Background: The distribution of healthcare resources across local and global communities has triggered alarms throughout the COVID-19 pandemic. Injustice and inefficiency in the transfer of lifesaving medical supplies are magnified by the urgency of the public health crisis, ramified through pre-existing socioeconomic tensions, and further aggravated by frictions that plague international cooperation and global governance. Aim: This article explores the ethical and economic dimensions of medical supplies, from the microcosm of distributive algorithms to the macroscope of medical trade. Methods: It first analyses the performance, strategy, and social responsibility of ventilator-suppliers through a series of case studies. Then, the authors seek to redress the need-insensitivity of existing distributive models with a new price-based and need-conscious algorithm. Next, the paper empirically traces the exchange of medical supplies across borders, examines the effect of trade disputes on medical reliance and pandemic preparedness, and makes a game-theoretical case for sharing critical resources with foreign communities. Conclusion: The authors argue that the equitable allocation of medical supplies must consider the contexts and conditions of need; that political barriers to medical transfers undermine a government's capacity to contain the contagion by reducing channels of access to medical goods; and that self-interested public policies often turn out to be counterproductive geopolitical strategies. In the post-pandemic world, the prospect of medical justice demands a balanced ethical and economic approach that cuts across the borders of nation-states and the bounds of the private sector and the public sphere.


The individual and combined effects of copper, cadmium, and zinc on the cell division rate of the tropical freshwater alga Chlorella sp. were determined over 48 to 72 h. Metal mixtures were prepared based on multiples of their single‐metal median effective concentration (EC50) values, i.e., toxic units (TU) using a triangular mixture design with five toxicant levels (0, 0.75, 1.0, 1.25, and 1.5 TU). Single‐metal EC50 values after a 72‐h exposure were 0.11, 0.85, and 1.4 μM for copper, cadmium, and zinc, respectively. Significant interactions were observed for all metal combinations after 48 and 72 h. An equitoxic mixture of Cu 1 Cd was more than concentration additive (synergistic) to the growth of Chlorella sp., while combinations of Cu + Zn, Cd + Zn, and Cu + Cd + Zn were all less than concentration additive or were antagonistic. To determine the effect of each metal on the uptake of the other, extracellular (membrane‐bound) and intracellular metal concentrations, both alone and in mixtures, were compared. The increased growth inhibition observed for mixtures of Cu + Cd was due to higher concentrations of cell‐bound and intracellular copper in the presence of cadmium compared with copper alone (i.e., cadmium‐enhanced copper uptake). In contrast, both extra‐ and intracellular cadmium concentrations were reduced in the presence of copper. In mixtures of Cu + Zn, copper also inhibited the binding and cellular uptake of zinc, which resulted in decreased toxicity. Zinc had no appreciable effect on the uptake of copper by Chlorella sp. Our results suggest that all three metals share some common uptake and transport sites on Chlorella cells and that copper out competes both cadmium and zinc for cell binding. Determination of metal cell distribution coefficients (Kd) confirmed that Kd values for cadmium and zinc in single‐metal exposures decreased in the presence of copper.


Pre-drinking, also known as pre-partying, pre-gaming, and front- or pre-loading, is the intensive pair or group consumption of alcohol in a private home prior to going out for the night, with the intention of ensuring maximum levels of intoxication. It has emerged as a distinct component of heavy drinking practice among young adults approximately between the ages of 18-25. This paper examines reflective accounts of female students' pre-drinking and club-drinking. It explores the experience of pre-drinking in the context of the overall drinking sequence undertaken throughout the evening in and the night out. It finds that pre-drinking has a specific purpose for young women in managing risk, as well as ensuring a shared level of intoxication in preparation for entry into public drinking spaces. Their accounts illustrate the performative nature of intoxication. Pre-drinking is highly directed, bounded, and ritualised. It was frequently, though not always, recounted as lacking in pleasure for these reasons. It was associated with preparation for entry to a particular kind of superpub or nightclub especially, where the emphasis was on further rapid alcohol consumption. Accounts of continued drinking in the nightclubs were dualistic, emphasising pleasure and disgust, along with risk and vulnerability. Risk was experienced as individualised, and the women had shared responsibility for guarding against risk from unsafe others in the nightclub environment. This coding of risk is supported by public health messages targeted at women drinkers and by the more general societal and drinks industry promoted representation of alcohol consumption as normal and abstinence as deviant, which students were critical of. One attraction of pre-drinking for female students was as a way of protecting and supporting female agency in conditions of generalised, individualised vulnerability.


The multiplication of direct investment in Indonesia is not equal to adequate tax regulations. In turn, it creates loopholes for the minimisation of tax burdens through thin capitalisation. The purpose of this research is to analyse the factors affecting tax avoidance using thin capitalisation. The independent variables in this research are multi-nationality, the utilisation of tax havens and institutional ownership, while the dependent variable in this research is tax avoidance. This study uses secondary data obtained from readily accessible sources and the annual reports of 122 multi-national enterprises listed on the Indonesian Stock Exchange. The determination method of sampling is by way of purposive sampling, that is sample selection according to specific criteria. The data analysis method used is path analysis. The results of the research show that multi-nationality and the utilisation of a tax haven positively affect thin capitalisation, while institutional ownership has a negative effect on thin capitalisation. Thin capitalisation has a positive impact on tax avoidance. Indirectly, multi-nationality and the utilisation of taxes have positive effects on tax avoidance through thin capitalisation, while institutional ownership negatively affects tax avoidance through thin capitalisation.


A previous article in this journal (Coelen and Sullivan, 1981) reported new evidence that many State hospital prospective reimbursement (PR) programs have been successful in reducing hospital cost inflation. Limiting proliferation of redundant technologies and community services may be one method of reducing this cost inflation. Data compiled from a sample of over 2,500 hospitals in 15 rate-setting and other States between 1969 and 1978 were used to determine PR's effect on both service adoption and sharing. Evidence indicates a consistent, retarding effect on all services for New York, the country's oldest, most stringent program. Several other States, notably Minnesota, Maryland, New Jersey, Washington, and Wisconsin showed retarding effects on costly rapidly diffusing services such as open heart surgery, intensive care units (ICUs), and social work, as well as accelerating the phasing-out of redundant services, such as the premature nursery. We found no consistent, significant effects on service sharing.


The African Union's new offices in Addis Ababa stand upon the site of the city's former central prison, known as Alem Bekagn, where thousands of people suffered and died. This article traces the history of the prison and examines efforts to create a memorial at the site. These initiatives illustrate the African Union (AU) in transition. They echo AU commitments to act against atrocities and in support of rights and justice and suggest a distinct vision of pan-African community and a corresponding institutional culture. But, much like the AU itself, the meaning of the planned memorial is ambivalent and contested. The fact that the AU bulldozed Ethiopia's most notorious prison in order to establish its new offices and a conference hall is richly symbolic of 'buried memory' – the tendency of post-colonial elites to suppress the memory of victims of state violence while celebrating chosen heroes. The AU still venerates leaders and is quiet about current violations, but the organization's promise and process to remember the ordinary victims of state violence indicate a political opening and may contribute a novel space for the recounting of human rights abuses.


We investigate the band properties of InAs/AlSb/GaSb (N-structure) and InAs/GaSb material based type II superlattice (T2SL) photodedectors. The superlattice empirical pseudopotential method is used to define band-structures such as the bandgap and heavy hole-light hole (hh-lh) splitting energies in the mid-wavelength infrared range (MWIR) and long wavelength range (LWIR). The calculations are carried out on the variation of AlSb/GaSb layer thickness for (InAs)10.5/(AlSb)x/(GaSb)9-x and the variation of InAs layer thickness for (InAs)x/(AlSb)3/(GaSb)6 T2SL structures at 77 K. For the same bandgap energy of 229 meV (5.4 μm in wavelength), hh-lh splitting energy is calculated as 194 meV for the (InAs)7.5/(AlSb)3/(GaSb)6 structure compared to the (InAs)10.5/(GaSb)9 structure with hh-lh splitting energy of 91 meV within the MWIR. Long wavelength performance of InAs/AlSb/GaSb structure shows superior electronic properties over the standard InAs/GaSb T2SL structure with larger hh-lh splitting energy which is lar...


A survey was conducted in the three district of south western region of Bangladesh like Khulna, Satkhira and Bagerhat, to observe the socioeconomic condition and problems facing by the chicken farmers under the existing management practices. Five hundred commercial chicken farms were considered in the present study. Data were collected using a pretested questionnaire by interview of the farmers. To observe the socioeconomic conditions, the age of selected farmers, their gender, occupation, education level, land size, annual income from chicken farms, experience, training exposure and bio-security score were considered. There are two problems are categorized like diseases outbreaks and socioeconomic problems. Among the respondents, maximum percentage of farmers were male groups within 31 to 40 years age had conjugated with the occupation of poultry and agriculture and belonged to HSC level of education. Highest percentage of medium land size farmer earned 01-03 lac BDT per year only from the chicken farms. Newcastle or Ranikhet disease was highly severed followed by Fowl cholera, Gumboro and Coccidiosis. Irregular fluctuation of market price was the major problem facing by the chicken farmer in the study area. Bio-security practice and proper marketing system should enhance the profitability of the chicken farms.


PURPOSE
Breast cancer patients face complex decisions about immediate breast reconstruction (BR) after mastectomy. We evaluated the efficacy of an online decision aid in improving the decision-making process, decision quality and health outcomes in breast cancer patients considering immediate BR.

METHODS
In a multicenter randomized controlled trial, patients were allocated to either the intervention group receiving care-as-usual (CAU) with access to an online decision aid, or the control group receiving CAU with an information leaflet. The primary outcome was decisional conflict. Secondary outcomes assessed the process of decision making (e.g. preparation for decision making, satisfaction with information), decision quality (decision regret, knowledge) and health outcomes (e.g. satisfaction with BR outcomes, body image). Patients completed questionnaires at baseline (T0), 1 week after consultation with a plastic surgeon (T1), 3 months (T2), and 12 months post-surgery (T3).

RESULTS
We included 250 patients. Decisional conflict decreased over time in both groups, with no between group differences. Intervention participants felt better prepared for decision making than controls (P = .002). At T2, 87% of intervention participants were (very) satisfied with the information about BR, compared to 73% of control participants (P = .011). No significant between group differences were observed in any other outcome.

CONCLUSION
Our online decision aid was as effective in reducing decisional conflict as an information leaflet about immediate BR after mastectomy. However, the decision aid substantially improved the decision-making process by better preparing breast cancer patients for decisions about immediate BR.


In this paper, an optimized space-vector modulation (SVM) to reduce DC-link ripple current in three-level inverters is presented. Various types of capacitors can be utilized to balance the voltage in the DC-link of voltage source inverters. Electrolytic capacitors are widely used owing to their large capacitance per volume. However, electrolytic capacitors have a short lifespan because the allowable ripple current is low. A conventional SVM that is focused on improving harmonic characteristics. Therefore, it cannot balance the DC-link ripple current properly because using some voltage vectors increases the DC-link ripple current. To overcome this limitation and extend the lifespan of the capacitors, an optimized SVM is proposed to reduce the DC-link ripple current. The proposed modulation scheme synthesizes the reference voltage by choosing voltage vectors that cause smaller increases in the DC-link ripple current, avoiding those that cause larger increases. The effectiveness of the proposed optimized SVM is verified by simulations and experimental results.


Burial metamorphism of regional extent throughout Mesozoic to Cenozoic sequences in the Andean Mountain belt has been attributed previously to a unique model of metamorphic development, involving episodic ∼40 m.y. cycles of extensional basin formation, burial, metamorphism, and then exhumation. A main premise of this model is that breaks in metamorphic grade occur at major stratigraphic unconformities, so marking successive metamorphic cycles. This model is tested in a Mesozoic–Cenozoic sequence east of Santiago, where three metamorphic episodes have been reported on the basis of sharp breaks in metamorphic grade at two main unconformities. In metabasites from this area, reaction progress in mafic phyllosilicates shows a continuum across the sequence without breaks at the unconformities. There are differences in mineral assemblages between the various stratigraphic units, from which contrasting subgreenschist facies can be recognized. However, consideration of the controls on mineral paragenesis at subgreenschist facies conditions demonstrates that these different facies cannot be used as evidence of sharp breaks in metamorphic grade at unconformities, as has been reported in many previous publications. Thus, metamorphic breaks within this Andean section cannot be confirmed. Accordingly, models of Andean burial metamorphism linked to episodic tectonic cycles throughout the Mesozoic and Cenozoic appear unfounded.


Hospital medicine is a field that requires a constant state of readiness and flexibility. With respect to patient care, constant preparedness is required because conditions change. This necessitates always having a backup plan, or Plan B. For example, your patient with a gastrointestinal (GI) bleed should have two large-bore intravenous (IV) catheters and packed red blood cells (RBCs) typed and crossed. If the patient becomes unstable, the response is not just doing more of the same (IV fluids and proton pump inhibitors); the focus shifts to your Plan B: call GI, transfuse blood, transfer the patient to the intensive care unit. In contrast to clinical scenarios, there is often a lack of readiness to deal with rapid changes in workflow. Without a plan, efficiency decreases, stress levels rise, and both patients and providers alike suffer the consequences. Patients spending extended periods of time in the Emergency Department (ED) receive less timely services and often don't benefit from the expertise that they would receive in inpatient units.1 This is particularly true in an era in which many hospitals are experiencing higher overall volume and surges are more common. Ideally, readiness should manifest as the ability to adapt to changes at the individual, hospitalist team, and leadership levels. Having a Plan B in the practice of hospital medicine is a focused exercise for anticipating future problems and addressing them prospectively. When thinking about a Plan B, the following are some steps to consider: 1. Identify Triggers. In the earlier example of the GI bleed, our triggers for Plan B would be a change in vitals or a brisk drop in hemoglobin. Regarding hospital workflow, the triggers might include low service or bed capacity or a decreased number of expected discharges for the day. Perhaps a high ED census or increased surgical volume will trigger your plan to handle the surge. 2. Define Your Response. At both an individual and service level, there are steps you might consider in your Plan B. On teaching services, this might mean prioritizing rounding on patients that you're expecting to discharge so they're able to leave the hospital sooner. For patients on observation status who are boarding in the ED for extended periods, there might be opportunities to safely discharge them with follow-up or even complete their work-up in the ED. There may be circumstances in which providers should exceed the usual service capacity and conditions in which it is truly unsafe to exceed that limit. If there are resources available to increase staffing, consider how to best utilize them. 3. Engage Broadly and Proactively. It is very difficult to execute a Plan B (or frankly a Plan A) without buy-in from your stakeholders. This starts with the rank and file, those on your team who will actually execute the plan. The leadership of your department or division, the ED, and nursing will also likely need to provide input. If financial resources for flexing up staff are part of your plan, the hospital administration might need to weigh in. It is best to engage stakeholders early on rather than during a crisis. 4. Constant Assessment and Improvement. Going back to our example of our patient with a GI bleed, you're constantly reevaluating your patient to determine if your Plan B is working. Similarly, you should collect data and reassess the effectiveness of your plan. There are likely opportunities to improve it.


This paper surveys the trends in gender gaps in education, their causes and potential policy implications. I show that female educational attainment has surpassed, or is about to surpass, male educational attainment in most industrialized countries. These gaps reflect male overrepresentation among secondary school drop-outs and female overrepresentation among tertiary education students and graduates. Existing evidence suggests that this pattern is a result of a combination of increasing returns to education and lower female effort costs of education. Widening gender gap in education combined with recent wage and employment polarization will likely lead to widening inequalities and is linked to declining male labor force participation. The paper discusses evidence on educational policies that both widen and reduce gender gaps in educational outcomes.


: A microorganism oxidizing As(III) to As(V) was isolated from the water of a gold-arsenic deposit; the process occurs under the autotrophic conditions. The microorganism is a motile Gram-negative rod with one flagellum. It does not assimilate organic carbon sources and grows in a mineral medium with 1.3 g of As(III) per litre and acidification of the medium from the pH 7.5-8 to 4.5. The source of nitrogen for the growth is ammonium salts, the source of phosphorous is KH2PO4. It can assimilate up to 41.2-41.7% of the carbon from carbonates as was shown using labeled carbon. The organism is capable of changing the crystal structure of arsenopyrite. In its physiologo-biochemical properties, the organism does not resemble any species described by Bergey (1975) and therefore referred to as Pseudomonas arsenitoxidans.


We demonstrate a prototype system called COLD that we are developing at IBM Research which provides optimized deployment of workload in the cloud. A workload refers to an application, consisting of virtual entities (e.g. VM, volume), to be deployed in a cloud infrastructure, consisting of physical entities (e.g. PM, storage). The resource requirements of the virtual entities, as well as metadata describing relations among virtual entities (e.g. location proximity requirement), are described using a declarative workload definition language, namely using a HOT template. COLD provides a clean separation between the underlying mechanisms offered by a given cloud environment for lifecycle management of virtual resources and policies that influence optimal placement. The current implementation of COLD is tied to Open Stack, though we have plans in the future to make it cloud agnostic. It is designed to be fault-tolerant. In a software defined environment of an Open Stack cloud with various hyper visors, we show the operation of COLD to place various Heat stacks that contain specific policies such as rack-level antic location.


Elite Education – International Perspectives is the first book to systematically examine elite education in different parts of the world. Authors provide a historical analysis of the emergence of national elite education systems and consider how recent policy and economic developments are changing the configuration of elite trajectories and the social groups benefiting from these. Through country-level case studies, this book offers readers an in-depth account of elite education systems in the Anglophone world, in Europe and in the emerging financial centres of Africa, Asia and Latin America. A series of commentaries highlight commonalities and differences between elite education systems, and offer insights into broader theoretical issues, with which educationalists, researchers and policy makers are engaging . With authors including Stephen J. Ball, Donald Broady, Ruben Gaztambide-Fernandez, Heinz-Hermann Kruger, Maria Alice Nogueira, Julia Resnik and Agnes van Zanten, the book offers a benchmark perspective on issues frequently glossed over in comparative education, including the processes by which powerful groups retain privilege and 'elite' status in rapidly changing societies. Elite Education – International Perspectives will appeal to policy makers and academics in the fields of education and sociology. Simultaneously it will be of special relevance to post-graduates enrolled on courses in the sociology of education, education policy, and education and international development..


Although learning-by-doing is believed to be an important source of productivity growth, there is limited evidence that production volume affects productivity in a causal sense. We document evidence of learning-by-doing in a highly skilled profession where stakes are high; advanced cancer surgery. For this purpose, we introduce a novel instrument that exploits the closure and opening of entire cancer clinics which have given rise to sharp and exogenous changes in the cancer surgical volumes at Swedish public sector hospitals. Using detailed register data on more than 100,000 episodes of advanced cancer surgery, our results suggest positive effects of surgery volumes on survival. In addition, we provide evidence on the mechanisms through which these improvements occur. We also show that the results are not driven by changes in patient composition or by other changes at the hospital level.


This paper reviews two sets of failure information, the GMTF (a parameter obtained from time-to-failure results) and GMBD stress (a parameter that is calculated from AC breakdown test results), and suggests a correlation. The test results were obtained from accelerated aging experiments on full-sized medium voltage cables in carefully controlled and monitored water-filled tanks. Results show that the ambient temperature AC breakdown strength for equivalently aged cables is influenced primarily by voltage stress during aging-not by the aging temperature. The AC breakdown strength on equivalently aged cables was also shown to decrease with reductions in the aging voltage at all aging temperatures.


I. INTRODUCTION On a warm July day in 1861, a Union spy named William Lloyd received secret orders from President Lincoln to infiltrate the southern states on a mission to ascertain Confederate troop positions, the plans of major fortifications, and other information which would be of benefit to the United States government. (1) For his services he was to be paid $200 a month, with his findings to be reported directly to the President. (2) One hundred and forty years later in the aftermath of September 11, President Bush would authorize the National Security Agency to conduct warrantless communications surveillance on persons with alleged ties to Al Qaeda and other terrorist organizations. (3) Though the circumstances of these two actions are decidedly different, their clandestine natures both invoke the issue of state secrets and the question of how courts are to proceed when the subject of litigation is a matter of national security. Given the current geopolitical climate and the advancing sophistication of intelligence gathering, an analysis of the state secrets privilege and its practical implications is increasingly relevant. II. THE BEGINNINGS OF THE STATE SECRETS PRIVILEGE IN AMERICAN LAW Although it would take some time for the state secrets privilege to develop its current scope and power, the case of Totten v. United States (4) marks the first general instance of its use in American jurisprudence. (5) As highlighted before, this case concerned a secret espionage agreement allegedly entered into between President Lincoln and William Lloyd during the Civil War. (6) Upon hearing the matter originally, the Court of Claims found that Lloyd did venture behind enemy lines where he remained for the duration of the war, and that over the course of his stay he transmitted information back to the President as directed under his contract, but that after the war's end he was only reimbursed for expenses. (7) Lloyd subsequently died and Mr. Enoch Totten brought suit on his estate's behalf to recover the compensation allegedly owed under the secret contract. (8) In affirming the Court of Claims' dismissal of the action, the Supreme Court recognized the power of the President to enter into such contracts, but expressed its concern with the dangers litigation of its contents might bring. (9) Writing for the Court, Justice Field held: Our objection is not to the contract, but to the action upon it in the Court of Claims. The service stipulated by the contract was a secret service; the information sought was to be obtained clandestinely, and was to be communicated privately; the employment and the service were to be equally concealed.... This condition of the engagement was implied from the nature of the employment, and is implied in all secret employments of the government in time of war, or upon matters affecting our foreign relations, where a disclosure of the service might compromise or embarrass our government in its public duties, or endanger the person or injure the character of the agent. If upon contracts of such a nature an action against the government could be maintained in the Court of Claims, whenever an agent should deem himself entitled to greater or different compensation than that awarded to him, the whole service in any case, and the manner of its discharge, with the details of dealings with individuals and officers, might be exposed, to the serious detriment of the public. (10) The Court then ruled that [i]t may be stated as a general principle, that public policy forbids the maintenance of any suit in a court of justice, the trial of which would inevitably lead to the disclosure of matters which the law itself regards as confidential, and respecting which it will not allow the confidence to be violated. (11) Totten's lawsuit was dismissed not because it had disclosed confidential information, but because it had the mere possibility of doing so. …


Tumors in the gastric cardia and the body/antrum were studied to determine the effect of ploidy and S-phase fractions on patient survival. Forty-two percent of tumors were located in the cardia and 58% in the body/antrum. Nodal metastases occurred more often with cardia tumors than with body/antrum tumors (86% vs 65%). Aneuploidy occurred more frequently in patients with cardia tumors than in patients with body/antrum tumors (39% vs 20%). Metastasis to lymph nodes was more common in patients with aneuploidy than in patients with diploidy (31% vs 7%). S-phase fractions were not different between aneuploid and diploid tumors. More patients with diploid cancer were alive at 5 years than were patients with aneuploid tumors (90% vs 10%). We conclude that primary cellular differences in gastric tumors of the cardia or body/antrum determine patient survival.


Introduction: The daily increase of using chemical, aromatic and cosmetic products has been associated with significant increase in frequency of skin diseases such as eczemas and contact dermatitis (CD). The aim of this study was to evaluate the use of patch testing (PT) for the diagnosis of CD and provide current data on the frequency of sensitization to various contact allergens among patients with CD in the Albanian population.Methods: We retrospectively analyzed all consecutive patients clinically suspected for CD during the period February 2010 – February 2011, in the outpatient setting. PT was done using Baseline European Series consisting of 31 allergens. Risk factors (age, gender, occupation and place of residence) and sensitization to various contact allergens were evaluated.  Results: In total, 193 patients clinically suspected for CD were included in the study and underwent PT. The highest prevalence of CD was found in the age-group of 31-40 years (32.6%), with a statistically significant difference between other age-groups (X2 = 141.2, p<0.01). Positive PT results with at least one allergen were seen in 144 (74.6 %) patients suspected for CD. The two most common allergens were nickel and potassium dichromate. Construction worker and hairdresser were the most affected professions. Females had a chance of 1.8 times higher for having a positive patch test result compare to males (OR = 1.8; 95% CI 0.91 – 3.39).Conclusion: Determination of allergens that cause contact dermatitis is a necessity not only to confirm the correct diagnosis, but also for the qualitative treatment and prevention of the disease. Patch testing, even though an old method, still remain a valuable and non-invasive approach to determine the causes of contact dermatitis.


The aim of this work is to obtain and characterize the Niobium Carbide (NbC) by a suitable high energy milling technique using a SPEX Mill vibratory type and niobium and carbon (graphite) powders. Since this carbide is scarced in the national market and it's necessary to apply this NbC as a reinforcement in two molybdenum high speed steels (AISI M2 and AISI M3:2) object of another work motivated this research. The powders were submitted to a high energy milling procedure for suitable times and conditions and then were characterized by means of Scanning Electronic Microscopy (SEM) and X-ray diffraction (DRX) techniques. The ball-to-powder weight ratio was 10:1. The analyzed samples showed that the high-energy milling is an alternative route of the NbC synthesis.


This paper presents a fuzzy queuing model that can be used to predict the possible delay that a vehicle will experience at an incident location based on real-time information on current queuing conditions, future traffic arrivals, lane closings and the vehicle's arrival time. Compared to most existing methods, the proposed model is unique in three aspects. First, it explicitly accounts for uncertainties involved in all influencing factors and thus allows easy incorporation of imprecise and vague information typically available in this type of prediction environment. Second, the model is adaptive in the way that it allows continuous update of estimates as new information is made available in real time. Third, delays obtained from the model are fuzzy numbers that can be conveniently mapped to linguistic terms for use in systems such as changeable message signs (CMS). A case study is presented to demonstrate the application of the proposed model in facilitating the composition of location-dependent delay messages for CMS.


[reaction: see text] An overall stereoconservative protection and deprotection method of amino and carboxyl groups is presented. N-Phthaloyl N'-alkyl secondary amides of alpha-amino acids can be generated from corresponding N-phthaloyl amino acids by coupling reaction of N-alkylamines using mixed anhydride method. These secondary amides can be transformed by thermal rearrangement of intermediate nitrosoamides to O-alkyl esters with retention of configuration and excellent yields.


This paper proposes a Dynamic Spectrum Assign- ment strategy in the context of next generation multicell Orthog- onal Frequency Division Multiple Access networks. The proposed strategy is able to dynamically find spectrum assignments per cell depending on the spatial and temporal distribution of the users over the scenario. Reinforcement Learning methodology has been employed to implement the strategy, which compared with other fixed and dynamic spectrum assignment strategies shows the best tradeoff between spectral efficiency and Quality-of-Service. Index Terms—Dynamic Spectrum Assignment, Multicell OFDMA, Reinforcement Learning.


In October, the CEO of JPMorgan Chase & Co., is preparing for the company's 2010 Q3 earnings conference call and wondering how to address the inevitable questions related to financial reform. It has been just over two months since the Dodd-Frank Financial Reform and Consumer Protection Act (Dodd-Frank Act) had been passed, and there was still much uncertainty as to how JPMorgan should address the reforms. JPMorgan had reported stronger than expected EPS in the third quarter, but analysts were more concerned about what strategic initiatives the CEO would implement in response to the Dodd-Frank Act. The act had introduced wide-ranging and industry-changing reforms that were aimed primarily at fully integrated financial institutions such as JPMorgan. While most of the rulemaking would be forthcoming from regulatory authorities, the CEO knew it would be best to address these issues immediately to protect shareholders by avoiding uncertainty.


STUDY OBJECTIVES
Sleep disturbances and decline in neuropsychological performance are common in older adults. Reduced social and physical activity is likely a contributing factor for these age-related changes in sleep and cognition. We previously demonstrated that a program of structured social and physical activity, with 2 daily activity sessions, 1 in the morning and 1 in the evening for a relatively short period of 2 weeks, improved sleep and neuropsychological performance in community-dwelling older adults. The goals of this pilot study were to determine whether a single daily morning or evening activity session for 2 weeks would also improve sleep and neuropsychological function and whether these effects were dependent on the timing of the activity sessions.

DESIGN
We compared the effect of morning or evening structured activity sessions in a repeated-measures crossover design. Subjective mood, neuropsychological performance tasks, and subjective and objective measures of sleep were assessed at baseline and after the intervention.

SETTING
All procedures took place in the participant's residence.

PARTICIPANTS
Twelve older men and women (74.6 +/- 5.5 years of age).

INTERVENTIONS
Subjects participated in 14 days of structured activity sessions in the morning (9:00-10:30 am) or evening (7:00-8:30 pm). Sessions consisted of stretching, low-impact aerobics, and game playing.

MEASUREMENTS AND RESULTS
Exposure to either morning or evening activity significantly improved performance on a neuropsychological test battery. Morning activity sessions increased throughput on 4 of 8 performance tasks, while evening activity sessions improved throughput on 7 of the 8 performance tasks. Subjective sleep-quality ratings, measured by the Pittsburg Sleep Quality Index, improved following activity sessions in either the morning or the evening. Objective measures of sleep did not improve when measured by actigraphy or polysomnography.

CONCLUSIONS
These results suggest that short-term exposure to either morning or evening social and physical activity improves objective measures of neuropsychological performance and subjective sleep quality in the elderly. Increasing exposure to social and physical activity may be a useful intervention to improve sleep quality and daytime function in older adults.


Abstract The date of a single divergence point—between living alligators and crocodiles—was estimated with quartet dating using calibrations of widely divergent ages. For five mitochondrial sequence datasets, there is a clear relationship between calibration age and quartet estimate—quartets based on two relatively recent calibrations support younger divergence estimates than do quartets based on two older calibrations. Some of the estimates supported by young quartets are impossibly young and exclude the first appearance of the group in the fossil record as too old. The older estimates—those based on two relatively old calibrations—may be overestimates, and those based on one old and one recent calibration support divergence estimates very close to fossil data. This suggests that quartet dating methods may be most effective when calibrations are applied from different parts of a clade's history.


This report describes a preliminary study in support of ongoing research to model soil stress resulting from vehicular traffic on unprepared ground. The soils used in this study were sand, wet sand, and silt. The soils in the prepared soil beds were first characterized as to strength, density, and plasticity. Then pressure sensors were embedded at depths of 2 and 5 in. These were then traversed several times by a Mine Detonation Trailer (MDT) and the pressure produced by a single chosen wheel recorded. The actual measured load of this wheel was 4700 pounds. The same series of measurements were made using the CRREL Instrumented Vehicle (CIV) with a measured wheel load of about 1500 pounds. The results were compared with the expected values calculated using the Froehlich modification of the Boussinesq equation. For the MDT the correspondence was very good for the sand tests, and acceptable for silt. However, for the CIV the correspondence was unsatisfactory, underpredicting by a significant amount. The Federal Aviation Administration's Layered Elastic Analysis (LEAF) program was also applied to the MDT case and yielded results similar to the MDT Boussinesq analysis. Possible causes for the observed discrepancies are suggested.


Sera from mice with transplanted 3-methylcholantrene-induced tumors have been shown previously to inhibit the function of normal lymphoid cells. When chromatographed on Sephadex G-150, the fraction eluting with immunoglobulin has been shown to inhibit the proliferative response of normal spleen cells to concanavalin A and to inhibit the in vitro antibody response to a T-dependent antigen, but has a lesser effect on the antibody response to a T-independent antigen. This paper deals with studies on the mode of action of the serum factor. The immunoglobulin containing fraction of serum from tumor-bearing mice inhibited the in vitro generation of both allogeneic and syngeneic cytotoxic lymphocytes. Time course studies demonstrate that the serum fraction inhibits the generation of antibody-producing and cytotoxic lymphocytes if added during the first 2 days of a 5-day culture. Serum fractions added after day 2 had no effect on the in vitro response. The serum factor appears to inhibit the generation of specific T cell function during the proliferative stage of development but has no effect on the differentiation stage which leads to either antibody-producing cells or cytotoxic lymphocytes.


This paper presents a multi-objective optimization model and its solution algorithm for optimization of pedestrian phase patterns, including the exclusive pedestrian phase (EPP) and the conventional two-way crossing (TWC) at an intersection. The proposed model will determine the optimal pedestrian phase pattern and the corresponding signal timings at an intersection to best accommodate both vehicular traffic and pedestrian movements. The proposed model is unique with respect to the following three critical features: (1) proposing an unbiased performance index for comparison of EPP and TWC by explicitly modeling the pedestrian delay under the control of TWC and EPP; (2) developing a multi-objective model to maximize the utilization of the available green time by vehicular traffic and pedestrian under both EPP or TWC; and (3) designing a genetic algorithm based heuristic algorithm to solve the model. Case study and sensitivity analysis results have shown the promising property of the proposed model to assist traffic practitioners, researchers, and authorities in properly selecting pedestrian phase patterns at signalized intersections. Copyright © 2013 John Wiley & Sons, Ltd. Language: en


In this paper, investigation has been made to analyse the marketable and marketed surpluses of leading crops viz. different varieties of rice, wheat, potato, mustard and lentil. This study suggests that marketed surplus as percentage of total production was found highest in potato (64 per cent) followed by lentil (59.5 per cent), Boro paddy (57.5 per cent), mustard (52.7 per cent), Aman paddy (48 per cent), Aus paddy (38 per cent) and wheat (14 per cent). Small farmers were the large suppliers of agricultural crops during harvest time and sell out crops to meet up their cash obligation when the prices remain low. On the other hand, they purchase the same crop at off-season to meet up their consumption requirement and at that time prices remain high. So, small farmers were worse off by this seasonal sales pattern and price variation. Large farmers received the highest prices prevailed in the market relatively with strong bargaining capacity with the market intermediaries and their pre-harvest time sales is higher than other size group of farms. This study suggested that among different explanatory variables, farmers were very much price sensitive irrespective of their farm sizes. Price elasticity of marketable surplus as estimated for Aman paddy, Boro paddy, wheat, potato and mustard appeared 1.89, 2.7, 1.23, 2.46 and 1.40, i.e. prices significantly influenced marketable surpluses of these crops. In general, marketable surpluses of crops reflect farmers well-being. So, price policy influencing output prices have important role in increasing marketable and marketed quantities. This study suggested some policy options based on research findings which should help the policy markers to adopt appropriate measures to increase marketed surplus in Bangladesh agriculture leading to a gradually commercialised agriculture.


Abstract : The viscous decretion disk (VDD) model is able to explain most of the currently observable properties of the circumstellar disks of Be stars. However, more stringent tests, focusing on reproducing multitechnique observations of individual targets via physical modeling, are needed to study the predictions of the VDD model under specific circumstances. In the case of nearby, bright Be star b CMi, these circumstances are a very stable low-density disk and a late-type (B8Ve) central star. Aims. The aim is to test the VDD model thoroughly, exploiting the full diagnostic potential of individual types of observations, in particular, to constrain the poorly known structure of the outer disk if possible, and to test truncation effects caused by a possible binary companion using radio observations. We use the Monte Carlo radiative transfer code HDUST to produce model observables, which we compare with a very large set of multitechnique and multiwavelength observations that include ultraviolet and optical spectra, photometry covering the interval between optical and radio wavelengths, optical polarimetry, and optical and near-IR (spectro) interferometry. A parametric VDD model with radial density exponent of n = 3.5, which is the canonical value for isothermal flaring disks is found to explain observables typically formed in the inner disk, while observables originating in the more extended parts favor a shallower, n = 3.0, density falloff. Theoretical consequences of this finding are discussed and the outcomes are compared with the predictions of a fully self-consistent VDD model. Modeling of radio observations allowed for the first determination of the physical extent of a Be disk (35[+10/-5] stellar radii), which might be caused by a binary companion. Finally, polarization data allowed for an indirect measurement of the rotation rate of the star, which was found to be W greater or equal 0:98, i.e., very close to critical.


A comprehensive system model for characterizing the effects of multipath propagation on digital radio systems in the 4 to 6 GHz band is shown in this thesis. The effects of terrain-induced multipath propagation in the presence of atmospheric anomalies are studied using data from experimental microwave links in the field and in the laboratory. This technique, which treats multipath propagation as digital signal distortions caused by interference from ground reflections, has not been shown previously. A forward multipath propagation model is used to identify the critical propagation parameters for a QAM signal. A normalized two ray channel model is developed to approximate the frequency response produced by interference from a ground reflection in a narrow band. The effectiveness of this channel model is evaluated using measured data from the test radio link in the field. The channel parameter values are also estimated from these data. Using the channel model, the channel distortions are simulated in the laboratory. The performance of the laboratory test link is characterized to identify the critical parameters for a QAM receiver model. This receiver model is then used to simulate digital signal distortions and a metric is developed for digital signal distortion as a function of multipath interference.


The grinding wheel will have a property of self-lubricating when the inclusion complexes of β-cyclodextrin (β-CD) and oleic acid are used as filler. The association constants and thermodynamic parameters of inclusion complex of β-CD and oleic acid were determined by competitive inclusion method in aqueous buffer solution (pH = 10.50, c = 0.025 mol/L) at different temperatures using phenolphthalein (PP) as a probe. Furthermore, the stoichiometric ratio of the complex was derived by equimolar series method. The results showed that the stoichiometric ratio of the complex was about 1:1 and the thermodynamic parameters of ΔG, ΔH and ΔS were all negative, which indicated that the formation of the inclusion complex was spontaneous, exothermic and enthalpy-driven. Thermogravimetric analysis revealed that the complex began to have a weight loss at 300°C and could withstand the hardening temperature of resin bond grinding wheel.


The defect structure of Fe28Al samples is examined with the Positron Annihilation Lifetime Spectroscopy. The studies are carried out for samples in as-cast state and after heat treatments: annealing for 24 hours at 900°C (or 1050°C) and either slow cooling with furnace or quenching to oil. The PALS spectra are analyzed using two-state trapping model. Only one type of defects is detected. The positron lifetime in these defects (V) suggests that they are quenched-in Fe-monovacancies (VFe). The vacancy concentration strongly depends on the rate of cooling. Besides, V also depends slightly on the rate of cooling of the material. This fact suggests, according to the predictions of latest theoretical calculations, that V is sensitive to the atomic configuration in the nearest neighborhood of VFe, which give hope to estimate the degree of atomic ordering in alloys by the PALS technique.


Background: In competing risks data, when a person experiences an event other than the one of interest in the study, usually the probability of experiencing the event of interest is altered. Therefore, it is necessary to analyze the competing risk data. The aim of this study was to analyze the breast cancer risk factors using the competing risk model in patients with breast cancer. Materials and Methods: In this cohort study, 6206 cancerous patients included all women diagnosed with breast cancer were identified during 1990-1999 by the British Columbia Cancer Center and followed until 2010. To compare the competing risk models, the stratified Cox and proportional sub-distribution hazards models were fitted. Results: Findings showed that for breast cancer death, the hazard ratio increased for age (29%, 40%), radiotherapy (71%, 55%) and hormone therapy (76%, 84%) in the stratified Cox and proportional sub-distribution hazards models, respectively. Surgery decreased the hazard ratio in both models (89%, 80%). For deaths not due to breast cancer, the hazard ratio for age (81%, 91%) and chemotherapy (67%, 61%) decreased in both models, respectively. Conclusion: The Cox model, which ignores the competing risks, presents the different estimates and results than the proportional sub-distribution hazards model. Thus, in the analysis of competing risks data, the sub-distribution proportion hazards model is more appropriate than the Cox model.


The structure of the Baiu frontal zone over the East China Sea on 27 June 2004 was investigated using data from aircraft observations. During the period of 09-12 JST (Japanese Standard Time: UTC + 9 hours), three cloud zones appeared over the East China Sea. The Baiu frontal zone is conveniently divided into three zones on the basis of the three cloud zones. The zones on the southern side, in the middle, and on the northern side are called FZ1, FZ2, and FZ3, respectively. The position of FZ2 corresponded with that of a stationary front on the surface weather map. Remarkable variations of winds, potential temperature, and moisture corresponding to the three zones were detected using in situ measurements at 500 m MSL (Mean Sea Level). In FZ1, a decreased southerly wind area associated with a remarkable moisture gradient was seen, although the potential temperature gradient was unclear. FZ2 had remarkable gradients of potential temperature and moisture associated with a drastic change from southwesterly to northwesterly winds. FZ3 also had remarkable gradients of potential temperature and moisture. This study shows observational evidence of the fact that multiple frontal structures exist inside the Baiu frontal zone.


The hapten-immune model for pulmonary fibrosis shows that a specific T-cell-mediated immune response is essential for the induction of a nonresolving fibrosis. Here, we report results from studies that identify soluble factors released by activated T lymphocytes that might mediate long-lasting fibrosis. Pulmonary fibrosis was induced by priming hamsters for contact hypersensitivity responses with an epicutaneous application of 2,4,6-trinitro-1-chlorobenzene (TNCB) in carrier and challenging intratracheally (IT) 5 days later with a single dose of the soluble form of the immunizing hapten. Bronchoalveolar lavage fluid was harvested at various time points after IT challenge and assayed for tumor necrosis factor (TNF) and interleukin-2 (IL-2) bioactivity. After IT challenge with the sensitizing hapten, only the immune animals contained IL-2 activity in the bronchoalveolar lavage fluid. TNF activity was detected in lungs of both immune and nonimmune animals. Interestingly, the TNF activity was significantly higher (P less than 0.05) in nonimmune challenged than in immune challenged animals on day 5. Molecular hybridization studies showed that a similar amount of TNF-alpha mRNA was expressed in adherent cells from both groups. The nonadherent subpopulation of mononuclear cells harvested from challenged-immune animals expressed TNF-beta (lymphotoxin) mRNA. These data show, for the first time, an association of lymphotoxin with the appearance of pulmonary fibrotic disease in an animal model for pulmonary fibrosis. These observations are consistent with the postulates that lymphotoxin and IL-2 participate in the immunopathogenesis of hapten-immune induced pulmonary fibrosis and that TNF-alpha is associated with the healing of the fibrotic process initiated by toxic lung injury.


The kinetics of triplet state decay and concomitant delayed fluorescence of tetraphenylporphyrin (TPP) incorporated into the multilayers of n-decanol adsorbed on the external surface of zeolites at different temperatures were studied by the laser flash photolysis via monitoring the emission and diffuse-reflectance. In deoxygenated samples, the kinetics of diffusion-controlled bimolecular triplet-triplet annihilation (TTA) has been used to probe the multilayers. A very large local concentration of reactants may be obtained using small bulk amounts. A fast TTA rate constant demonstrated the triplet energy migration in TPP assemblies formed at the liquid/solid interface. The TTA in aerated samples is mediated by molecular oxygen leading to 1O2 feedback—induced delayed fluorescence. Singlet oxygen works as an efficient mobile energy carrier between TPP triplets. The parameters of both TTA may be modified by multilayer, which acts as microreactor with supramolecular organization. The freezing of n-decanol results in dramatic apparent acceleration of both direct and 1O2 mediated TTA due to the increase in local TPP concentration because of displacement of TPP molecules into the residual liquid domains in polycrystalline matrix. The concentration of TPP in those microreactors can be three orders of magnitude larger than the solubility limit in a particular neat liquid solvent demonstrating the unique features of solid solution, which seems to be due to the presence of crystal/liquid interfaces.


How does the brain represent the reliability of its sensory evidence? Here, we test whether sensory uncertainty is encoded in cortical population activity as the width of a probability distribution, a hypothesis that lies at the heart of Bayesian models of neural coding. We probe the neural representation of uncertainty by capitalizing on a well-known behavioral bias called serial dependence. Human observers of either sex reported the orientation of stimuli presented in sequence, while activity in visual cortex was measured with fMRI. We decoded probability distributions from population-level activity and found that serial dependence effects in behavior are consistent with a statistically advantageous sensory integration strategy, in which uncertain sensory information is given less weight. More fundamentally, our results suggest that probability distributions decoded from human visual cortex reflect the sensory uncertainty that observers rely on in their decisions, providing critical evidence for Bayesian theories of perception. SIGNIFICANCE STATEMENT Virtually any decision that people make is based on uncertain and incomplete information. Although uncertainty plays a major role in decision-making, we have but a nascent understanding of its neural basis. Here, we probe the neural code of uncertainty by capitalizing on a well-known perceptual illusion. We developed a computational model to explain the illusion, and tested it in behavioral and neuroimaging experiments. This revealed that the illusion is not a mistake of perception, but rather reflects a rational decision under uncertainty. No less important, we discovered that the uncertainty that people use in this decision is represented in brain activity as the width of a probability distribution, providing critical evidence for current Bayesian theories of decision-making.


RANS simulations are implemented to analyse the hydrodynamic characteristics of twin-rudders, i.e. Flat plate rudders, NACA rudders, and Wedge-tail rudders. The study mainly focuses on small attack angles. Results show that the NACA series is the most efficient profile while the Wedge-tail rudder has the highest rudder effectiveness.


Alumina scale adhesion on high temperature alloys is known to be affected primarily by sulfur segregation and reactive element additions. However adherent scales can become partially compromised by excessive strain energy and cyclic cracking. With time, exposure of such scales to moisture can lead to spontaneous interfacial decohesion, occurring while the samples are maintained at ambient conditions. Examples of this Moisture-Induced Delayed Spallation (MIDS) are presented for NiCrAl and single crystal superalloys, becoming more severe with sulfur level and cyclic exposure conditions. Similarly, delayed failure or Desk Top Spallation (DTS) results are reviewed for TBC's, culminating in the water drop failure test. Both phenomena are discussed in terms of moisture effects on bulk alumina and bulk aluminides. A mechanism is proposed based on hydrogen embrittlement and is supported by a cathodic hydrogen charging experiment. Hydroxylization of aluminum from the alloy interface appears to be the relevant basic reaction.


OBJECTIVE
While SLE is found worldwide, there is diversity in clinical presentation of the disease according to geographical variations. The aim of this study is to describe geographical distributions of childhood onset SLE within Oman to identify geographical clustering and to compare the demographic, clinical, and immunological characteristics of this cluster against the rest of Oman.

METHODS
We retrospectively reviewed the hospital charts of 104 consecutive children with childhood onset SLE who were seen in pediatric rheumatology centers in the Sultanate of Oman over a 15-year period between 1995 and 2010.

RESULTS
Geographical clustering of childhood onset SLE was identified in Sharqiya region, which constituted 41% (n=43) of all cases in Oman. This cohort of patients had characteristic disease features which consisted of significantly more boys affected with SLE compared to the rest of the country (42% versus 15%; p=0.002). These children also tended to be younger (10.3 versus 16.5 years; p=0.001), diagnosed at an earlier age (6.4 versus 9.4 years; p<0.001) with a stronger family history of SLE (58% versus 33%; p=0.010). These children also had increased incidence of mucocutanous changes (81% versus 62%; p=0.036) and decreased hematological abnormalities (30% versus 51%; p=0.036).

CONCLUSION
We identified geographical clustering of childhood onset SLE to Sharqiya region in Oman which is associated with unique demographical and clinical features. Whether increased prevalence of disease in this region is due to geographical, environmental, ethnic or genetic factors is yet to be determined. However, it is likely to be interplay of known and other unrecognized factors.


In this paper, we propose a stochastic model to describe how search service providers charge client companies based on users' queries for the keywords related to these companies' ads by using certain advertisement assignment strategies. We formulate an optimization problem to maximize the long-term average revenue for the service provider under each client's long-term average budget constraint and design an online algorithm which captures the stochastic properties of users' queries and click-through behaviors. We solve the optimization problem by making connections to scheduling problems in wireless networks, queueing theory and stochastic networks. Unlike prior models, we do not assume that the number of query arrivals is known. Due to the stochastic nature of the arrival process considered here, either temporary "free" service, i.e., service above the specified budget (which we call "overdraft") or under-utilization of the budget (which we call "underdraft") is unavoidable. We prove that our online algorithm can achieve a revenue that is within O(ε) of the optimal revenue while ensuring that the overdraft or underdraft is O(1/ε) , where ε can be arbitrarily small. With a view towards practice, we can show that one can always operate strictly under the budget. In addition, we extend our results to a click-through rate maximization model and also show how our algorithm can be modified to handle non-stationary query arrival processes and clients with short-term contracts. Our algorithm also allows us to quantify the effect of errors in click-through rate estimation on the achieved revenue. We show that we lose at most Δ/1+Δ fraction of the revenue if Δ is the relative error in click-through rate estimation. We also show that in the long run, an expected overdraft level of Ω(log(1/ε)) is unavoidable (a universal lower bound) under any stationary ad assignment algorithm which achieves a long-term average revenue within O(ε) of the offline optimum.


In a recent account on the pigface breams from Andamail waters we (Silas and Toor, 1961) described fivej species of lethrinids, namely, Xe//ir/»MS ornatus Valenciennes,
i . harak (Forskal), D nebulosus (Forskal), Lethrinelld microdon (Valenciennes), and L. xanthocheilus (Kltnzinger). In addition, two specimens were provisionally placed under Lethrinella pjrox. xanthocheilus. Since the paper was sent to press we have come across Wheelerl's recently published work on' The genus Lethrinus in the Western Indian Ocean' (Wheeler, 1961), wherein a new species, Lethrinus floridus
is very briefly described and figured in colour. Wheeler's notes on this species are mostly based on recollections and as such, details regarding nature of dentition, morphometric measurements, etc. are wanting.


Demagnetizing factors have been calculated for hierarchical mixtures and dispersions of magnetic particles, such as columns of plate- like particles in a matrix and clusters of spherical particles. The theory involves a number of shape and density parameters describing particles, aggregates, and matrix. It approximates distant particles by a homogeneous medium and yields closed and easy-to-use expres- sions for the effective demagnetizing factor.


This paper investigates the soft decision decoding techniques for wireless COFDM systems. A new method to estimate the channel state information (CSI) for the Viterbi decoder is proposed, which overcomes the problem of reliability metric of transmitted signals in wireless as well as mobile channels. The CSI for each subcarrier is calculated as a properly defined squared Euclidean distance. On the basis of which, a soft decision decoding scheme to improve reception performance under multipath fading interference and co-channel interference (CCI) from existing analog broadcasting signals is also proposed. The simulation results show that the scheme can provide a compatible improvement to the terrestrial digital video broadcasting (DVB-T) system. The proposed scheme is also suitable for other wireless COFDM transmission systems.


When determining the Appropriate Level of Protection (ALOP), developed countries rely on the Food Safety Objective (FSO) to meet the requirements of WTO law and to provide a high level of protection based on insights from food safety science. Implementing an FSO/ALOP is resource-intensive and costly. Developing countries, which are subject to the same WTO law and would like to provide similar levels of protection, are restricted by limited resources and often face difficulties implementing such an FSO-based ALOP. As a consequence, developing countries may base their ALOP on other legally acceptable reasons, which are non-scientific and less effective. We illustrate a less resource-intensive way to implement the FSO in ALOP, which enables developing countries to design an ALOP that is based on food safety science. Depending on the resources available in the respective country, we map different possibilities to determine a science-based FSO/ALOP concept for developing countries, which also takes into account the requirements of WTO law.


STUDY OBJECTIVE
Bronchoscopic technique is not standardized. Controversies exist with regard to premedication with sedatives before the test. To evaluate safety and efficacy of conscious sedation, we studied 100 randomized patients undergoing diagnostic bronchoscopy; patients received premedication with lidocaine spray and atropine sulfate i.m. (nonsedation group; 50 patients) or lidocaine spray, atropine i.m. and diazepam i.v. (sedation group; 50 patients).

METHODS AND RESULTS
Monitoring during flexible fiberoptic bronchoscopy included continuous ECG and pulse oximetry. The procedure could not be completed in six patients. None received premedication with diazepam; among the patients who ended the examination, tolerance to the examination (visual analogue scale, 0 to 100; 0 = excellent; 100 = unbearable) was better in the sedation group. Low anxiety, male sex, but not age were also associated with improved patient tolerance to the test. Oxygen desaturation occurred in 17% of patients, and it was not more frequent after diazepam treatment.

CONCLUSIONS
In our study, sedation had a beneficial effect on patient tolerance and rarely induced significant alterations in cardiorespiratory monitoring parameters.


Encoded video is expected to contribute a significant portion of the load on future communication systems and networks, which often employ statistical multiplexing. In such systems, the number of video streams that can be supported depends both on the mean bit rate as well as bit rate variability of the video streams. At the same time, the utility (revenue) earned from video streaming depends both on the number of supported video streams as well as their quality level. In this paper we examine the interplay between video quality, traffic variability, and utility for open-loop encoded video. We introduce the rate variability-distortion (VD) curve which relates the bit rate variability to the quality level of an encoded video. We find that the VD curve generally exhibits a characteristic "hump" behavior of first increasing, peaking, and subsequently decreasing variability for increasing quality. We examine the impact of video content characteristics, encoding parameters, and traffic smoothing on the VD behavior. We describe a methodology for assessing (i) the set of the video streams that can be supported with a statistical quality of service requirement, and (ii) the utility earned from video streaming over a link. This methodology is based on the rate-distortion and rate variability-distortion characteristics of the videos. We find that the statistical multiplexing gain and the utility as a function of the video quality level typically exhibit a "hump" similar to the VD curve.


The concept of the wave filtering is followed in the derivation of high-order filter topologies by employing Current Feedback Operational Amplifiers as active blocks. For this purpose, the wave equivalent of an appropriate passive element chosen to be the elementary building block is introduced. As the wave equivalents of the other passive elements are derived by performing appropriate manipulations in the configuration of the wave equivalent of the elementary building block, an attractive characteristic offered by the derived filter topologies is the modularity of their structures. The validity of the proposed method is verified through experimental results in the case of a 3order lowpass filter.


BACKGROUND AND PURPOSE: The optimal TE must be calculated to minimize the variance in CBV measurements made with DSC MR imaging. Simulations can be used to determine the influence of the TE on CBV, but they may not adequately recapitulate the in vivo heterogeneity of precontrast T2*, contrast agent kinetics, and the biophysical basis of contrast agent–induced T2* changes. The purpose of this study was to combine quantitative multiecho DSC MRI T2* time curves with error analysis in order to compute the optimal TE for a traditional single-echo acquisition. MATERIALS AND METHODS: Eleven subjects with high-grade gliomas were scanned at 3T with a dual-echo DSC MR imaging sequence to quantify contrast agent–induced T2* changes in this retrospective study. Optimized TEs were calculated with propagation of error analysis for high-grade glial tumors, normal-appearing white matter, and arterial input function estimation. RESULTS: The optimal TE is a weighted average of the T2* values that occur as a contrast agent bolus transverses a voxel. The mean optimal TEs were 30.0 ± 7.4 ms for high-grade glial tumors, 36.3 ± 4.6 ms for normal-appearing white matter, and 11.8 ± 1.4 ms for arterial input function estimation (repeated-measures ANOVA, P < .001). CONCLUSIONS: Greater heterogeneity was observed in the optimal TE values for high-grade gliomas, and mean values of all 3 ROIs were statistically significant. The optimal TE for the arterial input function estimation is much shorter; this finding implies that quantitative DSC MR imaging acquisitions would benefit from multiecho acquisitions. In the case of a single-echo acquisition, the optimal TE prescribed should be 30–35 ms (without a preload) and 20–30 ms (with a standard full-dose preload).


Morrissey, Leikes, and Cochran (this issue) raise concerns about potential negative effects of state pre-kindergarten (pre-K) on the early care and education system. To put their study in context, I reviewed national demographic and enrollment trends. I found little evidence of negative effects from state pre-K policy. One reason may be that population growth and child care policies mitigated potential negative impacts of pre-K expansion. However, national averages could conceal important local variations or even nationwide variations when there are offsetting gains and losses. Children under age 5, their families, and their teachers all likely gained from increases in public pre-K. Infant/toddler care in private programs expanded as quickly as public pre-K. Morrissey and colleagues' small data set from New York has serious limitations, but some of the most salient findings are consistent with the national picture. The study offers lessons and suggests topics for future research on the influence of pre-K policy on the early care and education system.


3 ABSTRACT: This paper examines the SSM technique CATWOE, which focus on defining necessary elements that together constitute a human activity system from a certain perspective. Despite its recognition within the literature and its numerous use there are few studies on how the technique can be improved. This research reflects on each of the elements both from a theoretical and a practical perspective. Findings point to the fact that some of the terms have a meaning in everyday language that differs from its definition within CATWOE, other concepts are not well defined. This is unfortunate and may both lead to misunderstandings and limit analysis. The paper points at a number of ways in which the use of CATWOE can be developed in order to further support the process of eliciting novel ideas for future actions. Hence, the overall conclusion is that the elements need to be rethought and some of them renamed.


This study aimed to assess the effects of a proprioceptive exercises programme on disease activity and on ankle kinematic and kinetic parameters of post-menopausal women with rheumatoid arthritis. Twenty-seven post-menopausal women with rheumatoid arthritis were allocated to exercise group (n = 15) or control group (n = 12). Exercise group intervention: proprioceptive exercises (12 weeks; 3 one-on-one workouts/week; 30 min/workout). Control group intervention: stretching exercises (12 weeks; 1 one-on-one workout every two weeks; 30 min/workout). Disease Activity Score (28 joints) was used to assess disease activity. A 3D motion analysis system (9 cameras, 200 Hz) and a force plate (1000 Hz) were used to collect kinematic and kinetic data during a barefoot walking at self-selected speed. For each subjects' foot, 7 trials of the stance phase were collected. One subject withdrawal was registered in exercise group. Post-intervention, exercise group' subjects yielded higher gait speed, shorter stance phase, shorter controlled dorsiflexion sub-phase, and higher ankle power peak (p < 0.05), however, they showed no differences in Disease Activity Score, ankle moment of force peak, and variability of biomechanical parameters; control group' subjects showed no differences in all parameters. Proprioceptive exercises seemed to be a safe option to gain gait biomechanical improvements in post-menopausal women with rheumatoid arthritis.


Background PD1 immune checkpoint blockade (αPD1 ICB) has shown unparalleled success in treating many types of cancer. However, response to treatment does not always lead to tumor rejection. While αPD1 ICB relies on cytotoxic CD8+ T cells, antigen-presenting cells (APCs) at the tumor site are also needed for costimulation of tumor-infiltrating lymphocytes (TILs). It is still unclear how these APCs develop and function before and during αPD1 ICB or how they are associated with tumor rejection. Methods Here, we used B16 mouse melanoma and MC38 colorectal carcinoma tumor models, which show differential responses to αPD1 ICB. The immune composition of ICB insensitive B16 and sensitive MC38 were extensively investigated using multi-parameter flow cytometry and unsupervised clustering and trajectory analyses. We additionally analyzed existing single cell RNA sequencing data of the myeloid compartment of patients with melanoma undergoing αPD1 ICB. Lastly, we investigated the effect of CD40 agonistic antibody on the tumor-infiltrating monocyte-derived cells during αPD1 ICB. Results We show that monocyte-derived dendritic cells (moDCs) express high levels of costimulatory molecules and are correlated with effector TILs in the tumor microenvironment (TME) after αPD1 ICB only in responding mouse tumor models. Tumor-resident moDCs showed distinct differentiation from monocytes in both mouse and human tumors. We further confirmed significant enrichment of tumor-resident differentiated moDCs in patients with melanoma responding to αPD1 ICB therapy compared with non-responding patients. Moreover, moDCs could be targeted by agonistic anti-CD40 antibody, supporting moDC differentiation, effector T-cell expansion and anti-tumor immunity. Conclusion The combined analysis of myeloid and lymphoid populations in the TME during successful and non-successful PD1 ICB led to the discovery of monocyte-to-DC differentiation linked to expanding T-cell populations. This differentiation was found in patients during ICB, which was significantly higher during successful ICB. The finding of tumor-infiltrating monocytes and differentiating moDCs as druggable target for rational combination therapy opens new avenues of anti-tumor therapy design.


The authors have developed a processing method for whole-wafer tunnel junctions which allows the preparation of planar tunnel junctions with just two lithographic steps and largely eliminates the inherent capacitance and potential failure problems associated with overlap between the base electrode and the counterelectrode metallization common to all existing methods. The basic feature of this self-aligning whole-wafer (SAWW) process is that the pattern used to create the counterelectrode metallization also defines the junction area. Results of preliminary trials of this method are presented and possible future developments discussed. >


The term quality is frequently mentioned in the context of teaching. Every so often, we hear students' complaint of unclear teachers and we hear instructors state that they have explained a difficult concept clearly. Students expect that the teacher should explain step by step how to do things, explain in different ways, and give the chance to have particular misunderstandings clarified. Indeed the quality in teacher is crucial. In contrast, the real classroom teaching is very different from theoretical concept and commonly the students are not satisfied. It is also recognized that a blind acceptance of student feedback is inappropriate. Based on these facts, the writer would like to investigate the students' expectations on teachers' quality in classroom teaching. The purpose of this study is to find out the students' expectation on teachers' qualities in classroom teaching. In addition, the result of this study will give feed back to the teacher in teaching-learning process. It is expected to minimize mismatch and to bridge the gap between the students' expectations on teachers' qualities in classroom setting. The study is limited only on teachers' qualities which are related to classroom teaching and uses the fourth semester students of the English Department of Muhammadiyah University of Malang. The present study employs descriptive qualitative methodology. The writer uses simple random sampling to give equal opportunities to every member of the population to be selected as sample, and there are 52 respondents (it is 25 % of 206 total number of population). The writer uses questionnaire consisting of 10 items for the respondents to rearrange as the research instrument. Thus, the procedure of collecting the data are constructing, consulting, distributing and collecting the questionnaires. Meanwhile, classifying the questionnaire, calculating the number of similar responses and drawing conclusion are the steps of data analysis. Based on the research findings, the writer concludes that the most expected teachers' quality in classroom teaching was that the teacher should explain the subject clearly, as suggested by 44.23% of the respondents. On the other hand, the least expected quality was that the teacher should give an assessment properly (0% of the respondents) In conclusion, good teachers should possess these qualities and try to apply them based on the condition of classroom teaching and students' expectations.


Experiments conducted in West Java, Indonesia investigated the developmental biology and reproductive behavior of two sympatric soybean pod borers, Etiella zinckenella Treitschke and E. hobsoni Butler (Lepidoptera: Pyralidae). It was determined that: (1) significant interspecific differences occurred between the egg, larval, pupal and total egg‐to‐adult developmental periods of laboratory raised E. zinckenella and E. hobsoni; (2) the pre‐pupal and total egg‐to‐adult development periods of female E. zinckenella were significantly shorter than for males; (3) the longevity of virgin female E. zinckenella was significantly longer than that of virgin males, or virgin male and female E. hobsoni; (4) interspecific differences occurred in the female: male sex‐ratios of laboratory raised adults; (5) peak mating for both species occurred on the second night after eclosion; (6) interspecific differences occurred in the temporal distribution of calling and mating behaviors; (7) repeated mating was observed for both species at a very low frequency; (8) interspecific mating did not occur; (9) female E. zinckenella were significantly more fecund than E. hobsoni; (10) the duration in copulo of E. zinckenella was significantly longer than that of E. hobsoni; and (11) wingtraps baited with virgin females caught only conspecific males, and reduced numbers of males were captured in traps simultaneously baited with virgin females of both species. This study demonstrates distinct biological differences and reproductive isolation between the two Etiella spp.


Summary Rose hip, also known as wild rose, is a summer fruit. The aim of this research is to present physical, chemical, rheological, sensory and antioxidant properties of rose hip marmalades. Rose hips cultivated in Turkey are processed into pulp and then marmalade is made by using vacuum evaporator or classical method. For the purposes of this investigation, marmalades produced on a factory scale using two methods were compared to commercial marmalades purchased on market. The marmalades exhibited high levels of antioxidant activity as well as total phenolic content. The consistency indices for the marmalades were determined to be between 64.2 and 321 Pa·s n . Colour parameters, namely L, a, b, were measured and correlations between the examined parameters were calculated.


A polar gibberellin active in the dwarf rice (Oryza sativa L.) seedling and barley (Hordeum vulgare L.) half-seed assays was extracted from immature sour cherry (Prunus cerasus L.) seed and identified as gibberellin A(32) by gas-liquid chromatography and selected ion monitoring.


BACKGROUND
Women of reproductive age diagnosed with cancer are often interested in preserving gametes or reproductive tissue that would allow for future genetic parenthood. Preservation of fertility is often accomplished in young cancer patients via ovarian stimulation followed by oocyte or embryo cryopreservation. Conventional stimulation protocols, however, require 2-4 weeks to complete ovarian stimulation, oocyte retrieval and possible fertilization. Such a strategy may not be feasible in patients requiring urgent cancer treatment. Recent studies have highlighted that random start ovarian stimulation can be initiated irrespective of the phase of the menstrual cycle and is an attractive alternative to conventional ovarian stimulation. The primary aim of the current review is to discuss the feasibility and success of random start ovarian stimulation for oocyte or embryo cryopreservation in women desiring fertility preservation prior to gonadotoxic cancer therapy.

METHOD
We performed a systematic review of medical literature published between January 2000 to June 2017 reporting the utility of random start ovarian stimulation for fertility preservation. Search terms included "fertility preservation," "cancer," "ovarian stimulation," "random-start ovarian stimulation," "embryo cryopreservation, and" "oocyte cryopreservation." Publications were included in this review only if patients underwent random start ovarian stimulation prior to cancer therapy.

RESULTS
Nineteen publications were identified and perused by the authors. Most publications described the utility of random start ovarian stimulation in the setting of breast cancer. Radom-start stimulation was associated with a reduced time interval between ovarian stimulation initiation and oocyte or embryo cryopreservation. The yield of mature oocytes and their developmental potential into embryos was comparable between conventional and random-start protocols, albeit with higher gonadotropin doses in the latter.

CONCLUSION
The current review suggests that random start ovarian stimulation can shorten the interval between ovarian stimulation and oocyte retrieval, with the yield of oocytes and embryos being comparable to conventional stimulation protocols. Thus, random start ovarian stimulation may serve as a better option for fertility preservation in patients requiring urgent cancer treatment.


Microwave-assisted selective liquefaction was proposed and used as a novel method for the isolation of holocellulose fibers. The results showed that the bamboo lignin component and extractives were almost completely removed by using a liquefaction process at 120 8C for 9 min, and the residual lignin and extractives in the solid residue were as low as 0.65% and 0.49%, respectively. Increasing the reaction temperature or time could decrease the solid yield, but they can also enhance the removal of lignin and extractives from bamboo particles and increase the holocellulose content in the solid residue. The absorbance bands that characterized functional groups of lignin on the Fourier transform infrared spectra of the solid residue weakened or disappeared. The solid residue showed high crystallinity, indicating the removal of noncellulosic material. Small cracks were observed on the SEM images of the residue, which indicated that the fibers from liquefaction may be susceptible to chemical access or enzyme attack. VC 2016 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2016, 133, 43394.


High stopping power is one of the most important figures of merit for X-ray detectors. CdTe is a promising material but suffers from: material defects, non-ideal charge transport and long range X-ray fluorescence. Those factors reduce the image quality and deteriorate spectral information. In this project we used a monochromatic pencil beam collimated through a 20μm pinhole to measure the detector spectral response in dependance on the depth of interaction. The sensor was a 1mm thick CdTe detector with a pixel pitch of 110μm, bump bonded to a Timepix readout chip operating in Time-Over-Threshold mode. The measurements were carried out at the Extreme Conditions beamline I15 of the Diamond Light Source. The beam was entering the sensor at an angle of \texttildelow20 degrees to the surface and then passed through \texttildelow25 pixels before leaving through the bottom of the sensor. The photon energy was tuned to 77keV giving a variation in the beam intensity of about three orders of magnitude along the beam path. Spectra in Time-over-Threshold (ToT) mode were recorded showing each individual interaction. The bias voltage was varied between -30V and -300V to investigate how the electric field affected the spectral information. For this setup it is worth noticing the large impact of fluorescence. At -300V the photo peak and escape peak are of similar height. For high bias voltages the spectra remains clear throughout the whole depth but for lower voltages as -50V, only the bottom part of the sensor carries spectral information. This is an effect of the low hole mobility and the longer range the electrons have to travel in a low field.


A new method is developed to merge two spatially registered images with different focus based on multi-resolution wavelet decomposition and evolutionary strategy (ES). At first, the wavelet decomposition without down-sampling is used to perform an adding of wavelet high-frequency components of each image. Then, in terms of differences of area-based energy feature in two original images, ES is adopted to partition the region and perform the fusion. The experimental results show that the proposed method can achieve better fusion performance than wavelet transform (WT) method.


In December of 2002, the High Court of Australia issued its decision in Dow Jones & Co. v. Gutnick, holding that Dow Jones could be haled into court in Australia for the publication of defamatory material on the Internet. This decision was surprising because the material in question was published in the United States on Dow Jones's New Jersey web servers. This decision makes Australia the only country that allows an action against a foreign defendant based solely on an Internet download in that country. However, the structure of the Gutnick opinion may open the door for other countries to follow the High Court's example. The Gutnick decision raises concerns that the territorial borders of speech protection could break down in the Internet Age. Laws regarding the balance between free speech and the protection of reputation vary widely among nations. However, the Australian court ignored the implications that the breakdown of the borders between jurisdictions could have on this balance, and instead mechanically applied historical precedent to the Internet. This strict application to the Internet of precedent created for off-line publication may produce a chilling effect on Internet speech worldwide by reducing the level of speech protection on the Internet to the lowest common denominator. The Gutnick decision's narrow focus on precedent does not offer sufficient protection to international free speech, and the Australian Parliament should adopt a jurisdictional rule to protect Internet speakers that do not aim their speech at Australia.


BACKGROUND
Carbohydrate ingestion increases the relative production of carbon dioxide which results in an increase in ventilation in normal individuals. An increase in ventilation at altitude can result in improvement of altitude-induced hypoxemia.

HYPOTHESIS
Carbohydrate ingestion will increase the arterial blood oxygen tension and oxyhemoglobin saturation during acute high altitude simulation.

METHODS
There were 15 healthy volunteers, aged 18-33 yr, who were given a 4 kcal x kg(-1) oral carbohydrate beverage administered 2.5 h into an exposure to 15,000 ft (4600 m) of simulated altitude (5.5 h after the last meal). Altitude was simulated by having subjects breath a 12% oxygen/balance nitrogen mixture while remaining at sea level. Arterial blood gas samples were drawn at baseline and at regular intervals up to 210 min after carbohydrate ingestion. Subjects were evaluated for AMS by use of the Environmental Symptoms Questionnaire (ESQ) and a weighted average of cerebral symptom score (AMS-C).

RESULTS
Baseline PaO2 increased significantly (p < 0.01) from 43.0 +/- 3.0 mmHg at 4600 m before carbohydrate ingestion to 46.8 +/- 6.2 mmHg at 60 min after carbohydrate ingestion. Arterial oxygen saturation rose significantly (p < 0.01) from a baseline of 79.5% +/- 5.1 to 83.8% +/- 6.42 at 60 min.

CONCLUSIONS
Carbohydrate consumption significantly increased oxygen tension and oxyhemoglobin saturation in arterial blood of normal subjects during simulated altitude. Effects reached statistical significance across all subjects at 60 min. There was no significant difference in arterial oxygen levels or arterial oxygen saturation in subjects who developed AMS vs. those who did not develop AMS.


Dugi otok Island and Kornati archipelago islands are characterized by karst morphology. Small karst features are particulary well developed along the coast in the swash zone, and significant differences can be observed due to different interaction of wave action, bedding attitude, bed thicknesses and lithologies. Among other karren types, fissure- and network-type karren are particulary interesting, both of which start developing from initial pot karren which at small distance of just several meters turn into debris-karren. The age of some of these small karst features can be estimated by their occurrence in ancient quarries, and we suggest their historic age. We can envisage the future development of these small coastal corrosion.


Introduction Hypertension and insulin resistance are well established risk factors for atherosclerosis. Accumulated evidence also suggests that insulin resistance plays a contributory role in the development of essential hypertension. Previous studies have focused on patients with established hypertension, using clinic blood pressure (BP) measurements. Ambulatory Blood Pressure Monitoring (ABPM) records BP at 20-30 minute intervals over 24 hours, providing an average BP exposure over time. We tested the hypothesis that insulin resistance and blood pressure are associated in normotensive and prehypertensive patients, using ABPM to quantify average BP.

Methods Data were collected for 140 subjects (87 female, 53 male; 117 non-black, 23 black). In addition to clinic BP, ABPM was used to obtain average SBP and DBP over 24 hours. Insulin resistance (IR) was quantified using the QUantitative Insulin sensitivity ChecK Index (QUICKI), calculated from fasting glucose and insulin levels with the formula QUICKI = 1/(log [Fasting insulin in mU/l] + log [Fasting plasma glucose in mg/dl]). Multiple linear regression was used to assess IR as a predictor of ABPM-derived BP measures, controlling for BMI, gender, age, and race.

Results In the entire cohort using ABPM, there was a significant association of IR with DBP24 (p=0.012) but not SBP24 (p=0.11). The association between IR and clinic SBP was marginally significant (p=0.09); DBP NS (p=0.33). After stratifying by gender, IR was significantly associated with SBP24, Daytime SBP (p=0.064, 0.044), DBP24 and Daytime DBP (p=0.02 and p=0.015) in males; no association was found in females.

Conclusions This study demonstrates a significant association of IR with average 24-hour DBP in males and females combined. Stratified by gender, our finding using ABPM of a significant association of IR with SBP in males but not in females supports previous findings using clinic BP in the NHANES cohort. In conclusion, these data demonstrate the presence of IR in prehypertension, and lend support to the theory that IR may contribute to later development of sustained hypertension, particularly in males. Additionally, our study highlights the importance of further research using ABPM for a more precise estimate of average BP level.


Dr. Afrin Naz is an assistant professor at the Computer Science and Information Systems department at West Virginia University Institute of Technology. She is working with high school teachers to inspire the K-12 students to the STEM fields. In last four years Dr. Naz and her team launched six workshops for high school teachers. Currently her team is training the high school teachers to offer online materials to supplement their face-to-face classroom.


OBJECTIVE
To determine the attitudes, feelings, and beliefs of mothers and pediatric emergency department health care providers toward routine intimate partner violence screening.

METHODS
This qualitative project employed focus groups of mothers who brought their children to a children's hospital emergency department for care, and physicians and nurses who staffed the same department. We held 6 ethnically homogeneous mother focus groups (2 white, 2 African American, and 2 Latina) and 4 provider focus groups (2 predominately female nurse focus groups and 2 physician groups: 1 male and 1 female). Professional moderators conducted the sessions using a semistructured discussion guide. All groups were audiotaped and videotaped, and tapes were reviewed for recurring themes.

RESULTS
A total of 59 mothers, 21 nurses, and 17 physicians participated. Mothers identified intimate partner violence as a common problem in their communities, and most remarked that routine screening for adult intimate partner violence is an appropriate activity for a pediatric emergency department. However, many expressed concern that willingness to disclose might be affected by a fear of being reported to child protective services. They stressed the importance of addressing the child's health problem first, that screening be done in an empathetic way, and that immediate assistance be available if needed. Themes identified in the provider groups included concerns about time constraints, fear of offending, and concerns that unless immediate intervention was available, the victim could be placed in jeopardy. Many said they would feel obligated to notify child protective services on disclosure of intimate partner violence.

CONCLUSIONS
Intimate partner violence screening protocols in the pediatric emergency department should take into consideration the beliefs and attitudes of both those doing the screening and those being screened. Those developing screening protocols for a pediatric emergency department should consider the following: (1) that those assigned to screen must demonstrate empathy, warmth, and a helping attitude; (2) the importance of addressing the child's medical needs first, and a screening process that is minimally disruptive to the emergency department; (3) a defined, organized approach to assessing danger to the child, and how and when it is appropriate to notify child protective services when a caregiver screens positive for intimate partner violence; and (4) that resources must be available immediately to a victim who requests them.


The drug-drug interaction (DDI) potential of deleobuvir, an hepatitis C virus (HCV) polymerase inhibitor, and its two major metabolites, CD 6168 (formed via reduction by gut bacteria) and deleobuvir-acyl glucuronide (AG), was assessed in vitro. Area-under-the-curve (AUC) ratios (AUCi/AUC) were predicted using a static model and compared with actual AUC ratios for probe substrates in a P450 cocktail of caffeine (CYP1A2), tolbutamide (CYP2C9), and midazolam (CYP3A4), administered before and after 8 days of deleobuvir administration to HCV-infected patients. In vitro studies assessed inhibition, inactivation and induction of P450s. Induction was assessed in a short-incubation (10 hours) hepatocyte assay, validated using positive controls, to circumvent cytotoxicity seen with deleobuvir and its metabolites. Overall, P450 isoforms were differentially affected by deleobuvir and its two metabolites. Of note was more potent CYP2C8 inactivation by deleobuvir-AG than deleobuvir and P450 induction by CD 6168 but not by deleobuvir. The predicted net AUC ratios for probe substrates were 2.92 (CYP1A2), 0.45 (CYP2C9), and 0.97 (CYP3A4) compared with clinically observed ratios of 1.64 (CYP1A2), 0.86 (CYP2C9), and 1.23 (CYP3A4). Predictions of DDI using deleobuvir alone would have significantly over-predicted the DDI potential for CYP3A4 inhibition (AUC ratio of 6.15). Including metabolite data brought the predicted net effect close to the observed DDI. However, the static model over-predicted the induction of CYP2C9 and inhibition/inactivation of CYP1A2. This multiple-perpetrator DDI scenario highlights the application of the static model for predicting complex DDI for CYP3A4 and exemplifies the importance of including key metabolites in an overall DDI assessment.