Explainable AI transforms opaque decision strategies of ML models into explanations that are interpretable by the user, for example, identifying the contribution of each input feature to the prediction at hand. Such explanations, however, entangle the potentially multiple factors that enter into the overall complex decision strategy. We propose to disentangle explanations by finding relevant subspaces in activation space that can be mapped to more abstract human-understandable concepts and enable a joint attribution on concepts and input features. To automatically extract the desired representation, we propose new subspace analysis formulations that extend the principle of PCA and subspace analysis to explanations. These novel analyses, which we call principal relevant component analysis (PRCA) and disentangled relevant subspace analysis (DRSA), optimize relevance of projected activations rather than the more traditional variance or kurtosis. This enables a much stronger focus on subspaces that are truly relevant for the prediction and the explanation, in particular, ignoring activations or concepts to which the prediction model is invariant. Our approach is general enough to work alongside common attribution techniques such as Shapley Value, Integrated Gradients, or LRP. Our proposed methods show to be practically useful and compare favorably to the state of the art as demonstrated on benchmarks and three use cases.


Central America's trade has increased significantly in the past decade, in great part as a result of strong efforts to reduce tariffs within the region, as well as improvements in market access due to the entry into force of important free trade agreements. However, the growth of Central America's trade has not been as impressive from a global perspective and there is growing evidence that the gains from trade agreements and liberalization policies have been limited by transport and logistics barriers. Studies sponsored by the World Bank reveal that high domestic transportation costs, along with bottlenecks at land border crossings, continue to present large hurdles to intra and extra regional trade. Key factors that impede commerce include the lack of good-quality paved secondary roads, expensive trucking services, and lengthy border crossing procedures. Coordinated efforts to address these bottlenecks could help improve significantly the growth impacts of international trade in the region.


The structure and magnetic properties of Ho-2(Co1-xFex)(17) compounds with x = 0.0, 0.1, 0.2, 0.3, 0.4, 0.6, 0.8 or 1.0 have been investigated by x-ray diffraction (XRD) and magnetization measurements. XRD patterns demonstrate that all samples are single phase with the hexagonal Th2Ni17-type structure. The substitution of Fe for Co initially leads to a increase in the lattice constant a and unit cell volumes upsilon and then a small decrease. The Curie temperatures decrease monotonously with increasing Fe concentration. Saturation magnetization increases with x and then decreases, attaining a maximum at x = 0.2. The magnetic anisotropy phase diagram of Ho-2(Co1-xFex)(17) compounds has been determined from the temperature dependence of magnetization and the XRD patterns of magnetically oriented powder samples. The spin-reorientation temperature of Ho-2(Co1-xFex)(17) compounds is found to decrease with increasing Fe content for x 0.3, attaining a lowest value of 248 K at x = 0.3.


OBJECTIVE
To investigate how often and why people with dementia and their partners have contact with the general practitioner (GP) before and after the diagnosis of dementia.

DESIGN
Retrospective cohort study.

METHOD
Patients given the diagnosis of 'dementia' in the period 2006-2011 were selected from patient records of GP practices participating in the NIVEL Primary Care Database; data were also collected from the patients' partners. Patients and their partners were compared with a reference group. The number of GP contacts from 2 years before until 1 year after diagnosis were analysed.

RESULTS
There were data on 823 patients with dementia and 184 partners. People with dementia had more frequent GP contacts from 4 months before diagnosis until 8 months thereafter. The mean number of GP contacts was 21.5 for people with dementia versus 17.4 for people without dementia in the total 3-year period. Reasons for more frequent contact were depression, abrasions/scratches/blisters and memory/concentration/orientation disorders before diagnosis. After diagnosis, memory/concentration/orientation disorders and general decline were more common reasons for contact than in the reference group. The frequency of GP contacts for partners was not significantly higher.

CONCLUSION
People with dementia have more contact with their GP than people without dementia. From 1.5 years before diagnosis they visit the GP with specific complaints more often. Their partners also have regular contact with their GP, especially in the year after diagnosis.


Accurate identification of a dc-link ripple current is an important part of switched power-converter design, since the spectral content of this current impacts on dc bus-capacitor lifetime, the stability of the converter control, and the electromagnetic-interference (EMI) performance of the system. Conventionally, the rms magnitude of the ripple current is used to evaluate this impact, but this approach does not readily differentiate between pulsewidth-modulation (PWM) strategies, and can be challenging to evaluate for more complex converter topologies. This paper presents a new generalized approach that analytically determines the harmonic spectrum of the dc-link and dc-bus capacitor currents for any voltage-source switched converter topology. The principle of the strategy is that the product of a phase-leg-switching function and its load current in the time domain, which defines the switched current flowing through the phase leg, can be evaluated in the frequency do- main by convolving the spectra of these two time-varying functions. Since PWM has a discrete line-frequency spectrum, this convolution evaluates as an infinite summation in the frequency domain, which reduces to a simple frequency shift of the PWM spectrum when the load current is assumed to be a fundamental single-frequency sinusoid. Hence, the switched currents flowing through the phase legs of an inverter can be evaluated as a summation of harmonics for any PWM strategy or inverter topology and can then be readily combined using superposition to determine the dc-link and dc bus-capacitor currents. The analytical approach has been verified against experimental results for an extensive range of two-level and multilevel converter topologies and PWM strategies.


The dissertation highlights the expansion of Dutch financial companies in the American market during the last forty years. It aims to explain in which activities they expanded successfully and in which activities they failed. Three important Dutch companies were studied: ABN AMRO, Rabobank and Nationale-Nederlanden, and five activities were analyzed: retail, corporate and investment banking, and life and non-life insurance. The companies were studied in their institutional environment in order to understand how multinationals cope with different national business systems. To make the problem of different national business systems concrete, I used two ideal types as described in the relevant literature: liberal market economies (LME) and coordinated market economies (CME). Did Dutch companies coordinate their activities primarily via hierarchies and markets (LME) or more via networks (CME)? Did they transfer elements of the Dutch business system to their American activities or did they adapt to the American system? The first chapter discusses the expansion of retail and corporate banking, and of life and non-life insurance. Special attention is given to Dutch and American banking legislation. Chapters 2 and 3 deal with the management process after an acquisition: the shaping of the organizational structure and human resource management respectively. Based on annual reports profitability and market share are analyzed in chapter 4. Chapter 5 deals with the expansion of investment banking. The conclusion looks back on the main developments and explains the success and failures of the Dutch companies in the American market in the context of different national business systems. The study makes clear that some elements of the Dutch business system, such as its colonial past and open, international economy, favored international expansion. Moreover, the Dutch state was supportive in the development of large financial companies. The risk-avoiding attitude of the companies was seen as a positive factor as well. The study also concluded that the Dutch companies combined Dutch and American elements of the two business systems, which became in particular apparent in the organization and management of the American organization and which was the outcome of a process of trial and error. In organizing and managing investment banking activities the Dutch companies were less successful in combining the Dutch and American business system, because this sector resembled much more the characteristics of an LME. The detailed analysis revealed large differences in business system within America. There were geographic differences (for example between New York and the Midwest) and differences between activities (commercial versus investment banking).These differences partly explain why Dutch companies have been more successfully in certain activities than in others. In the 1990s ABN AMRO and ING imported more elements compatible with the LME in their organization, whereas elements of this ideal type were less visible at Rabobank. The extent of change depended on two variables: the degree of internationalization and the company's legal structure. Dutch institutions, such as corporate governance and the financial market, have changed during the past forty years as a result of external developments (liberalization of capital markets, development of European market). The Dutch financial companies had to react to these institutional changes, but they were not passive actors. They influenced the extent and the content of change. In short, multinationals and business systems influence and change each other.


An expert is able to tell the system developer in many image-related tasks what a prototypical image should look like. Usually he will choose several prototypes for one class, but he cannot provide a good and large enough sample set for the class to train a classifier. Therefore, we mapped his technical procedure into a technical system based on proper theoretical methods that assist him in acquiring the knowledge about his application and furthermore in developing a classifier for his task. This system helps him to learn about the clusters and the borderlines of the clusters even when the data are very noisy as is the case for microscopic cell images in drug discovery where it is unclear if the drug will lead to the expected result on the cell parts. We describe in this paper the necessary functions that a prototype-based classifier should have. We also use the expert's estimated similarity as a new piece of knowledge and based on that we optimize the similarity. The test of the system was done on a new application on microscopic cell image analysis -- the study of the internal mitochondrial movement of cells. The aim was to discover the different dynamic signatures of mitochondrial movement. Three results of this movement were expected: tubular, round, and dead cell. Based on our results we can show the success of the developed method.


The interdisciplinary field of reflections on food as politics goes through a process of expansion and overflow to the private sphere, and routine daily food consumption. This process seems to be a reflection of transformations in the global agrifood markets, the wide publicity and awareness of food hazards and the politicization of consumption. To the extent that individuals are to assume responsibility for the environmental and social consequences of their everyday choices, the specificity of political power in contemporary societies goes beyond the institutional level (food security and nutrition, social inequalities in access to food, agricultural policies and regulations advertising of food) to meet the private sphere. This paper shows, initially, some of the recent debates about the process of politicization of consumption and then explores a theoretical reflection on the ethical, political and ideological habits that relate to food consumption, including the locations and ways of acquiring and food preparation, the values of environmental preservation, solidarity with local producers and reflexive caution against food risks. Finally, points to a research agenda capable of capturing the processes of politicization of food and consumer practices in the field of political power.


We present a new technique for mapping the backpropagation algorithm on hypercube and related architectures. A key component of this technique is a network partitioning scheme called checkerboarding. Checkerboarding allows us to replace the all-to-all broadcast operation performed by the commonly used vertical network partitioning scheme, with operations that are much faster on the hypercubes and related architectures. Checkerboarding can be combined with the pattern partitioning technique to form a hybrid scheme that performs better than either one of these schemes. Theoretical analysis and experimental results on nCUBE and CM5 show that our scheme performs better than the other schemes, for both uniform and nonuniform networks. >


Background An increase in the complexity of patient's admitted to the Hospice and a greater use of acute interventions had resulted in staff feeling "too busy to care" with less time to provide high quality care. We recognised the need to change working practices to improve patient experience and staff satisfaction. After reviewing possible models and undertaking a scoping exercise, we agreed to implement the NHS Releasing Time to Care: The Productive Ward as a recognised quality initiative. This was previously restricted to hospital and community use, designed to help teams review working practices and minimise inefficient systems. This was supported at Network level in collaboration with 5 other Hospices. Aims Increase Time for Caring therefore improving patient experience Improve departmental/inter-departmental communication Improve patient /staff environment Improve staff satisfaction Approach used Network support Enhanced team working Staff and senior management commitment Collaborative module implementation training Phased roll out Evaluation at steering group level Outcomes Confirmed network funding in conjunction with other hospices Network training and support to empower staff Focus on collaborative approach, shared learning experience, making a wider impact than working in isolation Transparent care provision using quality measures Efficient staff working practices Cost effectiveness, efficient use of limited resources Improvement in communication across all services and local hospices Awareness of the importance of environment; little wins to improve patient care have a positive effect on staff morale Improved patient safety and standard of care evidenced by quality measures Benefit at local, organisational and network level Application to Hospice Practice Improved collaboration and networking Useful toolkit that has impacted on time for caring making a difference to patient experience and staff satisfaction Transferability Supports integrated working


Subject
 Political freedoms in Tanzania.

 Significance
 Tanzania's parliament passed a bill in late June to amend eight laws under the Written Laws (Miscellaneous Amendments) Act No. 3. Despite their innocuous title, these amendments, once signed into law, will further solidify the government's control over the economy and civil society, contributing to a deteriorating business environment and increasingly restricted civic space for religious and civil organisations.

 Impacts
 Some NGOs required to re-register may miss the two-month deadline to do so under the amended law.
 Potential investors may be put off by additional bureaucracy and increased risk.
 Civil society's influence on public policy will be constrained by fear of being targeted under the legislation.
 The government will gain more leverage to put pressure on NGOs on policies, sources of income and spending.


Drawing upon prior research that has examined participation in the military and criminal justice outcomes, the current study investigates whether service history elements are associated with arrest frequencies, types of criminal behavior, and if certain service components influenced these outcomes in a similar or different manner for male and female veteran inmates. Using data from a nationally representative sample of inmates incarcerated in state prisons, results indicated that various attributes of military service and veteran gender were directly related to lifetime arrests and offense types. Gender disparities also emerged across military experiences depending on the type of behavior examined. The findings lend support for a multifaceted approach to understand and implement gender-specific programming in meeting the needs of justice-involved veterans.


Abstract Theleflunomide (CAS 75706-12-6) metabolite (LFM) analog α-cyano-β-hydroxy-β-methyl-N-(2,5-dibromophenyl)-propena-mide (LFM-A13, DDE-28, CAS 244240-24-2) is a rationally-designed specific inhibitor of the TEC family protein tyrosine kinase, Bruton's tyrosine kinase (BTK). LFM-A13 exhibited favorable pharmacokinetics in CD-I mice, BALB/c mice, rats, and dogs. The intraperitoneal bioavailability was estimated to be ~100%, while the oral bioavailability was ~30%. LFM-A13 enters, but does not bind to multiple tissues followed by a rapid elimination from most of the tissues. Limited distribution of LFM-A13 to extravascular tissues and its corresponding low volume of distribution could be attributed to its plasma protein binding. LFM-A13 was not toxic to mice, rats, or dogs at daily dose levels as high as 100 mg/kg. LFM-A13 formulated as a suspension and hard gelatin capsules for oral administration showed a rapid absorption and favorable pharmacokinetic features. These preclinical research studies provide the basis for future pre-IND studies and clinical development of LFM-A13 as an intravenously or orally administered new anti-leukemia agent targeting BTK.


Since the impacts of climate change are felt most dramatically in Northern latitudes, local policy makers and practitioners in Nordic peripheries should respond quickly to climate change. This report tackles the question pragmatically, by way of loosely related cases that are of vital importance to local communities and livelihoods. The report focuses on the following cases: the management of transitions to sustainable energy systems in West Norden, the planning of an aluminium smelter in Greenland, climate policy in Swedish municipalities, and the implications of climate policy for reindeer management in Lapland. On the basis of the studies, the report summarizes a set of knowledge-based tools to assist policy makers and practitioners in their planning for sustainable adaptation to changes in energy provision and climate conditions. Knowledge-based tools are practical indicators or checklists. They provide critical signals of a significant turn of events in the policy process that the policy maker or practitioner in the field ought to be able to distinguish in her daily work. In the report, the indicators and checklists are presented in a generalizable form that practitioners and policy makers in peripheral regions beyond Norden should also find helpful.


A Time for Change In 2014 I joined the Canadian Journal of General Internal Medicine as its new Editor-in-Chief. During the past four years I have enjoyed the opportunity to steer the journal on its mission to improve communication amongst practising internists, internal medicine residents, health care planners, the Royal College and the CSIM. Enhancing resident engagement will continue to be very important for the journal, as the residents represent the future of GIM. During the past four years we have seen an increase in the number of submissions from medical residents in the form of case reports. Residents, in collaboration with their mentors, have also expressed their views in the journal regarding the transformation of the residency education environment. In addition, we have published the top abstracts from a resident research day conducted at a Canadian residency program. We hope to see other centres follow suit. But getting residents to submit manuscripts of systematic reviews and articles on quality assurance projects still needs work, and it will require further engagement with the residency program directors across the country. While we continue to strive to attain PubMed indexing for CJGIM , the journal's contents can already be found on Google Scholar and digital searching on health-related topics has brought viewers to the journal's web site. A number of informative articles relating to postgraduate medical education, particularly with a Canadian perspective, are available for reading through the journals on-line archives. The journal has been publishing for 12 consecutive years and it is once again a time for change. As of April 1 st , 2018 I will step down as Editor-in-Chief and Dr. Jim Douketis will assume that role. In addition, the journal has recently added three new Deputy Editors to the Editorial Board. I am confident that Jim and his team will bring with them new ideas and energy that will take CJGIM to a new level of activity and excellence.


Neoliberal reforms of public education do more than shape policy and curriculum; they also influence educators' understanding of themselves as professionals, driving at the very core of what it means to be a teacher or leader.  This article explores the effects of Neoliberal policies and New Public Management pracitces on teachers and principals and the ways they result in a "new professionalism." The authors provide a framework for studying how these new polices and practices might be resisted, as well as a description of characteristics of the new professional and what professionalism might look like if it were grounded in community and advocacy.


Sure System 2000, a fault-tolerant computer that couples multiprocessors to offer low-priced, high-performance systems that deal effectively with faults and failures, is presented. The architecture is based on the local redundancy technique, ensuring that no hardware or software fault can cause a system crash. Software errors can be fixed, and hardware can be replaced, upgraded, or added dynamically. Existing fault-tolerant computers are briefly reviewed, and the logic hardware system configuration of the Sure System 2000 is described. The multiprocessor and I/O architecture are examined. The SXO Sure System 2000 expandable operating system is described.<<ETX>>


Internal migration in China has resulted in large numbers of left-behind children. Despite growing attention to this population, existing research has not systematically addressed the mediating mechanisms linking parental migration to children's health. The present study examines the influences of migration on the health of left-behind children in China and the mediating channels, using data from a new nationally representative survey. We compare three groups of rural children ages 3-15 (N=2,473): those who were left behind by both parents, those who were left behind by one parent, and those living with both nonmigrant parents. Results show that the health of rural children left behind by both parents (but not by one parent) is worse than the health of children living with both parents. The health disadvantage of these children is mediated by their caregivers' poor health status and caregiving practices. These mediating factors not only have a direct impact on child health but also exert an indirect impact by shaping children's nutritional intake. Contrary to conventional wisdom, monetary remittances are not a significant mechanism linking migration to child health.


Nonalcoholic fatty liver disease (NAFLD) is the most prevalent liver disease worldwide, the morbidity of which closely correlates with diversity of ethnicity, minority, family and location. Its histology spans from simple steatosis, to nonalcoholic steatohepatitis, which ultimately results in fibrosis, cirrhosis and hepatocellular carcinoma. The accelerating prevalence of NAFLD is due to an incremental incidence of metabolic syndrome that is distinguished by dyslipidemia, glucose impairment, obesity, excessive oxidative stress and adipocytokine impairment. Additionally, the pathogenesis of NAFLD is thought to be a multifactorial and complicated disease associated with lifestyle habits, nutritional factors and genetics. However, the pathogenesis and underlying mechanism in the development of NAFLD caused by genetics remains unclear. People have been increasingly emphasizing on the relationship between NAFLD and gene polymorphisms in recent years, with the aim of having a comprehensive elucidation of associated gene polymorphisms influencing the pathogenesis of the disease. In the current article, the authors attempted to critically summarize the most recently identified gene polymorphisms from the facets of glucose metabolism, fatty acid metabolism, oxidative stress and related cytokines in NAFLD that contribute to promoting the progression of the disease.


This paper presents the development of monolithically integrated RF transmitters and antennas for MEMS sensors such as accelerometers. Integrating wireless-communication ability on-chip microsensor, sensors can communicate the sensing data with information network by wireless. Integration technology of MEMS sensors, and RF-CMOS including RF passive components is requited to realize highly integrated smart micro sensors. CMOS oscillators with 315 MHz carrier frequency are designed and fabricated by our CMOS/MEMS integration technology. Spiral inductors for resonators and monolithic antennas have been realized with IC metallization process. Each essential component have been fabricated and evaluated.


: Digital twins play a critical role in simulating industrial manufacturing systems to increase productivity and reduce time spent on troubleshooting. Owing to the complexity of real-world industrial systems, automatic sparse identification has emerged as an attractive approach to perform digital twin modelling. The sparse identification of nonlinear dynamics (SINDy) is a machine learning algorithm that performs feature engineering by generating a model term library and then solves a sparse regression problem between the objective outputs and the generated features. By solving a linear-in-parameter sparse regression problem, SINDy provides automatic discovery of system governing equations. However, the performance of SINDy-based algorithms may decline dramatically when applied to identify complex nonlinear relationships, such as implicit relationships. The substantial number of input variables for a real industrial process may further complicate the modelling procedure. We therefore propose the neural network and SINDy integrated algorithm to automatically select the critical features from a model term library and utilize the neural network to capture the process nonlinearity that cannot be captured by a linear-in-parameter model. SINDy performs feature generation considering both numerical methods and first-principles knowledge, making the proposed algorithm a hybrid system identification approach. A diesel hydrotreating unit case study with 37 input variables is analyzed in this paper to demonstrate the advantages of the proposed algorithm for nonlinear digital twin identification. By combining the advantages from both SINDy and neural networks, the proposed algorithm is able to improve the output prediction accuracy for all the three objectives.


Objective: Until now, long-term outcome studies have focused on general cognitive functioning and its risk factors following neonatal extracorporeal membrane oxygenation and/or congenital diaphragmatic hernia. However, it is currently unknown which neuropsychological domains are most affected in these patients and which clinical variables can be used to predict specific neuropsychological problems. This study aimed to identify affected neuropsychological domains and its clinical determinants in survivors of neonatal extracorporeal membrane oxygenation and/or congenital diaphragmatic hernia. Design: Prospective follow-up study. Setting: Tertiary university hospital. Patients: Sixty-five 8-year-old survivors of neonatal extracorporeal membrane oxygenation and/or congenital diaphragmatic hernia. Interventions: None. Measurements and Main Results: Intelligence, attention, memory, executive functioning and visuospatial processing were evaluated using validated tests and compared with Dutch reference data. Assessed risk factors of outcome were illness severity indicators, number of anesthetic procedures in the first year of life, and growth at 1 year. Patients had average intelligence (mean intelligence quotient ± SD, 95 ± 16), but significantly poorer sustained attention (mean z score ± SD, –2.73 ± 2.57), verbal (immediate, –1.09 ± 1.27; delayed, –1.14 ± 1.86), and visuospatial memory (immediate, –1.48 ± 1.02; delayed, –1.57 ± 1.01; recognition, –1.07 ± 3.10) than the norm. Extracorporeal membrane oxygenation–treated congenital diaphragmatic hernia patients had significantly lower mean intelligence quotient (84 ± 12) than other neonatal extracorporeal membrane oxygenation patients (94 ± 10) and congenital diaphragmatic hernia patients not treated with extracorporeal membrane oxygenation (100 ± 20). Maximum vasoactive-inotropic score was negatively associated with delayed verbal (B = –0.02; 95% CI, –0.03 to –0.002; p = 0.026) and visuospatial memory (B = –0.01; 95% CI, –0.02 to –0.001; p = 0.024). Conclusions: We found memory and attention deficits in 8-year-old neonatal extracorporeal membrane oxygenation and congenital diaphragmatic hernia survivors. The maximum dose of vasoactive medication was negatively associated with verbal and visuospatial memory, which may suggest an effect of early cerebral hypoperfusion in determining these abnormalities.


Software architectures have received increasing attention by playing a significant role in determining the success and quality of software systems. In particular, reference architecture is a special type of architecture that captures the essence of software systems of a specific domain, achieving therefore well-recognized understanding of that domain. In spite of this, it is not observed concern in order to widely disseminate reference architectures and, as a consequence, the knowledge encompassed by these architectures. At the same time, Open Source Software (OSS) has been largely developed and used in both academy and industry. A diversity of OSS has been made available and has contributed to the software development through dissemination of knowledge that is encompassed mainly in the source code. Specifically, its success is due to OSS licences that have adequately supported its development and evolution. Thus, applying this same idea in order to disseminate reference architectures seems to be very interesting. The main contribution of this paper is to propose Open Source Reference Architecture (OSRA) that, based on principles of OSS, aims at promoting dissemination and evolution of reference architectures, intending to contribute to a more effective software development.


The benefits of meadow restoration can be assessed by understanding the connections among geomorphology, hydrology, and vegetation; and multispectral imagery captured from unpiloted aerial systems (UASs) can provide the best method in terms of cost, resolution, and support for vegetation indices. Our field studies were conducted on northern Sierra montane meadows (with ≤70 km2 watershed area). The meadows exist in various stages of ecological restoration. Field survey methods included GPS + laser-leveling channel survey, cross-sections, LiDAR, vegetation sampling, soil measurements, and UAS imaging. A sensor captured calibrated blue (465–485 nm), green (550–570 nm), red (663–673 nm), near infrared (NIR) (820–860 nm), and red-edge (712–722 nm) bands at 5.5 cm resolution (as well as thermal at 81 cm resolution) and provided multispectral images and derivative vegetation indices such as the normalized difference vegetation index (NDVI) and red-edge chlorophyll index (Clre). This fine-scale imagery extended our morphometric assessment of post-restoration channel bedform patterns and sinuosity related to Carex-influenced soil properties and Salix influence, and also documented groundwater-related effects via Carex patterns evident from spring snowmelt images, as well as NDVI and Clre (derived from spring and summer images) in growing to senescent phenological stages. Carex was significantly associated with low bulk density and high soil moisture, NDVI, and Clre in low-lying areas, and channel sinuosity was significantly associated with willow influence. Our methods can be applied by restoration managers to assess where projects are threatened by renewed incision and to document levels of carbon sequestration significant to addressing climate change.


This paper addresses real challenges and ensuing issues facing the Singapore government in their endeavour to enhance global economic competitiveness through the adoption of innovative technologies development and usage; in this case, the acceleration of SOA. Key stakeholders have spearheaded a strategic and systematic project (called SOA1) to ensure that SOA is inculcated into the mainstream of businesses and industries. Outcomes, insights and lessons learned are presented along with a glimpse of the next phase of the SOA1 project (called Enterprise 2.0). IT Management complexities not accounted for in SOA1 and Enterprise 2.0 are examined with a call for empirical academic research in the areas of people and organisational behaviour within the context of SOA adoption and implementation.


A case of carbamazepine-induced leukopenia with subsequent successful carbamazepine management is presented. Despite WBC suppression to a level of 2000/cu mm on an initial trial of carbamazepine, a challenge with a much lower dose and gradual titration permitted a full treatment course with therapeutic blood levels. Although many physicians are wary of the leukopenia associated with carbamazepine, it is a distinct entity from the rare agranulocytosis and aplastic anemia that have been associated with the drug. With careful clinical management, carbamazepine can be successfully used in patients with neurologic disorders despite significant WBC suppression.


This paper aims to give a survey of full-reference image quality metrics, including metrics specifically designed to evaluate image quality, but also metrics for image difference, image fidelity, and more. These metrics have in common that they try to predict the perceived difference between an original image and a modified version of it, this modification can typically be compression, halftoning and blurring. They output one numerical value and/or an image difference map. More than 100 image quality metrics have been reviewed and categorized, and short descriptions and analysis of all metrics and their relationships are given. This should prove valuable to researchers in various fields, to find the most appropriate metric for their application, and to give a better understanding of the state of the art of the field of image quality metrics.


The Alfvén speed and plasma beta in photospheric bright points (BPs) observed by the Broadband Filter Imager (BFI) of the Solar Optical Telescope on board the Hinode satellite are estimated seismologically. The diagnostics is based on the theory of slow magnetoacoustic waves in a non-isothermally stratified photosphere with a uniform vertical magnetic field. We identify and track BPs in a G-band movie by using the 3D region growing method, and align them with blue continuum images to derive their brightness temperatures. From the Fourier power spectra of 118 continuum light curves made in the BPs, we find that light curves of 91 BPs have oscillations with properties that are significantly different from oscillation in quiet regions, with the periods ranging 2.2–16.2 minutes. We find that the model gives a moderate value of the plasma beta when γ lies at around 5/3. The calculated Alfvén speed is 9.68 ± 2.02 km s−1, ranging in 6.3–17.4 km s−1. The plasma beta is estimated to be of 0.93 ± 0.36, ranging in 0.2–1.9.


This special issue of Pediatrics honors the critical role that mothers play in their child's health during 3 important periods: preconception, prenatal, and early childhood. Two general public heath messages are highlighted by the researchers who explored maternal influences during the preconception period: the ongoing challenge of pregnancy-related health promotion among all women of childbearing age, and the implications of increased use of reproductive technology. In studies of the prenatal period, researchers focused on maternal influences such as healthy prenatal behavior and testing for diseases that can be transmitted perinatally. In studies of the early childhood period, researchers focused on what mothers can do to keep infants and young children safe and healthy, including accessing health care and creating a safe and healthy environment at home. Findings in this supplement are based on premier national data sets, including comprehensive health surveys such as the National Health and Nutrition Examination Survey and the Behavioral Risk Factor Surveillance System, specialized national surveys such as the National Immunization Survey and the Pregnancy Risk Assessment Monitoring System, and national vital statistics data. Also included are findings from a variety of state and local one-time and ongoing projects. In examining on ways that mothers influence the health of their infants and young children, we link 2 key areas of medicine—obstetrics and pediatrics—which have similar objectives but often work independently of each other. We also link numerous content areas and disciplines of public health research that frequently have little collaboration and interdisciplinary discussion, including immunization, birth defects, developmental disabilities, reproductive health, human immunodeficiency virus/ acquired immune deficiency syndrome, injury control, chronic disease, nutrition, health education, and psychology. While it may be convenient for operational purposes to divide health care and health research into ever-smaller units, we must remember to step back periodically and examine how these areas tie together—how they influence each other, and ultimately how they influence child health. Physicians and other health care workers know well the role they play in their own field of expertise, but may not always realize the opportunity they have to improve health beyond that scope. For example, in an obstetric practice for example, staff have the opportunity to talk with expectant mothers about the health and safety of their future newborns; preparing a safe home environment; infant's health care in the hospital, including vaccinations and newborn hearing screening; and breastfeeding. Pediatric health care workers, likewise, could discuss issues such as pregnancy planning and the importance of taking folic acid with women before they become pregnant, as no one is more likely to become pregnant than a woman who has young children. As with physicians and health care workers, public health researchers must take advantage of opportunities to integrate methods and findings to ensure that their research is responsive to public health needs and that the implications for health care are clear. With this in mind, public health researchers throughout the Centers for Disease Control and Prevention—and our research partners throughout the United States—were asked to submit articles for this issue. While "maternal influences on child health" brings together research from many different fields, this topic is itself part of a larger picture. Mothers certainly are not the only influence on their children's health. Fathers, families, friends, physicians, health care workers, teachers, and other community members all have an opportunity to play a role, either directly or indirectly, in the health and well-being of young children. From the point of view of the child, the preconception, prenatal, and early childhood periods focused on in this issue are just the beginning of mothers' influence, which continues throughout their lives. And while we have focused on the health of children, the maternal/infant relationship can also have a positive impact on mothers' health. During pregnancy, women are often more healthconscious than usual and receptive to advice from physicians and others. Pregnancy can be a unique opportunity to encourage women to make lasting changes—taking multivitamins, being tested for human immunodeficiency virus, quitting smoking and binge drinking, eating nutritiously, etc—that will improve not only the health of her child, but her own health as well. In the broadest sense, promoting health is just a part of improving the total well-being of individuals, families, and ultimately of society. We hope that this issue will encourage you to step back and search for critical links between your field and others. Building and strengthening these linkages will enable health care providers and researchers to make increasingly practical and valuable contributions to the public's health. In closing, we would like to wish a "Happy Mothers' Day" to all those who work to promote the health of mothers and their children. Elizabeth T. Luman, MS Mary Mason McCauley, MTSC Susan Y. Chu, PhD Coleen Boyle, PhD Laurie Elam-Evans, PhD Julia A. McMillan, MD Guest Editors


Abstract : This work involves development of an information theoretic viewpoint for the model-based ATR problem, bringing the problems of ATR and pose estimation (PE) into the framework of signal detection/demodulation theory. Specific goals are to predict maximum achievable ATR/PE performance for a given object/scene scenario, and to quantify the tradeoff between performance and system complexity. Progress has been made toward investigating the feasibility of developing useful system performance bounds. Extensions of classical results by Blabut and Fano have shown that tight upper performance bounds can be developed; however, the bounds thus far produced require more information and computation than is practical. Progress has been made toward the long-term goal of designing ATR strategies based directly on information theoretic considerations. A Hilbert Space Decision Tree approach has been developed and tested. This ATR algorithm consists of a series of binary decisions, each of which occurs in the native object image space and maximizes the amount of object discrimination information gained by the decision. In this way, heuristic assumptions regarding the importance of model and image information are avoided. This technique shows great promise for guiding the design of ATR systems.


Background Chronic hypoxia causes apoptosis of cardiac myocytes, however, energy production by anaerobic glycolysis protects myocardium against hypoxia injuries. Aldolase A is a well-characterised key enzyme of the glycolysis pathway. Ghrelin, a 28-amino-acid peptide, synthesizes in the stomach and has protective roles in cardiovascular systems and also affects metabolic pathways. Objectives Therefore, the aim of this study was to evaluate the effect of ghrelin on aldolase A gene expression after chronic hypoxia in the rat hearts. Materials and Methods Twenty four adult male wistar rats were randomly divided into three groups. Hypoxic rats with saline or ghrelin treatment were placed in a normobaric hypoxic chamber (O2 11 %), for two weeks. Controls remained in room air. Aldolase A gene expression was measured by Real-Time RT-PCR. Results the transcriptiom rate of Aldolase A in hypoxic animals did not change significantly compared to negative control ones. During chronic hypoxia, ghrelin treatment increased the amount of heart Aldolase A gene expression compared to negative controls (P = 0.029). Hypoxic animals that were treated with ghrelin were significantly more polycythemic than the controls and even hypoxic with saline treated rats (P < 0.001). Conclusions It seems that ghrelin interferes in the cardiac metabolism through upregulation of glycolytic enzymes. In other words, it may protect heart from possible hypoxia induced damages.


In this paper, we investigate the impact of the deformable bodies on the control algorithms for physically simulated characters. We hypothesize that ignoring the effect of deformable bodies at the site of contact negatively affects the control algorithms, leading to less robust and unnatural character motions. To verify the hypothesis, we introduce a compact representation for an articulated character with deformable soft tissue and develop a practical system to simulate two-way coupling between rigid and deformable bodies in a robust and efficient manner. We then apply a few simple and widely used control algorithms, such as pose-space tracking control, Cartesian-space tracking control, and a biped controller (SIMBICON), to simulate a variety of behaviors for both full-body locomotion and hand manipulation. We conduct a series of experiments to compare our results with the motion generated by these algorithms on a character comprising only rigid bodies. The evaluation shows that the character with soft contact can withstand larger perturbations in a more noisy environment, as well as produce more realistic motion.


Purpose Inadequate procedural training is of increasing concern in resident training, especially in prostate brachytherapy (PB). Transperineal rectal spacer placement (TRSP) requires many of the same proficiencies as PB. This work describes the assessment of teaching techniques focusing on developing critical competencies for PB using related clinical procedures (TRSP). Material and methods For PB and TRSP, key competencies were identified: 9 for PB and 7 for TRSP; 4 are shared between PB and TRSP. "Comfort level" with these procedures was assessed prior to and following participation in TRSP. Results 8 of 12 trainees at our institution participated in TRSP procedures. 2 of these trainees had prior experience with PB or related procedures and were excluded. Trainees self-reported "comfort levels" between 0 and 3 for four competency domains. Initial median comfort (MC) level for competency domains relevant to PB included: patient positioning (median 1, range 0-2), transrectal ultrasound imaging (median 1, range 0-1), fiducial placement (median 1, range 0-1), and hydrodissection (median 0, range 0-1). Median number of TRSP procedures performed by assessed trainees during the analysis period was 4 (range 1-6). Following TRSP procedure training, MC level increased: 2 points for patient positioning (median 3, range 1-3; p < 0.01), 1.5 points for transrectal ultrasound imaging (median 2.5, range 1.3, p < 0.001); 1 point for fiducial placement (median score 2, range 1-3; p < 0.001); and 1.5 points for hydrodissection (median score 2, range 1-3; p < 0.001). Conclusions Increasing trainee involvement in related procedures to develop core competencies may help facilitate increased comfort with common skills critical to the independent performance of PB.


INTRODUCTION
Moyamoya disease (MMD) is a vascular disease with significant risk of mortality due to ischemia or hemorrhage in the brain. The goal of the study was to explore three-dimensional arterial spin labeling (3D-ASL) to improve evaluation of cerebral hemodynamics in patients with MMD.

METHODS
Our study included 54 cases of ischemic MMD and 42 cases of hemorrhagic MMD. Dynamic susceptibility contrast-enhanced perfusion weighted imaging (DSC-PWI) and 3D-ASL were performed at 3.0 T. Based on these scans, cerebral blood flow (CBF), mean transit time (MTT) and time to peak (TTP) were calculated and compared between patients with different disease subtypes. Receiver operating characteristics (ROC) analysis was used to assess the diagnostic sensitivity and specificity of different imaging procedures and parameters.

RESULTS
Our data suggested that CBF in the lesion area was more severely reduced in patients with hemorrhagic MMD than in those with ischemic MMD. The CBF parameter in 3D-ASL diagnosed hemorrhagic and ischemic MMD with a significant sensitivity and specificity of 80.59% and 57.41% respectively, with an area under the curve (AUC) of 0.75. We also found that the relative CBF (rCBF) of 3D-ASL was more pronounced decreased and the relative MTT and TTP of DSC-PWI were significantly increased in patients with hemorrhagic MMD than those with ischemic MMD. Specificity and sensitivity, and AUC of 3D-ASL were better than the comparison of absolute values from DSC-PWI scans.

DISCUSSION/CONCLUSION
Our study indicated that 3D-ASL is powerful in differentiating patients with cerebral ischemic or hemorrhagic MMD, providing another diagnostic tool that could potentially improve precision medicine to monitoring MMD patients.


This work has been carried out at a company in the region which has about 30000 employeeswith about 400 sites all over the world. The company outsources their network including theLAN refresh and the WAN migration. They needed help with an upgrade of their LAN at theirScandinavian headquarters and to find a new solution for their WAN. The reason why the upgradeof the LAN was needed was that the equipment was too old and did not pass the securityrequirements. They also required a solution to segment their LAN, which consisted of a singlelarge VLAN with 1,300 employees. their WAN solution was made up of tunnels between all officesand the headquarter were used as the central point. They wanted to get away from beingdependent on a central point while redundancy was not always working as it should.The solution to the WAN problem was to use the ISPs backbone based on MPLS. There are two mainsolutions, layer 2 (Ethernet) VPN or layer 3 (IP) VPN. In the case of IP VPN, there are a couple of differentconnectivity options such as a static route, or use a routing protocol (eg OSPF or BGP). The final solutionwas IP VPN with OSPF as routing protocol to the ISP. With regard to the configuration of the OSPF solutionwas that every office became an own OSPF domain, configured with area 0. The report also includesthe implementation of the WAN migration with its problems.The upgrade of the LAN was a lot of planning, documentation and security. The solution for the segmentationwas to create a VLAN per floor. Because of the new software they can have the required securityfeatures.


OBJECTIVE
To explore the strength of the association between gait speed and community ambulation and whether this association is significantly distorted by other variables.

DESIGN
Cross-sectional study conducted 3 years after stroke.

SUBJECTS
A total of 102 patients after first-ever stroke following inpatient rehabilitation who are now living in the community.

METHODS
Community ambulation was determined by a self-administered questionnaire with 4 categories. Gait speed was assessed by the 5-m walking test. Possible confounding factors included in the analyses were: age, hemisphere, living alone, history of falls, use of assistive walking devices, executive function (Trail Making Test), depression (Center for Epidemiologic Studies-Depression scale), fatigue (Fatigue Severity Scale), motor function (Motricity Index), standing balance (Berg Balance Scale) and walking endurance (SF36).

RESULTS
Twenty-six percent of the patients were non-community walkers or limited community walkers. The optimal cut-off point for community ambulation was 0.66 m/sec, with an area under the curve of 0.85. Although gait speed was significantly related to community ambulation, this association was confounded by balance, motor function, endurance and the use of an assistive walking device. These factors reduced the regression coefficient of gait speed by more than 15%.

CONCLUSION
Gait speed is an important factor related to community walking; however, ability to walk in the community is determined by several underlying factors, e.g. balance, motor function, endurance and assistive walking device.


Despite the fact that India has a long tradition of ophthalmic surgeries, her contribution in the field remains largely unrecognized by the world. Sushruta (1000-800 BC), the father of Indian surgery, lived much before Hippocrates (460-370 BC) and Galen (129-216 AD), and described various ophthalmic surgeries, including surgeries for trichiasis, distichiasis, and entropion, in his treatise Sushruta Samhita. Sushruta and subsequent authorities on the subject also advocated para-surgical procedures such as chemical and heat cautery apart from surgeries. Their surgical techniques were practised all over India for more than 3000 years. It is very likely that their surgical knowledge spread even beyond the boundaries of the Indian subcontinent and benefited the world at large including the Arab and Europe. Here we describe the techniques of surgical and para-surgical procedures for trichiasis, distichiasis, and entropion practiced in India until recent past before it was replaced by modern procedures at large.


The paper compares two prominent approaches to assessing Human Well-Being, the Capability Approach and the Subjective Well-Being Approach. It investigates the differences and the similarities between these approaches. An argument is made for exploring the potential synergies between them. Finally, the papers of this special edition are briefly introduced.


In converting an object of one type to another, we expect some of the original object's behavior to remain the same and some to change. How can we state the relationship between the original object and converted object to characterize what information is preserved and what is lost after the conversion takes place? We answer this question by introducing the new relation, respects, and say that a type converter function C:A/spl rarr/B respects a type T. We formally define respects in terms of the Liskov and Wing behavioral notion of subtyping; types A and B are subtypes of T. We explain in detail the applicability of respectful type converters in the context of the Typed Object Model (TOM) Conversion Service, built at Carnegie Mellon and used on a daily basis throughout the world. We also briefly discuss how our respects relation addresses a similar question in two other contexts: type evolution and interoperability.


Background/Objectives: Leadership is required on leaders regardless of size where people come together. Leaders sometimes misunderstand how every leader is equipped with proper leadership. Methods/Statistical Analysis: Therefore, there are several people saying that 'I do not need to learn leadership.' Leaders might certainly be the ones equipped with all the qualifications. This means that leaders might be those who think they are equipped with leadership. However, leadership is a more of acquired feature instead of innate characteristics. Therefore, effective leadership is required on leaders. Findings: 7 essential leadership strategies are established to become a leader as follows in this study. First, it is the leadership to have vision, core values, and regular strategies. Second, it is the leadership to have matured personality. Third, it is to have self-control skill. Fourth, it is to have modest serving others. Fifth, it is to have the passion. Sixth, it is to have the communication skill. Lastly, it is to have the softness as well as the strength. The simple theory and scientific background of the leadership will be explained for these on the definition, characteristics, strengths and weaknesses of the established seven leadership strategies in this study. However, seven leadership strategies in this study will be suggested based on the books related to the leadership as well as the theories of the famous scholars. Application/Improvements: From this study, they will be suggested what the qualifications for the good leader are, what the leadership strategies are to be equipped as the good leader, and how they can develop the leadership strategy. In addition, it is anticipated that the study results could be utilized in the education as well as the leadership strategy that should be qualified as the good leader.


Some of the main experimental requirements limiting, till now, the clinical development of nuclear magnetic resonance (NMR) spectroscopy are discussed, with particular attention to the scarce sensitivity, low resolution and problems of spatial localization. A concise description is then given of the principal biological compounds which can be studied by this peculiar type of spectroscopy, together with the main categories of biochemical information that can be extracted from their detection, i.e. especially at the level of intermediate and energetic metabolism. In conclusion, some of the more outstanding examples selected from human clinical studies are depicted, particularly emphasizing those focused on the skeletal muscle system.


Cassava starch from nine varieties, namely, NR 8082, TMS 97/2205, TMS 97/0162, TMS 92/0057, TMS 98/0505, TMS 92/0326, TMS 30572, TMS 82/0058, and TME 419 were evaluated for their suitability as gelling substitute to conventional gelling agents (gellan gum and agar) in medium using cassava shoot tips and nodal segments as explants. Explants were seeded singly into a 15 ml cassava multiplication medium gelled either in 0.2% gellan gum, 0.7% agar or 7% starch from the nine cassava varieties. Cultures were maintained at 28 ± 2°C, 16 h photoperiod and 30 to 40 μEm-2 s-1 flux intensity supplied by white fluorescent tubes on shelves for four weeks. Percentage survival of explants irrespective of type ranged from 61.5 to 100 with NR 8082 and TMS 97/2205 cassava starch-gelled medium recording the highest score while the mean number of nodes produced per explant ranged between 3.6 ± 1.43 and 5.33 ± 0.87 for shoot tips and 2.73 ± 0.96 and 4.79 ± 0.97 for nodal segments. The nodal segments from TME 419 starch-gelled medium had the highest mean number of nodes though not significantly different (p>0.05) from those from gellan gum and agar media. TME 419 was the most consistent in influencing regeneration of cassava plantlets.

 Key words: TME 419, cassava starch, explants, gelling agent, micropropagation.


Effects-based operations emphasize actions performed to achieve effects beyond the most obvious tactical goals. In the case of riot control at a summit, these effects include the rights of societal institutions to meet and to make decisions, as well as the right of the people to protest against these decisions. Here, we propose a concept for a commander involved in riot control to evaluate different strategies in real-time against these conflicting goals. We describe, conceptually, how influence diagrams and different embedded simulation techniques need to be applied in order to implement this functionality. We also give an example of how the suggested approach will appear from an operational point of view


Children are strikingly underrepresented in COVID-19 case counts. In the United States, children represent 22% of the population but only 1.7% of confirmed SARS-CoV-2 cases. One possibility is that symptom-based viral testing is less likely to identify infected children, since they often experience milder disease than adults. To better assess the frequency of pediatric SARS-CoV-2 infection, we serologically screened 1,775 residual samples from Seattle Children's Hospital collected from 1,076 children seeking medical care during March and April of 2020. Only one child was seropositive in March, but nine were seropositive in April for a period seroprevalence of >1%. Most seropositive children (8/10) were not suspected of having had COVID-19. The sera of most seropositive children had neutralizing activity, including one that neutralized at a dilution >1:18,000. Therefore, among children seeking medical care, the frequency of SARS-CoV-2 infection increased markedly during the early Seattle outbreak despite few positive viral tests.


Abstract. The model PROCULTURE has been developed by the Universite Catholique de Louvain – UCL (Belgium) to simulate the progress of the septoria leaf blotch disease on winter wheat during the cropping season. The model has been validated in Luxembourg for four years at four distinct representative sites. It is able to identify infection periods due to the causal agent Mycosphaerella graminicola on the last five leaf layers by combining meteorological data with phenological data from PROCULTURE's crop growth model component. The meteorological forcing consists of hourly time-series of air temperature, relative humidity and cumulative rainfall since the time of sowing, retrieved from automatic weather stations for hindcast and numerical weather prediction model outputs for the forecast periods. In order to improve the model, leaf wetness – which is one of the most important drivers for the spread of the disease – shall be added as an additional predictor. Therefore leaf wetness sensors were set up at four test sites during the 2007 growing season. To get a continuous spatial coverage of the country, it is planned to couple the PROCULTURE model offline to 12-hourly operational weather forecasts from an implementation of the Weather Research and Forecasting (WRF) model for Luxembourg at 1 km resolution. Because the WRF model does not provide leaf wetness directly, an artificial neural network (ANN) is used to model this parameter.


The study was attempted to explore as to what extent English language teaching in Pakistan has been able to develop language skills among the target learners. The researcher intended to evaluate the limit to which the textbook helps in generating competence of all four integrated skills, especially as laid down in the standards of the National Curriculum (2006). The purpose of this study was to create pragmatic awareness among learners, teachers and educational professionals, working in the field of English as Foreign Language. By method , it was a qualitative study, semi-structured interviews and focus group discussions were the tools used to elicit the data. The participants of this research were selected from public sector schools and organizations including, teachers, policymakers, curriculum developers, subject specialists, and students to examine the effectiveness of grade VIII's English language textbook on students' performance . For data analysis themes were developed, coded and summarized in a descriptive mode. The findings of this study reflected that the relevant textbook does not cater to the target learners' future academic and professional language needs. As a solution to the problems while teaching and learning English as foreign language in Pakistan; this study also offered a model to be followed by the policy makers and practitioners in order to make the existing English language textbook more effectives in terms of foreign language teaching and learning and language skill development.


Thyroid nodules are found in 5% to 10% of the population. While these nodules carry only a 5% to 10% risk of malignancy, tests that complement fine-needle aspiration (FNA) cytology in preoperative diagnosis and risk stratification are lacking. Telomerase is a ribonucleoprotein polymerase with activity found in many malignant tissues, but absent from most normal adult tissue. In this study, we have investigated telomerase activity in 24 thyroid tumors, 14 matched adjacent thyroid tissues, and 3 chronic thyroiditis tissue samples. Using a telomeric repeat amplification protocol (TRAP) assay on frozen tissue, telomerase activity was detected in 11 of 20 thyroid carcinomas, including 10 of 14 papillary carcinomas and a Hurthle cell carcinoma. Telomerase activity was not detected in 4 benign adenomas, 3 follicular carcinomas, or a single case each of medullary and anaplastic thyroid carcinoma. Telomerase activity was detected in 3 of 14 samples of adjacent thyroid tissue from patients with thyroid tumors. Interestingly, all 3 cases of adjacent thyroid tissue that tested positive had a moderate to marked degree of chronic inflammation. In addition, 3 of 3 samples from chronic thyroiditis specimens tested positive for telomerase activity. When tumor invasiveness (vascular and/or capsular) was compared with telomerase activity in papillary carcinomas, only 1 of 4 telomerase-negative tumors was invasive, while 6 of 10 of telomerase-positive tumors were invasive. Moreover, 6 of 7 invasive papillary carcinomas had telomerase activity. In summary, this is the first report of telomerase activity in thyroid tissue and nodules. This activity was detected in a large percentage of papillary thyroid carcinomas, but not benign adenomas, follicular carcinomas, or most normal thyroid tissue. Telomerase activity may also correlate with tumor invasiveness. Further studies will focus on larger numbers of tumors, metastatic tissue, and undifferentiated carcinomas, as well as application of this assay to products from fine-needle aspirates as a potential diagnostic and prognostic marker in thyroid neoplasms.


The link between the magnitude of a bandwidth and the relevance of the corresponding covariate in a regression has recently garnered theoretical attention. Theory suggests that variables included erroneously in a regression will be automatically removed when bandwidths are selected via cross-validation procedure. However, the connections between the bandwidths of the variables that are smoothed away and the insights from these same variables when properly tested for statistical significance have not been previously studied. This paper proposes a variety of simulation exercises to examine the relative performance of both cross-validated bandwidths and individual and joint tests of significance. We focus on settings where the hypothesis of interest may focus on a single data type (e.g., continuous only) or a mix of discrete and continuous variables. Moreover, we propose an extension of a well-known kernel smoothing significance test to handle mixed data types. Our results suggest that individual tests of significance and variable-specific bandwidths are very close in performance, but joint tests and joint bandwidth recognition produce substantially different results. This underscores the importance of testing for joint significance when one is trying to arrive at the final nonparametric model of interest.


Case report: Dacrocystoceles is a rare clinical event due to proximal and distal obstruction of the lacrimal drainage system. Mucus accumulates in this region and a cyst is forming. Parents must be well informed about the condition due to the respiratory distress, the neonate facial appearance and must be well reassured for the complete resolution of the cysts and the airways obstruction after the surgical intervention, and the good cosmetic outcome. A 26-year-old woman, gravida 1 para 0, had her 3rd trimester scan in our unit. At the time of the 3rd scan she was 33 weeks and 1 day in her pregnancy. The scan revealed normal growth, normal amniotic fluid volume and normal values in basic anatomical structures. Uterine, umbilical, middle cerebral and ductus Doppler measurements were in the normal range for the gestational age. Estimated fetal weight was 2250 gr. During the examination of face, two symmetrical cystic structures were identified below and internally the orbital area. Measurements of those cystic structures were 9 × 10 × 10 mm for the right side and 9 × 11 × 11 mm for the left side. Our main potential diagnosis was cysts of the lacrimal drainage system (dacrocystocele). The 3D scanview of the face revealed two small cyst-like protrusions underneath the eye area. Differential diagnosis included cysts and tumors of facial bones. Neonatologists were informed about potential obstruction of respiratory system-respiratory distress. Mother gave birth (normal delivery) at 40th weeks + 3 days. A normal baby boy (weight 3550 gr.) was born with no signs of respiratory distress. Small cystic structures were obvious below the orbits. Neonatologist who examined the baby diagnosed bilateral dacrocystocele. The baby was referred to the otolaryngologists for further treatment. 3 days after delivery had a CT scan which confirmed diagnosis of bilateral dacrocystocele. The baby is due for endoscopic marsupialization-probing of those cystic structures.


Pattern mining is an important task in AI for eliciting hypotheses from the data. When it comes to spatial data, the geo-coordinates are often considered independently as two different attributes. Consequently, rectangular shapes are searched for. Such an arbitrary form is not able to capture interesting regions in general. We thus introduce convex polygons, a good trade-off between expressiv-ity and algorithmic complexity. Our contribution is threefold: (i) We formally introduce such patterns in Formal Concept Analysis (FCA), (ii) we give all the basic bricks for mining convex polygons with exhaustive search and pattern sampling, and (iii) we design several algorithms, which we compare experimentally.


We demonstrate that two-dimensional two-component bright solitons of an annular shape, carrying vorticities (m,+/-m) in the components, may be stable in media with the cubic-quintic nonlinearity, including the hidden-vorticity (HV) solitons of the type (m,-m) , whose net vorticity is zero. Stability regions for the vortices of both (m,+/-m) types are identified for m=1 , 2, and 3, by dint of the calculation of stability eigenvalues, and in direct simulations. In addition to the well-known symmetry-breaking (external) instability, which splits the ring soliton into a set of fragments flying away in tangential directions, we report two new scenarios of the development of weak instabilities specific to the HV solitons. One features charge flipping, with the two components exchanging angular momentum and periodically reversing the sign of their spins. The composite soliton does not directly split in this case; therefore, we identify such instability as an intrinsic one. Eventually, the soliton splits, as weak radiation loss drives it across the border of the ordinary strong (external) instability. Another scenario proceeds through separation of the vortex cores in the two components, each individual core moving toward the outer edge of the annular soliton. After expulsion of the cores, there remains a zero-vorticity breather with persistent internal vibrations.


An unusual case of a carcinoma of the prostate where the patient presented with rectal symptoms is described. A good initial response to oestrogen therapy occurred, with loss of perineal pain and rectal bleeding an improvement in urinary stream.


Research was conducted to explore the effect of underground travel on the character of the natural organic matter (NOM) originating from river water sources during riverbank filtration (RBF) at three Midwestern US drinking water utilities. Measurements of biodegradable dissolved organic carbon (BDOC) and assimilable organic carbon (AOC) showed significant reductions (50 to 90%) in the biodegradable portion of NOM at two of the sites. Specific UV-absorbance (SUVA) values suggested preferential reduction (26% reduction in SUVA) in UV-absorbing NOM at one of the sites but negligible changes in SUVA were observed at the other two sites. XAD-8 characterization was carried out on the river and well waters to investigate possible changes in the character of the NOM. The distribution of dissolved organic carbon (DOC) between the XAD-8 adsorbing ('hydrophobic') and non-adsorbing ('hydrophilic') fractions was similar between the river and well waters (40 to 70% hydrophilic and 30 to 60% hydrophobic), indicating no significant, consistent, preferential removal of either fraction upon ground passage. SUVA measurements on the separate XAD-8 fractions similarly showed no significant change during bank filtration. Disinfection by-product (DBP) formation testing was performed on the various fractions, keeping the ratio of chlorine:DOC:bromide constant. DBP formation testing showed no preferential formation between the hydrophobic and hydrophilic fractions in either the river or well waters. While the overall concentrations of organic DBP precursors are effectively reduced during bank filtration, the reductions appear to be largely the result of the reduction in NOM concentration rather than a consistent change in NOM character.


The research presented in this book discusses how to efficiently retrieve track and trace information for an item of interest that took a certain path through a complex network of manufacturers, wholesalers, retailers, and consumers. To this end, a super-ordinate system called "Discovery Service" is designed that has to handle large amounts of data, high insert-rates, and a high number of queries that are submitted to the discovery service. An example that is used throughout this book is the European pharmaceutical supply chain, which faces the challenge that more and more counterfeit medicinal products are being introduced. Between October and December 2008, more than 34 million fake drug pills were detected at customs control at the borders of the European Union. These fake drugs can put lives in danger as they were supposed to fight cancer, take effect as painkiller or antibiotics, among others. The concepts described in this book can be adopted for supply chain management use cases other than track and trace, such as recall, supply chain optimization, or supply chain analytics.


This paper contributes to the literature of flood risk capitalization and farmland valuation by taking the advantage of boundary discontinuities around flood zone to control for unobserved heterogeneities in estimating flood risk premium using hedonic regression. With a model controlling for building structures attached to farmland, distance to city center, flood exposure, farmland acreage, and municipality related time-invariant fixed effects, a spatial difference-in-differences framework based on boundary discontinuities is proposed. The proposed approach finds qualitatively different results than a conventional hedonic price model with municipality fixed effects. On average, in the study region (Lancaster County of Pennsylvania), the conventional hedonic price model suggests that there is a 6.66% (or $868.76/acre, in 2015 USD) value reduction due to potential flood risk in the 100-year (1% annual chance of flooding) FEMA (Federal Emergency Management Agency) flood zone. The proposed spatial difference-in-differences model, however, finds that the impact on farmland values due to the potential flood risk is insignificant with the same data. This suggests that estimating flood risk premium using a conventional hedonic price model directly may suffer from serious biases due to unobserved spatial heterogeneities. The proposed spatial difference-in-differences approach has an advantage of controlling for unobserved heterogeneities that are continuously distributed across the boundary of floodplain.


An adaptive smoothing method based on a least mean-square estimation is developed for noise filtering of spectroscopic data. The algorithm of this method is nonrecursive and shift-varying with the local statistics of data. The mean and the variance of the observed spectrum at an individual sampled point are calculated point by point from its local mean and variance. By this method, in the resultant spectrum, the signal-to-noise ratio is maximized at any local section of the entire spectrum. Experimental results for the absorption spectrum of ammonia gas demonstrate that this method distorts less amount of signal components than the conventional smoothing method based on the polynomial curve-fitting and suppresses noise components satisfactorily. The computation time of this algorithm is rather shorter than that of the convolution algorithm with seven weighting coefficients. The a priori information for the estimation of the signal by this method are: the variance of noise, which can be attainable in the experiment; and the window function which gives the local statistics. The investigation of various types of window functions shows that the selection of the window function does not directly affect the performance of adaptive smoothing.


This paper studies whether countries benefit from servicing their debts during times of widespread sovereign defaults. Colombia is typically regarded as the only large Latin American country that did not default in the 1980s. Using archival research and formal econometric estimates of Colombia's probability of default, we show that in the early 1980s Colombia's fundamentals were not significantly different from those of the Latin American countries that defaulted on their debts. We also document that the different path chosen by Colombia was due to the authorities' belief that maintaining a good reputation in the international capital market would have substantial long-term payoffs. We show that the case of Colombia is more complex than what it is commonly assumed. Although Colombia had to re-profile its debts, high-level political support from the US allowed Colombia do to so outside the standard framework of an IMF program. Our counterfactual analysis shows that in the short to medium run, Colombia benefited from avoiding an explicit default. Specifically, we find that GDP growth in the 1980s was higher than that of a counterfactual in which Colombia behaved like its neighboring countries. We also test whether Colombia's behavior in the 1980s led to long-term reputational benefits. Using an event study based on a large sudden stop, we find no evidence for such long-lasting reputational gains. JEL Codes: F34; F32; H63


Along the coastal plain of Israel, shell darkness of the polymorphic land snail Xeropicta vestalis is positively related to the extent of perennial vegetation. It is not related to rain, temperature, geographic position or darkness of the ground.

White shells reflect more radiation than dark ones do, and therefore in Israel's coastal plain, where solar radiation is very strong, they are favoured. Perennial vegetation, where it occurs, shields the snails from the sun by absorbing radiation, so that snails amongst them can afford to be darker, and thus more cryptic. Hence, the more perennial vegetation in the habitat, the darker the shells.

Also during the Pleistocene, when temperatures were 5–10°C lower than today, the shells of the coastal plain were as pale as recent ones are. The distribution of a snail-predator, Gerbillus allenbyi, which is restricted to sandy biotopes where perennial bushes occur, and which was absent from Israel during the Pleistocene, could perhaps explain the distribution of X. vestalis morphs, both today and in the past.


The high-degree Earth Gravitational Model EGM08 allows for geoid determination with a resolution of the order of 5'. Using this model for estimating the quasigeoid height, we estimate the global root mean square (rms) commission error to 5 and 11 cm, based on the assumptions that terrestrial gravity contributes to the model with an rms standard error of 5 mGal and correlation length 0.01◦ and 0.1◦ , respectively. The omission error is estimated to−0.7∆ḡ [mm], where ∆ḡ is the regional mean gravity anomaly in units of mGal. In case of geoid determination by EGM08, the topographic bias must also be considered. This is because the Earth's gravitational potential, in contrast to its spherical harmonic representation by EGM08, is not a harmonic function at the geoid inside the topography. If a correction is applied for the bias, the main uncertainty that remains is that from the uncertainty in the topographic density, which will still contribute to the overall geoid error.


The study aimed to evaluate the efficacy of the combination of CPP-ACP and fluorides compared with fluorides monotherapy on patients with early caries lesions. The Medline, Embase and Cochrane databases up to August 2017 were scanned, with no restrictions. Studies satisfied the guideline of randomised controlled trials (RCTs), the patients with early caries lesions and data considering the efficacy of fluorides and CPP-ACP versus fluorides alone were selected. There was no language restriction during the literature search process, however, only papers in English or Chinese were included during the selection process. Outcome variables include laser fluorescence, quantitative light-induced fluorescence, lesion area and visual inspection scores. Mean differences were calculated during the data extraction process. Ten studies including 559 patients were selected in the meta-analysis. Fluorides combined with CPP-ACP achieved the same efficacy for early caries lesions on smooth surfaces compared with fluorides monotherapy (mean difference: -13.90, 95% confidence interval: [-39.25, 11.46], P = 0.28), and the combination treatment showed significantly better efficacy than fluorides monotherapy for occlusal early caries lesions (mean difference: -21.02, 95% confidence interval: [-27.94, -14.10], P<0.01). However, further well-designed studies are still needed.


BACKGROUND
Primary care consultation data are an important source of information on morbidity prevalence. It is not known how reliable such figures are.

AIM
To compare annual consultation prevalence estimates for musculoskeletal conditions derived from four general practice consultation databases.

DESIGN OF STUDY
Retrospective study of general practice consultation records.

SETTING
Three national general practice consultation databases: i) Fourth Morbidity Statistics from General Practice (MSGP4, 1991/92), ii) Royal College of General Practitioners Weekly Returns Service (RCGP WRS, 2001), and iii) General Practice Research Database (GPRD, 1991 and 2001); and one regional database (Consultations in Primary Care Archive, 2001).

METHOD
Age-sex standardized persons consulting annual prevalence rates for musculoskeletal conditions overall, rheumatoid arthritis, osteoarthritis and arthralgia were derived for patients aged 15 years and over.

RESULTS
GPRD prevalence of any musculoskeletal condition, rheumatoid arthritis and osteoarthritis was lower than that of the other databases. This is likely to be due to GPs not needing to record every consultation made for a chronic condition. MSGP4 gave the highest prevalence for osteoarthritis but low prevalence of arthralgia which reflects encouragement for GPs to use diagnostic rather than symptom codes.

CONCLUSION
Considerable variation exists in consultation prevalence estimates for musculoskeletal conditions. Researchers and health service planners should be aware that estimates of disease occurrence based on consultation will be influenced by choice of database. This is likely to be true for other chronic diseases and where alternative symptom labels exist for a disease. RCGP WRS may give the most reliable prevalence figures for musculoskeletal and other chronic diseases.


Chronic metabolic and cardiovascular diseases, described as the epidemics of XXI century, are connected to the resistance of peripheral tissues, such as liver, muscle and fat, to insulin. Insulin resistance, which precedes the development of type 2 diabetes by several years, is difficult to diagnose, mainly because of practical limitations to the use of "gold standard" hyperinsulinemic euglycemic clamp technique for screening. It is also begins a certain vicious circle, in which insulin resistant peripheral tissues force pancreatic beta cells to increased insulin release, and sustained high concentrations of insulin cause further development of insulin resistance. Currently, there are two major hypotheses describing the mechanism of insulin resistance: one relating to the "lipid overload" in liver and muscle cells as the key factor and another one emphasizing the role of lipid accumulation in adipocytes, which leads to the overgrowth of fatty tissue and chronic local inflammation.


The literature has struggled to reach an acceptable definition for the construct of impulsivity. Different models have variously suggested that the crux of the impulsivity construct lies in lack of planning, difficulties in concentration, failure of inhibition or attraction to sensation or immediate reward. More recently, research has suggested that impulsivity is increased in conditions of extreme affect, either positive or negative. The development of a novel measure of affective impulsivity, termed the UPPS-P Impulsive Behaviour Questionnaire, has enabled quantitative investigation of the construct.

In spite of difficulties in defining impulsivity, there is a broad consensus as to the clinical utility of the construct. It has been shown to be highly predictive of a wide range of so-called impulsive behaviours, which include suicide, binge eating and substance use. At the same time, impulsivity is also an important trans-diagnostic construct. Trait impulsivity is elevated in many psychiatric disorders, including borderline personality disorder and attention deficit hyperactivity disorder. There is also strong evidence that both state and trait impulsivity are elevated in bipolar disorder, and that this elevation may explain a number of common comorbidities and behaviours found within the disorder.

The thesis begins with a review of the literature, examining six key perspectives on impulsivity and their corresponding measures within Chapter One. Chapter Three also explores the construct and measurement of emotion-mediated, affective impulsivity. The literature linking impulsivity to behaviour in both clinical and non-clinical samples is reviewed within Chapter Two. Within Chapter Four the evidence supporting continuum models of psychiatric disorder is introduced, with particular discussion of the bipolar spectrum. Chapter Five brings together the preceding chapters, reviewing the literature supporting an interaction between psychiatric disorder, affect, impulsivity and behaviour.

The first study of this thesis, a cross-sectional questionnaire study which can be found in Chapter Six, looked to extend these findings by exploring the presence and role of impulsivity in a wider bipolar spectrum sample. Experience of extreme positive mood state, as measured by the Mood Disorder Questionnaire, was found to relate to increased trait impulsivity and elevated engagement in a range of impulsive behaviour. A structural equation model demonstrated that impulsivity could be separated into cognitive and affective components, with affective impulsivity a key predictor of impulsive behaviour. Affective impulsivity was also shown to moderate the relationship between extreme mood experience and impulsive behaviour.

The second study, found in Chapter Seven, used semi-structured interviews and thematic analysis to develop an understanding of the individual's experience of impulsivity and impulsive behaviour. The themes arising from these data (preparatory set, influence of the environment and others, intense emotional state, (lack of) agency, premonitory urge, reflexive action and sensation seeking) suggested that context plays an important role in the prediction of impulsive behaviour, with the physical and social environment of the individual an important factor in their behaviour. Results also supported the validity of the affective impulsivity construct. Individuals described their emotional state as having a large impact upon their decision to act impulsively, either using behaviour as a tool to moderate their affective state or experiencing cognitive difficulties as a result of it. Finally, data suggested a link between impulsivity and loss of control. Models were developed which indicate the presence of a 'risky mood state' in which individuals feel unable to control or predict their behaviour.

Together the studies highlight the complexity of impulsivity, and the importance of a wide variety of other factors related to the construct. This is particularly true of affective state, which was seen through both studies to have a large impact on both the occurrence and experience of impulsivity and impulsive behaviour. The studies support the validity of the bipolar spectrum, with similar experiences found in our sample as in clinical samples. The finding that impulsivity is related to a wide range of high-risk behaviours, and that many of these behaviours are ego-syntonic, has important implications for the treatment of impulsivity.


In many parts of the world, education change might have the right goals--better outcomes for students, including students from groups that had previously lagged behind average achievement levels. But many of these efforts have used wrongheaded approaches or failed to pay enough attention to what we are learning about effective large-scale change. In particular, many strategies place too much emphasis on test results as the main way to drive improvement. In contrast, Ontario's education change strategy embodies vital principles, grounded in research, that are associated with meaningful and sustainable change. Changes are respectful of professional knowledge and practice, and their main elements are coherent and aligned at the provincial, district, and school levels. Key partners--the provincial Ministry of Education, school boards, schools, and provincial and local organizations of teachers, principals, and others--work together. Change strategies are comprehensive and emphasize building capacity for improvement through professional learning, strong leadership, necessary resources, and effective engagement of parents and the broader community. Great emphasis is placed on public communication so that people know what is happening and support the schools. Most of all, there has been a relentless focus over several years on the same basic strategy. We believe this is an example of large-scale change that is effective and sustainable. Ontario has about 2 million children in its public education system. The provincial government provides essentially 100% of the funds for all four sets of locally elected school boards, reflecting Canada's constitutional requirement for public support of minority-language and Catholic schools. School boards (the equivalent of a school district in the U.S.) range in size from a few hundred students to about 250,000 in the Toronto District School Board. The province has nearly 5,000 schools extending across 400,000 square miles--the size of the eight southeastern states put together. The average elementary school has about 350 students; the average secondary school, fewer than 1,000. Ontario also has a very diverse enrollment, with 27% of the population born outside of Canada and 20% visible minorities. Ontario's 120,000 or so teachers and most of its support staff are unionized. There is a mandatory provincial curriculum. Thus, education in Ontario has all the challenges one might anticipate--large urban areas and very remote rural areas, significant urban and rural poverty levels, high levels of population diversity, areas with sharply dropping enrollment and others with rapid growth. During the 1990s, Ontario education was troubled. The province had significant labor disruption, lots of public dissatisfaction, increasing private school enrollment, and poor morale leading to high teacher turnover. However, in 2003, a new government was elected with the renewal of public education as one of its highest priorities. A premier with a deep commitment to education and talented ministers brought strong political leadership to bear. The Ontario education strategy that began in 2003 has two main components: * A commitment to improve elementary school literacy and numeracy outcomes, and * A commitment to increase high school graduation rates. These priorities were chosen because public confidence in and support for education depend on demonstrated achievement of good outcomes for students. These core goals are supported by a large-scale strategy based substantially on Michael Fullan's work. (1) The core strategies are also complemented by a range of other initiatives. Some of these initiatives, such as strengthening school leadership or renewing curricula, are necessary to support the key goals. Of particular importance was a commitment to reduce class sizes in the primary grades. Other initiatives, including provincial support for negotiating four-year collective agreements with all Ontario teachers in 2005, were necessary so that all parties could focus on improving student outcomes instead of being distracted by labor issues. …


This paper explores the potential of Semantic Web technologies to support teaching and learning in a variety of higher education settings in which some form of case-based learning is the pedagogy of choice. It draws on the empirical work of a major three year research and development project in the United Kingdom: "Ensemble: Semantic Technologies for the Enhancement of Case-Based Learning" which has been oriented toward developing a better understanding of the nature of case-based learning in different settings, but also exploring the potential for Semantic Web technologies to support, enhance, and transform existing practice. The experience of working in diverse educational settings has highlighted Semantic Web technologies that may be particularly valuable, as well as some of the enablers and barriers to wider adoption, and areas for further research and development.


Background: Basrah has been exposed to massive environmental pollution during past years including depleted uranium (DU) as a consequence of military conflicts. Many studies have reported an increase in incidence of cancer in Basrah. Objectives: To explore the ecological relationship between DU and cancer incidence in Basrah. Material & methods: Basrah governorate was divided into seven geographical areas. Exposed areas to DU were dotted on the map of Basrah. Incidence rates of cancer were distributed in these seven areas. Statistical analysis included descriptive statistics and Spearman correlation analysis. Results: This study did not find ecological correlation between incidence rate of cancer and level of exposure to DU in Basrah. Conclusions: Although the result of the ecological study may be affected by the ecological fallacy, the power to generate hypothesis about the relationship between DU and cancer risk is still weak especially when taking into account the results of previous studies of uranium exposure and cancer risk. Further epidemiological studies are needed to clarify a possible carcinogenic effect of residential exposure to DU.


The behavior of pile foundations under axial loading is directly influenced by the effects that its installation process induces in the surrounding soil. Consequently, the consideration of these effects is essential for the correct numerical modeling of these geotechnical structures. In the present study, numerical simulations of driven cast-in-situ piles under axial loading have been carried out using finite element analysis. Three 3.5 m long piles with diameters ranging from 114.3 to 219.1 mm were analyzed. The pile installation effects have been considered indirectly by employing two distinct approaches, both based on the concepts of cylindrical cavity expansion. The behavior of the tropical soil profile is described with the Hardening Soil constitutive model. The load-displacement response and load distribution along the pile obtained with the numerical simulations have been analyzed and compared with in-situ load tests results. In the failure conditions, both approaches accurately predicted the bearing capacity of the piles, with an average error of only 2% compared to the measured values. The results in terms of load distribution over depth were also satisfactory. The difference between measured and numerical ultimate base resistance values ranged from 0% to 30%. The good agreement between the numerical and experimental results indicates that the proposed numerical approaches have been effective in simulating the piles installation process and reinforces the importance of considering the installation effects in the numerical modeling of these geotechnical structures. Both approaches can also be used to predict the bearing capacity of displacement piles.