release of first extensor compartment.


Neuroblastomas and many other solid tumors produce high amounts of macrophage migration inhibitory factor (MIF), which appears to play a role in tumor progression. We found that MIF expression in neuroblastoma inhibits T cell proliferation in vitro, raising the possibility that MIF promotes tumorigenesis, in part, by suppressing antitumor immunity. To examine whether tumor-derived MIF leads to suppression of T cell immunity in vivo, we generated MIF-deficient neuroblastoma cell lines using short hairpin small interfering RNAs (siRNA). The MIF knockdown (MIFKD) AGN2a neuroblastoma cells were more effectively rejected in immune-competent mice than control siRNA-transduced or wild-type AGN2a. However, the increased rejection of MIFKD AGN2a was not observed in T cell-depleted mice. MIFKD tumors had increased infiltration of CD8+ and CD4+ T cells, as well as increased numbers of macrophages, dendritic cells, and B cells. Immunization with MIFKD AGN2a cells significantly increased protection against tumor challenge as compared with immunization with wild-type AGN2a, and the increased protection correlated with elevated frequencies of tumor-reactive CD8+ T cells in the lymphoid tissue of treated animals. Increased numbers of infiltrating tumor-reactive CD8+ T cells were also observed at the site of tumor vaccination. In vitro, treatment of AGN2a-derived culture supernatants with neutralizing MIF-specific Ab failed to reverse T cell suppressive activity, suggesting that MIF is not directly responsible for the immune suppression in vivo. This supports a model whereby MIF expression in neuroblastoma initiates a pathway that leads to the suppression of T cell immunity in vivo.


The visual world composed by the human and computational cognitive systems strongly relies on shapes of objects. Skeleton is a widely applied shape feature that plays an important role in many fields of image processing, pattern recognition, and computer vision. Thinning is a frequently used, iterative object reduction strategy for skeletonization. Sequential thinning algorithms, which are based on contour tracking, delete just one border point at a time. Most of them have the disadvantage of order-dependence, i.e., for dissimilar visiting orders of object points, they may generate different skeletons. In this work, we give a survey of our results on order-independent thinning: we introduce some sequential algorithms that produce identical skeletons for any visiting orders, and we also present some sufficient conditions for the order-independence of template-based sequential algorithms.


Although according to Pfeiffer (2002) rating scales are the second most used type of diagnostic tools intended for identification of giftedness besides intelligence tests, they are often criticized due to the lack of validity. Some studies (eg. Miller, Manhal, & Mee, 1991) suggest that parents are able to assess the ability of their children only to some degree of accuracy. It appears that distortion in the assessment may also be caused by variables related to the evaluator. The aim of the study is to verify, if selecting the appropriate form of rating scale could reduce this distortion. For this purpose Preschooler's Ability Rating Scale (PARS) was developed. This method is designed to identify gifted children aged 4-6 years by their parents and consists of two parts. The first one focuses on the development of the child - it detects in which age period specific skills and particular behavior related to giftedness were first observed. The second part is similar to classic rating scales. During the verification of the method (N=263) part of rated children were also assessed by intelligence tests WJ IE II COG (n=90) and UNIT (n=94) to get objective view on their abilities. To capture potentially confounding variable related to the evaluator the FMPS questionnaire of perfectionism was administered to some parents (n=144). Exploratory factor analysis (maximum-likelihood method with geomin rotation) proved three factor structure of the method. The first factor consists of 4 items from developmental part, which are focused on the reading and counting. The second one is comprised by the remaining 8 items of the developmental part, probably due to of their same formal appearance. The same applies in the case of the third factor, which consists of all 12 items of the rating part. Regression and correlation analysis proved that developmental part (expressed by two first factors) has higher concurrent validity with intelligence tests than the rating part (third factor). The strongest relation was proved with the first (reading and counting) factor (eg. r=.44 for the total IQ of WJ). On the contrary unlike the developmental part the third factor correlates with total score of FMPS questionnaire (r=.21). Thus it appears, that classical form of rating scales could be more affected by other variables related to the evaluator than developmental form. These conclusions could have significant implications for further development of rating scales in this area.


For the synthesis of biocomposite materials for useful applications, it becomes necessary to modify the surface of natural fibers through chemical treatments. Morphology, structure and properties of natural fibers have an obvious effect on the mechanical properties of the biocomposite materials. It is thus necessary to know the morphology, thermal stability and crystalline behavior of original and modified fibers. In present paper, sunn hemp fibers (SHF) were chemically modified with ethyl acrylate and binary monomers (EA+MMA, EA+AA) through microwave radiations induced graft copolymerization. Various reaction parameters were optimized to get maximum grafting (91.8%). Morphology, thermal stability and crystalline behavior of original and modified fibers were investigated. Morphological and thermal studies showed that surface of sunn hemp fibers becomes rough and amorphous through graft copolymerization and thermal stability has been found to be increased. Microwave radiation induced grafting showed a diminutive effect on the crystalline behavior of the sunn hemp fibers as optimum time to get maximum grafting is very less (40 min) in comparison to conventional grafting. Synthesized graft copolymers were used as reinforcing material in preparation of polyhydroxybutyrate biocomposites. It has been observed that graft copolymers improved the interface between fiber and matrix and enhanced the mechanical strength of composites. Copyright © 2011 VBRI press.


The chapter overviews the methods, algorithms, and architectures for random number generators based on cellular automata, as presented in the scientific literature. The variations in linear and two-dimensional cellular automata model and their features are discussed in relation to their applications as randomizers. Additional memory layers, functional nonuniformity in space or time, and global feedback are examples of such variations. Successful applications of cellular automata random number/signal generators (both software and hardware) reported in the scientific literature are also reviewed. The chapter includes an introductory presentation of the mathematical (ideal) model of cellular automata and its implementation as a computing model, emphasizing some important theoretical debates regarding the complexity and universality of cellular automata.


Making decisions for a patient affected by sudden devastating illness or injury traumatizes a patient's family and loved ones. Even in the absence of an emergency, surrogates making end-of-life treatment decisions may experience negative emotional effects. Helping surrogates with these end-of-life decisions under emergent conditions requires the emergency physician (EP) to be clear, making medical recommendations with sensitivity. This model for emergency department (ED) end-of-life communications after acute devastating events comprises the following steps: 1) determine the patient's decision-making capacity; 2) identify the legal surrogate; 3) elicit patient values as expressed in completed advance directives; 4) determine patient/surrogate understanding of the life-limiting event and expectant treatment goals; 5) convey physician understanding of the event, including prognosis, treatment options, and recommendation; 6) share decisions regarding withdrawing or withholding of resuscitative efforts, using available resources and considering options for organ donation; and 7) revise treatment goals as needed. Emergency physicians should break bad news compassionately, yet sufficiently, so that surrogate and family understand both the gravity of the situation and the lack of long-term benefit of continued life-sustaining interventions. EPs should also help the surrogate and family understand that palliative care addresses comfort needs of the patient including adequate treatment for pain, dyspnea, or anxiety. Part I of this communications model reviews determination of decision-making capacity, surrogacy laws, and advance directives, including legal definitions and application of these steps; Part II (which will appear in a future issue of AEM) covers communication moving from resuscitative to end-of-life and palliative treatment. EPs should recognize acute devastating illness or injuries, when appropriate, as opportunities to initiate end-of-life discussions and to implement shared decisions.


Red-black planning is a state-of-the-art approach to satisficing classical planning. Red-black planning heuristics are at the heart of the planner Mercury, the runner-up of a satisficing track in the International Planning Competition (IPC) 2014 and a major component of four additional planners in IPC 2018, including Saarplan, the runner-up in the agile track. Mercury's exceptional performance is amplified by the fact that conditional effects were handled by the planner in a trivial way, simply by compiling them away. Conditional effects, however, are important for classical planning, and many domains require them for efficient modeling.Consequently, we investigate the possibility of handling conditional effects directly in the red-black planning heuristic function, extending the algorithm for computing red-black plans to the conditional effects setting. We show empirically that red-black planning heuristics that handle conditional effects natively outperform the variants that compile this feature away, improving coverage on tasks where black variables exist by 19%.


Chemoimmunotherapy is a promising strategy in tumor treatments. In this study, immunogenic dead cells were engineered by the sequential treatment of live tumor cells with ultraviolet (UV) irradiation and cryo-shocking. The dead cells could serve as a lung-targeting vehicle and tumor vaccine after differential loading of the chemo-drug 10-hydroxycamptothecin (HCPT) and immune adjuvant Quillaja saponin-21 (QS-21) via physical absorption and chemical conjugation, respectively. After intravenous administration, the dead cells could be trapped in pulmonary capillaries and could fast release HCPT to enhance the drug accumulation in local tissues. Further, the immunogenic dead cells elicited antitumor immune responses together with the conjugated adjuvant QS-21 to achieve the elimination and long-term surveillance of tumor cells. In a lung tumor-bearing mice model, this drug-delivery system achieved synergistic antitumor efficacy and prolonged the survival of mice.


Kalman filters have shown to be a very accurate and robust method for State of Charge estimation. However, their performance depends heavily on the accuracy of the used battery model and its parameters. These battery model parameters have shown to vary with the State of Health, cell chemistry, temperature and load current. This paper studies a data driven battery model parameter estimation technique based on the recursive least squares method as an alternative to extensively characterizing every cell of interest with time-consuming test procedures. The performance of two commonly used electrical models is compared and extensively validated on three different cell chemistries (Nickel Cobalt Manganese, Lithium Iron Phosphate and Lithium Titanate Oxide), under load conditions of varying dynamic nature representative for electric vehicle (EV) applications, using a Dynamic Discharge Pulse Test (DDPT) and the Worldwide harmonized Light vehicles Test Procedure (WLTP). The developed model is able to identify and update battery model parameters online, for three different chemistries, potentially reducing offline characterization efforts and allowing monitoring of battery electrical behavior and state estimation over its entire lifetime.


In this study, a new boost converter with an active snubber cell is proposed. The active snubber cell provides main switch to turn ON with zero-voltage transition (ZVT) and to turn OFF with zero-current transition (ZCT). The proposed converter incorporating this snubber cell can operate with soft switching at high frequencies. Also, in this converter all semiconductor devices operate with soft switching. There is no additional voltage stress across the main and auxiliary components. The converter has a simple structure, minimum number of components, and ease of control as well. The operation principle and detailed steady-state analysis of the novel ZVT-ZCT-PWM boost converter are given. The presented theoretical analysis is verified exactly by a prototype of 100 kHz and 1 kW converter. Also, the overall efficiency of the new converter has reached a value of 97.8% at nominal output power.


In recent years, it has been investigated how to gain non-technical skills as one of the most influential factors in the daily work activities of the human being. This deficiency manifests itself more frequently in people of small age and with little professional experience, causing different negative effects on the psychological behaviors (cognitive, emotional, etc.), damaging their personal, familiar and work well-being. However, this factor is often developed with repetition in high workload scenarios, such as the medical or hospital environments, and especially in areas of high labor demand and with a higher stress index such as the intensive care unit (ICU) and the emergency department, which are places where the medical staff is exposed to provide a high quality personalized attention, under the pressure of the patient, relatives, directors and administrative of the hospitals, often provoking the alteration of their capacities or psychological factors At the time of providing the service and maintaining patient safety. Thus the proposal of the following research is to support the health professionals to gain non-technical skills through virtual reality to control adverse situations of the environment without harming the patient safety.


The properties of the collective subluminal electrostatic fluctuations in isotropic plasmas are investigated using the covariant kinetic theory of linear fluctuations based on the correct momentum–velocity relation. The covariant theory correctly accounts for the differences in subluminal and superluminal fluctuations in contrast to the non-covariant theory. The general formalism developed here is valid in unmagnetized plasmas and in magnetized plasmas for wavevectors of electrostatic waves parallel to the direction of the uniform magnetic field. Of particular interest are potential differences between the covariant and the non-covariant approach and the consequences of these differences in modifying observational predictions. For thermal particle distributions of protons and electrons with nonrelativistic equal temperatures, the covariant and non-covariant theories yield exactly the same dispersion function and relation for weakly damped electrostatic waves. Also, the quasi-equilibrium wavenumber spectrum of collective thermal electrostatic noise agrees in both theories apart from the important wavenumber restriction | k | > k c = ω p , e / c. While the non-covariant analysis also yields eigenmode fluctuations at small wavenumbers with superluminal phase speeds, the correct covariant analysis indicates that subluminal electrostatic fluctuations are only generated at wavenumbers | k | > k c by spontaneous emission of the plasma particles. As a consequence, the nonrelativistic thermal electrostatic noise wavenumber spectrum is limited to the wavenumber range ω p , e ≤ | k | ≤ k max. Within a linear fluctuation theory, superluminal electrostatic noise cannot be generated.


Sorghum research, just like any research involving other crops, requires a knowledge of experimental techniques that will provide the maximum precision with a minimum of resources. The objective of the present work was to evaluate the implications of sampling size over the results obtained with the application of tests F and Tukey in the analysis of sorghum traits variance. Another objective was to identify ideal sample sizes for those traits, by using two methods: use of the experimental coefficient of variation value (CV) alone; use of formula involving the variance of an estimated plot mean based on a sampling units. Eight sorghum cultivars were evaluated in a random block design with four replicates. All plants in the plot (45), in addition to eight sample sizes (varying from 5 to 40 units, at 5-unit intervals) were utilized to evaluate plant height (PH), dry matter in the vegetative above-ground part of the plant (without the panicle) (DMP), length (PL), and panicle dry matter (PDM). It was observed that the F and Tukey tests, based on samples, could result in different conclusions from those obtained when all plants in the plot are utilized to evaluate DMP and PDM. About 25 units represent samples for the estimation of the four characteristics, when the CV value is used. The adoption of the sample size formula proved that to estimate PH, DMP, PL, and PDM, the ideal sample sizes would be 14 plants, 11 plants, 14 panicles, and 24 panicles, respectively.


BACKGROUND
The COVID-19 pandemic created pressure to delay inpatient elective surgery to increase US health care capacity. This study examined the extent to which common inpatient elective operations consume acute care resources.

METHODS
This cross-sectional study used the Premier Healthcare Database to examine the distribution of inpatient elective operations in the United States from the fourth quarter of 2015 through the second quarter of 2018. Primary outcomes were measures of acute care use after 4 common elective operations: joint replacement, spinal fusion, bariatric surgery, and coronary artery bypass grafting. A framework for matching changing demand with changes in supply was created by overlaying acute care data with publicly available outbreak capacity data.

RESULTS
Elective coronary artery bypass grafting (n = 117 423) had the highest acute care use: 92.8% of patients used intensive care unit beds, 89.1% required postoperative mechanical ventilation, 41.0% required red blood cell transfusions, and 13.3% were readmitted within 90 days of surgery. Acute care use was also substantial after spinal fusion (n = 203 789): 8.3% of patients used intensive care unit beds, 2.2% required postoperative mechanical ventilation, 9.2% required red blood cell transfusions, and 9.3% were readmitted within 90 days of surgery. An example of a framework for matching hospital demand with elective surgery supply is provided.

CONCLUSIONS
Acute care needs after elective surgery in the United States are consistent and predictable. When these data are overlaid with national hospital capacity models, rational decisions regarding matching supply to demand can be achieved to meet changing needs.


Lithium sulfur cells were prepared by composing with sulfur cathode, 0.5M LiCF3SO3 in tetra ethylene glycol dimethyl ether (TEGDME) solution and lithium anode. Multiwalled carbon nanotubes (MWNTs) were used to form the high electric network and prevent the dissolution of lithium polysulfides in sulfur cathode. The effects of additive contents were investigated by discharge test. The morphology of cathode with MWNTs (20wt.%) has rough and submicro porous. The initial discharge capacity of lithium sulfur cell using multiwalled carbon nanotubes (MWNTs) was 1,200mAh/g-sulfur, which was better than those of acetylene black (AB). The cycle performance of lithium sulfur cell was remarkably improved by the the addition of MWNTs.


Previous molecular phylogenetic studies of pygmy chameleons have identified several cases of undescribed cryptic diversity of species, some of which have remained undescribed due to a lack of morphological information. Here, we combine descriptive morphology with principal component analysis, to quantify the overall morphological variation, and phylogenetic analysis to describe six new species of Rhampholeon from the Eastern Arc Mountains, including populations found in the Udzungwa, Rubeho, Nguru, Ukaguru, and Nguu Mountains. From our study we detected only limited morphometric variation between species. We distinguish the new species using genetics, combined with assessment of morphological features, and their geographical distribution. We highlight the threats to pygmy chameleons in East Africa from habitat change and exporting live specimens for the wildlife trade. Based on our understanding, we note a few species that we consider at risk of decline – mainly based on their narrow distribution and their apparent popularity in the export market. This study also further underlines the extraordinary biological value of the relatively small forest patches (less than 3000 km2) of the Eastern Arc, which contain more species of chameleons than any other area in mainland Africa.


Motivational interviewing (MI) is a client-centred, directive, therapeutic approach that enhances clients' readiness to change by exploring their ambivalence about doing so, thus increasing their motivation to change, and by helping them to commit to the process of change. MI is now being applied to dentistry in the area of oral health e.g. smoking cessation and the prevention of early childhood caries. This aligns dentistry with other healthcare professions in their focus on utilising MI to bring about behavioural change. This paper focuses on how the profession of dentistry would benefit from examining how to integrate MI both in undergraduate teaching and practice. Currently the teaching focus in relation to MI has centred on the theoretical content and less on underlying philosophy. This paper explores how a teaching philosophy, as delivered in the behavioural science programme in the School of Dentistry, University College Cork, Ireland, can provide a framework for teaching MI. Key components within this teaching philosophy are: teaching for understanding, developing reflective practice and student-centred teaching.


Cardiopulmonary complications are a major cause of morbidity and mortality in patients undergoing high-dose therapy with stem cell transplant support. Since exercise tolerance testing (ETT) assesses the cardiopulmonary reserve of an individual, we hypothesized that ETT performed prior to transplant would predict respiratory failure and mortality and would be a superior predictor over resting cardiopulmonary function tests. We performed a retrospective study of 191 lymphoma patients who underwent ETT prior to transplant between 1 June 1990 and 31 December 1992 and compared the results of ETT with resting pulmonary function tests (PFT) and resting cardiac ejection fraction (EF). ETT revealed that cardiac, pulmonary and combined cardiopulmonary limitation were observed in 31, 20 and 16% of the patients, respectively, with a gas diffusion-type limitation being the most common exercise limitation. Resting PFT were abnormal in 58% of patients with a diffusion defect being the most common abnormality. Low EF was observed in 6.8% of patients. Twelve patients eventually required mechanical ventilation post-transplant with only the resting diffusion PFT predictive of this complication. There were five early deaths that were attributable to respiratory failure and neither resting nor ETT studies were predictive of these deaths. ETT and EF performed prior to transplant in lymphoma patients undergoing autologous transplant do not predict for either respiratory failure or short-term mortality. Our findings may be due to the rather low incidence of respiratory failure (6.3%) and low early mortality from cardiopulmonary complications (2.6%) seen in our patient population.


The thought and method are put forward to deal with the difficulties in prediction of water-gush yield in long tunnels. The conceptual model of hydrogeology should be developed first based on investigating and analyzing the hydrogeology conditions of tunnel. Then, several different models should be adopted together to comprehensive calculate water-gush yield. Finally, by adopting methods of numerical simulating method, rainfall infiltration method and fuzzy comprehensive evaluation method, the comprehensive prediction thought presented above is applied and verified in Nanliang tunnel engineering practice.


An adaptive pseudospectral method is presented for solving a class of multiterm fractional boundary value problems (FBVP) which involve Caputo-type fractional derivatives. The multiterm FBVP is first converted into a singular Volterra integrodifferential equation (SVIDE). By dividing the interval of the problem to subintervals, the unknown function is approximated using a piecewise interpolation polynomial with unknown coefficients which is based on shifted Legendre-Gauss (ShLG) collocation points. Then the problem is reduced to a system of algebraic equations, thus greatly simplifying the problem. Further, some additional conditions are considered to maintain the continuity of the approximate solution and its derivatives at the interface of subintervals. In order to convert the singular integrals of SVIDE into nonsingular ones, integration by parts is utilized. In the method developed in this paper, the accuracy can be improved either by increasing the number of subintervals or by increasing the degree of the polynomial on each subinterval. Using several examples including Bagley-Torvik equation the proposed method is shown to be efficient and accurate.


Phyllodes tumour is an uncommon fibroepithelial neoplasm of the breast with potential for aggressive biological behaviour manifesting as local recurrence or distant metastasis. Based on semiquantitative assessment of a constellation of histological parameters focusing on the stromal component, stromal cellularity and overgrowth, cellular atypia, mitotic activity and nature of tumour margin, these tumours are categorised into benign, borderline and malignant grades.1 Disease recurrence is mainly local, but malignant and rarely borderline tumours may develop distant metastases in a relatively small number of patients. While most metastases occur in the lung and skeleton, they have been described in almost every organ system. In this report, we document a rare case of cardiopulmonary tumour thromboembolism from a malignant phyllodes tumour with unusual histology and clinical course that posed diagnostic, clinical and management dilemmas.

This was a patient who first presented with a left breast lump to another institution in February 2012, which was investigated with core biopsy that disclosed a phyllodes tumour. A lumpectomy ensued, which confirmed a 9.5 cm malignant phyllodes tumour that abutted the resection margin. Completion mastectomy was performed 2 months later, and CT scans did not show any metastatic lesions.

She was seen in October 2012 for prolonged fever and was diagnosed with left-sided pneumonia as well as lobar thromboembolism. Echocardiogram and thrombophilia scan were within normal limits and did not identify any deep vein thrombosis or cardiac thrombus. CT scans of her thorax, abdomen and pelvis were also negative for tumour recurrence. She was commenced on warfarin anticoagulation. She continued to have intermittent low-grade fever but was otherwise well. However, she developed sudden onset of cough with shortness of breath, and her fever worsened 3 months later. CT thorax showed no change in the left-sided pulmonary thromboembolism; however, a mass was detected in the right atrium and ventricle associated …


Recent in situ measurements of volatiles (H2O, Cl and F), particularly in lunar and martian samples, have changed our understanding of the volatile inventory of the inner Solar System. Whilst this has provided a wealth of data for these planetary bodies, currently little is known about the history of volatiles in other bodies in the inner Solar System. The howardite, eucrite, diogenite (HED) meteorites form the largest suite of rocks representing a differentiated basaltic asteroid (4 Vesta) and are some of the oldest igneous rocks in the Solar System. Understanding their volatile histories, therefore, can help us to constrain some of the processes that operated on Vesta early in Solar System history.
Using the NanoSIMS 50L, six eucrites were analysed for their apatite H2O abundance and hydrogen isotopes, whilst seven eucrites (five of which were also investigated for H) were analysed for their apatite Cl content and isotopic composition. Apatite H2O abundances range from ~ 30 to ~ 3500 ppm and are associated with a weighted average δD value of - 34 ± 67 ‰. No systematic variations or correlations are observed in H2O abundance or δD value with eucrite geochemical trend or metamorphic grade. These results are comparable to published literature and confirm the striking homogeneity in the H-isotopic composition of water in eucrites, and are consistent with a common source of water in the inner Solar System. Chlorine abundance in apatite ranges from ~ 25 to 4900 ppm and the δ37Cl values range from – 3.98 to + 35.6 ‰. Samples with lower H2O content typically were enriched in δ37Cl, however, no obvious correlation between δ37Cl and δD values is seen. Cl isotope fractionation is likely to have occurred for some samples via magmatic degassing of ZnCl2. The observed variation in Cl isotopes, particularly the residual eucrites, however, remains enigmatic.


Atmospheric neutrinos open the way to alternative probing methods to study the structure and composition of the inner Earth, complementary to geophysical methods. At GeV energies, the flavour oscillations of neutrinos crossing the Earth are distorted due to coherent forward scattering on electrons along their path. The signature of these matter effects in the neutrino angular, energy and flavour distributions may provide sensitivity to the electron density, and thus the composition, in the different layers traversed.
The combination of this neutrino-based measurement with a reference mass density profile constrains the effective proton-to-nucleon ratio of the medium (Z/A). Since this parameter varies among chemical elements, this technique has the potential to provide unprecedented insights into the chemical composition of the core. Current geophysical data require the presence of a few wt% of light elements inside the iron core, whose nature and amount remain controversial.
Such a measurement requires large-sized neutrino detectors with good efficiency in the relevant energy range and precise determination of the neutrino energy, arrival direction, and flavour. Considering a generic but realistic model of detector response, we discuss the influence of various detector performance indicators on the sensitivity to the average Z/A in the core. Starting from specific examples of the next-generation detectors (ORCA, DUNE), we also identify the main improvements required to reach a measurement of the H content of the core at the 1 wt% level.


Acculturation process has taken up a relevant place in cross-cultural psychology by demonstrating the strong relationships between cultural context and individual behavioral development.

 The purpose of this study is to analyse acculturation strategies and attitudes in different life domains of native and immigrant adults living in Italy, following the Relative Acculturation Extended Model (RAEM).

 The participants were 250 Italian native and 100 immigrant adults who completed a questionnaire with items to measure their acculturation strategies (real plane) and attitudes (ideal plane), in general and related to different life domains (peripheral and central).

 Results revealed that the acculturation attitude of immigrants is integration, whereas Italians prefer their assimilation.

 However, when different life domains are taken into account, immigrants claim to put in practice and prefer integration in most of the domains, whereas Italians perceive immigrants are separated but they prefer their assimilation or integration, depending on the specific domain.


This study has assessed the psychometric proprieties of the Mental Toughness Inventory (MTI) within the context of Brazilian sports. About 12 professionals participated in the process of adapting and translating the scale to Brazilian Portuguese. Subjects were 575 athletes (23.54 ± 5.79 years old; 58% males) who answered the MTI and the 10-item Connor–Davidson Resilience Scale (CD-RISC-10). Data were analyzed through confirmatory factor analysis (CFA), Cronbach's alpha (α), composite reliability (CR), average variance extracted (AVE), Spearman correlation, and model invariance tests. Results from CFA showed adequate fit for the original 8-item structure of the scale [Chi-square (χ2) = 27.041; p = 0.078; normalized chi-square (χ2/df) = 1.50; comparative fit index (CFI) = 0.988; Tucker–Lewis Index (TLI) = 0.981; root mean square error of approximation (RMSEA) = 0.03 [0.00–0.05]; standardized root mean residual (SRMR) = 0.030] assessing mental toughness (MT) as a single factor and the scale presented satisfactory internal consistency (CR = 0.81; α = 0.82). MT was correlated with resilience (r = 0.607), age (r = 0.276), and time of experience in the sport (r = 0.215). The MTI has also shown partial measurement invariance for sex and complete invariance across sport types. It was concluded that the MTI is a suitable tool for assessing MT in the present sample of Brazilian athletes; this instrument has potential practical application for researchers and sports psychologists who seek to develop the well-being and performance of athletes.


Selected Proceedings of the 18th European and 1st Asian Junior Scientists Workshops

The papers in this volume were originally presented at the 18th European Junior Scientists Workshop (EJSW), Portugal, on 8-11 November 2003 and at the 1st Asian Junior Scientists Workshop (AJSW), Malaysia, on 7-10 February 2004. The workshops were organised by the SS&PWG (Sewer Systems and Processes Working Group) of the IWA/IAHR Joint Committee on Urban Drainage.

The two separate workshops were convened under the general themes of "Sewer Processes, Networks and Urban Drainage" and specific topics covered included integrated modelling of urban water systems; modelling of pollutant loads; calibration of models; bed-load transport; sewer pipe roughness; advection in sewers; anoxic processes; infiltration and exfiltration; runoff source control; pollutant loads; ventilation and oxygen uptake.

From the 37 full papers presented at the two workshops, 16 papers have been selected by independent reviewers from the SS&PWG for publication in Sewer Networks and Processes within Urban Water Systems. They reflect rather well the variety of topics presented during both workshops, and bring the high-quality work of these junior authors to the wider audience it merits.

This title belongs to Water and Environmental Management Series (WEMS)

ISBN: 9781843395065 (Print)

ISBN: 9781780402772 (eBook)


OBJECTIVES
The objective of this study was to compare ecological and recalled pain intensity assessments over 29 days in hip and knee osteoarthritis (O) and chronic low back pain (L).

PATIENTS AND METHODS
Rheumatologists were asked to enroll patients with O and L, with pain intensity above 40 mm, in a prospective study for 29 days. Pain intensity was assessed with physicians on Days 1 and 29, and ecologically, over the intervening 28-day period, by random phone calls.

RESULTS
We carried out correlation analyses for 353 (159 O, 194 L) patients: Overall recalled daily pain was strongly correlated with calculated 3-day mean pain assessments (r=0.96 [O]; 0.93 [L]) and evening pain (r=0.96 [O], 0.90 [L]). Correlations between ecological and recalled measures were stronger for recall over the last 7 days than for recall over the last 28 days in osteoarthritis patients (r=0.78, r=0.63), but were similar for both recall periods in low back pain patients (r=0.70, r=0.72). Correlations between assessments for the last 7 and 28 days were stronger for ecological (r=0.88 [O], 0.91 [L]) than for clinical (r=0.77 [O]; 0.86 [L]) assessments. After adjustment for current pain intensity, correlations remained significant for ecological assessments, but not for clinical assessments. Recalled pain assessments were more accurate when made after 24 hours (r=0.71 [O]; 0.70 [L]) than when made after 48 hours (r=0.63 [O]; 0.61 [L]).

CONCLUSIONS
For both low back pain and osteoarthritis, overall daily pain recall is a reliable measurement correlated with daily ecological measurements, whereas a rapid decrease in recall occurs after 48 hours. The most reliable period for pain recall was 7 days, but the results obtained were influenced by current pain.


We report an efficient algorithm using density fitting for the relativistic complete active space self-consistent field (CASSCF) method, which is significantly more stable than the algorithm previously reported by one of the authors [J. E. Bates and T. Shiozaki, J. Chem. Phys. 142, 044112 (2015)]. Our algorithm is based on the second-order orbital update scheme with an iterative augmented Hessian procedure, in which the density-fitted orbital Hessian is directly contracted to the trial vectors. Using this scheme, each microiteration is made less time consuming than one Dirac-Hartree-Fock iteration, and macroiterations converge quadratically. In addition, we show that the CASSCF calculations with the Gaunt and full Breit interactions can be efficiently performed by means of approximate orbital Hessians computed with the Dirac-Coulomb Hamiltonian. It is demonstrated that our algorithm can also be applied to systems under an external magnetic field, for which all of the molecular integrals are computed using gauge-including atomic orbitals.


Korea traditional dresses are making news everyday through popular media and a number of exhibitions and fashion shows that have been held as a way to activate the use of the hanbok. This study intends to examine the current status of handbook brands and analyze the aesthetic characteristics of the hanbok. This study defined the terms related with the hanbok and examined the chronological changes in the hanbok through a literature review, an examination of the aesthetic characteristics of Korean traditional clothing, and an analysis of the aesthetic characteristics by dividing currently available hanbok brands in to the traditional hanbok. According to the results of the study, hanbok brands were divided into Traditional Hanbok, Life Hanbok, and New Hanbok. The Traditional Hanbok brands represented traditional beauty, the beauty of formality, symbolic beauty, and the beauty of nature. The Life Hanbok brands represented symbolic beauty, natural beauty, the beauty of blending, and the proportional beauty. The New Hanbok brands represented natural beauty, unproportaional beauty, the beauty of line, and the beauty of moderation. Therefore the New Hanboks gave changes to the traditional clothing and the unique clothing of our nation. Its formative elements coexist according to their characteristics.


Cloud Computing is a term applied to large, hosted datacenters, usually geographically distributed, which offer various computational services on a "utility" basis. Most typically the configuration and provisioning of these datacenters, as far as the services for the subscribers go, is highly automated, to the point of the service being delivered within seconds of the subscriber request. Additionally, the datacenters typically use hypervisor based virtualization as a technique to deliver these services. The concept of a cloud operated by one service provider or enterprise interoperating with a clouds operated by another is a powerful idea. So far that is limited to use cases where code running on one cloud explicitly references a service on another cloud. There is no implicit and transparent interoperability. Use cases for interoperability, as well as work-in-progress around inter-cloud protocols and formats for enabling those use cases, are discussed in this paper.


The failure of the centralized management system and the intense over-exploitation of benthonic resources along the Chilean coast motivated the design and implementation of an innovative co-management policy in 1999. Although its positive effects have already been recognized at biological and organizational level, doubts have been posed with regards to its economic sustainability. In this paper, we present a bio-economic evaluation at national level for one of the most important and valuable benthonic resources, the Loco ecosystem. A dynamic simulation model is developed in order to compare and evaluate the effectiveness of the traditional centralized management and the co-management system recently implemented in Chile. The results show that the amount of captures and effort devoted during the centralized management period were significantly underestimated due to the existence of illegal captures. On the other side, the results reveal that, after a fearful beginning, the values for revenues, capture and stock were larger than those that would have been obtained in case the former centralized system had persisted.


In this paper, we consider physical reproduction of sound fields via planar and linear distributions of secondary sources (i.e., loudspeakers). The presented approach employs a formulation of the reproduction equation in spatial frequency domain which is explicitly solved for the secondary source driving signals. Wave field synthesis (WFS), the alternative formulation, can be shown to be equivalent under equal assumptions. Unlike the WFS formulation, the presented approach does not employ a far-field approximation when linear secondary source distributions are considered but provides exact results. We focus on the investigation of the spatial truncation and discretization of the secondary source distribution occurring in real-world implementations and present a rigorous analysis of evanescent and propagating components in the reproduced sound field.


Psychological research in to attitudes towards disability has mainly been conducted using quantitative methods.

By reducing attitudes to single scores, these studies overlook the complexity of beliefs about disability and the ways in which people present them.

The current study takes a qualitative approach to the investigation of attitudes towards relationships with persons with learning disabilities. Focus groups elicited rich responses in a more naturalistic environment, allowing for in-depth analysis by two methods.

Grounded theory highlighted three themes of what constitutes these attitudes: disability is seen as a burden on relationships, participants perceive disparity in emotional complexity, and the productivity requirements of the context predict the nature of attitudes.

Conversation analysis, on the other hand, depicted that evaluations are worked up for interactional purposes due to processes of alignment – thus questioning the traditional assumption that performed attitudes reflect an underlying, cognitive state.

The findings of the two analytic methods, alongside those of existing research, are discussed in relation to their contribution to our holistic understanding of attitudes towards disability.


In a study of the ownership of German corporations, we find a strong relation between board turnover and corporate performance, little association of concentrations of ownership with managerial disciplining and only limited evidence that pyramid structures can be used for control purposes. The static relation of ownership to control in Germany is therefore similar to the UK and US. However, there are marked differences in dynamic relations involving transfers of ownership. There is an active market in share blocks giving rise to changes in control but the gains are limited and accrue solely to the holders of large blocks, not to minority investors. We provide evidence of low overall benefits to control changes and the exploitation of private benefits of control.


Quarkonium production has been considered as a tool to study the medium formed in high-energy nuclear collisions, assuming that the formation of a hot and dense environment modifies the production pattern observed in elementary collisions. The basic features measured there are the relative fractions of hidden to open heavy flavor and the relative fractions of the different hidden heavy flavor states. Hence the essential question is if and how these quantities are modified in nuclear collisions. We show how the relevant data must be calibrated; that is, what reference has to be used, in order to determine this in a model-independent way.


The Sharing of water data across disparate computer hardware and software platforms is facilitated by the Consortium of Universities for the Advancement of Hydrologic Science, Inc. (CUAHSI) Hydrological Information System (HIS) and similar open and closed source systems. CUAHSI's WaterOneFlow (WoF) and WaterML 1.1 web services and data encoding standard have become widely recognized and implemented. This growth in demand for and use of standards for water data sharing has prompted the Open Geospatial Consortium (OGC), a major international standards setting organization, to promulgate a more widely applicable dataencoding standard called, WaterML2. This paper presents a generic OGC standards-based water data sharing approach using WaterML2 and the existing OGC standard for vector data encoding, Web Feature Service (WFS). A data sharing system built using these two standards has the benefit of being accessible by a much broader collection of software systems than previously available using WoF and WaterML1.1. The new approach requires encoding of data sites in a WFS accessible layer that includes attributes that identify a WaterML2 encoded data set available at each site. The system is prototyped in the open source HydroServer Lite data server. This serviceoriented architecture completes an essential link between two major standards in geospatial and temporal data management and sharing.


A model of energy budget of Lake Bolshoi Okunenok ecosystem was based on the data received during field studies from May through November 1986. The model takes into account 36 components including dissolved organic matter, bacteria, phytoplankton, zooplankton, meiobenthos, macrobenthos, fish, suspended and sediment detritus. The growing season has been divided into 16 intervals according to the number of observations. The balance equation for each live component describes the change in its biomass for a time interval between two successive sampling dates. The change is considered as a balance of energy input with assimilation or feeding, and energy loss due to respiration, excretion, predation, natural mortality, fishery catchment or and emergence of imago insects. For non-live components we estimate an increase and a decrease in their mass due to the activity of living organisms, as well as organic matter exchange between water and sediments. Seasonal value of balance elements for each component are equal to sums of appropriate interval value. Comparison of energy flows through different links of a trophic web has shown that the role of a bacterial-detrial link was extremely important in Lake Bolshoi Okunenok for the growth season of 1986. Detritus constituted 58% of seasonal diet of non-predatory zooplankton, 39% of diet of predatory zooplankton, 50% of diet of planktivorous fish (fry of whitefish) and 92% of diet of benthivorous fish (fry of carp). The contribution of bacteria to the total seasonal decomposition amounted to 46%. Approximately 57% of the forage phytoplankton production, 86% of non-predatory benthos production, and 23-38% of the other trophic groups production were consumed by all grazers. "Coefficient of energy transformation" is proposed. It is calculated as: CET(s, k) = Ps(k)/Pk, where Ps(k) is production of consumers "s", built due to consumption of source "k"; Pk is production of source "k" itself. In Lake Bolshoi Okunenok only 14% of energy built by phytoplankton were accumulated in organic matter of zooplankton due to direct consumption.


In a study of the neutralization capacity and limestone content the artificial recharge area of the Sydvatten waterworks Vombverket in Vomb, Skane, five samples from different locations in the area was collected, sieved and acidified with hydrochloric acid. The neutralization capacity measured as calcium carbonate content was
found to vary in the different sandy soil samples but was generally high (about 2–14 % by weight). The total mass of calcium carbonate in the infiltration area was determined taking into account the volume and density, i.e. possible porosity of the soil. There is at least equal to 4.3 million tons of calcium carbonate present in the
infiltration area. This corresponds to a neutralization capacity of 88 x 109 moles in the study area. The annual limestone dissolution in the area is about 750 tons. The limestone content in the area is generally high and has a good ability to buffer also more acidic water than water from Vombsjon. At present limestone consumption, the neutralization capacity lasts for at least 5700 years.


The poverty rate of Whites, Blacks, and Hispanics in the Chicago city decreased between 1990 and 2000. The picture provided by the decrease in poverty rate alone is incomplete and potentially misleading. This research proposes more comprehensive measure of neighborhoods. Track-level data from the 1990 and 2000 censuses are used to identify distressed communities and severely distressed communities within the official 77 communities in the Chicago city. Results show that despite the booming economy of the 1990s and encouraging turnarounds in Chicago city as a whole, neighborhood distress worsened in some communities. The greatest deterioration occurred in southern communities. Blacks fared worse than Whites and Hispanics in most communities in terms of the neighborhood distress index.


BACKGROUND
The lymph node yield (LNY) and the lymph node ratio (LNR) have been shown to be important prognostic factors in oral, colon, and gastric cancers. The role of the LNY and LNR in papillary thyroid cancer (PTC) is unclear. The aims of this study were to determine if a high LNR and a low LNY decrease disease-free survival rates. This study further aimed to determine an optimum nodal yield.

METHODS
A retrospective analysis was conducted of 198 patients with PTC undergoing total thyroidectomy with neck dissection between 1987 and 2011. The LNY and LNR were adjusted by relevant covariates in a multivariate Cox regression analysis with Andersen-Gill extension.

RESULTS
The LNR was associated with a decrease in disease-free survival (hazard ratio 3.2 [95% confidence interval 1.4-7.3], p=0.005). Patients with an LNR of 0.30 or higher had a 3.4 times higher risk of persistent or recurrent disease compared with patients with an LNR of 0.00 ([95% confidence interval 1.1-10.5], p=0.031). Conversely, patients with an LNR of 0.11 or lower had an 80% chance of remaining disease free during 5 years of follow-up. The LNY showed no significant independent effect and an optimum nodal yield was not determined.

CONCLUSIONS
The LNR is an important independent prognostic factor in PTC and can be used in conjunction with existing staging systems. A clinical relevant cut-off point of 0.3 (one positive lymph node out of three total) is proposed. No prognostic implications for LNY were identified.


An approach of representing patterns by trees rather than by strings is described. A review of tree systems that include tree grammars, transformations, and mappings on trees and tree automata is briefly presented. The tree system is then applied to the problem of syntactic pattern recognition. Tree grammars are used for pattern description, and tree automata are used for classification. Illustrative examples include the application of the tree system to the classification of bubble chamber events and some English characters.


Wilderness has been defined in diverse ways, but most famously in the Wilderness Act of 1964, which describes it "in contrast with those areas where man and his own works dominate the landscape … as an area where the earth and its community of life are untrammeled by man, where man himself is a visitor who does not remain." The idea of wilderness has played a curious and crucial role in American culture generally, and especially in the rise of American environmentalism. Conquering wilderness was central to colonial and pioneer narratives of progress. Reverence and nostalgia for wilderness became tangled with American nationalism at the end of the 19th century, with the end of the frontier. The passage of the Wilderness Act was an historically important event in American environmental politics, which tied the fate of much of America's public lands to disputes over the meaning of wilderness. Since then, critics both international and domestic, but mostly from within the environmental movement, have criticized the idea of wilderness. Not that preserving or protecting natural places is a bad idea, rather they argue that thinking about nature in terms of wilderness obscures important issues and leads to bad decisions.


Changes in marriage and employment patterns may have affected health insurance coverage rates differently for women and men. The author investigates changes in health insurance coverage between 1988 and 2008, focusing on employer-sponsored insurance (ESI) dependent and employee coverage. Using Oaxaca-Blinder decompositions and Current Population Survey data, the author finds that married men's coverage as dependents increased from 1988 to 2008, but a smaller share of men were married in 2008. Coupled with declines in ESI employee coverage, changes in marriage increased men's uninsurance rate. In contrast, marital changes for women were offset by their increased employment and insurance coverage as employees.


Background: Detection of IgG antibodies to Aspergillus fumigatus is important for diagnosing chronic pulmonary aspergillosis (CPA). Immunodiffusion assay has been widely used for detecting circulating anti- Aspergillus antibodies (precipitin), however, it appears to lack sensitivity. Recently, quantitative measurement of IgG to Aspergillus by using fluorescent immunoenzyme assay (ImmunoCap TM ) is commercially available. In this study, we examined performance of ImmunoCap TM with respect to diagnosis of CPA. Method: We detected serum Aspergillus precipitin in patients with following condition; 1) complaining subacute to chronic respiratory and/or systemic symptom, 2) developing radiological shadow in lung (cavitation, infiltration and thickness of pleura) within 3-6 months, and 3) existence of underlying chronic respiratory disease. These patients were divided to four groups (proven, probable, possible and control) according to classification criteria. We also examined specific IgG to Aspergillus for these collected sera by ImmunoCap TM . Result: From January 2007 to August 2013, 353 patients were studied. Aspergillus IgG values was significantly higher in the proven and probable groups than in the possible and control groups (p l0.01). ROC analysis revealed that cut off value of ImmunoCap TM for diagnosis of proven and probable cases was 50 mg A /L (AUC, 0.83; 95% CI, 0.786-0.874; sensitivity, 0.79; specificity, 0.74 ). Conclusions: The sensitivity and specificity of ImmunoCap TM for diagnosis of CPA were reliable. Thus, ImmunoCap TM may alternate with conventional precipitin test for diagnosing CPA. In addition, the quantitation of IgG might be useful for monitoring marker of antifungal treatment response.


Brain networks has attracted the interests of many neuroscientists. From functional MRI (fMRI) data, statistical tools have been developed to recover brain networks. However, the dimensionality of whole-brain fMRI, usually in hundreds of thousands, challenges the applicability of these methods. We develop a hierarchical graphical model (HGM) to remediate this difficulty. This model introduces a hidden layer of networks based on sparse Gaussian graphical models, and the observed data are sampled from individual network nodes. In fMRI, the network layer models the underlying signals of different brain functional units, and how these units directly interact with each other. The introduction of this hierarchical structure not only provides a formal and interpretable approach, but also enables efficient computation for inferring big networks with hundreds of thousands of nodes. Based on the conditional convexity of our formulation, we develop an alternating update algorithm to compute the HGM model parameters simultaneously. The effectiveness of this approach is demonstrated on simulated data and a real dataset from a stop/go fMRI experiment.


Gastrointestinal (GI) cancers presented an alarmingly high number of new cancer cases worldwide and highly characterised with poor prognosis. The poor overall survival is mainly due to late detection and emerging challenges in treatment, particularly chemoresistance. Thus, the identification of novel molecular targets in GI cancer is highly regarded as the main focus. Recently, long non-coding RNAs (lncRNAs) have been discovered as a potential novel molecular target for combating cancer, as it is highly associated with carcinogenesis and has a great impact on cancer progression. Amongst lncRNAs, HOTIIP has demonstrated a prominent oncogenic regulation in cancer progression, particularly in GI cancers, including oesophageal cancer, gastric cancer, hepatocellular carcinoma, pancreatic cancer and colorectal cancer. This review aimed to present a focused update on the regulatory roles of HOTTIP in GI cancer progression and chemoresistance, as well as deciphering the associated molecular mechanisms underlying their impact on cancer phenotypes and chemoresistance and the key molecules involved. It has been reported that it regulates the expression of various genes and proteins in GI cancers that impacts on the cellular functions, including proliferation, adhesion, migration and invasion, apoptosis, chemosensitivity and tumour differentiation. Furthermore, HOTTIP was also discovered to have a higher diagnostic value as compared to existing diagnostic biomarkers. In overall, HOTTIP has presented itself as a novel therapeutic target and potential diagnostic biomarker in the development of GI cancer treatment.


CONTEXT
Insulin receptors are ubiquitously found in the human brain, comprising the olfactory bulb, essential for odor processing, and the hippocampus, important for spatial memory processing.

OBJECTIVE
The present study aimed at examining if intranasal insulin, which is known to transiently increase brain insulin levels in humans, would improve odor-cued reactivation of spatial memory in young men.

DESIGN
We applied a double-blind, placebo-controlled, counterbalanced within-subject design.

SETTING
The study was conducted at the research unit of a university hospital. Interventions/Participants/Main Outcome Measures: Following intranasal administration of either insulin (40 I.U.) or placebo, male subjects (n = 18) were exposed to eight odors. During each odor exposure, a green-colored field was presented on a 17-in. computer screen. During immediate recall (comprising 3 runs), the participants were re-exposed to each odor cue, and were asked to select the corresponding field (with visual feedback after each response). The delayed recall was scheduled ∼10 min later (without feedback). To test if insulin's putative effect on odor-place memory would be domain-specific, participants also performed a separate place and odor recognition task.

RESULTS
Intranasal insulin improved the delayed but not immediate odor-cued recall of spatial memory. This effect was independent of odor type and in the absence of systemic side effects (eg, fasting plasma glucose levels remained unaltered). Place and odor recognition were unaffected by the insulin treatment.

CONCLUSIONS
These findings suggest that acute intranasal insulin improves odor-cued reactivation of spatial memory in young men.


Students increasingly engage with multimedia technologies and expect learning environments to support similar interactions. Although hospitality and tourism educators have started to integrate technologies into their teaching, the learning applications they use are often restricted to text posted on Web sites. This article argues that immersive systems are not only more engaging but can actually support students with difficulties regarding mental imagery processing. A study was conducted to investigate whether differences in mental imagery ability can be found among students. The findings suggest that significant differences in mental imagery processing exist and need to be recognized when designing and evaluating learning applications.


Testing and debugging tools for concurrent programs are often validated on known bugs. To aid the development of these tools, we present the Race, Atomicity, and Deadlock Benchmark (RADBench) suite. The RADBench suite contains the full source of 10 real concurrency bugs found in large open-source software projects including Mozilla SpiderMonkey, Mozilla NSPR, Memcached, Apache Web Server, and Google Chromium Web Browser. We discuss the difficulties we have found in reproducing these bugs that must be accounted for when building testing and debugging tools. Finally, we propose an approach to reproducibility that has a number of benefits over standard deterministic replay for debugging. RADBench is open source and publicly available.


Domestic coal combustion has had profound adverse effects on the health of millions of people worldwide. In China alone several hundred million people commonly burn raw coal in unvented stoves that permeate their homes with high levels of toxic metals and organic compounds. At least 3,000 people in Guizhou Province in southwest China are suffering from severe arsenic poisoning. The primary source of the arsenic appears to be consumption of chili peppers dried over fires fueled with high-arsenic coal. Coal samples in the region were found to contain up to 35,000 ppm arsenic. Chili peppers dried over high-arsenic coal fires adsorb 500 ppm arsenic on average. More than 10 million people in Guizhou Province and surrounding areas suffer from dental and skeletal fluorosis. The excess fluorine is caused by eating corn dried over burning briquettes made from high-fluorine coals and high-fluorine clay binders. Polycyclic aromatic hydrocarbons formed during coal combustion are believed to cause or contribute to the high incidence of esophageal and lung cancers in parts of China. Domestic coal combustion also has caused selenium poisoning and possibly mercury poisoning. Better knowledge of coal quality parameters may help to reduce some of these health problems. For example, information on concentrations and distributions of potentially toxic elements in coal may help delineate areas of a coal deposit to be avoided. Information on the modes of occurrence of these elements and the textural relations of the minerals and macerals in coal may help predict the behavior of the potentially toxic components during coal combustion.


This study investigates the acoustic realization of single vs. double focus in statements and yes/no questions in General American English. Four speakers produced four sets of utterances of different lengths with alternating focus and sentence type conditions. Results indicate that double focus increases max F0 and duration of the focused word to a similar degree as single focus in both statements and yes/no questions. Furthermore, post-focus pitch range suppression occurs in both singleand double-focused statements. However, in yes/no questions, post-focus pitch range compression and raising occur only after single focus and focus 2 of double focus. In contrast, F0 after focus 1 of double focus falls gradually until the stressed syllable in focus 2 in yes/no questions. These findings suggest that double focus interacts with sentence type in a more complicated way than single focus in shaping F0 contours of English sentences.


We believe that an outside group will be more productive, better skilled in the application, cheaper, or more efficient, working with less bureaucracy. We will look at those assumptions and suggest a sensible seven-step approach to outsourcing. Procurement personnel have an important job to do. Our aim was to stimulate teamwork and partnerships. we focus on building win-win relationships with our suppliers.


The characteristics of the isometric contractions of rabbit's left atria were studied during its activation by the slow response of the cardiac action potential. When compared to the conditions where activation occurs with normal action potentials it verifies that contraction amplitude decreases, becoming slowly and larger. Positive inotropic effects that enhance calcium entrance through the membrane (Ca and IPA), during action potential, increase contraction amplitude. Negative inotropic effects that depress the slow response (Ach and verapamil) also depress the contractions. Staircase becomes reversed, with contraction strength decreasing with increase in rate of beating. It was seen that adequate conduction is an important factor for the normality of contractions, and the importance of the fast component of the cardiac action potential, for this occurrence, was remembered.


Data on chromosome transformation in meiotic prophase I during mammalian oogenesis are summarized. The main peculiarity of the female meiosis in mammals is an unusually long diplotene stage which may be subdivided into four periods: 1) the early diplotene (up to the beginning of follicle formation); 2) the dictyotene or "diffuse diplotene", implying primordial follicle oocytes; 3) the most pronounced lampbrush chromosome stage coinciding with the large growth period; 4) the stage of chromosome inactivation and karyosphere formation corresponding to the terminal stage of oocyte development before ovulation. These stages are associated with changes in the transcriptional chromosome activity. A correlation is revealed between the spatial chromosome arrangement in the oocyte nucleus and the transcriptional activity. Some regularities are followed in the transformation of the main nucleolar component arrangement during meiotic prophase I in mammalian oocytes. At the late pachytene and at the early diplotene, a segregation of the main nucleolar components has been observed. These components are disposed in the direction: chromatin--fibrillar center--dense fibrillar component--granulo-fibrillar component. At the dictyotene, signs of nucleolar segregation are still observed. At the lampbrush chromosome stage, when the nucleus is most highly transcriptionally active, an integration of nucleolar components occurs. At the late diplotene--prediakinesis stage, i.e. in the course of transcriptional activity lowering and karyosphere formation, the secondary segregation of the main nucleolar components occurs. These move to the nucleolar periphery to be disposed around a large fibrillar mass which is gradually displacing the rest of the nucleolar components. The fibrillar mass formation in the preovulatory oocyte nucleoli is one of the peculiarities of the diplotene and prediakinetic mammalian oocytes.


A novel process for methanol and dimethyl ether(DME) synthesis was developed, in which two methanol-synthesis fixed-bed reactors were followed by an identical one for DME synthesis with cooling sections in between. Self-made Cu-Zn-Al catalyst for methanol synthesis and DME synthesis were used in this process. Tests of catalysts showed that both of them had activity and favorable stability and wound be capable of long-term industrial operation under the conditions. The investigation of processing parameters and stability led us safely to ensure the optimal condition: T1-200oC,T2-190 °C,T3-210 °C,5Mpa,total Space Velocity-1000h-1(T1,T2,T3 defined as temperature of catalytic beds in three serial reactors). Under that the catalytic system kept stable during the investigated hours.


In this paper, we propose a multihop medium access control (mMAC) scheme for time division duplexing-code division multiple access (TDD-CDMA) cellular networks with two-hop relay architecture to support packet data transmission. The proposed mMAC is based on joint CDMA/PRMA (packet reservation multiple access) protocol and it includes BCH code selection, power control and multihop relaying. Simulation results reveal that cellular networks with two-hop relay architecture with the proposed mMAC scheme can substantially provide a good performance as well as larger cell coverage as compared to conventional TDD-CDMA single-hop cellular networks.


Abstract This paper presents a strategy for autonomously resolving intersection contention between platoons of autonomous vehicles. Each member of a platoon is represented by a dynamic model and a path tracking controller as well as a vehicle gap controller. These models and controllers are incorporated in simulation environments. Multiple vehicles in convoys simultaneously arriving at an intersection are simulated to ensure an optimized intersection negotiation taking into account a raft of widely varying requirements that exist in a public transport environments. A set of concepts such as initiative, infrastructure adaptation, and priority propagation are introduced and used to promote globally and locally optimal crossing patterns, avoiding vehicle stoppage in most circumstances. Results from a multiple convoy dynamic model simulation validate the strategy presented.


The electronic and photophysical properties of a disk-like molecule that combines two electron donor and one electron acceptor segments in a π-conjugated planar backbone, namely, 10-dihydro-15H-indeno[1,2-a]indolo[3,2-c]carbazol-15-one (diazatruxenone) have been investigated through a joint experimental and theoretical study, in order to explore its potential applications in the area of organic electronics. The influence that peripheral substitution and functionalization at the bridging nitrogens exerts on the electronic properties as well as in the supramolecular arrangement of this donor–acceptor scaffold has also been investigated. It has been found that by varying the electronic nature of the attached peripheral groups it is possible to tune its redox and optical properties. On the other hand, N-alkylation barely affects its electronic properties; however, it strongly influences how molecules interact with each other in the bulk. Interestingly, the calculated charge-transport parameters (reorganization energy and electronic coupling) confirm the potential of this disk-shaped platform to act as an ambipolar charge transporter.


Previously, we reported that tolerance to nickel, induced by oral administration of Ni2+ ions, can be adoptively transferred to naive mice with only 102 splenic T cells. Here we show that 102 T cell-depleted spleen cells (i.e., APCs) from orally tolerized donors can also transfer nickel tolerance. This cannot be explained by simple passive transfer of the tolerogen. The APCs from orally tolerized donors displayed a reduced allostimulatory capacity, a tolerogenic phenotype, and an increased expression of CD38 on B cells. In fact, it was B cells among the APCs that carried the thrust of tolerogenicity. Through serial adoptive transfers with Ly5.1+ donors and two successive sets of Ly5.2+ recipients, we demonstrated that nickel tolerance was infectiously spread from donor to host cells. After the transfer of either T cells or APCs from orally tolerized donors, the spread of tolerance to the opposite cell type of the recipients (i.e., APCs and T cells, respectively) required recipient immunization with NiCl2/H2O2. For the spread of tolerance from a given donor cell type, T cell or APC, to the homologous host cell type, the respective opposite cell type in the host was required as intermediate. We conclude that T suppressor cells and tolerogenic APCs induced by oral administration of nickel are part of a positive feedback loop that can enhance and maintain tolerance when activated by Ag associated with a danger signal. Under these conditions, APCs and T suppressor effector cells infectiously spread the tolerance to naive T cells and APCs, respectively.


The Upper Jurassic-Lower Cretaceous interval in the Neuquen basin, Argentina, provides a good example of carbonate sedimentary response to eustatic sea-level change in a rifted basin that has produced hydrocarbons for over 50 years. We analyzed the area using an integrated stratigraphic approach, including seismic stratigraphy for sequence identification and configuration, wells and outcrops for lithologies and porosity types, and outcrops for paleontological age, ecological data, and detailed physical stratigraphy. Our study shows that the Vaca Muerta, Quintuco, Loma Montosa, and Mulichinco formations are time-transgressive lithofacies units within a series of prograding sequences that laterally filled the shallow, stable basin. There are at least nine clinoform-shaped d positional sequences, and they span the Tithonian, Berriasian, and Valanginian stages. All of them consist of seismically mappable shelf, shelf-margin, slope, and basin facies. In the wells tied to seismic data, the predominantly carbonate reservoir rocks of the Loma Montosa and Quintuco formations represent, respectively, the inner- and outer-shelf segments of individual clinoform sequences. Hydrocarbon-source shales of the Vaca Muerta Formation occur in slope and basin positions. The youngest prograding unit is characterized by shelfal to continental sandstones of the Mulichinco Formation. The degree of shelfward restriction, lateral progradation, and vertical aggradation of the sequences appears to be strongly controlled by global trends of eustatic rises and falls. Other depositional controls, such as thermal subsidence and sediment influx, occur at slow, nearly constant rates in medial to late stages of basin evolution. An idealized shelf-to-basin lithologic model of a given sequence progresses from terrestrial sandstones and shales through marine inner-shelf micritic limestone, dolomites, and shales; middle-shelf oolitic and skeletal carbonates and shales; outer-shelf molluscan-micritic limestone and shales; and slope and basin dark organic shales. Outcrops along the western basin margin exhibit depositional characteristics similar to those of the subsurface. In the western outcrop area, lithostratigraphic units are time-transgressive from south to north toward the basin center. In the northwestern outcrop area (Malargue), the timing and depositional response to eustatic changes can be documented through interpretation of detailed stratigraphic and paleontologic observations by other authors.


UNLABELLED
There was a study of the condition of mucous membranes of upper parts of the gastrointestinal tract in patients with gastrointestinal bleedings (GIB), who were taking non-steroidal anti-inflammatory drugs (NSAID); the blood loss severity was assessed. 2,042 health records of patients, who came to surgical departments with the gastrointestinal bleeding diagnosis, were studied pro- and retrospectively. A group of 342 patients with GIB induced by NSAID was selected. The age of the group of patients under examination was from 17 to 86.

RESULTS
Chronological relation between the application of NSAID and GIB was discovered in 16.7% of all cases. When assessing the bleeding source area, stomach affections were discovered in 68% of cases; duodenal affections were discovered in 20% of cases; associated stomach and duodenal affections were recorded in 9% of cases; esophagus erosion was found in 3% of cases. Bleedings were most often induced by the application of Aspirin, Indometacin, Diclofenac and Ibuprofen. Severe bleedings were revealed in 28.9% of cases, medium bleedings were recorded in 20.8% of cases, and 50.3% of cases were attributed to light bleedings.


During the last decade, social media has had a great impact on the way we communicate. It has also expanded our awareness of the world.!However it has become harder for the lay person to find news, because of too many conflicting interests in the mass media industry on one hand, and simply too much free information available on the other!This report documents my study of how social media has affected the way we collect, consume and share news. I describe how democratization of information has made some things easy, but some other things hard - filtering data to find meaningful content has become harder!My studies were targeted mainly at people younger than 30, and mainly in India, and much of its design is informed by problems characteristic to the Indian context. So while I do not explicitly target my end result at the Indian market, a news network by its very nature needs to be global, and this process reflects that.!I go on to use Design Methods including Brainstorming, Participatory Workshops and Service Design theory to arrive at a product that aims to provide people a way to stay up to date with meaningful and relevant news. ! I propose a social network for individuals to exchange news with each other. I try to understand what makes some pieces of information more important than others, and how a network can self filter information so that participants can get high quality content.!In the final result, I describe the framework of this network and how people would contribute to it and consume from it.


The two-dimensional verification of intensity-modulated radiation plans is one of the major requirements for the safe application of this technique. The present study examines the resolution and sensitivity of a two-dimensional ionisation-chamber array (PTW2D-Array, type 10024), which can be used for plan verification instead of films. According to the Shannon-Nyquist theorem, the resolution of the 2D-Array is sufficient for dose distributions with a minimal field size of 2 cm x 2 cm. The minimal field size can be reduced to 1 cm x 1 cm by shifting the array 5 mm in the direction of the MLC movement and by repeating the measurements. The high sensitivity against a monitor decalibration for a single field of a sequence is demonstrated on the basis of an individual case. The minimal threshold for MLC misalignment detected by a chamber of the array is less than 1 mm. Therefore, the resolution capabilities of the 2D-Array are sufficient for most intensity-modulated radiation therapy (IMRT)fields.


In B-cell precursor acute lymphoblastic leukemia, the initial leukemic cells share the same antigen receptor gene rearrangements. However, due to ongoing rearrangement processes, leukemic cells with different gene rearrangement patterns can develop, resulting in subclone formation. We studied leukemic subclones and their distribution in the bone marrow and peripheral blood at diagnosis. Antigen receptor gene rearrangements (IGH, IGK, TRG, TRD, TRB) were analyzed by next-generation sequencing in seven paired bone marrow samples and five paired bone marrow-peripheral blood samples. Background-thresholds were defined, which enabled identification of leukemic gene rearrangements down to very low levels. Paired bone marrow analysis showed oligoclonality in all 7 patients and up to 34 leukemic clones per patient. Additional analysis of evolutionary-related IGH gene rearrangements revealed up to 171 leukemic clones per patient. Interestingly, overall 86% of all leukemic gene rearrangements, including small subclones, were present in both bone marrow samples (range per patient: 72–100%). Paired bone marrow-peripheral blood analysis showed that 83% of all leukemic gene rearrangements in bone marrow were also found in peripheral blood (range per patient: 81–100%). Remarkably, in the paired bone marrow samples and paired bone marrow-peripheral blood samples the vast majority of leukemic gene rearrangements had a similar frequency (<5-fold frequency difference) (96% and 96% of leukemic rearrangements, respectively). Together, these results indicate that B-cell precursor acute lymphoblastic leukemia is generally highly oligoclonal. Nevertheless, the vast majority of leukemic clones, even the minor antigen receptor-defined subclones, are homogeneously distributed throughout the bone marrow and peripheral blood compartment.


The influence of some mineral salts on the recombinant strain Escherichia coli Z9051 was investigated. It was shown that the composition (NaCl, Na2SO4, MgCl2 and MgSO4) and concentration (5 and 10%) of the salts substantially affect the expression of genes for the luminescence system of light-emitting bacteria cloned in the plasmid under the control of the lac-promoter. In some cases, the luminescence level of the microorganism in the presence of salts was similar to the luminescence level under catabolite repression by glucose, the more strong influence of the salts exceeding the effect of catabolite repression. The possibility of adaptation of the genetically modified microorganism to the salinity factor is discussed.


Pleomorphic adenoma is a rare type of major salivary gland tumour that occurs in the nasal septum. We present the case of a 40-year-old woman with pleomorphic adenoma. A CT scan was performed and a well-defined soft tissue lesion at the left anterior nostril was found. An endonasal endoscopic excision of the mass was achieved. To reach the free margin of the mass, the perichondrium of the nasal septum was dissected. The post-operative course was uneventable.


The work explores whether self-storytelling is a powerful predictor of personal reputation in a collaborative community of the sharing economy realm. By proposing that powerful self-storytelling allows an attractive positioning in respect to potential others, the paper extends the literature of brand storytelling and brand archetypes shifting the perspective to a personal level. This study adopts a qualitative-quantitative approach to investigate the meanings and stories contained in personal profile descriptions and their relation with reputation. Personal descriptions are interpreted as storytelling activities, labels/glosses that allow members to access the services of the community by facilitating personal reputation building. The findings show that powerful storytelling structures have defined phases and are crucial in reputation building when the story evolves in a metaphoric, symbolic lesson. The presence of archetypes, in particular the Sage and the Ruler, also confer reputational power to the stories. The results reveal opportunities for peer-to-peer communities, traditional companies, and social businesses. Marketers should design tools and platforms able to trigger consumers' desire to express their individuality through personal descriptions and suggest the drivers that affect reputation.


Introduction : Navigating the maze of the health system can be challenging for families of children with chronic and complex conditions. These children often slip through the gaps, are managed by multiple teams and become disengaged with primary and local services. The Sydney Children's Hospitals Network (SCHN) Care Coordination Service helps care teams partner with families and local health services so that children with chronic and complex conditions spend less time in hospital and more time at home. Practice change implemented (methodology) : The SCHN Care Coordination program (Kids GPS – Guided Personalised Services) applies a quality improvement framework using 'Plan, Do, Study, Act' (PDSA) cycles to continually implement, evaluate and modify approaches to care coordination. The service consists of nurses and social workers – 'the Care Coordinators' who work in partnership with the hospital, community and family 'lead' to develop a contemporaneous care plan. A strategy of combining ambulatory models of care and a 24/7 telephone service has made this program more robust. The program was implemented in February 2014. Outcomes are measured on a monthly basis with data comparison driving further PDSA cycles. Aim / targeted population : To implement a model of care coordination for children with medical complexity that aims to improve efficiency and patient outcomes by supporting families to navigate services/providers within SCHN, Local Health Districts (LHDs) and Primary Health Networks (PHNs). Care Coordination for this cohort of children intends to reduce avoidable hospital attendance and improve the integration of care between community health providers and the hospital. Highlights (outcomes) : Kids GPS has achieved significant outcomes measured both in terms of hospital encounters saved and patient-focussed outcomes. The program currently has 446 children enrolled. Between July 2015 and June 2017, the service demonstrated: 875 hospital encounters saved, equating to  approximately $977,000 in financial savings for SCHN 51,500 KM travel saved for families and 370 school absences prevented 204 ED presentations avoided, with implementation of a 24/7 Hotline in August 2016 increasing the  average ED presentations saved per month from 1.6 to 16.7  Analysis of the past six months data (Jan-Jun 2017) demonstrates a 400% increase in encounters saved (448 compared to 111 between Jul-Dec 2016) following service design changes though various PDSA cycles. Sustainability and transferability : Members of the SCHN Care Coordination team are part of the Children's Healthcare Australasia (CHA) Complex Care Special Interest Group. The networking from this group has resulted in referrals of complex patients moving interstate, enabling care coordination to commence prior to the patient relocating. This has proven an innovative way of inter-state agency collaboration. It is anticipated that future funding will lead to additional care coordinators with a focus on aboriginal patients/families, and children/youth presenting frequently to the ED for mental health or behavioural disorders. Conclusion : Effective care coordination can significantly benefit the lives of patients/families with chronic and complex conditions. Key lessons learned: Combining ambulatory models of care with care coordination makes the integrated model of care more robust 24/7 hotline access providesa further safety net to empower parents/carers Outcome measurements that are patient focussed helps to create organisational cultural change


Intrusion detection systems monitor system activities to identify unauthorized use, misuse, or abuse. IDSs offer a defense when your system's vulnerabilities are exploited and do so without requiring you to replace expensive equipment. The steady growth in research on intrusion detection systems has created a demand for tools and methods to test their effectiveness. The authors have developed a software platform that both simulates intrusions and supports their systematic methodology for IDS testing.


The nation's highways are in need of extensive maintenance and reconstruction work. High traffic demand requires state and local transportation agencies to consider practical strategies for minimizing a work zone's impacts on the traveling public and construction workers. Work zone safety audit is a proactive tool to serve the purpose. This paper presents the guidelines for highway work zone safety audits at the construction stage. After a brief description of the key features of work zone safety audit, an eight-step audit process is presented. Then, the article focuses on the five key audit tasks which are performed in the audit process including pre-audit reviews, audit meetings, audit field inspections, audit analyses and audit recommendations. Finally, a case study is introduced to show the proposed guidelines.


In this paper, we derive closed form expressions for average symbol error rate of M-ary signalling for MIMO-MRC (MRT) systems over Rayleigh fading channels taking account of channel estimation errors. Following the moment generating function (mgf), we formulate the final expressions in the form of hypergeometric functions. The expressions are valid for an arbitrary number of antennas and any modulation levels. MRT system suffers significant performance degradation due to Gaussian estimation errors. Evenly distributed antenna system offers better trade-offs.