Increased wildfire activity and climate change have intensified disturbance regimes globally and have raised concern among scientists and land managers about the resilience of disturbed landscapes. Here we test the effects of climate, topographic variation and pre‐fire stand structure on regeneration in lodgepole pine (Pinus contorta var. latifolia) forests following high‐severity fire over the past seven decades. We surveyed lodgepole pine regeneration 8–67 years after eight high‐severity fires in western Colorado and southern Wyoming. We used dendroecological methods and machine learning to (a) identify temporal trends in post‐fire regeneration and (b) examine influences of climate on post‐fire regeneration, with focus on post‐fire establishment, initial post‐fire density and radial growth. All burned sites reached a median stocking density of ≥150 seedlings/ ha, but there was a large range of spatial heterogeneity, with regeneration being absent or scarce in many plots, implying a trend of increasing patchiness with likely cascading effects on subsequent patterns and processes. Our analysis indicated that (a) post‐fire regeneration is influenced by pre‐fire stand structure (stand age and density), elevation and post‐fire minimum temperature; (b) pre‐fire densities of >14,000 stems/ha promoted successful stocking (≥150 seedlings/ha) and reduced lag between the disturbance and initial regeneration; and (c) minimum post‐fire temperatures >−1.6°C reduced lag of initial regeneration and promoted initial radial growth. Synthesis. Our study demonstrates that lodgepole pine in high‐elevation forests are regenerating following fires under recent climatic trends, but that regeneration is affected by post‐fire climatic conditions. Importantly, forest patchiness may be increasing in a way that affects future ecological dynamics and may compromise the resilience of these systems.


A 35-year-old man presented with an acute, painful lower left quadrant and groin mass with signs of sepsis. On examination, it was difficult to tell whether this was a strangulated hernia or collection. Biochemical investigations revealed raised inflammatory markers and radiological investigations showed a rare inflammatory condition, acute suprascrotal vasitis, which is mistaken for various other 'surgical' groin masses. This case report summarizes the importance of realizing this differential diagnosis for an acute groin masses and how imaging can prevent unnecessary surgery. Case Presentation This 35 year old gentleman presented to A & E on the 27th of April, 2017 with a 5/7 day history of left lower quadrant pain which was constant in nature, increasing in intensity, and worsened by movement. There was no association with eating or opening bowels, he had no lower urinary tract symptoms, though he did show signs of sepsis. He had experienced rectal bleeding in the evening for the preceding week, and night sweats. He had a recent diagnosis of IBD (Inflammatory Bowel Disease) and IDDM (Insulin Dependent Diabetes Mellitus). He developed a swelling in his left groin, which was not reducible and had mild skin changes overlaying this. On examination, there were no scrotal signs of epididymitis, he was tender left lower quadrant and over his left inguinal canal. An USS (Ultrasound Scan) showed a no hernia, but inflammation within his inguinal canal. He was put on ciprofloxacin to cover possible epididymitis. Despite this he did not improve over the next week, so a CT abdomen/pelvis was done (Figure 1), showing a collection and inflamed vas from inguinal canal to seminal vesicles. He was changed to IV Meropenem for 72 hours, then stepped down to a higher dose of oral ciprofloxacin. His collection was drained using US guided aspiration. This gentleman was discharged home, and had his US guided aspiration of his collection as an outpatient procedure (Figure 2). Investigations USS-both testes and epididymi are symmetrical in size shape and echogenicity as well as color Doppler imaging. There is a small amount of left sided hydrocele and varicocele. There is diffuse thickening and enlargement of the left inguinal canal with mild increased vascularity within it. I suspect this represents an inflamed spermatic cord. CT (Figure 1)-normal liver, spleen, pancreas and both adrenals and both kidneys are normal calibre of the aorta, no paraaortic lymphadenopathy. Faecal residue is seen round the colon. The rest of the abdomen and pelvis is unremarkable. In the left groin region extending to the scrotum there is a localized fluid collection seen which measures approximately 5.9 cm × 3.2 cm in size .The exact nature of this collection is not clear? Cyst around the spermatic cord/? Localized abscess, USS (Figure 2)-there is a dense-fluid-collection measures approx 1.7 cm × 2.8 cm × 4.8 cm situated medially and dorsally to the spermatic cord in the upper inguinal canal. There are few tiny septation inside this collection. Differential Diagnosis Originally he was diagnosed with acute exacerbation of his IBD, as he was admitted with PR bleeding, high white cell count, and left lower quadrant pain. Due to the swelling in his groin he was then diagnosed to have a hernia which was excluded on the USS. Due to the swelling if his groin and the suspicion of the sonographer that he had an inflamed spermatic cord within his inguinal canal he was diagnosed with epididymo-orchitis, though due to the lack of scrotal signs this was ruled out. The CT scan was done to investigate if there was an intra-abdominal cause for his inguinal inflammation, though this proved acute suprascrotal vasitis. Matthew Megson*, Adam Jones and Sid Singh Department of Urology, George Eliot Hospital, UK Matthew Megson, et al., World Journal of Surgery and Surgical Research Neurosurgery 2018 | Volume 1 | Article 1037 2 Remedy Publications LLC., | http://surgeryresearchjournal.com Discussion The condition was first described in 1795 by Benjamin Bell [1]. It has often been confused with epididymitis, orchitis, testicular torsion, or inguinal hernia, with the correct diagnosis usually being made at the time of surgery [2], this surgery being unnecessary. On USS acute vasitis usually presents with infection combined with acute epididymitis, and it usually appears as a heterogeneously hypoechoic lesion in the scrotal segment, suprascrotal segment, or both [3]. Most of the literature denotes patients who have scrotal signs or have epididymitis as well as vasitis [4-9]. Whereas our patient had very minimal scrotal signs, which made the diagnosis more challenging to come to. The Pathogens are similar to those of epididymitis and are usually not isolated in the urine. For those patients less than age 40 years of age it could be an STI pathogen (Chlamydia, N gonorrhea) [10], or a UTI pathogen (Escheria coli, Haemophilus influenzae) [11]. For those patients over the age of 40 it is more likely to be UTI pathogens. Rare pathogens also described in case reports include Mycobacterium tuberculosis and Schistosoma haematobium [12,13]. In summary, this is a case of a rare condition which is often misdiagnosed. There is often confusion over the diagnosis which may result in unnecessary surgery. However, this is a condition which can be treated medically with antibiotics and therefore clarification of the diagnosis is essential. This is a diagnosis which should be thought of as a possibility for those patients presenting with an acute groin mass. Learning Points 1. There are many differential diagnoses for an acute groin mass, some of which do need urgent surgical intervention, others it's inappropriate to operate on. 2. If the patient does not improving during treatment for your working diagnosis then there is a need to re-evaluate the diagnosis. 3. This is likely an under reported diagnosis and therefore it should form part of your differential diagnosis of an acute groin mass. 4. A good sonographer/radiologist may be able to distinguish this on USS, however if not then a CT may be warranted. References 1. Bell B. A treatise on gonorrhea virulenta and lues venerea. Philadelphia: Printed for Robert Campbell, bookseller; 1795. 2. Eddy K. Acute Infectious Vasitis: Potentially Under-reported Condition Mimicking Inguinal Hernia. DAL. 2015. 3. Yang DM, Kim HC, Lee HL, Lim JW, Kim GY. Sonographic findings of acute vasitis. J Ultrasound Med. 2010;29(12):1711-5. 4. Bissada NK, Redman JF, Finkbeiner AE. Unusual inguinal mass secondary to vasitis. Urology. 1976;8(5):488-9. 5. Maitra AK. Odd inguinal swelling. Lancet. 1970;1(7636):45. 6. Ryan SP, Harte PJ. Suppurative inflammation of vas deferens: an unusual groin mass. Urology. 1988;31(3):245-6. 7. Wolbarst AL. The vas deferens, a generally unrecognized clinical entity in urogenital disease. J Urol. 1933;29(4):405-12. 8. Wilson SR, Katz DS. Computed tomography demonstration of epididymitis with extension to vas deferens. Urology. 2006;68(6):1339-40. 9. You SH, Sung DJ, Han NY, Park BJ, Kim MJ. Emphysematous vasitis misdiagnosed as strangulated inguinal hernia. J Emerg Med. 2014;47(1):e15-7. 10. Dylewksi J, Sygal V. Infectious vasitis caused by Chlamydia trachomatis. Infec Dis ClinPract. 2014;22(3):e16-7. 11. Chan PT, Schlegel PN. Inflammatory conditions of the male excurrent ductal system. Part II. J Androl. 2002;23(4):461-9. 12. Yang DM, Kim HC, Kim SW, Lee HL, Min GE, Lim SJ. Sonographic findings of tuberculous vasitis. J Ultrasound Med. 2014;33(5):913-6. 13. Durand F, Brion JP, Terrier N, Pinel C,  Pelloux H. Funiculitis due to Schistosoma haematobium: uncommon diagnosis using parasitologic analysis of semen. Am J Trop Med Hyg. 2004;70(1):46-47. Figure 1: This is a CT axial view through this patients' pelvis. This shows the inflamed left vas originating from the inguinal canal. Figure 2: This is an USS of the collection in this patients' left groin.


From Nov. 1978 to Dec. 1988, autotransfusion was done in 25 patients, of which 23 suffered from traumatic hemothorax and 2 from spontaneous hemothorax. The amount of blood autotransfused was 500-2300ml (average 950ml). The time elapsed from accident was 5-44 hours (average 21 hours). Two patients had febrile reaction for a short period of time after operation. The rest recovered uneventfully. Hematological examination revealed that the quality of the blood collected from hemothorax was similar to that of the systemic blood of the patients and was superior to the stored blood. Free hemoglobin determination showed that 40% was in normal value (average 18.9%), and hemolysis was less serious than that of the blood after CPB. The results of aerobic and anaerobic cultures were negative. We believe that the quality of the blood collected from traumatic hemothorax was quite acceptable, and autotransfusion with such blood was adequate not only for war casualties but also for everyday emergency patients.


Through-silicon via (TSV) technology has been widely investigated recently for 3-D electronic packaging integration. Reducing TSV wafer warpage is one of the most challenging concerns for successfully subsequent processes. In this paper, a wafer-level warpage modeling methodology has been developed by the finite element analysis method using an equivalent material model. The developed modeling methodology has been verified by numerical results and experimental data. Using the developed model, wafer warpage has been simulated and analyzed by considering different factors, such as annealing temperature, copper (Cu) overburden thickness, TSV depth, and diameter. Simulation results show that wafer warpage increases with increasing annealing temperature and Cu overburden thickness. Such findings have been successfully used in TSV process optimization to reduce wafer warpage after annealing process. A global-local modeling methodology has also been implemented to determine wafer stress accurately. Wafer bending stress is high at wafer surface and close to TSV edge. Wafer bending stress increases with increasing TSV diameter and it is higher at the edge of TSVs with finer pitch.


Modeling the cloud microphysics processes is essential to improve our understanding in climate changes and reduce the uncertainties in weather predictions. Aircrafts, remote sensing and ground-based infrastructures provide either sparse or coarse spatial measurements that are not sufficient to develop fine cloud models. UAVs have shown their ability to collect relevant cloud in-situ measures, and can be even more efficient when deployed in fleets. However, collecting relevant cloud data call for specific trajectories: this paper introduces a series of flight patterns dedicated to cloud exploration by a fleet of UAVs. The patterns definition comprise both a priori geometric information and real-time reactions to collected data. Results in simulated clouds assess their relevance for cloud in situ data collection.


Background: We are presenting a rare case of an elderly female who had been asymptomatic until the age of 56 years and had successfully completed three pregnancies. She presented with an episode of acute onset chest pain of moderate intensity and was initially suspected to have an evolved inferior wall myocardial infarction on the basis of the electrocardiogram. The echocardiogram performed subsequently surprisingly revealed the presence of a severe form of Ebstein`s anomaly. Methods & Results: Various forms of electrocardiographic abnormalities and conduction defects are reported in Ebstein's anomaly but the presence of a normal ECG pattern or pseudoinfarct pattern with the absence of any associated conduction blocks or axis deviation is highly unlikely especially in severe forms of the disease. There are three aspects of this cases which make it rare. Firstly, the presentation of a patient with severe form of Ebstein`s anomaly with an isolated evolved inferior wall myocardial infarction pattern on the ECG ,secondly the presence of an extra-ordinarily long asymptomatic period and thirdly the presentation with angina as the presenting symptom with normal epicardial coronaries. Key words : Ebstein`s pseudoinfarct pattern angina inferior wall infarction pattern normal coronaries.


Background: HIV counseling and testing is the critical entry-point for engagement into treatment and care as well as for primary and secondary HIV prevention efforts. Despite the importance of this step, most HIV infected patients globally, and particularly in resource-poor settings, are unaware of their HIV status and the uptake of voluntary counseling and testing (VCT) services is relatively limited. Objectives: To assess the magnitude of Provider Initiated Testing and Counseling (PITC) acceptance and disclosure and factors related to them among outpatient department patients. Methods: A facility-based cross-sectional quantitative survey was taken from December 1, 2010 to January 10, 2011 among 414 clients coming to the outpatient department in Debre Berhan Referral Hospital. Data were collected, entered into EPI info version 3.5.1 and analyzed using SPSS version 16. A logistic regression model was used to assess factors associated with PITC acceptance and disclosure of test results. Results: A total of 414 study participants (with a response rate of 100 %) responded to the questionnaire. Acceptance of PITC among OPD patients was 83.6%. Adjusted correlates of PITC acceptance included female gender (AOR=2.27, 95% CI=1.16-4.42) and knowledge about HIV transmission (AOR=4.08, 95% CI=1.98-9.91). Key barriers to accepting PITC included being apparently healthy (25%), being tested before (22.1%) and fear of stigma and discrimination (19.1%). Of the 346 respondents who accepted PITC, 288 (83.2%) had a plan to disclose their results to any other person. Compared with the age group 45 and above, those 15-24 years old were less likely to disclose their HIV status (AOR=0.16, 95% CI=0.04-0.62). Disclosure of test result was associated with occupation (AOR=5.42, 95% CI=1.44-20.43) and negative test result (AOR=4.00, 95% CI=1.53-10.47). Conclusion and recommendations: In this study, PITC acceptance was promising and should be expanded to other health facilities. Efforts should be strengthened to decrease factors which impede HIV test result disclosure.


Background: Hydrocephalus is a pathological condition caused by abnormalities of production or absorption of CSF in the brain. The goal of this study was to evaluate the current management and outcome of children (aged 13 years and below) who were treated for hydrocephalus in a single institution in Kenya. Methods: A retrospective analysis was conducted on 200 childrenwho were admitted to the neurosurgical unit at the Kenyatta National Hospital and diagnosed with hydrocephalus between January 2000 and April 2013. The records were analyzed for demographic characteristics, clinical presentation and management variables. Outcome was assessed according to the Glasgow Outcome Scale (GOS) score at the time of discharge from hospital. Results: There were 95 male (47.5%) and 105 female (52.5%) patients. The median age was 3.5 months. 16.5% had associated congenital anomalies, the commonest being spina bifida (18.2%) and dandy walker cyst (18.2%). 162 (81%) of the patients had surgical intervention which included shunts (92.6%), drains (0.6%), therapeutic aspiration (0.6%) and endoscopic third ventriculostomy (6.2%). Good functional recovery was achieved by 94.6% patients whereas residual disabilities accounted for 0.6% and mortality accounted for 4.8%. Conclusion: Outcome depended on initial AVPU score, admission into our Intensive Care Unit and type of management. Surgical management resulted in better outcome but vigilant monitoring for shunt complications is warranted. We recommend follow-up studies using population-based longitudinal data and quantitative quality-of-life measures to identify the specific long-term outcomes including the individual and social impacts of childhood hydrocephalus in Africa. Keywords: Functional outcome, Hydrocephalus, Pediatric neurosurgery


Background: Non-communicable diseases are the most common causes of death worldwide. Alongside mortality, noncommunicable diseases also cause high rates of morbidity and disability. The common comorbidity issues of depression worldwide are not a rare occurrence and as depression is chronic in nature it would double or even triple these health threats. Objectives: This paper highlights the epidemiology of the comorbidity of depression as a chronic non-communicable disease, highlighting the health effects of depression and examines specialized tools used to identify depression in patients. Methods: This literature search included the following computerized databases: MEDLINE, Academic Search Premier, Nexus, EBSCOhost, and CINAHL to review articles published from 1991 to 2012. The reviewed articles were quantitative and data were analysed using mostly different versions of SPSS® statistical package. Results and Conclusion: Worldwide established tools were utilized to identify depression in patients with non-communicable diseases. The validated tools include Beck's Depression Inventory, the Patient Health Questionnaire and the Hospital Anxiety and Depression Scale. The prevalence of depression was found to be significantly higher in those with chronic non-communicable diseases in all regions of the world. The health effects of depression found in literature review included a high morbidity and mortality, as well as increased health costs. Conclusion: Significantly higher depression among patients with chronic NCDs suggests that regular screening of depression in this population is warranted. Likewise, the use of validated tool for assessment of depression is essential. Keywords: Depression, Non-communicable diseases, comorbidity of depression and non-communicable diseases, detection of comorbidity


It is observed that an algorithm proposed in the 1980s for the solution of nonconvex constrained optimization problems is in fact a primal-dual logarithmic barrier interior-point method closely related to methods under current investigation in the research community. Its main distinguishing features are judicious selection and update of the multiple barrier parameters (one per constraint), use of the objective function as merit function, and careful bending of the search direction. As a pay-o , global convergence and fast local convergence ensue. The purpose of the present note is to describe the algorithm in the interior-point framework and language and to provide a preliminary numerical evaluation. The latter shows that the method compares well with algorithms recently proposed by other research groups.


Abstract. We conducted simulations using the Weather Research and Forecasting model coupled with Chemistry (WRF-Chem) version 3.5 to study air quality in East Asia at a spatial resolution of 20 km  ×  20 km. We find large discrepancies between two existing emissions inventories: the Regional Emission Inventory in ASia version 2 (REAS) and the Emissions Database for Global Atmospheric Research version 4.2 (EDGAR) at the provincial level in China, with maximum differences of up to 500 % for CO emissions, 190 % for NO, and 160 % for primary PM10. Such discrepancies in the magnitude and the spatial distribution of emissions for various species lead to a 40–70 % difference in surface PM10 concentrations, 16–20 % in surface O3 mixing ratios, and over 100 % in SO2 and NO2 mixing ratios in the polluted areas of China. WRF-Chem is sensitive to emissions, with the REAS-based simulation reproducing observed concentrations and mixing ratios better than the EDGAR-based simulation for July 2007. We conduct additional model simulations using REAS emissions for January, April, July, and October of 2007 and evaluate simulations with available ground-level observations. The model results illustrate clear regional variations in the seasonal cycle of surface PM10 and O3 over East Asia. The model meets the air quality model performance criteria for both PM10 (mean fractional bias, MFB ⩽ ±60 %) and O3 (MFB ⩽ ±15 %) at most of the observation sites, although the model underestimates PM10 over northeastern China in January. The model predicts the observed SO2 well at sites in Japan, while it tends to overestimate SO2 in China in July and October. The model underestimates observed NO2 in all 4 months. Our study highlights the importance of constraining emissions at the provincial level for regional air quality modeling over East Asia. Our results suggest that future work should focus on the improvement of provincial-level emissions especially estimating primary PM, SO2, and NOx.


N-Carboxymethyl chitosan (NCMC) is a water soluble derivative of chitosan. The NCMC beads were prepared by using ionotropic gelation process with the counter polyanion tripolyphoshate at pH 4.0 and characterized by scanning electron microscopy. The swelling behavior of the beads at different time intervals was monitored at different pH conditions. The in vitro drug release behavior in various pH solutions was studied using indomethacin as a model drug with two different concentrations (0.3 and 0.6% w/w). The release percent of indomethacin from NCMC beads was found to increase with increasing of pH in phosphate buffer solution medium due to the ionization of carboxymethyl group and high solubility of indomethacin in alkaline medium. These results indicated that the NCMC beads are useful for controlled drug delivery systems through oral administration by avoiding the drug release in the highly acidic gastric fluid region of the stomach.


Edmund Neville Hey ("Ed") was a pioneer in the care of newborn babies. He made major contributions to understanding babies' physiology, the evidence base for their clinical care, and perinatal epidemiology. Babies, especially those born prematurely, need to be kept warm; they need to be looked after by highly skilled nurses; and their care is best organised in tiers so that those needing the greatest medical and nursing expertise can be referred to centres with the necessary skills. Ed provided evidence on the physiology of thermal regulation and the organisation of neonatal care that continues to be central to clinical care and policy decisions today.

Ed's work on thermoregulation in babies was as a DPhil student in Oxford working with Kenneth Cross. After birth from a very warm environment babies very quickly lose heat especially if they are born too early. His early clinical training was in Oxford, but he was appointed consultant in respiratory paediatrics at Great Ormond Street Hospital before he moved to Newcastle as senior lecturer in child health in 1970. Here he came under the influence of Gerald Neligan, who was one of the first paediatricians to specialise in the care of newborn babies. Along with Mike Parkin, they developed a system of care which was comparatively non-interventionist at a time when others were developing much more intrusive care. They believed in doing simple things well and assisting nature's normal processes.

Hey recognised at an early stage the importance of data collection to evaluate …


Diffracted waves carry valuable information that can help improve our velocity modeling capability for better imaging of the subsurface. They are especially useful for anisotropic media as they inherently possess a wide range of dips necessary to resolve the angular dependence of velocity. We develop a scheme for diffraction traveltime computations based on perturbation theory for transverse isotropic media with tilted axis of symmetry (TTI). The formulation has advantages on two fronts: firstly it alleviates the computational complexity associated with solving the TTI eikonal equation and secondly it provides a mechanism to scan for the best fit anellipticity parameter without the need for repetitive modeling of traveltimes. The accuracy of such an expansion is further enhanced by the use of Shanks transform. We establish the effectiveness of the proposed formulation with tests on a homogeneous TTI model and the BP TTI model.


Modern day evaluation of thyroid disorders requires a combination of accurate clinical judgement and reliable, sensitive, and specific thyroid functions tests. Principle among the latter are thyroxine (T4) 3, 5, 3'-triiodothyronine (T3), and thyroid-stimulating hormone (TSH). Also playing an important role in special situations are free thyroxine, an assessment of bound and unbound thyroid-binding globulin, TRH stimulation, long-acting thyroid stimulator (LATS), antibodies to thyroid hormone and to thyroid receptors. Basic to interpretation of these tests in the clinical setting is a comprehension of the relationship of the hypothalamus, the pituitary, and the thyroid gland as well as a knowledge of the peripheral metabolism of thyroxine and triiodothyronine. The role of each of these laboratory tests in the evaluation of hyper- and hypometabolic states, their alteration in nonthyroid and other endocrine disorders, and the effects of environmental and physiological factors on these tests are reviewed.


Interconnection damping assignment passivity based control (IDA-PBC) is an emerging control design method which allows an engineer to systematically design an advanced controller for complex non-linear systems. As a result specific gain ranges can be determined which can prevent an operator (adversary) from accidentally (maliciously) setting control gains which could potentially destabilize the system. However in order to generate the controller the engineer will have to resort to using symbolic numerical solvers in order to complete the design. This can be both a cumbersome and error-prone task which can be automated. We present initial results of a tool which simplifies IDA-PBC. In addition many fluid control problems posses tight operating regions in which pumps degrade over time. As a result actuator saturation may occur for given set-point profiles which will lead to integrator wind-up and more oscillatory behavior. We provide a non-linear anti-windup control-law which greatly improves system resilience to such degradation. Finally we demonstrate that IDA-PBC works reasonably well for moderately large sampling times by simply applying the bilinear transform to approximate any additional (non-linear) integral control terms.


The first thing I need to say in response to this question is: I am not an art therapist. One half of my professional life is now spent running the MA in Participatory and Community Arts at Goldsmiths. For the rest of my time I identify myself as an advisor, consultant, trainer and practitioner using arts methodologies in other contexts. The reason the invitation to be part of this panel fascinated me was because, in many ways, what I do is not so dissimilar from the role of the art therapist; enabling growth and change through engagement with art. I am also aware that, especially outside the UK, the boundaries between what I call participatory arts and arts therapy are increasingly blurred. So how have my professional identity and my practice informed each other? Why do I call my work participatory art? And what is it in my individual history, education, training and professional context that has informed the way I identify myself? Being part of this panel provided me with a unique opportunity to interrogate all these questions.


This chapter considers the ways in which writing about Britain's canals, from the Duke of Bridgewater's Canal to the opening of the Manchester Ship Canal, took influence from, framed, and contributed to contemporaneous discourses of region and nation. It proposes that, while schemes and management were often local affairs concerned with specific regional trade and industry interests, successes were considered to be British, with engineering and organisational innovation seen as national points of pride. Writing about the waterways contributed to the overwhelming sense in this period that Britain was a modern (perhaps the modern) nation, despite its ancient institutions and the fact that it often followed the lead of others in canal technology. The chapter thus takes the well-understood early history of the waterways and considers the ways in which they were represented in relation to discourses of region, nation, and modernity of the eighteenth and nineteenth centuries, using interpretive methodologies from historical, literary, and social/cultural studies to interrogate a national social hydrological discourse. It connects specialist waterways history to the larger question of nationhood to demonstrate the ways in which an understanding of historical representation offers insight into the cultural dynamics of water management.


[1] We examine relations for hydraulic geometry of alluvial, single-thread gravel bed rivers with definable bankfull geometries. Four baseline data sets determine relations for bankfull geometry, i.e., bankfull depth, bankfull width, and down-channel slope as functions of bankfull discharge and bed surface median sediment size. These relations show a considerable degree of universality. This universality applies not only within the four sets used to determine the forms but also to three independent data sets as well. We study the physical basis for this universality in terms of four relations, the coefficients and exponents of which can be back calculated from the data: (1) a Manning-Strickler-type relation for channel resistance, (2) a channel-forming relation expressed in terms of the ratio of bankfull Shields number to critical Shields number, (3) a relation for critical Shields number as a function of dimensionless discharge, and (4) a "gravel yield" relation specifying the (estimated) gravel transport rate at bankfull flow as a function of bankfull discharge and gravel size. We use these underlying relations to explore why the dimensionless bankfull relations are only quasi-universal and to quantify the degree to which deviation from universality can be expected. The analysis presented here represents an alternative to extremal formulations to predict hydraulic geometry.


Abstract This paper reports on the influence the volume an organisation buys from alcoholic beverage suppliers has on their service quality expectations. The primary alcoholic beverage focus areas used in this study in the North West Province were Rustenburg, Mafikeng and Potchefstroom. A non-probability judgment sample method was used, and the sample size quantity was 220 respondents. The questionnaire requested respondents (high and low-volume) to rank their customer service expectations and opinions with reference to Parasuramans's service delivery dimensions. Ranking was done using a five-point Likert scale. The findings of the study indicated that both the high and low-volume customers felt that alcoholic beverage supplying companies had to deliver on all five service delivery dimensions but failed to do so to full satisfaction. There were also differences between the high and low-volume customers' opinions and expectations. Thus, the results indicated that there are differences between customers' (high and low-volume) expectations and opinions of service delivery from alcoholic beverage supply companies. These findings, if used strategically and as a guideline, can improve an alcoholic beverage supply company's retention and profit growth.


Coxiella burnetii is an intracellular bacterium and the causative agent of Q fever. The zoonotic impact of Q fever was recently underlined by the Dutch Q fever outbreak, which emerged from an endemic state. In this outbreak dairy goats and dairy sheep were deemed responsible for the human cases, although information about the genetic background of human and animal isolates was lacking. Also tissue dissemination, excretion pathways and immune responses in C. burnetii-infected goats are still poorly understood. The aim of this thesis is to investigate the epidemiology and pathogenesis of C. burnetii infection in goats in the recent large outbreak of Q fever in the Netherlands. The epidemiology of C. burnetii was studied by characterising outbreak isolates from infected goats, sheep and humans using multiple locus variable number tandem repeats analysis (MLVA) and multispacer sequence typing (MST). In addition, potential presence of the Q fever agent in roe deer, cats, dogs, pigs, horses and cattle was investigated. Pathogenesis, excretion patterns and immune responses were investigated during experimental infections in pregnant goats inoculated with a Dutch outbreak isolate. Genotypic characterisation revealed that one unique genotype of C. burnetii was predominantly present in dairy goat herds representing 60% of all dairy goat herds with abortion problems, and in two sheep herds in the human Q fever outbreak area in the south of the Netherlands. This genotype was also present in human outbreak samples. In roe deer, dogs, horses and cattle samples C. burnetii DNA was detected. Genotyping results suggest species-specific genotypes for roe deer and cattle that are unrelated to the Dutch outbreak genotype, although the outbreak genotype was detected in one bovine placenta. In experimental infections, pregnant goats were successfully inoculated via the intranasal route. C. burnetii showed a strong tropism towards the placenta. Bacterial replication seemed to occur predominantly in the trophoblasts of the placenta and not in other organs of goats or kids. High numbers of C. burnetii were excreted during abortion, but also during parturition of liveborn kids. C. burnetii was not detected in faeces or vaginal mucus before parturition. Two weeks post-inoculation a strong anti-C. burnetii Phase 2 IgM and IgG antibody response was observed, succeeded by an anti-Phase 1 response. Four weeks before parturition, the number of IFN-γ producing cells in peripheral blood increased and reached high levels during the first week after parturition. These results confirm dairy goats and sheep as the source of the Dutch Q fever outbreak, while in cattle a specific cluster of C. burnetii genotypes was found, unrelated to the outbreak genotype. C. burnetii has a strong tropism for the trophoblasts of the placenta and is not excreted before parturition; pathogen excretion occurs during birth of dead as well as live, healthy kids. Upon C. burnetii infection a strong phase-specific antibody response is detected. This may be useful in the early detection of C. burnetii-infected pregnant goats. These animals should be considered as a major zoonotic risk via abortions, but also via normal deliveries


Instrumental assessment techniques are needed to acquire quantitative information concerning the form and function of the nasal cavity. Until recently, aerodynamic methods were virtually the only source of such information. Two additional instruments are now available that purport to provide information useful to clinicians interested in assessing nasal form and function. This paper describes both the Nasometer and the acoustic rhinometer. In addition, a more traditional measure involving acoustic analysis of nasal consonants is discussed. Both the known and potential benefits and limitations of each technique are discussed.


The electronic efficiency and binding energy of contacts formed between graphene electrodes and poly-aromatic hydrocarbon (PAH) anchoring groups have been investigated by the non-equilibrium Green's function formalism combined with density functional theory. Our calculations show that PAH molecules always bind in the interior and at the edge of graphene in the AB stacking manner, and that the binding energy increases following the increase of the number of carbon and hydrogen atoms constituting the PAH molecule. When we move to analyzing the electronic transport properties of molecular junctions with a six-carbon alkyne chain as the central molecule, the electronic efficiency of the graphene-PAH contacts is found to depend on the energy gap between the highest occupied molecular orbital (HOMO) and the lowest unoccupied molecular orbital (LUMO) of the corresponding PAH anchoring group, rather than its size. To be specific, the smaller is the HOMO-LUMO gap of the PAH anchoring group, the higher is the electronic efficiency of the graphene-PAH contact. Although the HOMO-LUMO gap of a PAH molecule depends on its specific configuration, PAH molecules with similar atomic structures show a decreasing trend for their HOMO-LUMO gap as the number of fused benzene rings increases. Therefore, graphene-conjugated molecule-graphene junctions with high-binding and high-conducting graphene-PAH contacts can be realized by choosing appropriate PAH anchor groups with a large area and a small HOMO-LUMO gap.


Serpentine are the soils derived from 'serpentinised' (altered by hydration) ultramaffic rocks. These are poor in plant-essential nutrients, organic matter, water availability, etc., but, rich in Mg, Fe, and heavy metals Ni, Cr and Co. Serpentine flora may be assisted by various bioactivities beneficial for mankind. This study aimed to investigate the antimicrobial properties of selected serpentine plant species from two serpentine sites in Sri Lanka: Ussangoda (in Hambantota District) and Yodhaganawa (inside Wasgomuwa National Park). Eleven (11) plant samples from 10 species were collected from the two serpentines for screening for antimicrobial activity against Gram positive (Bacillus cereus, Staphylococcus aureus) and Gram negative (Escherichia coli, Pseudomonas aeruginosa) bacteria, and fungi (Aspergillus niger, Candida albicans, Trichodermavirens). Plant materialsof 04 species were collected from both the serpentine and the neighboring non-serpentine soils in Ussangoda, for comparative analysis of the effect of substrate on the antimicrobial activity of these plants. Crude extracts were obtained by soaking dried, powdered leaf material in 1:1 mixture of Methanol: Dichloromethane for two weeks and subsequent concentrating. Samples re-dissolved in 10% DMSO in methanol were used in the Kirby- Bauer Antibiotic Disc Diffusion Assay and Micro-Titre Plate Based Resazurin Assay. Data obtained from the assays were analyzed using SPSS 16.0 software. When screened, 10 extracts (Azadirachta indica, Lantana camara, Toddalia asiatica, Eupatorium odoratum, Bauhinia racemonsa, Carissa spinarum, Garcinia spicata, Atalantia monophylla, Tarenna asiatica) showed activity against at least one test microorganism. The extract of Tarennaasiatica showed activity against all the test microorganisms. Sapindus saponaria extract did not show activity against any of the test organisms. When comparing, Azadirachta indica extract did not show any significant difference (P>0.05) in the mean diameter of the inhibition zone (±SD) between the serpentine site and the adjacent non-serpentine site for all the tested bacterial species. However, significantly higher (P<0.05) mean diameter of the inhibition zone (±SD) against E. coli was shown by the serpentine Lantana camara extract (13.3±1.1mm) compared with the non-serpentine plant extract(mean diameter of the inhibition zone 9.5±0.9mm). In contrast, non-serpentine extract of Eupatorium odoratum showed slightly higher activity than that of the serpentine plant extract against the same bacterial strain, with respective mean diameters (±SD) of inhibition zones being 10±0.9 mm and 8±0.8 mm. The results indicate that serpentine flora may have altered antimicrobial activities compared to the plants of the same species growing in non-serpentine soils, probably due to the influence of the serpentine substrate. Keywords: Serpentine, Ultramaffic, Plants, Bioactivities, Antimicrobial, Properties


Cloud storage auditing is viewed as an important service to verify the integrity of the data in public cloud. Current auditing protocols are all based on the assumption that the client's secret key for auditing is absolutely secure. However, such assumption may not always be held, due to the possibly weak sense of security and/or low security settings at the client. If such a secret key for auditing is exposed, most of the current auditing protocols would inevitably become unable to work. In this paper, we focus on this new aspect of cloud storage auditing. We investigate how to reduce the damage of the client's key exposure in cloud storage auditing, and give the first practical solution for this new problem setting. We formalize the definition and the security model of auditing protocol with key-exposure resilience and propose such a protocol. In our design, we employ the binary tree structure and the preorder traversal technique to update the secret keys for the client. We also develop a novel authenticator construction to support the forward security and the property of blockless verifiability. The security proof and the performance analysis show that our proposed protocol is secure and efficient.


The yeast Torulaspora delbrueckii, which propagates as a haploid, was made into a diploid by treatment with dimethyl sulfoxide (DMSO) on the regeneration of protoplasts. The diploid state was stably inherited; the cell volume was three times that of the parent strain and the cellular DNA content was two times that of the parental strain. No essential difference was found between diploids induced by DMSO and those formed through intraspecific protoplast fusion. The diploid strains sporulated fairly well, with their cells converting directly into asci. Random spore analysis revealed that diploids induced through protoplast fusion gave rise to auxotrophic segregants (haploids) with the parental genetic marker or to segregants formed by recombination, while diploids induced by DMSO from a doubly auxotrophic parent gave rise to no recombinant, indicating that it was chromosomally homoallelic in nature. The magnesium level in the protoplast regeneration medium was found to be an important factor for inducing diploid formation. At 0.2 mM magnesium diploids appeared even in the absence of DMSO, while at 2 mM magnesium diploids never appeared unless DMSO was added to the regeneration medium. Evidence is provided that the diploids induced by DMSO or a low magnesium level are due to direct diploidization but not protoplast fusion. UV light irradiation of intact cells (without protoplasts), 10% of which survived, also produced diploids among this surviving population. From these results we conclude that the perturbation of protoplast regeneration or of cell division by the treatments mentioned above somehow induced direct diploidization of T. delbrueckii.


We provide a model-free framework to study the global factor structure of exchange rates. To this end, we propose a new methodology to estimate international stochastic discount factors (SDFs) that jointly price cross-sections of international assets, such as stocks, bonds, and currencies, in the presence of frictions. We theoretically establish a two-factor representation for the cross-section of international SDFs, consisting of one global and one local factor, which is independent of the currency denomination. We show that our two-factor specification prices a large cross-section of international asset returns, not just in- but also out-of-sample with R2s of up to 80%.


ABSTRACT ObjectiveThe aim of this study was to evaluate the effectiveness of two amoxicillin protocols for antibiotic prophylaxis in implant placement surgeries. MethodsA clinical study was performed with 66 volunteers of both genders (mean 51,9 ± 2,5 years) that met the inclusion criteria and were randomly assigned into 2 groups: Group 1 (n=35) – oral administration of amoxicillin (2g) 1 hour before the surgical procedure and Group 2 (n=31) oral administration of amoxicillin (2g) 1 hour before the surgical procedure and 500mg every 8 hours during 7 days after the surgeries. The following clinical parameters were evaluated: adverse reactions, pain and implants failure. The pain was evaluated in the surgery day (before, immediately after and at night), 24h, 48h, 72h and one week after the surgery and other clinical parameters were evaluated in daily appointments until the third postoperative day, 7 days and three months after the surgeries. Data were analyzed and statistical significance was 5%. ResultsAdverse reactions (headache, diarrhea, stomachache and nauseas) and implant failure occurred only in G2 (4 volunteers and 3 implants, respectively). Regarding pain, higher values for G2 on "at the night (p=0.0043), 24h (p=0.0013), 48h (p=0.0187) e 72h (p=0.0445) were observed. ConclusionThe present study showed that a single dose of amoxicillin was effective in antibiotic prophylaxis in implant placement surgeries, suggesting that the use of amoxicillin in the postoperative period did not bring additional benefit. Indexing terms: Amoxicilin. Antibiotic prophylaxis. Dental implants.


The difficulties of regular drug intake in long term treatments for psychotic patients gave rise to the need of using medicines at the longest possible intervals, facilitating thus adequate control and regularity. Penfluridol is a neuroleptic meeting that requirement: it is necessary only one dose per week. This paper reviews the results of Penfluridol in 26 patients (20 inpatients and 6 outpatients), ages between 17 and 54 with a mean of 36.8, sex feminine, and the following diagnoses: schizophrenia, paranoid: 14, simple: 8, hebephrenic: 3, catatonic: 1. The patients, divided in two groups of 13 each, had one oral dose a week, of between 10 and 100 mg, during 90 days. The first group took only Penfluridol, suppressing any other medicaments. The other group added Penfluridol to the prescriptions already in use. The results, as described in tables I and II, were evaluated according to 36 items. The general evaluation was positive with no negative biases. The side effects were scarce and temporary: insomnia in 7 cases during the first week, and extra-pyramidal symptoms in another 7 cases, that were controlled with antiparkinsonians. The conclusion is that Penfluridol is a valuable contribution to longterm treatments in psychoses.


Numerical simulation of nonlinear waves to reproduce the laboratory measurements has been a topic of great interest in the recent past. The results reported in the literature are mainly focused on qualitative comparison or on the relative errors between the numerical simulation and measurements in laboratory and hence lack in revealing the existence of phase shift in nonlinear wave simulation. In this paper, the simulation of nonlinear waves in mixed Eulerian and Lagrangian framework using finite element method (FEM) is investigated by applying two different velocity calculation methods viz, cubic spline and least squares (LS). The simulated wave surface elevation has been compared with the experimental measurements. The coherence analysis has been carried out using the wavelet transformation, which gives a better understanding between the numerical and the experimental results with respect to the time–frequency space, compared with the conventional Fourier transformation. It is observed that the application of cubic spline approach leads to a higher phase difference for steeper waves. The present study has shown that the phase difference exists at the higher modes rather than at the primary period. For waves with steepness (wave height/wave length) higher than 0.04, LS approach is found to be effective in capturing the higher‐order frequency components in the event of nonlinearity. In addition, the comparison of numerical simulations with that from PIV measurements for the tests with solitary waves is also reported. Copyright © 2009 John Wiley & Sons, Ltd.


Introduction Trauma-focused psychotherapy for post-traumatic stress disorder (PTSD) is effective in about half of all patients. Investigating biological systems related to prospective treatment response is important to gain insight in mechanisms predisposing patients for successful intervention. We studied if spontaneous brain activity, brain network characteristics and head motion during the resting state are associated with future treatment success. Methods Functional magnetic resonance imaging scans were acquired from 46 veterans with PTSD around the start of treatment. Psychotherapy consisted of trauma-focused cognitive behavioral therapy (tf-CBT), eye movement desensitization and reprocessing (EMDR), or a combination thereof. After intervention, 24 patients were classified as treatment responders and 22 as treatment resistant. Differences between groups in spontaneous brain activity were evaluated using amplitude of low-frequency fluctuations (ALFF), while global and regional brain network characteristics were assessed using a minimum spanning tree (MST) approach. In addition, in-scanner head motion was assessed. Results No differences in spontaneous brain activity and global network characteristics were observed between the responder and non-responder group. The right inferior parietal lobule, right putamen and left superior parietal lobule had a more central position in the network in the responder group compared to the non-responder group, while the right dorsolateral prefrontal cortex (DLPFC), right inferior frontal gyrus and left inferior temporal gyrus had a less central position. In addition, responders showed less head motion. Discussion These results show that areas involved in executive functioning, attentional and action processes, learning, and visual-object processing, are related to prospective PTSD treatment response in veterans. In addition, these findings suggest that involuntary micromovements may be related to future treatment success.


Acculturation of expatriate executive managers was examined in the sample of 16 sojourners transferring managerial know-how to companies in Czechia, using a structured longitudinal interview survey including in depth personal interviews. The interviews were conducted six and eighteen months after the arrival of respondents in Czechia. The respondents were contacted as they became available during the period 2006 to 2010. The results indicate that acculturation of sojourners in Czechia proceeded, as expected according to the international literature, broadly in line with the Hofstede's acculturation "U" curve (Hofstede 1997). The qualitative analysis points to a number of problems, the sojourners had to deal with during their acculturation including: dependence on communication in English, while recognising potential advantages associated with the knowledge of Czech language, cultural distance – particularly the uncertainty arising from the inability to correctly predict Czech behaviour, lack of openness limiting the Czech ability to form a broader world view, lack of mutual respect between the Czech co-workers, a degree of Czech xenophobia and underestimation of certain predictors of successful acculturation such as social engagement with the Czech hosts. Research also points to a number of helpful coping strategies.


Weeds can bring benefits to agriculture, but when incorrectly managed they can compete with commercial crops for resources. The objective of this work was to evaluate the effect that cover crops, associated with Coffea canephora cv. Conilon, imposes to the weed community. Cover crops were planted between the rows of a 6.5 years old organic coffee plantation spaced 2.0 x 1.5 m. The experiment was arranged in a complete randomized block design, with four replications, in a factorial scheme with the following treatments: control, Pennisetum glaucum and the legume plants: Canavalia ensiformis, Mucuna deeringiana and Cajanus cajan , with and without Rizobium inoculation. Cover crops dry weight and nutrient contents on coffee trees were determined. Weeds density, frequency, relative abundance, importance value index and plant similarity index were also determined. Twenty seven weed species were identified, with special emphasis on Bidens subalternans and Commelina benghalensis . Cover crops promote modifications on the succession dynamics of weeds and do not interfere with the development of the coffee trees. Canavalia ensiformis, Mucuna deeringiana and Pennisetum glaucum help on weed control.


In many real world planning scenarios, agents often do not have enough resources to achieve all of their goals. Consequently, they are forced to find plans that satisfy only a subset of the goals. Solving such partial satisfaction planning (PSP) problems poses several challenges, including an increased emphasis on modeling and handling plan quality (in terms of action costs and goal utilities). Despite the ubiquity of such PSP problems, very little attention has been paid to them in the planning community. In this paper, we start by describing a spectrum of PSP problems and focus on one of the more general PSP problems, termed PSP NET BENEFIT. We develop three techniques, (i) one based on integer programming, called OptiPlan, (ii) the second based on regression planning with reachability heuristics, called AltAltps, and (iii) the third based on anytime heuristic search for a forward state-space heuristic planner, called Sapaps. Our empirical studies with these planners show that the heuristic planners generate plans that are comparable to the quality of plans generated by OptiPlan, while incurring only a small fraction of the cost.


CONTEXT
The Closing the Quality Gap series from the Agency for Healthcare Research and Quality summarizes evidence for eight high-priority health care topics: outcomes used in disability research, bundled payment programs, public reporting initiatives, health care disparities, palliative care, the patient-centered medical home, prevention of health care-associated infections, and medication adherence.

OBJECTIVE
To distill evidence from this series and provide insight into the "state of the science" of quality improvement (QI).

METHODS
We provided common guidance for topic development and qualitatively synthesized evidence from the series topic reports to identify cross-topic themes, challenges, and evidence gaps as related to QI practice and science.

RESULTS
Among topics that examined effectiveness of QI interventions, we found improvement in some outcomes but not others. Implementation context and potential harms from QI activities were not widely evaluated or reported, although market factors appeared important for incentive-based QI strategies. Patient-focused and systems-focused strategies were generally more effective than clinician-focused strategies, although the latter approach improved clinician adherence to infection prevention strategies. Audit and feedback appeared better for targeting professionals and organizations, but not patients. Topic reviewers observed heterogeneity in outcomes used for QI evaluations, weaknesses in study design, and incomplete reporting.

CONCLUSIONS
Synthesizing evidence across topics provided insight into the state of the QI field for practitioners and researchers. To facilitate future evidence synthesis, consensus is needed around a smaller set of outcomes for use in QI evaluations and a framework and lexicon to describe QI interventions more broadly, in alignment with needs of decision makers responsible for improving quality.


We study the locality properties of the vortex operators in compact U(1) MaxwellChern-Simons and SU(N) Yang-Mills-Chern-Simons theories in 2+1 dimensions. We find that these theories do admit local vortex operators and thus in the UV regularized versions should contain stable magnetic vortices. In the continuum limit however the energy of these vortex excitations generically is logarithmically UV divergent. Nevertheless the classical analysis shows that at small values of CS coefficient κ the vortices become light. It is conceivable that they in fact become massless and condense due to quantum effects below some small κ. If this happens the magnetic symmetry breaks spontaneously and the theory is confining. PACS:


Surface water chemistry from a tropical and temperate rivers system was studied in order to understand the controls on longitudinal variation of stream chemistry. In the Rio Icacos-Blanco system in Puerto Rico, I examined changes in stream chemistry associated with a change in bedrock composition from intrusive quartz diorite (upstream) to volcaniclasitc material (downstream). Overall, after sea-salt correction, most solutes decreased consistently with distance downstream. The silica to alumina ratio, however, changed sharply with changes in the underlying bedrock. Other indices of weathering rates and processes showed strong similarities despite the change in bedrock. The dominance of silica, alkalinity, calcium and sodium (after sea-salt correction) in surface waters suggests that anorthite and albite are the dominant minerals within the entire basin, and they are weathering rapidly (silicon to Na + K ≥4) with the bisiallitization type of weathering (silica to alumina >2). Human influences on river chemistry in the Icacos-Blanco system appear to be minor, as nutrients (N and P) show little change along the drainage network. Sampling of tributaries and source points at high and low elevation within the uniform intrusive bedrock of the Icacos was undertaken to identify spatial variability in weathering processes. Landslides are frequent in the basin, and expose fresh mineral surfaces to weathering. Concentrations of weathering products were inversely related to pCO2, suggesting that the availability of primary reactive minerals, rather than carbonic acid concentrations, limits weathering. In the temperate Bagmati drainage system in Kathmandu valley, Nepal, population density appears to be the most fundamental control on the chemistry of surface waters. Concentrations in the Bagmati were extraordinarily high for nitrogen and phosphorus, and both nutrients and major ions were found in proportions similar to those in raw domestic sewage. The contribution of chemical weathering processes to water quality of the Bagmati does not seem to be significant within the Kathmandu valley. Ammonium contributes almost all nitrogen in the total dissolved nitrogen and the concentration of nitrate is negligible, probably due to rapid denitrification and limited nitrification within the stream channel under relatively low oxygen conditions.


Credit rating agencies state that their clients prefer ratings that are stable as well as accurate. While accuracy could in some cases be increased by tracking market-based credit signals more closely, the required increase in rating volatility might be substantial. In this article, we discuss why users of the rating system may value both accuracy and stability and why a tradeoff between the objectives may be unavoidable. We illustrate the potential tradeoff by comparing the combinations of the accuracy and stability associated with the many different "rating systems" that can be derived by applying various filters to Moody's-KMV's expected default frequencies ("EDFTM's). The performance of Moody's traditional ratings—both adjusted and unadjusted for rating reviews and outlooks—is then compared to the performance of the various filtered versions of EDF-implied ratings.


It is important to understand the occupant behavioural response in fire emergency in high-rise buildings so that proper decisions for a fire safety management plan could be made. In this study, behavioural responses of building occupants to an audible fire alarm cue in high-rise buildings in Hong Kong were investigated by a survey of 327 building occupants. They were divided into two groups, where Group 1 had experienced a building fire before while Group 2 had not. The results showed that occupant experience of fire incidents might influence their perception of a fire alarm cue. Group 1 respondents would likely recognize an audible fire alarm cue as a true fire alarm and give immediate response, while the Group 2 respondents would treat the cue as a false alarm or a fire alarm test. Group 2 respondents would investigate the situation if only the fire alarm sustained for a few minutes. Regarding the evacuation routes, respondents tended to select a staircase for emergency evacuation. The choice of route did not depend on the floor on which the evacuation of an occupant started. Apart from the nearest staircase, some occupants would choose a familiar staircase. The results of this study would be a useful source of reference for evacuation plan development of high-rise buildings by taking human behaviour into account.


We present the discovery of a unique object, a chemically peculiar Ap-type star showing fi Scuti pulsations that, is bound in an eclipsing binary system with an orbital period shorter than 3 d. HD 99458 is therefore a complex astrophysical laboratory opening doors for studying various, often contradictory, physical phenomena at the same time. It is the first Ap star ever discovered in an eclipsing binary. The orbital period of 2.722 d is the second shortest among all known chemically peculiar (CP2) binary stars. Pulsations of (S Scuti type are also extremely rare among CP2 stars and no unambiguously proven candidate has been reported. HD 99458 was formerly thought to he a star hosting an exoplanet, but we definitely reject this hypothesis using photometric observations from the K2 mission and new radial velocity measurements. The companion is a low-mass red dwarf star (M? = 0.45(2)Mo) on an inclined orbit (i = 73.2(6) deg) that shows only grazing eclipses. The rotation and orbital periods are synchronized, while the rotation and orbital axes are misaligned. HD 99458 is an interesting system deserving of more intense investigations.


Abstract Cytochrome c oxidase (CcO) is an enzyme that catalyzes efficient, selective, and fast reduction of molecular oxygen to water as a means of respiratory energy generation. The biomimetic approach provides a valuable alternative to traditional biochemical methods to unravel the structural and electronic properties of the CcO's catalytic (heme/CuB) site that endow the enzyme with its unique reactivity. However, the contribution of biomimetic studies of CcO to our understanding of CcO's biochemistry has been complicated by the lack of convincing evidence that the reactivity of the biomimetic analogs is relevant to that of CcO. Recently reported porphyrin-based compounds are the first analogs that reproduce key aspects of the reactivity of CcO toward O2. Extensive data collected with these biomimetic analogs demonstrate that the bimetallic nature of the CcO's catalytic site may be an adaptation to reduction of O2 under turnover-limiting electron flux; a monometallic heme-only site appears sufficient for rapid O2 reduction under physiologically relevant conditions of pH and electrochemical potential, provided that electron flow to the heme is not kinetically limited. These biomimetic data suggest that in CcO the distal Cu ion (CuB) may serve as an electron-preloading site to allow the enzyme to accumulate a sufficient number of external reducing equivalents before it even binds O2. This mechanism minimizes the population of enzymatic species containing partially reduced oxygen species.


Abstract. A web-based survey to assess the benefits and gaps in reanalyses as part of growing climate services was carried out in 2013–2014. The survey elicited responses from about 2500 users of climate information. One of the eleven survey points specifically addressed the observations used in reanalysis, with a multiple-choice question "Have you used reanalysis input observations and feedback data?". Almost half of the respondents admitted to not knowing what such data were about. Among the others, specific queries asked for these observations to be made available more openly. This paper summarizes the main findings in regard to use of existing reanalyses as well as user awareness and needs in regard to reanalysis feedback data and input observations. In the future, the information obtained via the survey makes it possible to perform various statistically robust analyses addressing different aspects of the use of reanalysis data.


This chapter tries to reread, or to hear again, examples of the ways popular music has been used in some recent productions of Shakespeare. Given their number, this account can only be selective, suggesting ways of addressing what happens when popular music meets Shakespearean performance that go beyond the focus here on two different productions: one fairly faithful to an editorially established Shakespearean text, and one looser, more radical adaptation. In turn, this chapter contributes to a field of study developed by Stephen Purcell in his Popular Shakespeare, where he says 'an area … which remains as yet relatively unexplored is that of Shakespeare and 'the popular' in performance'. We might note that there has been even less attention paid to Shakespeare and popular music in performance, and this silence continues. Titus Andronicus, directed by Pia Furtado in 2014 in a Peckham car park, featured 'beatboxing, breaking and more'. One review praised the production's 'visual impact', while complaining it was 'full of loud music': this was the extent of the analysis of the staging's sonic aesthetic. This chapter's rereading, or rehearing, tries to address several questions, questions informed by research into the interactions between music and literature, as articulated by William E. Grim: The first way in which music may influence literature is on the inspirational level. … This is the case of music being the writer's muse. … Music can also influence literature at a metaphorical level. At this level, music serves as the subject matter, point of departure, or intertextual reference within the work of literature. … The third type of influence that music may have on literature is at the formal level. At this level, the work of literature utilizes or attempts to imitate musical forms and/or compositional procedures within a literary context. On reading this, one might wonder what it has to do with popular music in recent Shakespearean performance. Grim focusses on what classical (not popular) music does to or for literature as text (not as performance), and on the creation of texts (not their consumption).


This paper uses a new dataset of 3,717 US CEO employment contracts to study the time horizon of CEOs. Longer contracts offer better protection against dismissals: turnover probability increases by 20% each year that passes towards contract expiration. In theory, this should encourage CEOs to pursue long-term projects. Using an instrumental variable approach based on inter-state judicial differences, I show that contract horizon is indeed positively correlated with investment. However, longer contracts also make it harder to dismiss undisciplined managers and therefore impose less discipline. Consistent with this argument, CEOs under short-term contracts perform better in (the fewer) acquisitions that they make, and CEOs under longer contracts enjoy more salary increases and perquisites. Overall, firm value does not differ across contract types.


In this paper we introduce a pitch wave force predictor for a wave energy converter. The designed predictor is composed of two subsystems. First, we design a virtual sensor in order to provide a real-time estimate of the pitch wave force acting on the converter, from measurements provided by a set of on-board sensors. Then, we build an autoregressive predictor on such a virtual measurement to predict the future value of the wave force over a finite prediction horizon length. Simulation results, performed by applying the proposed algorithm on a first-principles based Simulink model of the considered sea wave energy converter, demonstrate the effectiveness of the proposed approach.


Direct-sequence code division multiple access (DS-CDMA) is a promising uplink access technology for broadband cellular mobile communication systems. In this paper, we propose a joint transmit (Tx)/iterative receive (Rx) frequency-domain equalization (FDE) for DS-CDMA. In the proposed scheme, simple one-tap FDE at the transmitter and iterative one-tap FDE at the receiver are jointly performed using the common knowledge of channel state information (CSI). Before transmitting the signal, the transmitter predicts the degree of residual inter-chip interference (ICI) power after the iterations of Rx FDE to determine the Tx FDE weight while the receiver performs the iterative Rx FDE. In practice, it is almost impossible to share the perfect knowledge of CSI. In this paper, a Gaussian approximation of channel estimation (CE) errors is introduced. We theoretically derive a set of Tx and iterative Rx FDE weights based on the minimum mean square error (MMSE) criterion in the presence of the CE error. We show by computer simulation that the proposed scheme provides better bit error rate (BER) performance than the conventional scheme which uses iterative Rx FDE only (i.e., without Tx FDE) even in the presence of CE error. Copyright © 2010 John Wiley & Sons, Ltd.


The study examines the role of intersectoral linkages in the Punjab economy which is an agriculturally dominant state. Rapid growth in the agricultural sector had widespread impact on the entire economy. To increase agricultural production the industrial sector had to cope up with this sector, Growth in the agricultural seetor generated a strong demand for industrial consumption goods thus promoting the growth of the non-farm sector along with its own growth. further improvements in the growth rates in the agricultural sector would require the industrial sector to improve at an even taster rate.


Interconnected porous MnO nanoflakes on nickel foam were prepared by a reduction of hydrothermal synthesized MnO2 precursor in hydrogen. The architectures were applied to lithium ion batteries as electrodes. Compared with the as-synthesized MnO2 anode, porous MnO nanoflakes showed superior cycling stability and rate performance. A high reversible capacity of 568.7 mA h g−1 was obtained at a current density of 246 mA g−1 for the second discharge. It retained a capacity of 708.4 mA h g−1 at the 200th charge–discharge cycle after cycling with various current densities up to 2460 mA g−1 and delivered a capacity of 376.4 mA h g−1 at a current density as high as 2460 mA g−1, indicating that the architecture of the porous MnO nanoflakes grown on Ni foam is a promising electrode for lithium ion batteries.


In this issue of theArchives, Hansen and associates 1 present data from a chart audit reflecting physician behavior in the interpretation of RBC indexes. The authors begin with the fact that patients having low mean RBC volumes and high RBC counts relative to those volumes will commonly be found to have thalassemic syndromes if properly examined. Physicians working in areas with large populations of patients from racial stock originating in the Mediterranean basin and large populations of black patients have had to concern themselves with this problem for years. Now the influx of refugees from Southeast Asia increases the numbers of persons at risk and distributes the problem to new regions of this country. Additionally, the need for cost control in medical care increases the incentive to make appropriate clinical decisions based on relatively inexpensive tests such as RBC indexes. Since RBC indexes are routinely provided as part of


The Upper Jurassic–Lower Cretaceous carbonate sediments developed in a narrow, Ukrainian part of the basement of the Carpathian Foredeep show high facies diversity. Based upon thin section studies, the authors identified eleven principal microfacies varieties. Three main stages of development of carbonate platform were distinguished: (i) Oxfordian–Early Kimmeridgian, (ii) Kimmeridgian–Tithonian, and (iii) Berriasian–Valanginian. The Oxfordian sediments are rather thin and represent both the outer and inner, distally steepened ramp facies. In the Late Kimmeridgian and, mainly, in the Tithonian, the intensive growth of rimmed platform took place with distinct zones of peritidal, margin barrier and platform slope, bearing calciturbidite facies. Development of the rimmed platform was controlled by synsedimentary tectonic movements along faults rejuvenated southwest of the Holy Cross Mts. Fault Zone. In the Berriasian–Valanginian, the dominant process was sedimentation onto not-rimmed platform controlled by small sea-level changes.

Both the facies development and literature data indicate that the Late Jurassic sedimentation in the Ukrainian part of the Carpathian Foredeep basement shows considerable differences in comparison to that of the Polish part. In the studied successions, large Oxfordian microbial-siliceous sponge reef complexes, known from the Polish part of the Carpathian Foredeep basement and other areas in Europe, were rare. In the study area carbonate buildups were encountered mainly in the intervals representing the Upper Kimmeridgian–Tithonian where small, microbial-sponge and microbial-coral biostromes or patch-reefs were formed. Their growth was presumably restricted to a narrow zone of the upper slope, close to ooidal-bioclastic margin platform facies. In the Polish part of the Carpathian Foredeep basement, the Late Jurassic sedimentation took place on a vast, homoclinal ramp while in the Ukrainian part it proceeded on a narrow, distally steepened ramp and rimmed platform with distinct marginal platform barrier. Similar platform facies distribution in both regions appeared mainly in the Early Cretaceous, although with some stratigraphical differences.

The facies distribution of the Upper Jurassic sediments was closely controlled by the block structure of the basement and by orientation of the main, transcontinental Holy Cross Mts. Fault Zone, which supports the opinion on its activity in the Mesozoic era. The Ukrainian part of the Carpathian Foredeep basement located over the Palaeozoic Kokhanivka Block, between the Krakovets and Holy Cross fault zones, includes predominantly the slope, marginal and inner platform facies. Facies observed over the Palaeozoic Rava Ruska Block (south-western part of the East-European Platform), between the Holy Cross and Rava Ruska fault zones, represents mainly the inner platform and the peri-shore deposits.


Functional magnetic resonance imaging (fMRI) of the human spinal cord faces many challenges, such as signal loss due to local magnetic field inhomogeneities. This issue can be addressed with slice-specific z-shimming, which compensates for the dephasing effect of the inhomogeneities using a slice-specific gradient pulse. Here, we aim to address outstanding issues regarding this technique by evaluating its effects on several aspects that are directly relevant for spinal fMRI and by developing two automated procedures in order to improve upon the time-consuming and subjective nature of manual selection of z-shims: one procedure finds the z-shim that maximizes signal intensity in each slice of an EPI reference-scan and the other finds the through-slice field inhomogeneity for each EPI-slice in field map data and calculates the required compensation gradient moment. We demonstrate that the beneficial effects of z-shimming are apparent across different echo times, hold true for both the dorsal and ventral horn, and are also apparent in the temporal signal-to-noise ratio (tSNR) of EPI time-series data. Both of our automated approaches were faster than the manual approach, lead to significant improvements in gray matter tSNR compared to no z-shimming and resulted in beneficial effects that were stable across time. While the field-map-based approach performed slightly worse than the manual approach, the EPI-based approach performed as well as the manual one and was furthermore validated on an external corticospinal data-set (N>100). Together, automated z-shimming may improve the data quality of future spinal fMRI studies and lead to increased reproducibility in longitudinal studies.


I (ummins D, Heuischkcl R, Davies S. P'enicillin prophylaxis in children with sickle cell disease in 13rent. BAIJ 1991;302: 989-9(0. (27 April.) 2 Ferguson AD, Scott RB. Studies in sicklc cell anaemia. XIII. The management olt pneumonia in childrenl with sickle cell anemia. ,Medical Annals of the District of Columbil 1958;27:636-4 1. 3 Warlcy MA, Hamilton P'JS, Marsden PI), Brown RE, Miersellis JG, Wilks N. Chemoprophylaxis of homozygous sicklers with antimalarials and long term penicillin. BMtfj 1965;ii:86-8. 4 Serjeant GR. Sickle cell disease. Oxford: Oxford Univcrsity Press, 1985: 132. 5 Konotev-Ahulu FID. TIhe sickle cell disease patient. Iondon: Macmillan Education, 1991:414. 6 Konotev-Ahulu FlI). 'I'he spectrum of phenotypic expression ott clinical haemoglobinopathy in west Africa. Ntewz Istanbul Contribution to Clinical Science 1978;12:246-57.


The prohibition of torture considered an absolute rule has been the cornerstone of modernity in law. After the Enlightenment critique and rejection, the question was held as settled forever and cruelty definitively banned from the precinct of law. No serious attempt was done to reintroduce torture as legitimate. The Pandora's box of degradation and torment in the law was in principle sealed. This at least until very recently. In the aftermath of September 11 attacks in New York, however, the moral climate suddenly changed and we have faced several attempts to legalize torture and to accept it as a possible means for public security policies. We have also faced a substantive number of responses that were all more or less torture friendly. Different arguments were produced, morally and legally. Especially four main strategies are used to affirm torture as possible part of positive law, basing on redefinition, analogy, gaps in the law, and principles weighing. The article deals with this story and each of those strategies. It also tries to elucidate the usual more or less hidden assumption of torture friendly approaches, that there might be moral monstrous situations or beings that to be fought require and justify torture. A short conclusion will hint at the legal theory that lurks behind the proposed relegalization of torture.


What do you use every day that is small and large, worthless and beyond price? It's easily found in the gutter, yet you may never be able to replace it. You are always losing it but it faithfully protects you; sexy and uptight, it is knitted in to your affections or it may give you nightmares. It has led to conflict, fostered and repressed political and religious change and epitomizes the great aesthetic movements. It's Eurocentric, and is found all over the world. On the Button is an inventive and unusual exploration of the cultural history of the button, illustrated with a multiplicity of buttons in black and white and colour. It tells tales of a huge variety of the button's forms and functions, its sometimes uncompromising glamour, its stronghold in fashion and literature, its place in the visual arts, its association with crime and death, its tender call to nostalgia and the sentimental. There have been works addressed to the button collector and general cultural histories. On the Button links the two, revealing why we are so attracted to buttons, and how they punch way above their weight.


This article integrates institutional and rational choice approaches to policy making to explain the emergence of delegative democracy in presidential systems. Delegative democracy, in essence, is a polyarchy which violates the rules and norms that secure the checks on the effective political power of democratically elected presidents at the horizontal level of the relations of the executive, legislature and judiciary. The article argues that delegative democracy is the result of the interaction of two variables: the strength and types of presidents' legislative powers and the configuration of institutional and partisan veto players. Strong, proactive legislative powers and weak veto players permit presidents to establish a delegative democracy; weak, reactive legislative powers and strong veto players hamper the emergence of delegative democracy. This general assumption explains why presidentialism in South Korea and in the Philippines developed in different directions in the 1980s and 1990s. The analysis shows that in case of moderate legislative powers of the president, the number, coherence and ideological distance of partisan veto players becomes particularly important. It suggests that studies of democratic regimes should give special emphasis to the rules regulating the distribution of legislative powers between presidents and parliaments and the configuration of veto players.


In the paper, the authors address the issue of training computer science specialists, from the perspective of the interdisciplinarity of abstract algebra and computer science. The application of nonassociative algebraic systems in cryptography is examined. The stages of implementation of quasi-groups in the elaboration of cryptographic algorithms are described. It was demonstrated, from a methodological point of view, the need to study mathematical concepts by computer scientists, in order to understand the operation, use and application of the Markovski cryptographic system


We compare the damage potential of three recent eastern North American (ENA) earthquakes (Nahanni, 1985; Saguenay, 1988; and Mont Laurier, 1990) to that of the 1989 Loma Prieta, California earthquake. The Saguenay and Mont Laurier events were noteworthy due to their unusually high stress drops. The comparisons are based on synthetic ground motion records generated by the stochastic method, using source and attenuation models that were derived from actual records for each event. Damage potential is characterized by inelastic strength demand spectra, obtained by analyzing the response of nonlinear oscillators to each record. There is a strong similarity between the inelastic spectra and the more familiar elastic response spectra, although some significant differences are observed. Comparisons between events show that a moderate high-stress ENA earthquake, like Saguenay, can be as damaging to high-frequency structures as a major California earthquake.


Background and aims: Patients with chronic illnesses such as stroke have different physical and mental problems and need the care and support of their family members. Family caregivers face many different problems and experience burnout during caregiving to their patients. The aim of this study was to investigate the effects of care-oriented group discussion (GD) on burnout among the caregivers of patients with stroke. Methods: This two-group pretest-posttest quasi-experimental study was conducted in 2019. Participants were forty family caregivers of patients with stroke randomly selected from the neurology and stroke care ward of Sina hospital, Hamadan, Iran. They were randomly allocated to two twenty-person groups. Participants in the control group received routine care services, while participants in the intervention group received routine care services in addition to care-oriented GD in six two-hour sessions. Burnout was assessed before and two weeks after the study intervention and the SPSS program (v. 22.0) was used to analyze the data through the Kolmogorov-Smirnov, paired-sample t, independent-sample t, and Chi-square tests. Results: Groups did not significantly differ from each other respecting the pretest mean scores of burnout and all its dimensions as well as the posttest mean scores of the personal and financial dimensions of burnout (P > 0.05). However, the posttest mean scores of burnout and its social and emotional dimensions in the intervention group were significantly less than the control group (P < 0.05). Conclusion: As an effective strategy, care-oriented GD can be used to reduce burnout among the family caregivers of patients with stroke.


&NA; Experience in treating 1,275 skin cancers with Mohs' chemosurgery is presented. The Mohs technic uses microscopic examination to avoid excision of normal tissue and assure complete removal of the tumor. Chemosurgery is indicated for tumors which are poorly demarcated or which arise in areas known to have a high recurrence rate. It is the procedure of choice for almost all recurrent lesions.


This paper deals with a new bearing structure of one-axis controlled repulsive type magnetic bearing system that has a motor function of a surface permanent magnet (SPM). We evaluated the magnetic bearing structures by using the 4-pole 4-segment type and 4-pole Halbach array, which were placed around cylindrical permanent magnet sets as field magnets. The comparison of magnetic flux density in the radial direction measured by finite-element analysis indicated that the Halbach array has advantages over the 4-segment type in terms of the total harmonic distortion and internal magnetic influence. Additionally, levitation and rotation tests were performed by implementing each bearing configuration in a newly developed equipment. In both bearing configurations, stable levitation at zero-power position was established and high-speed rotation up to around 16 000 rpm was achieved. As a result, the Halbach array slightly saved electric power. Its total input power to the motor was approximately 1.2 W.


Devising a method capable of distinguishing a low - dimensional chaotic signal that might be embedded in a noisy stochastic process has become a major challenge for those involved in time-series analysis. Here a null hypothesis approach is used in conjunction with a known nonlinear predictive test, to probe for the presence of chaos in epidemiological data. A probabilistic set of rules is used to simulate a historic record of New York City measles outbreaks, generally understood to be governed by a chaotic attractor. The simulated runs of 'surrogate data' are carefully constructed so as to be free from any underlying low-dimensional chaotic process. They therefore serve as a useful null model against which to test the observed time series. However, despite the assumed differences between the dynamics of measles outbreaks and the null model, a nonlinear predictive scheme is found to be unable to differentiate between their characteristic time series. The methodology confirms that, if there is in fact a chaotic signal in the measles data, it is extremely difficult to detect in time series of such limited length. The results have general relevance to the analysis of physical, ecological and environmental time series.


The solitary cosmopolitan cold-water coral Desmophyllum dianthus (Esper, 1794)
(A, scale bar approximately 1 cm) occurs as a deep-water emergent species in Patagonian
fjords, Chile, and can form extensive banks (Forsterra et al. 2005). This coral
functions as a bioengineer by providing a 3D habitat for a diverse benthic community
(Forsterra et al. 2005). With skeletal growth, the living tissue is retracted by the organism
to the upper part of the calyx, leaving the lower skeleton uncovered. Endolithic
algae are then able to enter the tissue covered skeleton from below and start to encrust
the tissue covered part of the skeleton (Forsterra et al. 2005, 2008). They are visible
as a greenish coat on the skeleton (A). The algae are able to bore into the skeleton
(Forsterra et al. 2005) and thus could interfere with the coral's calcifying process.
This process could result in a parasitic behavior (Forsterra et al. 2012) rather than the
previously hypothesized (Forsterra and Haussermann 2008) symbiotic or even mutualistic relationship. This infection by algae may be the primary reason for the peculiar
behavior we observed on several specimens both in situ (A) and in our aquaria system
(B–D, scale bar approximately 1 cm).
After an acclimatization time in our aquaria system, wild collected corals were
well adapted and well fed, and secondarily expanded their tissue toward their lower
skeleton (about 1 cm in 4 mo, CJ and GMS pers obs), recovering an area that had
been without any tissue. Concomitantly, the corals everted their mesenterial filaments
between this re-entered outer-skeleton and the covering tissue layer (A, B; C, D: both
enlargements of B). During the eversion of the mesenterial filaments the new tissue
generally appeared unusually pleated (C, D) in contrast to a less common smooth
tissue surface (A). This was not a short-term or rare mechanism: corals maintained
this behavior in the aquaria over multiple months. Several tropical coral species are
known to eject their mesenterial filaments to digest prey too large to be swallowed
(Yonge 1930). The tropical, branching coral Acropora pulchra (Brook, 1891) has even
been observed to clean the substrate before it expands its tissue and skeleton (Roff et
al. 2008). Our preliminary observations suggest a combination of both mechanisms
in this cold-water coral. Mesenterial filaments could be digesting the growing algae
below their tissue, but also may be cleaning the substrate (their own skeleton) prior to
further tissue expansion.


Dear Editor: Central and peripheral nervous system lesions might induce paralysis, weakness, and/ or loss of dexterity, which are the main target of rehabilitative interventions.1 In fact, a specific training with intensive practice on actions in an appropriate context is mandatory to regain specific skills. Further, to reduce disability and improve quality of life in patients with disabilities, the individual also must take part in social and recreational activities. In this view, the rehabilitation environment, consisting of the physical setting, type, intensity and dosage of intervention, and knowledge and attitudes of the staff, has an important role in patient outcomes.2 It is worthwhile to note that the environment needs to be functionally organized, depending on patient's disabilities to be trained.2 Further, gains in motor improvement are negatively influenced by soft tissue adaptations induced by muscle weakness and postlesion inactivity and disuse.1 Physical therapy practice has changed among the years, from the use of corrective exercise and muscle re-education applied early in the 20th century to treat poliomyelitis to the neurophysiological or neurofacilitation approaches applied following World War II to treat young adults with acute brain injury. Later on, Bobath3 (using Bobath therapy or neurodevelopmental therapy) and Kabat et al.4 (by means of proprioceptive neuromuscular facilitation) changed the focus from muscle to non-muscle elements. It was in the 1980s that how humans acquire and learn motor skills, together with psychology, muscle biology, and adaptability, became the new focus of the physical therapy practice.5 Moreover, neuroimaging and noninvasive mapping studies have demonstrated the potential of the adult cerebral cortex to undergo a functional reorganization, the so-called cortical plasticity, which better works when physiotherapy is started earlier.6 Nowadays, further developments in motion analysis and electromyography, demonstrating the kinematics and kinetics of each action and postural adjustments contribute to make neurological rehabilitation a more deductive process. Horse-assisted therapy (HAT) has emerged among innovative and alternative rehabilitation techniques7 able to improve the kinematics and kinetics of each action and postural adjustments.7 To this aim, Portaro et al. applied finite element analysis as a theoretical model,8 investigating the stress shielding through the skeleton of a rider during a horse therapeutic training and showing that the rider had to continuously adjust their movements to accommodate the mechanical interaction with the horse. Indeed, HAT stimulates motion, coordination, agility, and balance and reduces physical or postural asymmetry of the rider.8 Of note, the rehabilitation training must not be confined to the acute phase of the disabling event but should be considered a long-term process. In fact, one of the main concerns of physiotherapy is the management of the patient after discharge, since post-discharge services for individuals with chronic disability are lacking.9 The provision of facilities directed to all disability levels requires collaboration between public health and community services. However, how might HAT overcome such issues? HAT consists of the application of a horse in a therapeutic setting, using the rhythmic horse's back movements, which induce continuous adaptive stimulations to the rider, altering motor output in response to vestibular, proprioceptive and psychosomatic stimulation.7,8 Indeed, HAT provides an afferent stimulus, reducing spasticity and promoting alignment and posture control.7,8 As the American Hippotherapy Association stated, there are two main forms of horse therapy, (1) one being using the equine movement and the environment of the horse to gain the therapeutic goals in one-to-one session between the therapist and patient (namely, HAT) and (2), the other one, provided in groups, implying recreational horseback riding lessons adapted for disabled patients.10 The rationale of HAT consists of the rhythmic movement induced by the horse pace to the patient. The use of a horse as a cophysiotherapist has old roots. Over the years, its efficacy has been demonstrated to improve balance, functional capacity, posture, spasticity, and gait ability in several neurological disorders.7 In all cases, HAT can be considered as a neuromuscular re-education technique, improving muscle strength, relaxation, body awareness, balance, tone, gait, coordination, posture, and quality of life.7,8 As compared with conventional rehabilitation training, HAT provides an additional element: the possibility for the rider to interact in a positive and enjoyable environment, which is psychologically helpful, improving confidence, self-esteem, and motivation.7,8 Finally, based on the patient's clinical condition, there could be a possibility to continue treatment at a sportive level in paralympic sport activities, with a consequential further implication in social acceptance and functioning. Unfortunately, to date, there are no standardized guidelines for HAT application. Methods are usually defined based on the clinician's skills and whether the benefit is determined by the dosage of therapy or the way of its administration or by the causative disease are still under debate. In addition, considering that HAT programs are not always applied by expert clinicians or under clinician supervisors with expertise in interventions with animals, we should concentrate our efforts on the definition of standardized protocols for different neurological diseases to obtain improved and beneficial results from such therapy. In conclusion, we may argue that HAT is a comprehensive rehabilitation treatment, covering the motor, cognitive, psychological, and social fields, that, if properly administered, might facilitate important results in several neurological disorders.


Diabetic pregnancy is often complicated by a number of pathological conditions among which is increased oxidative stress. This study was conducted to investigate the parameters of oxidative stress in 90 patients divided into the three groups: pregnant women with Type 1 diabetes mellitus, healthy pregnant women and non-pregnant women. In pregnancy groups all parameters were followed in 1st, 2nd and 3rd trimester. Diabetic control was monitored by fasting blood glucose and glycosylated hemoglobin (HbA1c) and these values, as well as measured biochemical parameters (urea, creatinine, total cholesterol and uric acid), were appropriate throughout the study. The concentration of TBARS, as a measure of lipid peroxidation, and activity of antioxidant enzymes superoxide dismutase (Cu, Zn-SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) were investigated in hemolysate of erythrocytes. TBARS concentration increased significantly in pregnant women when compared with control group (non-pregnant women), as well as in pregnant diabetics compared with healthy pregnant women. The SOD activity was gradually increased in the group of normal pregnant women vs. non-pregnant group, but decreased significantly in the group of diabetic pregnant women. Catalase activity was significantly increased only in 3rd trimester diabetic pregnant women. Increased lipid peroxidation and reduced antioxidant status, despite good diabetic control, show that pregnant women are exposed to oxidative stress to a greater degree than controls.