It is supposed that radon in the apartment and the products of its decay facilitate the increase of lung cancer morbidity rate and other oncological diseases risks of total population. The main source of radon getting into apartment (up to 90%) for most buildings is soil gas. For the inhabitants of Rivne, situated on the western hill-side of the Ukrainian crystal shield concentrated with uranium and radium, broken by a complicated system of fracture by which radon easily go up with the help of soil waters and on its own, increasing its concentration in surface soils, is extremely important. The article gives the results of complex determination of average volumetric activity of Radon 222 in the air of low-ground apartments of 48 testing areas of Rivne urban ecosystems, compares the received results with the indices of lung cancer morbidity and mortality of population, that died in the given areas during the period of 2014-2016. The values of additional relative risk concerning the given disease are calculated, using the models of permanent relative risk and GSF (Jacoby Model). It is ascertained that average geometric value of Radon 222 volumetric activity (VA) in the apartments of the ground floors of testing areas under research made up 200 Bk/m3 with standard geometric error 0.7865, average arithmetic value of radon volumetric activity in the air of the same apartments made up 262.5 Bk/m3 with standard error 194.4 Bk/m3. That is evidence of considerable variations of radon level in the air of houses in the territory of Rivne. Maximum measured value of volumetric activity makes up 1000 Bk/m3 and maximum prognosticated value is 1420 Bk/m3. Under 70-years-old radon exposition with volumetric activity 200 Bk/m3, value of additional relative risk make up 0.0446 for the model of permanent relative risk and 0.0633 for Jacobi model, according to the same time period radon exposition with volumetric activity 1426 Bk/m3-0.26 for the model of permanent relative risk and 0.33 for Jacobi model. According to permanent radon exposition in the apartment with volumetric activity 200 Bk/m3 the upper level of adopted individual risk (individual risk border) for the inhabitants of Rivne come approximately at the age of 30-34 when calculated after model of permanent relative risk and at the age of 25-29 when calculated according to Jacobi model.
Keywords: Radon; apartment; air; volumetric activity; equivalent balanced volumetric activity; lung cancer; models of permanent relative risk and Jacoby model
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As data emerges on the pathophysiological underpinnings of severe acute respiratory syndrome coronavirus (SARS-CoV)-2, it is clear that there are considerable variations in its susceptibility and severity/fatality, which give indications as to its pathophysiology and treatment. SARS-CoV-2 modulatory factors include age, vitamin D levels, cigarette smoking, gender and ethnicity as well as premorbid medical conditions, including diabetes, cancer, obesity, cardiovascular disease, and immune-compromised conditions. A complex picture is emerging, with an array of systemic physiological processes interacting including circadian, immune, intestinal, CNS and coagulation factors. This article reviews data on SARS-CoV-2 pathoetiology and pathophysiology. It is proposed that a decrease in pineal and systemic melatonin is an important driver of SARS-CoV-2 susceptibility and severity, with the loss of pineal melatonin's induction of the alpha 7 nicotinic acetylcholine receptor (α7nAChR) in pulmonary epithelial cells and immune cells being a powerful regulator of susceptibility and severity, respectively. Stress, including discrimination stress, and decreased vitamin D also regulate SARS-CoV-2, including via gut dysbiosis and permeability, with a resultant decrease in the short-chain fatty acid, butyrate, and increase in circulating lipopolysaccharide. Stress and cytokine induction of the kynurenine pathways, leads to aryl hydrocarbon receptor activation, which primes platelets for heightened activity, coagulation and thrombin production, thereby driving elevations in thrombin that underpin many SARS-CoV-2 fatalities. On the basis of these pathophysiological changes, prophylactic and symptomatic treatments are proposed, including the use of melatonin and α7nAChR agonism.


Abstract Current high-end visualization (using Insight Earth software) of various salt and sediment features in the Gulf of Mexico from use of watershedding, corendering, and other visualization technologies lead to insights. These insights include economically important findings related to structural history, depositional stratigraphy, and drilling environment parameters. Examples include a documented thrusted extrusive body near Mad Dog and the documented Rum roho allochthonous salt sheets as originally detailed by other authors. Watershedding is a descriptive term for volume segmentation, which is a statistical technique for dividing a volume into different regions as demonstrated by use of a watershed algorithm. This algorithm separates a volume into regions based on the grayscale value of an attribute, and falls into the class of algorithms that are used for image processing. The result is the creation of enclosed contoured regions, called "basins" and "watersheds," that mark the division of discrete regions based on a selection criterion within an area of interest. Segmenting the structural analysis of a seismic volume in this fashion allows for the creation of attributes that may be useful for structural interpretation, seismic facies analysis, and geologic reservoir modeling. Watershedding yields internal structural details within salt bodies which are difficult to discriminate on typical reflectivity data due to low reflectivity or low reflectivity contrast. The ability to see internal salt structure gives the interpreter the opportunity to image overturned sections near the base of salt bodies and recurrent toe thrusts which resemble offset stacked anvils. Identifying and mapping these features can lead to the ability to characterize intra-salt boundaries for drilling risks. Visualizations of the Rum roho enhance understanding of regional and local stresses. Inferences of pre-roho stratigraphy may impact many phases of asset assessment.


The European Accessible Information Network (EUAIN) was established to support the move to incorporate accessibility within mainstream content processing environments. EUAIN has brought together a considerable base of knowledge that has now been structured into a series of training modules and curricula which are intended to meet the real needs at this point in time.In this paper we outline how the EUAIN training and learning framework is primarily intended to provide support for everyone who is directly involved in digital content creation and document distribution channels. This target audience requires general courses and training materials as well as domain-specific materials. These general training materials include information about digital document standards and formats, accessibility guidelines and different kinds of publishers and distribution channels. Also important is knowledge about accessibility and alternative forms of presentation that fulfil special requirements for print impaired people. The curricula are illustrated by good practices of accessible content publishing and good examples of accessible digital documents. The specific training materials are addressed to different branches of publishing (books, newspapers, magazines, etc) and content creators (multimedia content designers, web designers, authors of e- learning content). A significant part of the materials are curricula that demonstrate tools and techniques for accessible content processing. Additionally, the training materials are in modular form to allow them to be adopted within courses and programs to meet the requirements of particular groups. These modular materials are also extensible and scalable, and it is our intention that many new curricula will be developed using this ever-growing resource base. Indeed, the newly-established PRO-ACCESS project is disseminating this information across the publishing industries.


Background The present study aimed to evaluate the effects of the probiotic strain Lactobacillusacidophilus D2/CSL (CECT 4529) on nutritional condition and faecal quality in cats. Methods Ten healthy adult cats from the same cattery were included (aged >9 months; male:female sex ratio=3:7). The animals were randomly assigned to a control group (CTR; n=5; male:female=1:4; room 1: 16 m2) and to a treated group (LACTO; n=5; male:female=2:3; room 2: 16 m2) receiving the same commercial dry diet. The LACTO group diet was supplemented with the probiotic (5 x 109 cfu/kg feed at least). A five-week experimental period was applied, and nutritional status was monitored by bodyweight (BW) and body condition score (BCS). Faecal quality was evaluated using faecal score (FS) and faecal moisture (FM) parameters. Plate counts of some faecal bacteria species were carried out. The data obtained were analysed using MIXED, GLM and NPAR1WAY procedures (SAS V.9.4; P≤0.05). Results The two groups did not show differences in BW and BCS data. A clear effect of the probiotic supplementation on FM was recorded (LACTO 44 per cent v CTR group 46 per cent; P=0.04). FS in the LACTO group (3.35) was close to ideal values (2–3) in comparison with the CTR group (3.75). Positive effects of Lacidophilus D2/CSL have been recorded in terms of increase in faecal lactobacilli counts and reduction in faecal coli counts. Conclusions This study's preliminary results describe how inclusion of Lacidophilus D2/CSL (CECT 4529) probiotic strain in cats' diets could effectively improve faecal quality parameters and consequently gut health in adult healthy cats.


It is our great pleasure to welcome you to the UMAP 2017 LBR, Demo, and TOR Track, the 25th User Modelling, Adaptation and Personalization, held in Bratislava, Slovakia organized between the July 9-12th, 2017. This track of UMAP wraps three categories: (i) Demos, which showcase research prototypes and commercially available products of UMAP-based systems, (ii) Late-breaking Results, which contain original and unpublished accounts of innovative research ideas, preliminary results, industry showcases, and system prototypes, addressing both the theory and practice of UMAP and (iii) Theory, Opinion and Reflection (TOR). TOR is an additional category introduced in this edition of UMAP. Papers in this category critically look at ongoing research topics, reflect on persistent or fleeting trends in the field and offer blue sky future agendas for UMAP research. A novelty related to the TOR category is the presentation format. TOR papers will be presented in the form of an interactive campfire session in a discussion corner during the poster session. In total, we received 13 LBR, 6 TOR, and 4 Demo submissions out of which 8, 3 and 3 were deemed of high quality by the reviewers. Further 6 LBR papers were accepted from the main conference.


Abstract. Endovenous laser ablation (EVLA) of the great saphenous vein (GSV) is thought to minimize postoperative morbidity and reduce work loss compared with high ligation and stripping (HL/S). However, the procedures have not previously been compared in a trial with parallel groups where both treatments were performed in tumescent anesthesia on an out-patient basis. Patients with varicose veins due to GSV insufficiency were randomized to either EVLA (980 nm) or HL/S in tumescent anesthesia. Miniphlebectomies were also performed. In our clinics, 87 varicosis patients were treated between September 2006 and December 2009. EVLA was applied in 90 cases and HL/S was applied in 84 cases. Clinical features and demographic characteristics of the patients were summarized. EVLA procedure was done by 980 nm diode laser (Ceralas D 980, Biolitec) at continues mode with 15 W energy.  Patient visits were done at post-operative 10th day, 6th month, 1st year and 2nd year. Routine physical examination and Doppler USG assessments were performed at these visits. EVLA and HL/S procedures were done in complete success in all cases at both groups.  All cases were invited for control visits. At post-operative 10th day all patients were evaluated, at 1st year control visit number of attended patients was 130 (EVLA: 68, HL/S: 62) and at 2nd year control, visit number of attended patients was 104 (EVLA: 56, HL/S: 48). When complications developed after procedures were evaluated; no infection, hematoma or paresthesis were observed in EVLA group. However in HL/S group; infections, hematomas and paresthesis were observed in 2, 6 and 24 cases respectively.  In terms of treatment success there was not significant difference between EVLA procedure and HL/S methods. However, in terms of post-op complication, EVLA method was associated with significantly less paresthesis, hematoma and pain. EVLA method is a method as effective and safe as standard treatment. However, when a long term result of this method is shown completely, its effectiveness will be cleared and its clinical utility will be established. Key words: Endovenous laser ablation, great saphenous vein, high ligation and stripping


After the creation of the State of Israel in 1948, Palestinian refugees fled over the border into Jordan, which in 1950 formally annexed the West Bank. In the wake of the 1967 War, another wave of Palestinians sought refuge in the Hashemite Kingdom. Today, 42 per cent of registered Palestinian refugees live in Jordan. In this historical context, one might expect Palestinian refugee camps to be highly politicised spaces. Yet Luigi Achilli argues in this book that there is in fact a relative absence of political activity. Instead, what is prevalent is a desire to live an 'ordinary life'. It is within the framework of the performing and creating everyday life - working, praying, leisure activities - that Achilli examines nationalism and identity. He concludes that it is through this focus on the everyday that these Palestinian refugees are able to assert their own meanings and understandings of national identity against the more inflexible interpretations provided by the political systems in Gaza and the West Bank.


Background: The Eastern Mediterranean Region (EMR), comprising of 22 countries, has a high burden of conduct disorder (CD) and has the largest burden of displaced populations. Violence and displacement increase the need for mental health services. Methods: Using descriptive study design, 2015 global CD burden (disability-adjusted life years DALYs per 100,000 populations) was compared to the EMR burden. Across 25 years (19902015) trend of CD in 22 EMR countries was graphed and compared with the global CD burden. Association of CD with a) Corruption Perception Index; b) Global Peace Index; c) Human Development Index was assessed using correlation analysis. CD data was obtained from 2015 Global Burden of Disease Study. Results: In the majority of EMR countries CD DALYs were higher in comparison to the rest of the world (99 vs 81) DALY's. Countries with the highest burden of CD are ranked as follows: Afghanistan, Somalia, Sudan, Syria, Yemen, Iraq. Correlation analyses demonstrated that CD burden was positively associated with indices of corruption and violence. However, CD was inversely associated with human developmental index. Conclusion and recommendation: EMR countries in crisis present the highest burden of CD. To the best our knowledge this is the first exploration of CD with indices of violence and corruption. Since CDs can lead to delinquency and criminal behavior in adulthood, if kept undetected and not treated can result to disastrous consequences.


Accurate and consistent medical terminology has a fundamental value in medicine. It enables medical students to understand the meaning of each term, medical physicians to communicate with each other, and it also enables science to adopt a logical language of high-level understanding and scientific regularity. Medical terminology inexpediencies caused by the adoption of etymologically illogical or linguistically false terms lead to misunderstanding and confusion among clinicians. The medical terms epidemic and pandemic are as old as Hippocrates and Sophocles, respectively. The present article evaluates the new medical terms tripledemic and triple epidemic, which were introduced during the recent COVID-19 pandemic.


Background: Primary hyperparathyroidism (PHPT) is a common endocrine disorder with increasing prevalence, but the majority of cases (over 85%) are now perceived to be mild and remain untreated. Objectives: The main focus of this thesis is to provide an accurate update of the epidemiology of PHPT based on population data, and to investigate its long-term outcomes in the mild untreated subgroup compared with those with severe disease. Design: A large retrospective cohort study using routinely collected data in Tayside, Scotland, 1997-2006. Results: The prevalence of PHPT is increasing annually during the study period with an unexpected cyclic incidence. Although most of the patients do not progress in the long-term, patients with mild untreated PHPT have an increased risk of mortality and of developing co-morbidities; the risks are similar in those with a severe PHPT condition. Parathyroid hormone predicts both disease progression and associated adverse outcomes in untreated patients. Parathyroidectomy normalises calcium and parathyroid hormone, as well as reducing the risks of adverse outcomes. Conclusions: Based on the study findings, this thesis concludes that although PHPT has become a mild stable condition, the increased risk associated with untreated PHPT should not be neglected and requires vigorous management to avoid a future


Major features of the new Massachusetts health law are ERISA-preempted as forbidden regulation of employer-provided health care. This is a regrettable conclusion but one mandated by the ERISA Section 514 and the controlling case law. ERISA preempts the new law's mandate requiring covered Massachusetts employers to sponsor medical plans for their employees and to make "fair and reasonable" contributions to such plans. ERISA also preempts the new law's requirement that Massachusetts residents maintain "minimum creditable coverage" for health care as that requirement effectively mandates for Massachusetts employers the substantive medical coverage they must offer their employees. Employer-provided medical coverage is today central to health care in the United States. ERISA Section 514(a) precludes the states from experimenting with alternative approaches to health care, like the new Massachusetts health law, which impact employer-provided health care. At a minimum, Congress should amend ERISA Section 514 to validate the new Massachusetts health law. More comprehensively, Congress should amend Section 514 to permit all states to experiment with health care reform insofar as such experiments "relate to" employer-provided health care. Ideally, Congress should repeal Section 514 and thus abolish altogether the jurisprudence of ERISA preemption.


Abstract Objective: Health-care workers (HCWs) are often seen as the most reliable source of vaccine-related information for their patients; nevertheless, various studies show that HCWs experience vaccine hesitation. In this study, the aim was to determine the reasons for vaccine hesitation among HCWs working in a large public hospital and its affiliated units in Istanbul. Methods: A descriptive method for collecting qualitative data was designed for this study. The data of the HCWs were analyzed in line with the vaccine hesitancy factors put forward by the World Health Organization (WHO). Results: The most important vaccine hesitancy theme that emerged was the fear and lack of confidence in the vaccines, which was expressed at a higher rate than any other theme in all HCWs. The most cited reason for fear/lack of confidence in the vaccine was the fear of its side effects. It was observed that the HCWs who reported hesitation about vaccination due to pregnancy and breastfeeding consisted of women. The second most common theme for vaccine hesitation was reported as an inconvenience in accessing the vaccines. Although HCWs have priority, they stated that their reason for vaccine hesitancy was due to heavy personal issues or workloads. The final theme was about complacency, or thinking they do not need the vaccine. Conclusions: Vaccine hesitation is a challenge that can be overcome with detailed monitoring and policy-making. Although the vaccine seems to be more significant, we do not want to see vaccine hesitancy grow more than the vaccine itself.


Hyaluronic acid (HA) also known as hyaluronan, is a natural polysaccharide—an anionic, non-sulfated glycosaminoglycan—commonly found in our bodies. It occurs in the highest concentrations in the eyes and joints. Today HA is used during certain eye surgeries and in the treatment of dry eye disease. It is a remarkable natural lubricant that can be injected into the knee for patients with knee osteoarthritis. HA has also excellent gelling properties due to its capability to bind water very quickly. As such, it is one the most attractive controlled drug release matrices and as such, it is frequently used in various biomedical applications. Due to its reactivity, HA can be cross-linked or conjugated with assorted bio-macromolecules and it can effectively encapsulate several different types of drugs, even at nanoscale. Moreover, the physiological significance of the interactions between HA and its main membrane receptor, CD44 (a cell-surface glycoprotein that modulates cell–cell interactions, cell adhesion and migration), in pathological processes, e.g., cancer, is well recognized and this has resulted in an extensive amount of studies on cancer drug delivery and tumor targeting. HA acts as a therapeutic but also as a tunable matrix for drug release. Thus, this review focuses on controlled or sustained drug release systems assembled from HA and its derivatives. More specifically, recent advances in controlled release of proteins, antiseptics, antibiotics and cancer targeting drugs from HA and its derivatives were reviewed. It was shown that controlled release from HA has many benefits such as optimum drug concentration maintenance, enhanced therapeutic effects, improved efficiency of treatment with less drug, very low or insignificant toxicity and prolonged in vivo release rates.


Friction force oscillations caused by changes in the properties of the contact zone between brake disc and pad are well known from various applications. Resulting effects like brake judder are known phenomena in brake technologies and in the scope of various scientific work. A new potential measure to reduce brake torque oscillations is the active compensation with the use of the control system of a self-energizing hydraulic brake (SEHB).The SEHB for railway application developed at the Institute for Fluid Power Drives and Controls (IFAS) of RWTH Aachen University offers high dynamic properties with its capability to reduce brake torque oscillations actively. New — in comparison to other braking systems — is the fact that the brake torque is measured by sensing the pressure in an additional supporting cylinder. Within this paper the influence of the hydraulic-mechanical system of the supporting cylinder on the oscillation properties of the SEHB is analyzed. The experimental investigation is conducted using a full scale brake test for railway applications. The brake disc is driven by hydraulic motors in secondary control mode. Measurement results will be used to define requirements of a superimposed dynamic pressure control to minimize brake torque oscillations. Future work will be experimental investigation of the influence of the self-energizing effect and the development of measures to compensate brake torque oscillations actively with the hydraulic actuator of the SEHB.Copyright © 2015 by ASME


The process in this study was conducted on removal of chromium(III) in a solution simulating a typical spent chrome tanning bath by the resin having matrix of styrene-divinylbenzene-based macroporous sulphonate, Amberjet 1200Na. The column experiments were carried out with the bed volumes of the resin as 751 mL and 1016 mL for different installation systems of the laboratory-scale pilot plant. The feeding solutions in the bed volumes of 200 and 190 were used for each installation system. The regeneration behaviour of the resin was determined by using reverse regeneration procedure with the solution of hydrogen peroxide in alkaline. The regeneration kinetics of the exhausted resin was examined with a range of the solutions having different concentration series of the alkaline hydrogen peroxide. The solutions of the basic chromium sulphate were recycled for each installation system following the regeneration cycles. The chromium ions in effluent were quantitatively eluted, and satisfactory removal of chromium(III) and recovery of chromium(VI) were achieved.


This work reports some experimental results regarding to a Li2O-ZrO2-SiO2-Al2O3 (LZSA) sintered glass-ceramic material obtained by roll pressing of glass powders (mean particle size ≈ 5 μm) with an added (7 wt.%) inorganic material (bentonite) as binder. The composition was characterized using chemical analysis, laser-scattering particle size analysis, DTA, XRD, thermal expansion, modulus of rupture (MOR) and deep abrasion (DA) measurements as well as density measurements and SEM observations. From the results it was verified that the glass-ceramic materials obtained by sintering and controlled crystallization, in the 850-1030°C temperature range, of glass powders, have properties and characteristics decisively better than those of other traditionally used materials. It is concluded that roll pressing technology is a potential candidate to produce sintered glassceramics for many applications, such as, for example, large sheets panels for electrical and thermal insulation.


We define and propose an efficient and provably secure construction of blind signatures with attributes. Prior notions of blind signatures did not yield themselves to the construction of anonymous credential systems, not even if we drop the unlinkability requirement of anonymous credentials. Our new notion in contrast is a convenient building block for anonymous credential systems. The construction we propose is efficient: it requires just a few exponentiations in a prime-order group in which the decisional Diffie-Hellman problem is hard. Thus, for the first time, we give a provably secure construction of anonymous credentials that can work in the elliptic group setting without bilinear pairings and is based on the DDH assumption. In contrast, prior provably secure constructions were based on the RSA group or on groups with pairings, which made them prohibitively inefficient for mobile devices, RFIDs and smartcards. The only prior efficient construction that could work in such elliptic curve groups, due to Brands, does not have a proof of security.


Recent studies on specific aspects of the history of the Olivetti Company and its entrepreneurs allow us to outline a general view of the growth and the decline of the firm during the twentieth century. The firm has operated for a long time in a highly competitive market, presenting innovative products. In the age of globalization, the competitive advantages and capabilities of the firm are no more sufficient to avoid the decline. This decline symbolizes, at least in part, the decline of the Italian manufactures. The experience of Olivetti has been relevant even in the field of corporate social responsibility and still offers suggestions and questions for the challenges of the present time.


Programs such as Respecting Choices® in the United States and Respecting Patient Choices® in Australia have been developed to address the need for improved advance care planning. Numerous guidelines, policies and pieces of legislation exist to provide guidance on requirements for developing and documenting advance care plans. However the problem of sub-optimal advance care planning persists. A multifactoral approach is needed to address this problem. Within such an approach there may be benefits in looking at the role accreditation can play in driving improvements in advance care planning. Accreditation is part of a comprehensive system to support safe and high quality care. It can verify that actions are being taken, that system data and information are being used to identify problems and develop solutions and that improvements are being achieved. Accreditation processes have been widespread for many years, but have generally not included a requirement to have advance care planning systems in place. In Australia, requirements to have systems for preparing and receiving advance care plans, and for documenting them in the clinical record, are included in new mandatory accreditation standards. These National Safety and Quality Health Service Standards provide explicit statements of the expected level of safety and quality of care to be delivered to patients. Hospitals will need to be assessed against these standards from January 2013. This innovative strategy of using mandatory accreditation standards – targeted at a high level – complements more detailed policy and educational programs that already exist. Such an approach will support the implementation of advance care planning programs.


Internet addiction (IA) is widespread, comorbid with other conditions, and commonly undetected, which may impede recovery. The Internet Addiction Test (IAT) is widely used to evaluate IA among healthy respondents, with less agreement on its dimensional structure. This study investigated the factor structure, invariance, predictive validity, criterion validity, and reliability of the IAT among Spanish women with eating disorders (EDs, N = 123), Chinese school children (N = 1072), and Malay/Chinese university students (N = 1119). In school children, four factors with eigen values > 1 explained 50.2% of the variance, with several items cross-loading on more than two factors and three items failing to load on any factor. Among 19 tested models, CFA revealed excellent fit of a unidimensional six-item IAT among ED women and university students (χ2(7) = 8.695, 35.038; p = 0.275, 0.001; CFI = 0.998, 981; TLI = 0.996, 0.960; RMSEA = 0.045, 0.060; SRMR = 0.0096, 0.0241). It was perfectly invariant across genders, academic grades, majors, internet use activities, nationalities (Malay vs. Chinese), and Malay/Chinese female university students vs. Spanish women with anorexia nervosa, albeit it was variant at the scalar level in tests involving other EDs, signifying increased tendency for IA in pathological overeating. The six-item IAT correlated with the effects of internet use on academic performance at a greater level than the original IAT (r = −0.106, p < 0.01 vs. r = −0.78, p < 0.05), indicating superior criterion validity. The six-item IAT is a robust and brief measure of IA in healthy and diseased individuals from different cultures.


PURPOSE/OBJECTIVES
To describe oncology nurses' complementary and alternative medicine (CAM) knowledge and attitudes.

DESIGN
Descriptive, cross-sectional.

SETTING
A national medical center and research institute.

SAMPLE
A random sample of 850 Oncology Nursing Society members who are RNs involved in direct care.

METHODS
Respondents completed a demographic questionnaire and the Nurse Complementary and Alternative Medicine Knowledge and Attitude survey. Descriptive analysis was used to describe the participants' CAM knowledge and attitudes. In addition, participants' comments were transcribed and content analysis was conducted.

MAIN RESEARCH VARIABLES
CAM knowledge and attitudes.

FINDINGS
The participants' mean CAM knowledge score was 70%. Attitudes varied according to beliefs, practice, and role, but were positive overall.

CONCLUSIONS
Assessing oncology nurses' CAM knowledge is important for developing appropriate educational programs that will help nurses support and advocate for patients. In addition, assessing CAM attitudes will provide insight for realizing and sustaining robust changes to health care.

IMPLICATIONS FOR NURSING
Oncology nurses should be prepared with insightful CAM knowledge and attitudes to provide prudent and unbiased information to patients.


Society has witnessed a rapid growth in the prevalence and use of social media. The influence and impact of this expansion has sparsely, if at all, been considered within the context of desistance from crime. This article draws upon the narratives of male and female service users subject to community supervision by a Community Rehabilitation Company, collected as part of a doctoral thesis. Evidence demonstrates how social media plays a largely negative role, with some gendered difference on a service user's identity and relational desistance, alongside individual agency and wider social structures. This enables the article to develop the evidence base of interactionist perspectives of desistance, while also recognising gender.


Governments, companies, banks and civil society are placing more emphasis on the rigorous application of the mitigation hierarchy to avoid, minimize and compensate for projects' impacts on biodiversity. The final step in the mitigation hierarchy sequence are biodiversity offsets to achieve No Net Loss (NNL) or Net Gain (NG). Thirty-nine countries have existing laws or policies on NNL/NG, biodiversity offsets or compensation, and twenty-two countries are developing them. The purpose of this paper is to contribute to the consideration of policy options by the IUCN Technical Study Group on biodiveristy offsets and the subsequent Working Group and to provide information more broadly to governments and their advisors. It is intended as a basic introduction to policy on NNL or NG of biodiversity and biodiversity offsets.


Two sets of experiments were conducted to compare the relative stability of partial and complete resistance in rice to Pyricularia grisea (causal agent of the rice blast disease) in a disease hot spot in eastern Colombia. In the first set of experiments, 186 breeding lines selected at the site over the F 2 to F 4 generations, ranging from completely to partially resistant in the F 4 , were evaluated under heavy disease pressure at the site every season from 1987 to 1990 (two seasons per year). A set of 92 lines from the International Rice Blast Nursery (IRBN) with initial evaluations of resistant (standard evaluation system [SES] ≤ 5), also ranging from completely to partially resistant, were evaluated under the same conditions. Locally developed materials were rated as susceptible less frequently than lines from the IRBN set. In both sets, significantly fewer lines initially scored as highly resistant (SES = 1 to 3) were later scored as susceptible (SES > 5) or showed any increase in susceptibility to local pathogen populations compared to those initially rated as partially resistant (SES = 4 to 5). In the second set of experiments, locally developed and exotic lines were grouped according to partial (few susceptible-type lesions [SES type 5]) and high resistance (few resistant-type lesions [SES type 1 to 3]). After three seasons of evaluation, lines with high levels of resistance had a significantly lower rate of change to susceptible levels. The rice cultivar Oryzica Llanos 5 was selected at this site from a line with complete blast resistance and was released for commercial cultivation in blast-prone eastern Colombia. It is grown on approximately 5 x 10 4 ha/year and has remained resistant to blast over 10 consecutive growing seasons, both in experimental blast nurseries and in farmers' fields where blast normally is a severe problem. This cultivar also showed uniformly high levels of blast resistance when evaluated at seven high blast level sites in four Asian countries in blast nurseries with 72 other cultivars with differing levels and origins of blast resistance. The results suggest that selecting high levels of resistance when diverse sources are combined can be used to develop cultivars with stable resistance to rice blast.


Nickel based composite coatings have attracted a lot of interest particularly for wear resistant and corrosion resistant applications. Among the various composite coatings Ni-SiC is of special interest as it is commercially used as wear resistant coating in rotary and reciprocating engines. However, at temperatures above 450oC SiC reacts with the nickel matrix to form brittle nickel silicide which deteriorates the performance of the Ni-SiC coating. Oxide particle reinforced nickel composite coatings can be an alternate to Ni-SiC coating as the distributed phase- oxides are thermally more stable compared to carbides. In the present study, mullite (3Al2O3.2SiO2) particles have been reinforced in nickel matrix. The advantages of mullite include low thermal conductivity, excellent creep resistance, high-temperature strength, and good chemical stability.
The electrodeposition conditions were optimized to obtain maximum particle incorporation. The thermal stability of electrodeposited Ni-mullite coating in terms of microhardness was studied at temperatures upto 800oC and compared with Ni-SiC coating. The hardness value of as plated electroforms was similar for both Ni-mullite and Ni-SiC coating (400Hk). A marginal decrease in the microhardness of Ni-mullite coating occurred at temperatures of 600oC while, significant reduction was observed beyond 400oC for Ni-SiC coating. Thus, the incorporation of mullite particles in nickel matrix improves its thermal stability to a temperature of 600oC. The tribological studies showed that the wear volume loss for Ni-mullite coating is 2.38X10-5mm3/m while, that of Ni-SiC coating is 9.58X10-5mm3/m under identical testing conditions. The corrosion studies using potentiodynamic polarization and electrochemical impedance studies showed that the corrosion resistance of Ni-mullite coating is better than that of Ni-SiC coating. Thus, from the above studies it can be concluded that Ni-mullite has better wear and corrosion resistance compared to Ni-SiC coating in other words it is a multifunctional coating


Accumulating evidence suggests that phosphatidylinositol (PI) pathways have been involved in the secretion of dopamine (DA) and the regulation of DA transporter, which is a target of methamphetamine (METH). A recent large‐scale gene‐association study in a Dutch population demonstrated that the PIK4CA gene was closely linked to schizophrenia [Jungerius et al. (2007); Mol Psychiatry]. Here, we conducted a case (N = 232)–control (N = 233) study of the PIK4CA gene on Japanese METH abusers, which can manifest severe psychosis similar to schizophrenia. The genotype and allelic distributions of all four single nucleotide polymorphisms (SNPs) did not differ significantly between the METH abusers and the controls. The comparisons based on the classification of the psychosis as transient or prolonged and on the presence or absence of spontaneous relapse revealed no significant distribution of the four SNPs compared to the controls. Furthermore, haplotype analyses showed almost the same frequencies between the METH abusers and the controls. The present study suggests that the PIK4CA gene does not play a significant role in the vulnerability to METH use disorder in the Japanese population. © 2008 Wiley‐Liss, Inc.


The objective of the study is to establish the hydrological characteristics, the hydrological behavior of river basins in arid and semi-arid south-eastern Algeria (establish of methodologies and necessary working tools for planning the development and management of water resources). The study on floods in Algeria is established by the National Agency of Water Resources (ANRH shows that the country is confronted with the phenomenon of very destructive floods and floods especially in arid and semi-arid regions). Flooding of rivers in these areas is less known. They are characterized by their sudden duration (rain showers, thunderstorm). The duration of the flood is in the order of minutes to hours. The human and material damages caused by these floods are still high. The study area encompasses three watersheds in semi-arid, arid south and Algeria. There are pools of Chott-Melghir (68,751 km2), highland Constantine-07 (9578 km2) and El Hodna-05 basin (25,843 km2). The total area of this zone is about 104,500km2. Studies of protection against floods and design studies of hydraulic structures (spillway, storm basin, etc.) require the raw data which are often unknown in several places particularly at ungauged wadis of these areas.


PURPOSE To describe the frequency and patient-reported readiness to change, desire to discuss, and perceived importance of 13 health risk factors in a diverse range of primary care practices. METHODS Patients (n = 1,707) in 9 primary care practices in the My Own Health Report (MOHR) trial reported general, behavioral, and psychosocial risk factors (body mass index [BMI], health status, diet, physical activity, sleep, drug use, stress, anxiety or worry, and depression). We classified responses as "at risk" or "healthy" for each factor, and patients indicated their readiness to change and/or desire to discuss identified risk factors with providers. Patients also selected 1 of the factors they were ready to change as most important. We then calculated frequencies within and across these factors and examined variation by patient characteristics and across practices. RESULTS On average, patients had 5.8 (SD = 2.12; range, 0–13) unhealthy behaviors and mental health risk factors. About 55% of patients had more than 6 risk factors. On average, patients wanted to change 1.2 and discuss 0.7 risks. The most common risks were inadequate fruit/vegetable consumption (84.5%) and overweight/obesity (79.6%). Patients were most ready to change BMI (33.3%) and depression (30.7%), and most wanted to discuss depression (41.9%) and anxiety or worry (35.2%). Overall, patients rated health status as most important. CONCLUSIONS Implementing routine comprehensive health risk assessments in primary care will likely identify a high number of behavioral and psychosocial health risks. By soliciting patient priorities, providers and patients can better manage counseling and behavior change.


This study highlights an attempt of comparing the performance of several energy storage (ES) devices like battery ES, flywheel ES, capacitive ES, superconducting magnetic ES, ultra-capacitors and redox flow battery (RFB) in automatic generation control under bilateral deregulated scenario. The considered system comprises gas and thermal generations wherein a geothermal power plant (GTPP) is also incorporated. Gas and thermal systems are provided with appropriate generation rate constraints. A new fractional order (FO) cascade controller named as FO proportional-integral-FO proportional-derivative (FOPI-FOPD) is proposed as secondary controller and its performance is compared with commonly used classical controllers. A novel stochastic algorithm, sine cosine algorithm, has been used to optimise controller gains and other parameters. Analyses of dynamic responses reveal the superiority of FOPI-FOPD over others in terms of settling time, peak deviation and magnitude of oscillation. The effect due to GTPP introduction has been examined and the responses disclose that the integration of GTPP leads to better dynamics. Performances of various ES devices in the presence of FOPI-FOPD controller are also compared and dynamic responses of RFB found superior to others. For a more realistic scenario, analysis is done considering time delay and some practical plants of Nevada, USA.


The agreement trap occurs when negotiators reach deals that are inferior to their best alternative agreements. The paper extends prior negotiation research by investigating whether teams display greater wisdom than solos in knowing when to walk away from the negotiating table, and thereby avoid the agreement trap. Two experiments compared teams and solos in a negotiation in which reaching agreement was unwise because of misaligned interests. The negotiation involved a real-estate transaction in which the optimal solution was for the parties to declare an impasse. Study 1 found that two- and three-person teams were significantly more likely than solos to impasse. Study 2 found that the party faced with the greater need to make accurate judgments about the alignment between their own and their counterpart's interests benefited most from the addition of a teammate. These findings offer insight into why the agreement trap occurs and how it can be reduced.


Thepoor prognosis and adverse outcomes following standard chemoimmunotherapy forpatients with high-grade B-cell lymphomas harboring rearrangements of MYC and BCL2 and/or BCL6 (HGBL-DH/TH) is now well-established, withless than 20% estimated long term survival following standard therapies.Fortunately, the frequency of HGBL-DH/TH in unselected aggressive B-celllymphomas is relatively uncommon and estimated at 10% of all cases. Thesedouble- and/or triple-hit lymphomas are often, but not universally, associatedwith a clinically aggressive presentation, high-grade morphologic features, orincreased protein expression of the corresponding genes. However, a substantialnumber of patients have no clear indicators of underlying DH/TH. The paradox ofan exceedingly poor prognosis coupled with a relatively uncommon frequencyraises the practical challenge of determining which patient warrants FISHtesting and is an area of substantial controversy and emerging data. Theclinical consequence of missing HGBL-DH/TH is dire, as these patients arelikely undertreated by standard chemoimmunotherapy (RCHOP). However, in acost-conscious era, routine and widespread testing for biologic determinants ofoutcome may not be appropriate, and a critical appraisal of predictors iswarranted. This review will discuss the clinical implications of theserearrangements in aggressive B-cell lymphomas and the potential clinical, pathologic,or biologic predictors of underlying HGBL-DH/TH biology.


Carbon nanotubes can be generated on a surface through chemical vapor deposition. If part of a surface is covered with a transition metal catalyst such as iron or cobalt, simple hydrocarbons such as ethylene (C2H4) can decompose at high temperatures and form straight single-walled nanobutes growing normal to the surface. Dosa et al. have been exploring whether larger hydrocarbons with many double and triple bonds would react to form nonotubes at lower temperatures. These species reacted explosively however and yielded only a small fraction of carbon particles. Adding metal catalysts simply produced carbon soots. They now report that large unsaturated hydrocarboins that incorporate cobalt, nickel, or iron (complexed with carbonyl ligands) did react at relatively low temperatures (below 200) and prodced multiwalled carbon nanobutes with the metals trapped as particles withing nanotubes. Because numerous variants of these starting materials can be prepared, this lower temperature route may lead to greater synthetic control of nanotube fabrication.– BH

Ecological Monographs 69 , 491 (1999)


A problem of joint optimal bandwidth and power allocation in cognitive networks under fading channels is considered. It is assumed that multiple secondary users (SUs) share the spectrum of a primary user (PU) using frequency division multiple access. The bandwidth and power are allocated so as to maximize the sum ergodic capacity of all SUs under the total bandwidth constraint of the licensed spectrum as well as different combinations of the peak/average transmit power constraints at the SUs and the peak/average interference power constraint imposed by the PU. Although the optimization problem is convex, its dimension and, thus, complexity may be high. Therefore, computationally efficient ways of solving the problem are of importance and are investigated here by finding structures of the optimal solutions to the problem under different combinations of the constraints.


ABSTRACT Previous research has demonstrated that school processes can be significantly associated with (in)equality in schools. However, it is unclear what these practices in schools look like. This study aims to understand support practices for students in primary schools in a highly selective education system. The findings are based on a contrastive case comparison of five primary schools in Switzerland with a large percentage of children with a migration background. Quantitative surveys with students in Grades 4, 5, and 6 (n = 372) and qualitative analyses of group discussions with teachers were conducted. The results of the qualitative study, and in part also of the quantitative study, show that schools differ systematically in providing support for students. None of the schools was found to have a support milieu that could be described as non-discriminatory. In the majority of the schools, the support milieu is oriented towards high performing students with a higher socio-cultural family background or high educational aspirations; this may lead to the reproduction of inequalities. Only two schools seem to have implemented compensatory support strategies, at least partially. Further, the schools can be differentiated regarding the teachers' perceived degree of their active participation in supporting students.


Pregnant women undergoing mechanical valve replacement are at a considerable risk of thromboembolic events, bleeding, and fetotoxicity associated with the administration of vitamin K antagonists and some other anticoagulants. We present our clinical experience of pregnancy and childbirth in a young woman who underwent aortic valve replacement (AVR) with a mechanical valve. A young woman underwent AVR with a bioprosthetic valve for a diagnosis of aortic regurgitation and bicuspid aortic valve at age 23. Four years later, structural valve deterioration(SVD) of the prosthetic valve necessitated redo AVR with bioprosthesis. Three years after the redo AVR, she developed recurrent SVD of the bioprosthesis, and the 3rd AVR operation was performed using an On-X mechanical valve, which allows reduced anticoagulation. She conceived 5 months after AVR using the On-X valve. Anticoagulation therapy was administered with a low-dose vitamin K antagonist combined with heparin infusion during pregnancy. No anticoagulation-induced maternal and fetal complications occurred throughout the pregnancy. The On-X valve, which allows lower levels of anticoagulation is useful in women wishing to get pregnant.


Hospitalists are known as change agents for their fierce patient advocacy and expertise in hospital systems redesign. The field of hospital medicine has claimed numerous successes and the hospitalist model has been embraced by institutions across the country. Yet the lived experiences of hospitalists surveyed by Bhandari et al in this month's issue of JHM suggest a grim undertone.1 Hospital medicine is a field with high physician burnout rates, stark gender inequities in pay, leadership, and academic opportunities, and an unacceptably high prevalence of sexual harassment and gender discrimination. Women hospitalists disproportionately bear the brunt of these inequities. All hospitalists, however, can and should be an integral part of the path forward by recognizing the impact of these inequities on colleagues and hospital systems. The study by Bhandari et al adds to the increasing body of knowledge documenting high levels of sexual harassment and gender discrimination in medicine and highlights important gender differences in these experiences among hospitalists nationally.1,2 Among 336 respondents across 18 academic institutions, sexual harassment and gender discrimination were both common and highly problematic within the field of hospital medicine, confirming what prior narratives have only anecdotally shared. Both men and women experienced harassment, from patients and colleagues alike, but women endured higher levels compared with men on all the measures studied.1 Qualitative comments in this study are noteworthy, including one about a hospitalist's institution allowing potential faculty to be interviewed about plans for pregnancy, childcare, and personal household division of labor. One might argue that this knowledge is necessary for shift-based inpatient work in the context of a worldwide pandemic in which pregnant workers are likely at higher risk of increased morbidity and mortality. It remains illegal, however, to ask such questions, which are representative of the types of characteristics that constitute a toxic workplace environment. Moreover, such practices are particularly problematic given that pregnancy and childbearing for women in medicine come with their own set of well-documented unique challenges.3 The considerable body of research in this field should help guide new research priorities and targets for intervention. Does the experience of sexual harassment impact hospitalists' intentions to leave their institutions or the career as a whole? Does sexual harassment originating from colleagues or from patients and families affect patient safety or quality of care? Do interventions in other international hospital settings specifically targeting respectfulness translate to American hospitals?4 These questions and a host of others merit our attention. Hospital system leaders should work with hospital medicine leaders to support wholesale institutional cultural transformation. Implementation of antiharassment measures recommended in the 2018 report on sexual harassment from the National Academies of Sciences, Engineering, and Medicine is critical.2 This means supporting diverse, inclusive, and respectful environments at all levels within the organization, improving transparency and accountability for how incidents are handled, striving for strong and diverse leadership, providing meaningful support for targets of harassment, measuring prevalence over time, and encouraging professional societies to adopt similar actions. Furthermore, we believe it is critical to adopt a zero-tolerance policy for harassing behaviors and to hold individuals accountable. Encouraging all individuals within health care systems to uphold their ethical obligations to combat harassment and bias on a personal level is important.5 If left unaddressed, the unmet needs of those who are subjected to harassment and bias will continue to be problematic for generations to come, with detrimental effects throughout healthcare systems and the broader populations they serve.


Background: It was the aim of this study to evaluate the efficacy of docetaxel and vinorelbine combination in well-defined anthracycline-'exposed' or -'resistant' advanced breast cancer patients. Patients and Methods: A phase II trial was carried out enrolling 43 advanced breast cancer patients, all previously treated with anthracyclines, both in an adjuvant or advanced setting. Docetaxel 75 mg/m2 as 1-hour infusion and vinorelbine 25 mg/m2 as 30-min infusion were administered on day 1, every 3 weeks. Results: According to an intent-to-treat analysis, the response rate was 37.2% (95% CI 22.8–51.6) in 43 patients, whereas responses were observed in 16 (1 complete response, 15 partial response) out of 39 evaluable patients (41%, 95% CI 25.6–56.5); there were 50% with first-line and 33% with second-line therapy, and 50 and 29% of patients were considered anthracycline 'exposed' and 'resistant', respectively; responses by estrogen receptor (ER) status were given in 48% (ER positive) and 25% (ER negative), and by HER2 status, in 21% (HER2 positive) and 52% (HER2 negative). Median time to progression and median overall survival were 7.7 and 28.7 months, respectively. Toxicity was generally acceptable, with grade 3 neutropenia encountered in 15 (35%) patients and grade 4 neutropenia in 1 (2%) patient. Neutropenic fever occurred in 7 patients (16%), usually short-lasting. Grade 3 mucositis was encountered in 2 patients (5%). Conclusions: The combination of docetaxel and vinorelbine as a 3-weekly schedule is active and manageable in advanced breast cancer patients previously treated with anthracyclines.


Cold spray (CS) technique is a process whereby metallic particles are utilized to form coatings using ballistic impact upon substrate materials. This technique is based on the high velocity (3001500 m/s) impinging of small solid particle (generally 1050 mm in diameter) on substrates. In this process, the particles are accelerated by the supersonic gas jet at the heated gas temperature, which is usually lower than melting temperature of powder materials. Consequently, this process solved the problem of thermal spraying, such as high temperature oxidation, phase transformation etc. Until now, the CS has a good track record in almost metallic coatings, such as copper, stainless steels, Ni base superalloys etc. Recently, some kinds of ceramics and polymers can be coated by the CS. The CS is expected as not only coating technique but also thick ˆlm formative technique. In this article, the present situation and future prospects of the CS are explained.


Author(s): Khalil, Alexander Konrad | Abstract: This dissertation explores the significance of a concept known as yphos among the last remaining psaltes (chanters) of the millennium-old tradition at the Patriarchal church of Constantinople, in Istanbul, Turkey. Collaborating with Stilianos Floikos, the youngest--and possibly the last--of these psaltes, I take as my point of departure his beliefs and practices regarding yphos, which he conceives as manifest through complex processes of melodic interpretation as he chants from contemporary traditional neumatic scores. These interpretations, through which Stilianos manifests yphos, directly contradict the melody explicitly written on the scores from which he chants. While this may appear to reflect a break with tradition I demonstrate, by conducting comparative analyses between contemporary and older neumes, that Stilianos' processes of melodic interpretation are rooted in oral practices associated with these older neumes. Informed by this historical background, I identify elements of yphos in Stilianos' processes of interpretation by comparing seven of his performances of a single score. My melographic and formal analyses, combined with Stilianos' explanations, demonstrate that his interpretations involved a process of reconstruction based on underlying implicit musical structures. Having explicated this process, I am able to address directly the central focus of this dissertation: the phenomenology of yphos. From Stilianos' description of his experience, it becomes clear that when chanting a written line he perceives multiple layers of remembered melody, together with people and events associated with them. By chanting with and against these melodies he creates resonances. These resonances create for him an environment of constant recontextualization, imbuing his every act with multiple meanings while bringing him into dialogue with psaltes of the past. Borrowing the term from literary theorist Sarah Dillon, I describe this experience of interaction with multiple layers, paradoxically discrete yet inseparable, as "palimpsestuous." From this, I develop a palimpsest theory, which not only provides a framework that renders transparent Stilianos' experience of yphos, but also can inform studies of musical style and affect, oral and written transmission, and processes of human memory. Like a space resounding with echoes, Stilianos' community continues to reflect, transmit, and reshape the echoing resonances of its past


The steady increase in the number of patients with diseased aortic valves demands the development of effective aortic valve replacement procedures. Engineering and technology offer various manufactured alternatives, but none can exactly match the natural human valve. In addition to the experts of heart valve tissue engineering, many researchers focus on specific aspects of the manufacturing of artificial valves. The aim of this study was to benefit such manufacturing processes. From the contributor's perspective, it is vital to gain comprehensive knowledge before embarking on this project. The perfect/optimal shape of the valve is the fundamental aspect that needs to be considered by all participants. It is noteworthy that the geometry not only limits the functionality of the structure but also determines the choice of material and engineering methods. In this study, we attempt to determine if current knowledge is sufficient to reach consensus on the issue of the optimum shape of the valve. Here, we not o...


Abstract Celiac Disease (CD) is a gluten-sensitive enteropathy, and an autoimmune disorder involving an innate and adaptive immune response that occurs in genetically predisposed patients who are exposed to gluten-containing foods and other environmental factors. Early diagnosis and treatment are essential in preventing complications of the disease. Symptoms may appear both in childhood or adulthood by the ingestion of gluten and are usually characterized by gastrointestinal symptoms; however, the diagnosis may be delayed because of various extraintestinal manifestations, such as iron deficiency anemia, osteoporosis, or non-specific skin lesions in adult patients. Although CD has been shown to have an increased risk of all malignancies, plasma dyscrasias, especially multiple myeloma (MM) associations, are rare and reported to be seen in elderly patients. The current report presents a 42-year-old female patient with a recent dysphagia after a hot food ingestion with no other complaints. Laboratory investigations revealed a mild anemia and high serum protein levels. CD was diagnosed after a small bowel biopsy and MM was diagnosed after a serum protein electrophoresis with immunotyping studies (IgA lambda as the monoclonal protein) and bone marrow biopsy. In the laboratory, Immunotyping studies of monoclonal protein included two alternative methods; Immunofixation electrophoresis and immunosubtraction method with capillary electrophoresis. Our patient, is young to have MM, since the median age at diagnosis of MM is 66 years and only 2% of patients are younger than 50 years. We believe that celiac disease played a significant role in the development of MM in this particular patient with IgA monoclonality and conclude that CD patients, even if they are young, must be monitored for plasma dyscrasias in addition to other malignancies.


We introduce a general theoretical approach for the simulation of photochemical dynamics under the influence of circularly polarized light to explore the possibility of generating enantiomeric enrichment through polarized-light-selective photochemistry. The method is applied to the simulation of the photolysis of alanine, a prototype chiral amino acid. We show that a systematic enantiomeric enrichment can be obtained depending on the helicity of the circularly polarized light that induces the excited-state photochemistry of alanine. By analyzing the patterns of the photoinduced fragmentation of alanine we find an inducible enantiomeric enrichment up to 1.7%, which is also in good correspondence to the experimental findings. Our method is generally applicable to complex systems and might serve to systematically explore the photochemical origin of homochirality.


B222 Tamoxifen is an established effective chemopreventive agent against estrogen receptor positive breast cancer. Although the long term administration of tamoxifen substantially reduces the risk of breast cancer it significantly increases the risk of endometrial cancer as well as the incidence of benign endometrial pathologies. In a previous study (European J Cancer, 41: 647-654, 2005) we have found that the combination of tamoxifen with daidzein prevented 7,12, dimethylbenz[a]anthracene (DMBA)-induced rat mammary carcinogenesis in female Spraque-Dawley Rats more effectively than tamoxifen alone. Since daidzein is converted in the gut of the rats to equol and is found in the blood in this form we attributed the effect of daidzein to its metabolite equol. The objective of the present study is to determine if daidzein (or equol) diminishes the risk for endometrial cancer introduced by tamoxifen. Four groups of female rats were fed the basal AIN-76A diets supplemented with: 1) vehicle (control), 2) tamoxifen (0.125 mg/Kg diet), 3) daidzein (140 mg/Kg) diet, or 4) tamoxifen (0.125 mg/Kg diet) plus daidzein (140 mg/Kg diet) combination. Rats were sacrificed at either after 28 days (short term exposure) or 185 days (long-term exposure) and the endometrium removed and processed for immunohistochemical and biochemical evaluations. We determined that the most significant differences were within the glandular cells of the endometrium. In these cells, both short-term and long term exposure to the tamoxifen diet produced increased DNA damage, increased PCNA expression, and reduced PTEN expression. The combined tamoxifen/daidzein diet reversed to a large degree these effects. The daidzein diet alone did not effect the level of DNA damage when compared to the control diet whereas it increased PCNA and reduced PTEN exression. These data demonstrate for the first time that the soy isoflavone daidzein reduces the risk of endometrial cancer in female rats. Furthrmore, it seems that soy products (through daidzein and its end-metabolite equol) may abolish one of the most severe adverse effects of tamoxifen.


Rotary steerable systems (RSS) and steerable motors pose their own unique challenges when modelling the bottomhole assembly (BHA) directional behavior. This paper aims to present a methodology that allows the anticipation of problems such as mechanically stuck pipe or lock up situations when running in hole casing or completion strings. The methodology consists of 3 tasks: evaluation of intermediate doglegs and wellbore tortuosity using a unique Rock-Bit-BHA analysis, modelling of the casing deformation including potential centralization and then modelling the run in hole (RIH) of the completion. The directional capabilities of a BHA are affected significantly by the selection of the drilling bit, type of directional drilling driving system and the type of formation. The resulting trajectory can be either very smooth or very tortuous with significant additional local doglegs. The deformation of the casing as well as the completion post buckling analysis is completed using a robust and field validated 3D stiff string Torque & Drag & Buckling model. This methodology can be applied before, during or after the well has been drilling. Used before or during the well construction process, an indication can be given as to whether the casing or completion can reach total depth (TD) using planned or actual data. Used after a lockup or stuck pipe incident, the methodology can give an indication if tortuosity was a contributing factor. Various field cases are presented and clearly show the benefit of the methodology including post-analysis of stuck standalone-screen (SAS) completion string in complex 3D drain and pre-analysis of completion run in hole (RIH) targeting a specific drain. Correctly evaluating the risk of BHA, casing and/or completion strings getting stuck or locked-up when RIH can ultimately provide a template for ultimate reduction of non productive time (NPT). This modeling results has been verified and discussed in the field.


Seven hundred and fifty bean plant samples with root rot symptoms were collected from farmers' fields during two surreys carried out in Embu district, Kenya. Various fungal pathogens were isolated in the laboratory from these samples; among them were 50 isolates of Rhizoctonia solani, which were subjected to pathogenicity tests in a glasshouse. Thirty-six isolates of R. solani obtained from beans with root rots were subjected to DNA microsatellite analysis. Five isolates of R. solani that cause black scarf of potatoes (Solanum tuberosum L.) were also analysed alongside those from the beans. A total of 50 alleles were detected when six micro satellite loci were typed in the 41 samples, with the mean of 8.33 and a range of 3 at locus RB23 to 19 at locus AF5130l4. The smallest allele size was 129 basepair at locus REI02 and the largest was 297 basepair at locus A Y212027. Microsatellite analysis showed a moderate variation among the isolates from different agro-ecological zones and administrative boundaries (divisions). Phylogenetic analysis revealed 3 major clusters within the population of 41 isolates of R. solani from Kenya. Clusters 1, 2 and 3 had 15, 10 and 75% isolates, respectively. However, cluster 3 had 4 sub-clusters and cluster 1 had 2 sub-clusters, while cluster 2 did not have a subcluster. There was no relationship between microsatellites and geographical origin of the isolates. This is the first study on the genetic diversity of R. solani us ing DNA microsatellite analysis in Kenya.


We investigate the effects of roughness and fractality on the normal contact stiffness of rough surfaces. Samples of isotropically roughened aluminium surfaces are considered. The roughness and fractal dimension were altered through blasting using different sized particles. Subsequently, surface mechanical attrition treatment (SMAT) was applied to the surfaces in order to modify the surface at the microscale. The surface topology was characterised by interferometry based profilometry. The normal contact stiffness was measured through nanoindentation with a flat tip utilising the partial unloading method. We focus on establishing the relationships between surface stiffness and roughness, combined with the effects of fractal dimension. The experimental results, for a wide range of surfaces, showed that the measured contact stiffness depended very closely on surfaces' root mean squared (RMS) slope and their fractal dimension, with correlation coefficients of around 90\%, whilst a relatively weak correlation coefficient of 57\% was found between the contact stiffness and RMS roughness.


While multilingual training is now an essential ingredient in machine translation (MT) systems, recent work has demonstrated that it has different effects in different multilingual settings, such as many-to-one, one-to-many, and many-to-many learning. These training settings expose the encoder and the decoder in a machine translation model with different data distributions. In this paper, we examine how different varieties of multilingual training contribute to learning these two components of the MT model. Specifically, we compare bilingual models with encoders and/or decoders initialized by multilingual training. We show that multilingual training is beneficial to encoders in general, while it only benefits decoders for low-resource languages (LRLs). We further find the important attention heads for each language pair and compare their correlations during inference. Our analysis sheds light on how multilingual translation models work and also enables us to propose methods to improve performance by training with highly related languages. Our many-to-one models for high-resource languages and one-to-many models for LRL outperform the best results reported by Aharoni et al. (2019).


Citation for published version (APA): Sleeman, P. (2012). The suffixal nature of the post-nominal article in Swedish and Romanian: evidence from L1 acquisition. In H. van der Liet, & M. Norde (Eds.), Language for its own sake: essays on language and literature offered to Harry Perridon (pp. 189-207). (Amsterdam contributions to Scandinavian studies; No. 8). Amsterdam: Scandinavisch Instituut Universiteit van Amsterdam.


: Endoscopic extraction of gallbladder stones were performed, as far as we know for the first time, in three patients with combined choledochocystolithiasis. Following endoscopic papillotomy (EPT) and subsequent mechanical lithotripsy of multiple choledochal concrements measuring up to 3 cm the gallbladder stones were successfully extracted with a Dormia basket through the cystic duct. The patients have remained free of complications after the endoscopic intervention.


We found that the catecholamine biosynthetic enzymes, tyrosine hydroxylase, dopamine B-hydroxylase and phenylethanolamine N-methyltransferase share similar protein domains in their primary structures, and therefore are coded for by a single gene or a family of genes. In a recent report, we also demonstrated that antisera directed against tyrosine hydroxylase, choline acetyltransferase and glutamate decarboxylase cause specific complement-mediated lysis of dopaminergic, cholinergic and GABA-ergic subpopulation of synaptosomes, respectively. This implies that the neurotransmitter biosynthetic enzyme and the specific nerve ending protein(s) also share similar protein domain(s). Therefore, we postulate that the specific neurotransmitter biosynthetic enzyme and a certain membrane protein of the nerve endings probably share similar gene coding sequences and that coordinate expression of these proteins may determine the phenotype of the neuron.


Continuous efforts are made by many educational researchers and quality experts to measure Program learning outcomes (PLO) by using direct and indirect methods in medical education. To overcome the challenges and limitations in the measurement of PLO, educational researchers use different sources of data to increase the probability that the measured value represents the accurate scenario. In the recent past, education researchers showed more interest in CCEAS. It emerged from the fact that student learning is assessed all the time in the courses to move ahead in the program. Many higher education institutions (HEI) and accreditation bodies recommend the course-embedded assessment method to measure PLO. However, the HEI uses randomization method to embed the course assessments on the PLO. In all these methods, the measurement of PLO is analyzed to improve the quality of the program than focusing on improving the learners in the program. In the perspective of internal quality assurance, the measurement of PLO is not only the retrospective analysis of the learner's exit the program; rather it should identify the "outcome gap" in the learners of all the phases in the program. Finally, the improvisation must benefit the learners entering the phase as well as the learner's progress to the next phase. The best fitting answer will be "implementation of CCEAS to measure the PLO, and it acts as a magnifying lens to visualize the microenvironment (courses and learners) in the program and analyze the standard of learning and teaching to improve the overall performance of all the learners and program (Assurance of learning (AOL))". However, the importance of macro-level measurement of PLO cannot be negated because it acts as a validation of what is measured and implemented at the micro-level (courses level).


This Major Research Paper explores the phenomenon of second generation African-Canadians young adults and their identity formation process. Through semi-guided interviews, 8 participants, 5 males and 3 females ages 18-30 of this demographic shared their experiences of identity formation in Toronto. The findings indicated that the participants have formed hybrid identities as a result of growing up between two cultures; they lived transnational lives which endowed them with the ability to have the best of both worlds; they have inter-generational conflicts with their parents, and their personal experiences have shaped their personal sense of identity. The literature in this study gives the reader an overview of the African Diaspora, the socio-economic challenges faced by African immigrants, the new acculturation process and the experiences of the second generation African-Canadians.


Contesting History is an authoritative guide to the positive and negative applications of the past in the public arena and what this signifies for the meaning of history more widely. Using a global, non-Western model, Jeremy Black examines the employment of history by the state, the media, the national collective memory and others and considers its fundamental significance in how we understand the past.
Moving from public life pre-1400 to the struggle of ideologies in the 20th century and contemporary efforts to find meaning in historical narratives, Jeremy Black incorporates a great deal of original material on governmental, social and commercial influences on the public use of history. This includes a host of in-depth case studies from different periods of history around the world, and coverage of public history in a wider range of media, including TV and film. Readers are guided through this material by an expansive introduction, section headings, chapter conclusions and a selected further reading list. Written with eminent clarity and breadth of knowledge, Contesting History is a key text for all students of public history and anyone keen to know more about the nature of history as a discipline and concept.


For the study of the origin of cholecystitis a method was devised which allowed introduction of material into the gallbladders of experimental animals (dogs) without causing appreciable damage to the wall of the gallbladder. 1 This method consisted of leading a fine rubber catheter through an incision in the common duct into the cystic duct and into the gallbladder and, after withdrawal of the catheter, restoring a fairly normal flow of bile by inserting a glass cannula into the common duct. The animals were killed after two to five days. Absence of infection and dilatation of the biliary system was noted in a large number of control animals. In order to study the effect which long-standing cannulation might have on the biliary system, 3 of these dogs, together with 2 others, in which cholecystectomy was performed in addition to insertion of the cannula, were kept alive for a period ranging


Background The outbreak of coronavirus disease 2019 (COVID-19) that occurred in Wuhan, China, has become a global public health threat. It is necessary to identify indicators that can be used as optimal predictors for clinical outcomes of COVID-19 patients. Methods The clinical information from 126 patients diagnosed with COVID-19 were collected from Wuhan Fourth Hospital. Specific clinical characteristics, laboratory findings, treatments and clinical outcomes were analyzed from patients hospitalized for treatment from 1 February to 15 March 2020, and subsequently died or were discharged. A random forest (RF) algorithm was used to predict the prognoses of COVID-19 patients and identify the optimal diagnostic predictors for patients' clinical prognoses. Results Seven of the 126 patients were excluded for losing endpoints, 103 of the remaining 119 patients were discharged (alive) and 16 died in the hospital. A synthetic minority over-sampling technique (SMOTE) was used to correct the imbalanced distribution of clinical patients. Recursive feature elimination (RFE) was used to select the optimal subset for analysis. Eleven clinical parameters, Myo, CD8, age, LDH, LMR, CD45, Th/Ts, dyspnea, NLR, D-Dimer and CK were chosen with AUC approximately 0.9905. The RF algorithm was built to predict the prognoses of COVID-19 patients based on the best subset, and the area under the ROC curve (AUC) of the test data was 100%. Moreover, two optimal clinical risk predictors, lactate dehydrogenase (LDH) and Myoglobin (Myo), were selected based on the Gini index. The univariable logistic analysis revealed a substantial increase in the risk for in-hospital mortality when Myo was higher than 80 ng/ml (OR = 7.54, 95% CI [3.42–16.63]) and LDH was higher than 500 U/L (OR = 4.90, 95% CI [2.13–11.25]). Conclusion We applied an RF algorithm to predict the mortality of COVID-19 patients with high accuracy and identified LDH higher than 500 U/L and Myo higher than 80 ng/ml to be potential risk factors for the prognoses of COVID-19 patients in the early stage of the disease.


OBJECTIVES
To describe the predictive utility of the D-dimer assay among patients with the coronavirus disease 2019 syndrome for unprovoked lower extremity deep venous thrombosis.

DESIGN
Prospective observational study with retrospective data analysis.

SETTING
Academic medical center surgical ICU.

PATIENTS
Seventy-two intubated patients with critical illness from coronavirus disease 2019.

INTERVENTIONS
Therapeutic anticoagulation after imaging diagnosis of the first three deep venous thrombosis cases was confirmed; therapeutic anticoagulation as prophylaxis thereafter to all subsequent ICU admissions.

MEASUREMENTS AND MAIN RESULTS
Seventy-two patients with severe coronavirus disease 2019 were screened for deep venous thrombosis after ICU admission with 102 duplex ultrasound examinations, with 12 cases (16.7%) of lower extremity deep venous thrombosis identified. There were no differences between groups with respect to age, renal function, or biomarkers except for D-dimer (median, 12,858 ng/mL [interquartile range, 3,176-30,770 ng/mL] for lower extremity deep venous thrombosis vs 2,087 ng/mL [interquartile range, 638-3,735 ng/mL] for no evidence of deep venous thrombosis; p < 0.0001). Clinical screening tools (Wells score and Dutch Primary Care Rule) had no utility. The C-statistic for D-dimer concentration was 0.874 ± 0.065. At the model-predicted cutoff value of 3,000 ng/mL, sensitivity was 100%, specificity was 51.1%, positive predictive value was 21.8%, and negative predictive value was 100%.

CONCLUSIONS
Lower extremity deep venous thrombosis is prevalent in coronavirus disease 2019 disease and can be present on ICU admission. Screening has been recommended in the context of the pro-inflammatory, hypercoagulable background milieu. D-dimer concentrations are elevated in nearly all coronavirus disease 2019 patients, and the test appears reliable for screening for lower extremity deep venous thrombosis at or above a concentration of 3,000 ng/mL (more than 13-fold above the normal range). Full anticoagulation is indicated if the diagnosis is confirmed, and therapeutic anticoagulation should be considered for prophylaxis, as all coronavirus disease 2019 patients are at increased risk.


Somatic mutation as an index of in vivo T-cell amplification is a powerful tool to analyze the specificity and size of the autoreactive T-cell repertoire. Using this strategy, we determined the precursor frequency of T cells reactive to myelin basic protein (MBP) and overlapping MBP peptides spanning regions p84-168 in patients with MS and controls in the HPRT mutant T-cell population. Among 19 MS patients, nine had estimatable frequencies to MBP or MBP peptides, p93-112, p124-142 and p143-168 in the HPRT mutant T-cell population. Only one of the 10 controls showed measurable frequency to MBP in the HPRT mutant T-cell population. These studies suggest that increased frequency of T cells reactive to MBP and MBP peptides might indicate putative disease-related epitopes in MS.


We consider a model for a two-dimensional kagome lattice with defocusing nonlinearity, and show that families of localized discrete solitons may bifurcate from localized linear modes of the flat band with zero power threshold. Each family of such fundamental nonlinear modes corresponds to a unique configuration in the strong-nonlinearity limit. By choosing well-tuned dynamical perturbations, small-amplitude, strongly localized solutions from different families may be switched into each other, as well as moved between different lattice positions. In a window of small power, the lowest-energy state is a symmetry-broken localized state, which may appear spontaneously.


The giant unicellular alga Acetabularia enters the reproductive phase of growth when the cap has completed its expansion. The primary nucleus then divides and the resulting secondary nuclei take up fixed equidistant positions in the coenocytic cap cytoplasm. These positions are visible as colourless areas in the otherwise green caps. Studies on the cytology and ultrastructure of the caps at this stage showed that each secondary nucleus was surrounded by a layer of cytoplasm which was free from chloroplasts and mitochondria, but which contained many microtubules, some of which were closely associated with the nuclear envelope, while others appeared to touch the plasmalemma adjacent to the cell wall. (Microtubules are not a regular feature of Acetabularia cells; they have not been reported in the stems, young caps or cysts, and vegetative growth is not inhibited by colchicine.) The function of the microtubules was investigated by treatment with colchicine or vinblastine sulphate, both of which depolymerize microtubules in many other systems. Administration of these drugs at 10 -3 M and greater concentrations had the following effects: (1) the colourless areas were lost as chloroplasts and mitochondria invaded the cytoplasm around each secondary nucleus; (2) the nuclei began to migrate from their fixed positions; and (3) cyst formation (in which the cytoplasm cleaves into uniformly sized cysts, each containing a single secondary nucleus) either was inhibited, or proceeded abnormally. It is therefore proposed that a major function of these transitory microtubules is to anchor the secondary nuclei at fixed equidistant positions in the cytoplasm. This function is probably mediated by their association both with the nuclear envelope and cell membrane.


The acceleration of drug discovery due to combinatorial chemistry and high-throughput screening methods has increased the numbers of candidate pharmaceuticals entering the drug development phase, and the capability to accurately predict whether drug candidates will induce various members of the drug-metabolizing cytochrome P450 (CYP) enzyme superfamily is currently of great interest to the pharmaceutical industry. In the present study, we describe the rapid and reliable analysis of CYP induction in a readily obtained model system (cultured rat hepatocytes) using both real-time quantitative reverse transcription-polymerase chain reaction (real-time RT-PCR) and the RNA invasive cleavage assay. The levels of members in the three primary inducible rat CYP subfamilies (CYP1A1, CYP2B1/2, and CYP3A1) were analyzed in untreated and induced (beta-naphthoflavone, phenobarbital, and hydrocortisone) hepatocyte cultures under various media conditions to screen for optimal CYP induction profiles. The fold inductions measured by real-time RT-PCR and the RNA invasive cleavage assay were also compared with enzyme activity measurements in parallel cultures using liquid chromatography/double mass spectrometry-based assays, and the sensitivity and the specificity of the two RNA analysis methods were compared. Using these techniques, various culture conditions were examined for optimizing induction of the three CYP subfamily members. Both real-time RT-PCR and the RNA invasive cleavage assay prove to be effective methods for determining the effects of drugs on specific CYPs in primary rat hepatocytes.


This collection of essays by the eminent financial and monetary historians Forrest Capie and Geoffrey Wood examines and offers explanations of the parts played by money and the banking system in the British economy over the last two centuries. Structured in three chronological parts, it covers: the period of the classical gold standard from 1870 until the First World War, and the associated key issues of the time; the troublesome interwar years, when there was a breakdown in the international economy, the Second World War and immediate post-War years; and the international dimensions of the post-War period up to the present day. It deals with financial crises, periods of stability, and Britain in the international system, and covers topics such as debt management, money and the exchange rate, interest rates and velocity, as well as central bank independence, monetary unions, price controls and the role of the IMF. Combining empirical research and economic theory, this timely publication is essential reading for all scholars of financial, monetary, and economic history. Contributors to this volume - (with Professor Terence C. Mills) (with Professor Terence C. Mills) (with Dr Dimitrios Tsomocos)


The electrical properties of particle solutions can be investigated on a single particle basis by using micro fluidic channels. The impedance can be measured across the channel using at least one pair of conductive electrodes, at least one electrode of a pair being a fingered electrode having a plurality of fingers. The pattern of fingered electrodes creates a longer and more complicated measurement signal shape which leads to a significant improvement of measurement sensitivity. An application for the proposed technologyis to significantly improve the measurement sensitivity of impedance measurements on blood cells, leading to a better differentiation between different types of white blood cells. Better measurement sensitivity also enables the measurement of smaller particles and higher throughput.


The first two policy papers in this series explored the demand for further regulation of football
from supporters. Taken together, they conclude that supporters have an acute understanding of the
problems with current football governance and are highly critical of how it is governed at the top
level. A number of suggestions were made to address the problems highlighted including reform,
government intervention and increased supporter involvement.
This paper explores the latter point in more detail. If supporters are to be more involved in football
governance – and there has been a recent policy focus on the way that this could improve football
governance – what form might this take? Are supporters seeking out opportunities to involve
themselves in football governance, at their clubs or elsewhere? Calling for greater supporter
involvement is an important step, but it is vital to gain a greater understanding of how supporters
feel about this. Policy recommendations in the area (DCMS 2011, 2013) very much focus on the role
of supporter trusts and the work of Supporters Direct. However, one of the findings is that there is
a variety of avenues through which supporters would like to be involved with football, not
necessarily club ownership via a supporters trust., This paper analyses the supporters' extent of
engagement with football governance themselves, and the dynamics around this. It further
investigates the scope for supporter engagement and the potential barriers that fans see to their
involvement by current governance structures.
The following paper in the series – Policy Paper #4 – focuses exclusively on club ownership and
supporter trusts.


Various efforts aimed at representing digital assets have emerged from several communities over the last years, including the Metadata Encoding and Transmission Standard (METS), the IMS Content Packaging (IMS-CP) XML Binding and the XML Formatted Data Units (XFDU). The MPEG-21 Digital Item Declaration (MPEG-21 DID) is another approach that can be used for the representation of digital assets in XML. This paper will explore the potential of the MPEG-21 DID in a Digital Preservation context, by looking at the core building blocks of the OAIS Information Model and the way in which they map to the MPEG-21 DID abstract model and the MPEG-21 DIDL XML syntax.


Crosstalk between bitlines induces read failure and limits the coverage of applicable code-patterns for high-speed contact/via-programming read-only memories (ROMs) in SoC. Owing to the variation in bitline loading across code-patterns, the amount of coupled noise on an accessed bitline is code-pattern-dependent. This crosstalk effect worsens, with larger coupling capacitance and smaller intrinsic loading, as the technology node shrinks. This study proposes dynamic virtual guardian (DVG) techniques for contact/via-programming ROM macros and compilers to eliminate the crosstalk-induced read failure and increase the code-patterns coverage. Compared with conventional ROMs, DVG techniques achieve higher speed, lower power consumption and better design for manufacturing (DFM) capability with full code-patterns coverage. Experiments on fabricated designs, a conventional ROM and two 256 Kb DVG ROMs, using 0.18 /spl mu/m 1P5M CMOS technology have demonstrated that DVG techniques achieve 100% code-pattern coverage under a small sensing margin.


The dynamics of power system blackouts and the associated Self-Organized Criticality (SOC) behavior is a subject that receives continuous attention in view of its inherent complexity and relevant consequences. Within this context, the paper focuses on the short-term dynamic and, more specifically, aims at studying the role of the spinning reserve and frequency control on the blackout mechanism. The main contribution is to study the influence of the power system interconnections on the pre and post blackout system behavior. For this investigation, a statistical procedure, based on the Monte Carlo Simulation (MCS) method, is proposed to perform a blackout risk analysis considering cascading outages and generators frequency responses. The proposed procedure is then applied to the IEEE 118 bus system as an interconnected network characterized by three areas. The distribution of the blackout size and the number of component outages are assessed for the whole system as well as for each area.


The literature on 'knowledge translation' presents challenges for the reviewer because different terms have been used to describe the generation, sharing and application of knowledge and different research approaches embrace different philosophical positions on what knowledge is. We present a narrative review of this literature which deliberately sought to highlight rather than resolve tensions between these different framings. Our findings suggest that while 'translation' is a widely used metaphor in medicine, it constrains how we conceptualise and study the link between knowledge and practice. The 'translation' metaphor has, arguably, led to particular difficulties in the fields of 'evidence-based management' and 'evidence-based policymaking' – where it seems that knowledge obstinately refuses to be driven unproblematically into practice. Many non-medical disciplines such as philosophy, sociology and organization science conceptualise knowledge very differently, as being (for example) 'created', 'constructed', 'embodied', 'performed' and 'collectively negotiated' – and also as being value-laden and tending to serve the vested interests of dominant élites. We propose that applying this wider range of metaphors and models would allow us to research the link between knowledge and practice in more creative and critical ways. We conclude that research should move beyond a narrow focus on the 'know–do gap' to cover a richer agenda, including: (a) the situation-specific practical wisdom (phronesis) that underpins clinical judgement; (b) the tacit knowledge that is built and shared among practitioners ('mindlines'); (c) the complex links between power and knowledge; and (d) approaches to facilitating macro-level knowledge partnerships between researchers, practitioners, policymakers and commercial interests.


150 childless couples from the infertility clinic of the department of gynecology and obstetrics, University of Graz, received a questionnaire. Psychosocial factors and special problems of childless marriage represented the background at which the investigation was aimed. Of special interest were the reactions of the male partner regarding the andrological investigation within the gynecological department. The patients were confronted by a total of 41 questions. 15 of them were equal for both partners, whereas the male partner had to answer 11 additional questions. The questionnaire concerned problems such as interactions of the couple, motivations for the desire of children, psychosomatics, andrological investigation within the gynecological department and the organization of the andrological outpatient section. 72% of the questionnaires were returned. More than 50% of the sterile couples preferred to attend the infertility clinic together. 26% felt restrictions in their sexual behaviour due to the unrealized desire of children, 48% expected an improvement in their partnership if they could have children. 98% considered their childless marriage as a problem of both partners. The desire to set up a family ranks first on the list of motivations. The evaluation of the questionnaire yielded valuable results for the infertility clinic and especially for the andrological department. 72% of the andrological patients did not feel embarrassed by being evaluated and treated in a women's department. 63% preferred to attend the andrological department jointly with their wife.