OBJECTIVE
To integrate the resources from a local statewide managed care organization (MCO) and a supermarket pharmacy chain to conduct a comprehensive health risk appraisal (HRA). Collected data were used to assess cardiovascular risk factors and identify disease management opportunities.

METHODS
An analysis to determine the prevalence of risk factors was conducted on a cross-sectional HRA survey. The HRA involved point-of-care cholesterol screening (with a follow-up risk factor questionnaire) conducted by pharmacist employees of the employer group (a regional supermarket chain). Those eligible for the screening were employees of the supermarket chain and their dependents covered by the participating MCO.

RESULTS
A total of 12,915 completed HRA questionnaires were received. The mean age of the employees participating was approximately 44 years. Of note, 14%, 24%, 21%, and 69% of questionnaires had abnormal values for total cholesterol, high-density lipoprotein (HDL) cholesterol, blood pressure, and body mass index (BMI), respectively. Compared with national benchmarks, low HDL cholesterol and BMI more than 30 kg/m2 were more common in this cohort. More than one-fourth of the employees in this analysis were identified as being at high risk for a coronary heart disease event.

CONCLUSION
The unique collaboration presented here allowed for an expanded role of pharmacists to implement a quality improvement program. In response, the employer decided to continue the HRA screening and offer a employee contribution reduction-based health incentive to covered members. The employer also is considering offering cardiovascular disease management interventions that will be performed by the supermarket chain's pharmacists and targeted toward the identified risk factor trends.


Programming by example (PBE) is an important subproblem of program synthesis, and PBE techniques have been applied to many domains. Though many techniques for accelerating PBE systems have been explored, the scalability remains one of the main challenges: There is still a gap between the performances of state-of-the-art synthesizers and the industrial requirement. To further speed up solving PBE tasks, in this paper, we propose a novel PBE framework MaxFlash. MaxFlash uses a model based on structural probability, named topdown prediction models, to guide a search based on dynamic programming, such that the search will focus on subproblems that form probable programs, and avoid improbable programs. Our evaluation shows that MaxFlash achieves × 4.107− × 2080 speed-ups against state-of-the-art solvers on 244 real-world tasks.


Broadcasting a request or challenge is a classic method of collecting local information in distributed wireless networks. Neighbor discovery is known to be a fundamental element in ad hoc and sensor networks topology formation, which takes advantage of such methods. Most of the current neighbor discovery protocols rely on a challenge or request broadcast by the discovering node called "Hello." Hello flooding attack was specifically designed to exploit the broadcasting nature of these protocols in order to convince a large group of nodes that the sender is their neighbor by using very high transmission power. Several studies have been done to mitigate the effectiveness of the flooding threats but little effort has been made in modeling and analyzing this problem. Arguing that random channel access protocols must be inevitably employed in neighbor discovery, we propose an analytical approach for stochastic modeling of the challenge-broadcasting scenarios in networks using slotted carrier sense multiple access with collision avoidance (CSMA/CA) protocols. We model the nonstationary channel right after issuance of the request by a recursive method and then put forward an approach to find the broadcaster's approximate payoff. The model also supports the cases where the broadcaster is a malicious node with an abnormally high transmission and reception range, which is found in severe flooding attacks. We investigate the applications of the model in finding the optimal attack range for the flooding adversaries and deriving a flood-resilient medium access control (MAC) protocol design framework to increase the security of challenge-response protocols. The latter one is especially relevant to mobile networks as it provides a low-cost solution. This paper describes the detailed analysis of the proposed theoretical framework as well as the comprehensive evaluations that have been carried out via simulations.


Aims: Jaws are seldom affected by pathologies which require resection for comprehensive management to ensure clearance and minimise recurrence. This paper highlights the importance of intra operative radiography in deter - mining adequate margins during surgery. Methods: Ten patients were operated for surgical resection of jaws wherein the resected specimens were subjected to radiography for evaluat- ing the adequacy of clear margins which was later sent for histopathology. Patients were followed up for least three years. Results: Intra operative radiograph revealed adequate clearance which was confirmed by histopathology. The follow up period was free of any disease thereof. Conclusion: Intra operative radiography is a helpful tool during surgical resection of pathologies afflicting the jaws. It proves to be a very economical, low hazard and a quick means to assist the operating surgeons in assessing the clearance of the margins.


Background: In a context of growing incidence of chronic diseases and aging populations, there is the need to research and find new solutions to shift resources into the community in an effort to deal more effectively with chronic conditions. In that direction, patient empowerment plays an important role. Approaches to increase patient empowerment vary from patient self-management programs to promoting patient involvement in treatment shared decision-making, to facilitating the clinician-patient cooperation. Methods: In the CONNECARE project ID: 689802, we focus on patient's monitoring with the final goal of providing self-management features to people in needs, such as chronic patients. To be modular and scalable and to allow us to have a disease-independent system, the proposed solution is based on the software-engineering concept of microservices. They are modularization concepts that may be developed independently of each other, possess their own data storage, and can bring their own support service. In CONNECARE, each microservice is in charge of performing a simple task; whereas a complex task is achieved by the collaboration, interaction, and coordination of one or more simple microservices. In so doing, the proposed solution allows a better maintenance and bugs fixing. Seemly, scalability is obtained by dividing each task into less complex ones. Thus, when changes are needed in a microservice, they do not affect the rest of the system. Moreover, when a new functionality is required, a new microservice or set of microservices collaborating together may be defined and simply added to the system. In so doing, the proposed solution is robust to changes and improvements. Right now, 9 microservices have been defined and developed, each one aimed at providing a functionality to provide self-management to the patients. Patient's monitoring is performed through the following microservices: physical activity, self-checked questionnaires, sleeping, and health status. Also 5 further functionalities are provided, each one by a specific microservice: notifications, alerts, recommendations, third-party integration, and messaging. Results: According to a co-design approach with clinicians of the 4 sites in the project i.e., Barcelona, Lleida, Israel, and Groningen, clinical studies have been designed for field-testing the self-management system in real clinical practice. Those studies will be carried out during 18 months starting in March 2018 and will focus on 3 use cases: community-based management of chronic complex patients, integrated management of patients undergoing surgical procedures, and pre-habilitation of high-risk candidates for complex abdominal surgical procedures the latter only in Barcelona. Currently, a feasibility test with selected clinicians and patients is running in the 4 sites. Conclusions: The first release of the presented system is under testing to be ready to be evaluated and refined in 4 sites throughout clinical studies next March. CONNECARE will consequently help to improve real practice deployment of integrated care in those sites and will be able to bring practical insight to the potential of transferability of new methods and technologies to other regions in Europe and beyond.


In the last few years, high-throughput (or 'next-generation') sequencing technologies have delivered a step change in our ability to sequence genomes, whether human or bacterial. Further comparative genome analysis enables us to reveal detailed knowledge of genetics or physiology of industrial important strains obtained in laboratory, to analyze genotype-phenotype correlations of mutants with improved performance. Based on identified key mutations or mutation combinations, Inverse Metabolic Engineering (IME) can be performed by using accurate genetic modification system. Recently, IME has been successfully used for strain improvement and has become a research hotspot, including improving substrate utilization, engineering the robustness of industrial microbes and enhancing production of bio-based products. Here, we describe recent advances in research methods of IME, with an emphasis on characterization of genotype-phenotype and the latest advances and application of IME. Possible directions and challenges for further development of IME are also discussed.


Background. A formative assessment of the implementation of HIV testing and counseling (HTC) at school showed high acceptability and willingness to test among learners. However, the success of the proposed HTC depends on the support and acceptability of key stakeholders, including the parents. The aim of the study was to assess the opinions and acceptability of the implementation of HTC at school among parents of adolescents in high school. Methods. This was a cross-sectional household survey conducted with parents of adolescents attending high schools in educational districts in North West and Gauteng provinces, South Africa. Results. A total of 804 parents participated, and 548 (68.3%) were biological mothers, 85 (10.6%) were fathers, and the remaining were other relatives including grandmothers. Almost all (n = 742, 92.9%) parents were in support of implementation and provision of HTC at school, 701 (87.7%) would allow their children to be tested at school, 365 (46%) felt that parental consent was not needed to test at school, and 39.4% preferred to receive the HIV test results with their children. Conclusion. Parents accept the roll-out of an HTC program at school and have a role to play in supporting children who test positive for HIV.


Friedreich's Ataxia (FRDA) is an autosomal recessive neurodegenerative disorder and the most common of the hereditary ataxias. Pathological degeneration primarily involves the spinal cord with the degeneration of neurones in the spinocerebellar tracts. Dysarthria is a diagnostic clinical feature of FRDA. While the dysarthria associated with FRDA is classically described as ataxic, neurological involvement can extend beyond the spinocerebellar tracts, particularly as the disease progresses, resulting in a mixed dysarthria. The current keystone of knowledge regarding the dysarthria associated with FRDA has arisen largely from perceptual descriptions. Hence, the primary aim of this thesis is to provide a comprehensive assessment of speech function in individuals with a confirmed genetic diagnosis of FRDA, applying perceptual and instrumental techniques. Thirty-eight individuals with FRDA participated in the perceptual speech assessment with a subgroup of seven participants completing an instrumental battery of assessments. Perceptual speech assessment was conducted on the cohort of 38 individuals with FRDA and a group of 20 non-neurologically impaired individuals, who served as controls. Assessment included the perceptual analysis of a speech sample investigating 30 different dimensions of speech, an overall dysarthria severity rating, and the Assessment of Intelligibility of Dysarthria Speech (ASSIDS). The FRDA participants presented with dysarthria of severities ranging from mild to moderate. Correlation analysis revealed a significant relationship between dysarthria severity and parameters of disease duration and overall disease severity, but not with age of onset or the size of the genetic mutation. The perceptual profiles obtained from the perceptual analysis were subjected to a cluster analysis, suggesting the existence of three subgroups, defined according to their perceptual speech characteristics. The first subgroup presented with mild dysarthric symptoms, the second was characterised by the presence of hypernasality and the third distinguished by an increased phonatory dysfunction. A subgroup of seven individuals with FRDA participated in a series of instrumental assessments, including acoustic and physiological measures (Nasometer and Respitrace), selected to provide an overview of motor speech function encapsulating all aspects of speech production including: articulation, phonation, resonance and speech breathing. Instrumental assessment supported the perceptual findings and the clustering of subgroups, representing distinct impairments of the speech mechanism and perhaps reflective of differing evolutions beyond the cerebellum. A further aim of this thesis was to specifically investigate the articulatory impairment that is prominent in the dysarthria associated with FRDA, using physiological instrumentation. Electropalatography (EPG) was used to describe the pattern of linguopalatal contact and the consonant phase durations exhibited by seven individuals with FRDA. The FRDA group exhibited significantly increased consonant durations compared to the controls while maintaining normal linguopalatal contact patterns, suggesting that the articulatory impairment in FRDA manifests as a temporal rather than spatial disturbance. Lingual kinematics were investigated in two subsequent studies using electromagnetic articulography (EMA). Due to the demands of the assessment, a smaller group of four individuals with FRDA participated in the study. The first study investigated lingual movements across sentence productions of the tongue–tip sentence Tess told Dan to stay fit and the tongue-back sentence Karl got a croaking frog. Kinematic parameters included velocity, acceleration/deceleration, distance travelled and duration of movement for the approach phase and release phase of consonant productions across the sentence. The FRDA group demonstrated greater movement durations, increased articulatory distances and reduced speed measures during the approach phase of consonant productions. The final EMA study sought to further investigate the articulatory kinematics in the dysarthria associated with FRDA, by looking specifically at the production of the alveolar consonant /t/ and the velar consonant /k/ as produced within a sentence utterance, as well as in a syllable repetition task. Results revealed significantly greater movement durations and increased articulatory distances, most predominantly during the approach phase of consonant production. A task difference was observed with lingual kinematics more disturbed during the syllable repetition task than during the sentence utterance. Despite expectations of slowed articulatory movements in FRDA dysarthria, the EMA data indicated that the observed prolongation of consonant phase durations was generally associated with greater articulatory distances, rather than slowed movement execution. Slowed movement execution was evident only in the participant who presented with a more severe dysarthria, associated with a more severe disease progression. This thesis provides the largest study of the dysarthria associated with FRDA to date. It is anticipated that this research will provide a baseline for a longitudinal study of speech function in FRDA. The quantification of speech function in this population may have an important role in providing a significant functional measure of neurological decline. This may lead to the development of more sensitive assessment tools to measure change in performance in clinical trials, for determining the benefits of speech pathology interventions and for therapies targeting the central nervous system (CNS) involvement in FRDA.


Ginger (Zingiber of icinale) has beenutilized since ancient times in various traditional systems of medicine like Ayurveda, Unani, and naturopathy because of antifungal and antimicrobial potential against diverse fungal and microbial infections. Moreover, in the Asian subcontinent like India, Pakistan, Bangladesh, etc., ginger is used inmany food preparations as a condiment and boiled decoction to treat cold-cough and indigestion. The present research was conducted to ind out the antifungal potential of various extracts of dried ginger powder, by means of paper disc diffusion method, with petroleum ether, ethyl acetate, ethanol and aqueous solvents in 25 μml, 50 μml and 100 μml concentrations against Microsporum gypseum. Clotrimazole was used as a standard. The present study revealed that ginger is a potent antifungal agent against Microsporum gypseum. The ethanol extract of ginger using 100 μml concentrations depicted the highest zone of inhibition of 19.840+ 0.65mm and 46.139% of mycelial inhibition against the tested pathogen. While other drug extracts in different solvents also revealed reasonable to least antifungal potential. This inding tells us that ginger extracts tested proved to be a potent antifungal agent against Microsporum gypseum. It was found that ethanol extract of ginger is best effective against tested strain. This exploration of ginger extracts has con irmed its importance, particularly in the area of in luence on dermatophytic fungal strain.


When taking the real, inhomogeneous and anisotropic matter distribution in the semi-local universe into account, there may be no need to postulate an accelerating expansion of the universe despite recent type Ia supernova data. Local curvatures must be integrated (over all space) to obtain the global curvature of the universe, which seems to be very close to zero from cosmic microwave background data. As gravitational structure formation creates bound regions of positive curvature, the regions in between become negatively curved in order to comply with a vanishing global curvature. The actual dynamics of the universe is altered due to the self-induced inhomogeneities, again more prominently so as structure formation progresses. Furthermore, this negative curvature will increase as a function of time as structure formation proceeds, which mimics the effect of "dark energy" with negative pressure. Hence, the "acceleration" may be merely a mirage. We make a qualitative and semi-quantitative analysis, for pedagogical reasons using newtonian gravity corrected for special relativistic effects (which works surprisingly well) to corroborate and illustrate/visualize these statements. This article may be seen as an attempt to communicate to a larger number of people the necessity of starting to take seriously the real, observed inhomogeneous distribution and the nonlinearities of nonperturbative general relativity, and their impact on the dynamics and behavior of the cosmos instead of allowing an oversimplified cosmological model to generate a consensus world-view of a cosmos allegedly dominated by mysterious dark energy.


Author Oduro William Apotogse Title A Review Of Ghana`s Renewable Energy Policy Year 2014 Language English Pages 49+1 Appendix Name of supervisor Adebayo Agbejule This thesis work describes Ghana`s renewable energy policies and the barriers the policy is facing. It further explains the various renewable energy policies used in the world and how Ghana can learn from those polices, especially the policies from Cape Verde. The method used in this thesis work was a desktop research to come out with the various polices that Ghana can implement and an interview with one of the experts in renewable energy in the energy commission of Ghana. The outcome of the study was that-Ghana has some policies in place such as feed in tariff, tax exemptions, biofuel and heat obligation, reduction in sales, renewable energy portfolio and public investments but it also faces some barriers in the renewable energy sector and those barriers are land access, structure of the energy sector, transmission access, lack of education and infrastructure, assistance from the government and banks. Despite those barriers Ghana can still achieve their target in 2020 by learning from Cape Verde.


In these experiments, we tested two hypotheses: first, that Triton WR‐1339, a nonionic detergent which is sequestered in hepatocyte lysosomes, undergoes biliary excretion; and second, that Triton WR‐1339, which also alters serum lipid levels and modifies hepatic catabolism of lipoproteins, affects the biliary output of proteins and lipids. When 3H‐Triton WR‐1339 was administered to rats, biochemical and morphologic studies showed that hepatocyte lysosomes sequestered Triton WR‐1339: (i) the subcellular distribution of 3H was identical to that of lysosomal enzymes after liver fractionation by differential or isopycnic centrifugation, and (ii) lysosomes appeared engorged with Triton WR‐1339 on electron microscopy. 3H was also excreted into bile in parallel to three lysosomal enzymes. Triton WR‐1339 administration caused a coordinate increase in the biliary excretion of three lysosomal enzymes and also increased the biliary output of total protein, bile acids, and phospholipid. Triton WR‐1339 administration did not affect bile flow or the biliary outputs of cholesterol, plasma membrane, and cytosolic enzymes, but did decrease biliary cholesterol saturation by 50%. These results demonstrate that an exogenous compound which is sequestered in hepatocyte lysosomes may be excreted directly into bile in parallel with endogenous lysosomal constituents. The data also show that such a lysosomotropic agent may also selectively modify the biliary excretion of proteins and lipids. The findings are consistent with the existence of a lysosome‐to‐bile hepatic excretory pathway and suggest that hepatocyte lysosomes may be important in modulating biliary protein and lipid secretion


Due to the traffic accidents over the last few years; the development of surveillance systems with multifunctional techniques has received increasing attention. The use of the smart camera is one solution to solve the traffic problems, Smart cameras are cameras that can perform tasks far beyond simply taking photos and recording videos. Highways Traffic Surveillance System (HTSS) is used to monitor the roads in preventing accidents at the same time finding what causes the accidents. This is done by implementing some image vision protocols as that of Gaussian and Canny. This paper will discuss about the camera-video-surveillance capabilities of tracking across different and varied road environments including detection of moving vehicles. The programming method used will be the functional programming of OpenCV which could be operated under both, Windows and Linux OS. This paper will also examine the result of the combination of computer vision programming and the network socket programming under GNU Linux. At the end, this paper will attempt to discuss the design issues and challenges.


Private Cloud Computing Services  is one of current technology advances that can meet the needs of companies and organizations, many cloud service providers to offer facilities at affordable costs. However, in addition to bringing the benefits, cloud services can be misused by insiders in the company to commit cyber crimes that hurt companies such as leakage of confidential data, take advantage of the company itself, data manipulation etc. Handling process in such cases it is necessary to use a digital forensic investigation to obtain information from the digital evidence. This research used EEDI (End to End Digital Investigation) in the process of investigation on the desktop side by getting the files and folders associated with crimes. The results of an investigation carried out in the form of information proving that the offender is committing a crime, The information then presented in the form of a forensic report which will be used during the trial. Keywords — Acquisition, Digital evidence, Digital forensic, investigation


This report describes the design and implementation of a general purpose gamification framework developed in JavaScript on the Metor platform. Gamification is described as the use of game elements in none-game contexts. The purpose is to encourage and change user behaviour. Examples of existing gamification use cases and frameworks are described. A demo game shows how a general purpose framework can be used.


Problem statement: This research attempts to identify the relation between the empowerment level of Employee and organizational factors. To gauge the power of employees, it employs psychological empowerment model which is multi-dimensional, covering facets such as competence, self-determination, meaningfulness, impact, and trust. Moreover, other organizational factors can be referred to as having clear goals, reward system, availability of resources, organizational structure, performance evaluation and professional development. Approach: The methodology in this study is descriptive- measuring. And the statistical population involves the entire official Employee of University of Isfahan with B.A or M.S. degrees which overall consists of 304 individuals. But as a sample, 57 people are sifted by Cochran formula and sampling method of clustering. Results: The results of this research demonstrate the empowerment level of employees is in a favorable state in all respects except for the dimension of trust. Also, the findings indicate that there is a meaningful and straight relationship between the empowerment level of Employee and organizational factors such as having clear goals, reward system, availability of resources, performance evaluation system and professional development; however, there is no meaningful relationship between organizational structure and the empowerment level of Employee.


Objective: To explore the impact of risk factors from three
different time periods on negative birth experience. Design:
Register-based cohort study. Setting: Sweden.
Population: Nulliparous women giving birth to singleton, term
infants in 2013–2018 (n = 83 335), elective caesarean sections (CS)
excluded. Methods: Hierarchical logistic regression was
performed to calculate adjusted odds ratios (aOR) with 95% confidence
intervals (CIs) in three blocks, each representing risk factors from one
of three time periods: I) before pregnancy, II) pregnancy, III) labour.
Main Outcome Measurement: Negative birth experience, defined as
ratings of ≤ 4 on a ten-point scale. Results: Poor self-rated
health (SRH) was the only pre-gestational factor remaining associated
with negative birth experience after adjustment for pregnancy- and
labour-related factors (aOR 1.22, 95% CI 1.10–1.36). Fear of
childbirth and treatment for psychiatric disorder during pregnancy were
both associated with negative birth experience (aOR 1.53, 95% CI
1.36–1.73; aOR 1.51, 95% CI 1.35–1.68), as were all labour-related
factors included in the model. Women giving birth by operative vaginal
delivery or unplanned CS under regional anaesthesia had three-fold
higher ORs for rating their overall birth experience as negative (aOR
3.23, 95% CI 2.99–3.50; aOR 3.04, 95% CI 2.77–3.33). The highest OR,
5.38, was seen among women undergoing unplanned CS under general
anaesthesia (95% CI 4.52–6.40). Conclusions: The main
contributing factors to a negative birth experience are labour-related.
Poor SRH, psychiatric treatment and fear of childbirth places the woman
in a vulnerable position requiring extra attention.


This paper is a summary of a qualitative research project that focused upon meaning-making processes as described by intentionally childless women. A grounded theory exploration, it involved semi-structured interviews with 30 cisgendered women aged 27–61 who chose childlessness early in life. Based on principles inherent to social constructivism and feminist theories, the subjective voices of the participants were analyzed as normative expressions of female identity. The main category that accompanied intentional childlessness was a sense of freedom. In addition, two additional thematic categories focused on ways the women view their contributions to their communities and experience belonging and a sense of meaning in the world. Some negative experiences associated with being intentionally childless were also reported. The majority of the women in this study noted that they feel no regret or have no second thoughts about their decision, while a third of the participants spontaneously noted that they experience their lives as superlative.


Research suggests that exposure to #fitspiration content can result in increased body dissatisfaction. Employing a data-driven approach, the present study examines the nature of images and text contained within #fitspiration posts on social media. First, a content analysis of images labeled as #fitspiration on popular site Instagram (N = 1,000) was performed. People featured in 52% of images, of which nearly 90% of individuals were coded as having low body fat and 55% were coded as muscular. Individuals were typically presented in sexually objectified ways, which varied as a function of gender. Second, a thematic analysis of text from the same set of images (N = 400) was conducted to identify common themes and underlying meaning embedded within the messages. Six themes were developed: (a) Fit is sexy, (b) A "fit" physique requires commitment and self-regulation, (c) Your choices define you, (d) Pleasure and perseverance through pain, (e) Battle of the selves: You versus you, and (f) Here's to us! A celebration of a community. In combination, the analyses demonstrate how text and images found in #fitspiration posts perpetuate pervading sociocultural appearance ideals for men and women, positioning exercise as means to achieving these ideals. Furthermore, #fitspiration sexually objectifies the fit body, with text and images encouraging self-objectification and the distancing of the self from internal bodily functions in physical activity settings. Future research should focus on how #fitspiration content influences individuals in relation to how they think and feel about their body and physical activity.


The trend in localization is towards using more and more detailed models of the world. Our aim is to deal with the question of how simple a model can be used to provide and maintain pose information in an in-door setting. In this paper a Kalman filter based method for continuous position updating using a laser scanner is presented. By updating the position at a high frequency the matching problem becomes tractable and outliers can effectively be filtered out by means of validation gates. The experimental results presented show that the method performs very well in an in-door environment.


As our population ages, increasing numbers of patients will seek rejuvenation procedures in the facial region. At the same time, there is a growing emphasis on interventions that require less downtime, resulting in pressure on the provider to offer less invasive procedures, with the hope that they will be as effective. To quote Keith LaFerriere, ''minimally invasive often means minimally effective.'' Therefore, proper counseling ensures mutual success. As the number of novel techniques and trends grows, it is incumbent upon providers to remain current. To do so, one must carefully assess the literature, as well as critically review one's own work and its effectiveness. Proper photodocumentation and unbiased assessment will lead to improvements in the latter. Critical analysis of new techniques will prevent the provision of services that are patient-driven rather than time-tested. This issue of Facial Plastic Surgery is designed to provide a general overview of options for facial rejuvenation. Although attention must be paid to the face as a whole, for the purpose of discussion, each region of the face will be considered individually. However, it becomes clear that to achieve the best result, adjacent subunits must be addressed appropriately. Clearly, the interplay between forehead, eyebrow, upper eyelid, lower eyelid, midface, cheek, and jowls necessitates comprehensive planning when treating the aging face. We thank each individual author for his or her contribution to this edition of Facial Plastic Surgery. Although this issue includes a general overview of techniques used for management of the aging face, it is by no means comprehensive in scope. In addition to the many individual texts and articles on these topics, the following articles should serve as useful reviews to both the amateur surgeon as well as those with more experience. We hope you enjoy this compilation as much as we have enjoyed putting it together.


The Church of England is living through a time of significant change in attitudes towards local church ministry, congregational participation and pastoral practices. As it seeks to respond with integrity to changes in contemporary society the Church's dialogue with empirical social research is beginning to develop more fully. This thesis focuses on a pioneer national project to explore the effectiveness of pastoral ministry in contemporary church weddings. The social science research methods used in this project revealed insights into the ministry of contemporary church weddings with the intention of shaping responsive parochial wedding policies. This thesis considers the potential for further local enquiry by individual marrying clergy to understand the ordinary theology (proposed by Astley) of their communities using methods of ordinary research alongside a shared reflective practice. It highlights the socio-theological interface within reflective empirical theology by pastoral practitioners in the Church.

A model of participatory action research incorporating online clergy forums and change agent groups is explored to stimulate parochial and institutional change among clergy in partnership with each other. The role of priest researchers is proposed and identified in other pastoral contexts to examine factors that motivate clergy to participate in the development of pastorally responsive national policies. A methodology of personal diaries, focus groups and one to one interviews is used to explore the responses of clergy to participating in reflective praxis.

The findings point to key factors in developing pastoral practice and policies involving the place of ministerial development and attitudes towards collaborative working. A typology of pastoral ministry is developed towards identifying priest researchers in the Church. The research affirms the contribution of pastoral practitioners towards the development of pastorally responsive national policies but the nature of parochial deployment and clergy relationships with each other and the Church institutions frequently preclude much of this contribution.


The Parent Education Profile (PEP) is an instrument used by family literacy programs to rate parents' support for children's literacy development. This article uses Critical Discourse Analysis to examine how the PEP constructs the ideal parent, the text's underlying assumptions about parenting and education, and its ideological effects. The analysis shows how many features of the PEP evaluate parents according to a middle-class, predominantly White model of parenting and family-school interaction. Furthermore, the PEP tends to assume a universal, normative model of parental support for literacy, parental (mothers') responsibility for educational outcomes, equal access to resources required to meet the PEP standards, and a limited parental role in assessment. In so doing, the PEP lends support to several dominant discourses regarding poor and minority families, such as the discourse of parent involvement and the "mothering discourse," which encourages mothers' supplementary educational work. Implications for policy, research, and practice are discussed.


Background/Objectives: This study was conducted to review the relation among the elderly participation in life dance, their health perception and lifestyle. Methods/Statistical Analysis: This study carried out a survey with 210 the elderly aged 60 or older. The survey as the research tool consists of total 32 questions. A self-assessment was used and for those who had difficulty understanding the questions, 1 researcher and 2 research assistants helped the subjects. The verification between each variable was done through a one-way ANOVA, after which a multiple regression analysis was conducted. Findings: In terms of health perception in accordance with individual characteristics, there was a difference in physical confidence across gender, education. The more they perceived themselves to be rich, the higher the physical confidence and improvement in stamina. The more they perceived their health status to be very good, their physical confidence, improvement in stamina and mental confidence were higher. Second, the more they perceived their health status to be overall good, the sub-categories of the lifestyle which are the socially active and the traditionalists ranked higher. Third, the health awareness of the life dance experience was significantly improved on physical fitness and stamina. Forth, the socially active lifestyle was significant in terms of dance period, while the traditionalist was significant for dance type and duration. Fifth, health perception appeared to have a significant effect on all lifestyle types. Application/Improvements: The participation by the elderly in life dance has a positive effect on health perception and lifestyle. Health perception was applied differently according to the lifestyle type.


The present paper describes the microstructural evolution of AZ31 alloy along the process chain, from the melt treatment, the direct chill casting up to the extrusion process. Each step in the process chain will be considered in order to design the appropriate properties of the endproducts. The research has been done in industrial scale at ARC Leichtmetallkompetenzzentrum Ranshofen GmbH (LKR), in order to analyse the grain size dependency of AZ31 alloy on different casting conditions. The casting trials with and without grain refinement were carried out at the vertical direct chill casting machine MAGNUMCAST®. After the extrusion process metallographic analysis and mechanical tests were carried out.


Green rated buildings have come to attract people's attention, although there is a diffused scepticism on whether their performance will comply with design expectations throughout the building's life. This paper provides a literature review on limitations of the rating system. According to previous studies, barriers to facilitate certification schemes are still present in many countries. Some of the main reasons are related to i) high costs, ii) insufficient knowledge about certification, and iii) time‐consuming procedures. Inexperienced clients have difficulties in understanding the assessment process, as third‐ party organizations do not have a suitable system to show guidelines and approaches for a client, such as Pre‐Occupancy Evaluation. To date, researchers have conducted some studies on Post‐Occupancy Evaluation in order to show the effectiveness of certified buildings. However, no attention has been paid to Pre‐Occupancy Evaluation by the rating tool based on a customer's self‐assessment which enables clients to estimate costs, a rating level (or total point) and implementation time in advance, selecting suitable options in the building information and requirements of each credit. This paper shows that identifying existing obstacles is essential to further develop and improve rating systems so as to be more acceptable in New Zealand. This preliminary investigation will also inform future studies on the development of the Pre‐Occupancy Evaluation framework for New Zealand.


The development of public health surveillance systems requires multidisciplinary knowledge and advanced technologies. Scientific Technologies Corp. has developed the NH Pharmaceutical Sales Surveillance (NHPSS) for the New Hampshire Department of Health and Human Services (NH DHHS). The NHPSS was developed as a distributed information system. In addition to the database server, enterprise application servers and the Web-browser-based user interface, its architecture features knowledgebase technology, a new dynamic system model with rule systems, and automated data analysis in supporting public health surveillance. Internet mapping was also embedded in the system to provide for spatial analysis. Since its pilot application, started in December of 2002 in the Bureau of Communicable Disease Control and Surveillance, NH DHHS, the NHPSS has assisted NH DHHS in successful detections of gastrointestinal and respiratory events. This article first introduces the methodology and the technology in the NHPSS development. Next, the system functionalities are introduced. Then, a new dynamic system model with a rule system for public health surveillance is described in detail. Finally its application and preliminary results are summarized.


Abstract:Mary Casey's essay on mission history traces the tendency of early SCQ articles, in parallel with contemporaneous educational standards and cultural productions, to idealize the padres' work and romanticize the mission era, a trend that persisted into the late 1960s. It was only at that point that a more critical appraisal emerged. Critical analysis and new methodologies revealed the padres' ill treatment of Indigenous peoples, the mission system's role in imperial conquest, and the mission plants as instruments of control. The multiple perspectives and interactions of multiple groups of historical actors placed in the context of a wider borderlands in the recent articles in the Southern California Quarterly extend California history from a California-exceptionist mold into a richer understanding of continental history.


Abstract Aims: To explore how policy actors attempted to deliberately frame public debate around alcohol minimum unit pricing (MUP) in the UK by comparing and contrasting their constructions of the policy in public (newspapers), semi-public (evidence submissions) and private (interviews). Methods: Content analysis was conducted on articles published in ten national newspapers between 1 January 2005 and 30 June 2012. Newsprint data were contrasted with alcohol policy documents, evidence submissions to the Scottish Parliament's Health and Sport Committee and 36 confidential interviews with policy stakeholders (academics, advocates, industry representatives, politicians and civil servants). Findings: A range of policy actors exerted influence both directly (through Parliamentary institutions and political representatives) and indirectly through the mass media. Policy actors were acutely aware of mass media's importance in shaping public opinion and used it tactically to influence policy. They often framed messages in subtly different ways, depending on target audiences. In general, newspapers presented the policy debate in a "balanced" way, but this arguably over-represented hostile perspective and suggested greater disagreement around the evidence base than is the case. Conclusions: The roles of policy actors vary between public and policy spheres, and how messages are communicated in policy debates depends on perceived strategic advantage.


Objective: To estimate the prevalence of parkinsonism in welders in Alabama and to compare this prevalence with that in a general population sample. Methods: The authors screened 1,423 welders from Alabama who were referred for medical–legal evaluation for Parkinson disease (PD). Standardized videotaped assessments using the Unified Parkinson's Disease Rating Scale motor subsection 3 (UPDRS3) were obtained. Patients provided information regarding exposure to welding fumes and job titles. Job titles were matched with Department of Labor Standard Occupational Codes (SOCs). Diagnoses were assigned based on quantitative criteria for the diagnosis of PD using two thresholds for diagnosis. With use of the number of active welders in this screening with parkinsonism as the numerator and the age-adjusted number of welders in each SOC as the denominator, the prevalence of parkinsonism in Alabama welders was estimated using conservative assumptions and compared with general population data from Copiah County, MS. Results: With use of conservative and liberal case definitions of parkinsonism, the estimated prevalence of parkinsonism among active male welders age 40 to 69 statewide was 977 to 1,336 cases/100,000 population. The prevalence of parkinsonism was higher among welders vs age-standardized data for the general population (prevalence ratio = 10.19, 95% CI 4.43 to 23.43). Conclusion: The estimated prevalence of parkinsonism was higher within a sample of male Alabama welders vs the general population of male residents of Copiah County, MS.


ABSTRACT In Indonesia, access to services for the prevention of mother-to-child transmission (PMTCT) is quite low. The objective of this study was to design and implement a model to improve access to PMTCT services. This study was a quasi-experimental design involving 770 pregnant women in 2 districts (intervention and control district; n = 385 each). The implementation model had four stages: exploration, installation, initial implementation, and full implementation. The key activities included the provision of health education, an offering HIV testing, and the implementation of HIV tests for pregnant women in the community. The success of the model was assessed using three indicators: 1) the increase in the proportion of health facilities offering PMTCT services, 2) increase in the proportion of pregnant women who were offered HIV testing, and 3) increase in the proportion of pregnant women underwent HIV testing. The effectiveness of the model was assessed using multiple logistic regression analysis. In the intervention district, the number of facilities that offered PMTCT services increased from 6% to 34%, and the number of pregnant women who underwent HIV tests increased from 4.7% to 85.5%. Pregnant women in the intervention district showed greater access to PMTCT after controlling by the education of pregnant women, the role of decision making in the family, education and knowledge of the husband (odds ratio = 63.6; 95% confidence interval: 38.9–103.8; p = 0.000). The implementation model effectively improved access to PMTCT services. A multi-phased approach implemented in this study was able to overcome the barriers to access PMTCT services.


Holographic techniques are being applied to medical imaging with greater focus and increasing benefit than ever before. Exploratory uses for the hologram in medicine go back more than 15 years, but the recent increased appreciation of three-dimensional (3-D) rendering of medical radiological data has provided the opportunity to employ holographic rendering as an additional means of displaying the radiological volume. Our work in this area is described. With the increasing availability and use of 3-D in radiology, and especially the more advanced technology of the hologram, a number of issues have emerged which bear directly on the 3-D radiological image and precede the utilization of holography in the practice of medicine. These issues may well affect the acceptability and adoption of true 3-D radiology as a beneficial part of the medical practice. Issues include: resolution of the image; clarity of the image; usefulness of the third dimension; incremental cost in terms of time and reimbursement; and the means to evaluate the clinical effectiveness of the volumetric image in medical practice. Discussions include: limitations derived from the holographic transformation; a review of the underlying "data" from which the radiological imagery is derived; factors that enhance or degrade the apprehension of the image; and the assumptions that guide the interpretation of the radiological image. Conclusions indicate that the limitations of holographic 3-D radiological image is due more to the underlying data rather than by the holographic transformation. Further, an initial evaluation protocol for 3-D versus 2-D formats of radiological imagery is referenced, and clarification of issues regarding the evaluation of safety, effectiveness, reliability and appropriateness of the holographic rendering of 3-D radiology for use in medicine are encouraged, so that this important technique can benefit the practice of medicine and enhance the quality of health care.


An evaluation to assess the implementation of NHS delivered alcohol brief interventions: final report. Parkes T, Atherton I., Evans J. et al. Edinburgh: NHS Health Scotland, 2011. In three years from 2008 Scottish national policy drove delivery of nearly 175,000 brief alcohol interventions, testament to what can be done when policy is backed by funding and infrastructure and incentive payments contingent on implementation. Leverage and acceptance were greatest in primary care, where the vast majority of the work took place. Summary Brief interventions in healthcare settings are a significant component of the Scottish government's alcohol strategy. The aim is to use quick screening questionnaires to identify people drinking above sensible drinking guidelines and to offer brief advice to hazardous and harmful drinkers to reduce their consumption and risk of alcohol-related harm. The government established a health improvement target (HEAT H4) for NHS health boards in 2008 supported by a substantial increase in funding for alcohol treatment and support services. Between April 2008 and March 2011 this required the Scottish national health service to deliver 149,449 brief interventions across three priority settings: primary care, emergency departments, and antenatal care. Later it was extended to the delivery of 61,081 alcohol brief interventions during April 2011 to March 2012, with the aim of embedding these interventions in health service practice. The featured evaluation focused on implementation in primary care but also reported on some dimensions of implementation in the other two settings. Data was collected mainly in 2010 at national, health board, practitioner and patient levels. The next section is based on the report's own summary.


In this paper, a novel type of a corona discharge plasma reactor was designed, which consists of needle-plate-combined electrodes, in which a series of needle electrodes are placed in a glass container filled with flue gas, and a plate electrode is immersed in the water. Based on this model, the removal of NO and SO2 was tested experimentally. In addition, the effect of streamer polarity on the reduction of SO2 and NO was investigated in detail. The experimental results show that the corona wind formed between the high-voltage needle electrode and the water by corona discharge enhances the cleaning efficiency of the flue gas because of the presence of water, and the cleaning efficiency will increase with the increase of applied dc voltage within a definite range. The removal efficiency of SO2 up to 98%, and about 85% of NO~ removal under suitable conditions is obtained in our experiments.


The Euroradar Consortium has successfully developed and demonstrated an Active Electronically Scanned Array (AESA) technology upgrade for the Eurofighter Typhoon Captor Radar. This technology demonstrator, designated Captor Active Electronically Scanned Array Radar (CAESAR), enables E-scan capability to be fully exploited by the existing Captor radar, while retaining all features and capabilities of the original system. Advanced waveforms, designed and optimized for electronically-scanned radar systems, have been evaluated in recent CAESAR flight trials. Production of the CAESAR system will address repackaging of the AESA and associated components to minimize mass and volume, reduce cost, and ensure ease of supportability. CAESAR has demonstrated that AESA benefits can be provided within the existing Captor framework, enhancing sensor capability while retaining existing Eurofighter Typhoon interfaces.


Series hybrid electric vehicles (SHEVs) are efficiently used in many cities to reduce harmful exhaust emissions, as well as, fuel consumption. The vehicles are propelled with an electric motor that can achieve high efficiency at low speed with an internal combustion engine being operated at optimum fuel consumption for battery charging. Human interaction is being increasingly used to assist the development propulsion systems for road vehicles. The modelling of the hybrid electric powertrain for mobility is indeed challenging. The model should not only adequately simulate the vehicle longitudinal dynamics, it should also account for the load control of the propulsion system. The aims of this study are to design a control strategy for an electric motor of a SHEV longitudinal model and to assess its mobility performance. A mathematical model, for a vehicle with an internal combustion engine, was set-up to simulate its longitudinal dynamics using a high-level programming language software; i.e. Matlab Simulink. The multibody system approach was employed to model the vehicle dynamics with six degree of freedoms. Cases to investigate the inertia performance, such as sudden acceleration and braking, were conducted. The model was verified using a commercial vehicle simulation software; i.e. Car Simulation for Education (CarSimEd). The finding suggests that the model works as desired and was verified by CarSimEd. The SHEV propulsion system utilises a PMSM model to provide a driving effort to propel the vehicle. The SHEV operates at high efficiency when the model had applied a control strategy for the PMSM model to track a desired torque. The gain scheduling controller was selected for the motor due to its effectiveness provide a drive torque in various driving conditions. The performance for the control strategy was tested using the sine, square, sawtooth and step inputs. The results indicate that the controller for motor control is sufficiently efficient to track various types of the desired inputs. The SHEV was set up by integrating the vehicle longitudinal model and the electric motor model. Longitudinal tests were performed; i.e. sudden acceleration and braking, tracking road gradient and unbounded motion. The findings suggest that the SHEV model is suitable for use in the preliminary assessment for other types of HEVs or EVs. Simulations using the CarSimEd show similar results.


This article will address the question whether publicly traded US corporations owe a duty to their shareholders to minimize their corporate tax burden in any way that they may be able to get away with from a purely legal perspective. First, however, to render the subsequent discussion a bit more concrete, I will describe a recently unveiled case study of corporate tax aggressiveness.


The chapter reviews the studies available to date about the impact of the introduction of the biofuel crop Jatropha curcas on greenhouse gas GHG emissions from land use change in tropical regions. The limited available data consistently point to Jatropha's GHG reduction potential when the plant is grown on wastelands or severely degraded agricultural lands. At the same time, the studies suggest - directly or indirectly - that the GHG balance will tip in the other direction if Jatropha were to be introduced on more productive lands, where considerable carbon is being stored in the existing biomass and/or soil. However, none of the available studies has taken account of land use change in a comprehensive and realistic fashion, and therefore there is no information as to where the GHG tipping point lies in specific situations. Further research should be aimed in particular at measurement of soil organic carbon (SOC) levels under different climatic and ecosystemic conditions, and at refming concepts of 'wastelands', 'degraded lands' and so on, in order to prevent wrong estimations and misallocation of lands for Jatropha production on a vast scale. Furthermore, efforts should be devoted to standardizing LCA methodologies and their application in terms of boundary assumptions, input and output assumptions and measurement units so that GHG results from different studies can be more easily compared.


The convergence between business process modeling and the service-oriented architecture has created a significant opportunity for Information Technology (IT) system integrators: they can offer effective business process outsourcing for Small Medium Enterprises (SME)s that often cannot afford the cost of designing, provisioning, and operating their own software service bus. In this paper, we present a methodology, and a corresponding implemented system Prosero, for managing multiple customized business processes, all derived from a small set of reference models. The methodology is based upon a semantic repository. The paper focuses on the structure of the semantic repository, and explains how specific operations in the end-to-end lifecycle of outsourced business processes benefit from the semantic services the Prosero repository delivers.


We compare three methods for the elicitation of time preferences in an experimental setting: the Becker-DeGroot-Marschak procedure (BDM); the second price auction; and the multiple price list format. The first two methods have been used rarely to elicit time preferences. All methods used are perfectly equivalent from a decision theoretic point of view, and they should induce the same `truthful' revelation i dominant strategies. In spite of this, we find that framing does matter: the money discount rates elicited with the multiple price list tend to be higher than those elicited with the other two methods. In addition, our results shed some light on attitudes towards time, and they permit a broad classification of subjects depending on how the size of the elicited values varies with the time horizon


Diffuse serotonergic fibers are presumed to project to the talencephalon from the nucleus raphe dorsalis (NRD) of the mid brain, in a manner similiar to the cholinergic projections from the nucleus basalis of Meynert (nbM) to the cerebral cortex. Neuropathological changes in both of these nuclei have been reported in Alzheimer's disease (AD). Although many morphometric studies of the nbM in AD have been documented, only one such study of the NRD has been documented, only one such study of the NRD has been conducted so far; it demonstrated a six fold increase in neurofibrillary tangles in AD but no statistically significant difference in the number of neurons in patients with AD and age‐matched controls. A study of the NRD utilizing different stains and wider anatomical boundaries is detailed in this report of 5 patients with AD and 7 age‐matched controls. In AD the NRD showed 39 times more neurofibrillary tangles and the number and cell density of large neurons were reduced to 23% and 28%, respectively, of those in the controls. A small number of senile plaques were found in the NRD in all patients with AD but none were found in the controls.


Culture change and teamwork are often cited in healthcare policy and research as central to improvements in patient care. A critical review of the literature suggests that theory is insufficiently used to inform culture change or team development interventions. Culture change interventions are rarely evaluated in implementation research with few rich qualitative accounts of clinical team development in context.
This case study drew on the principles of realist evaluation to identify what worked, or did not work, for whom, in what circumstances in relation to an eighteen-month culture change intervention that had been carried out with a frontline clinical team identified as being in difficulty. It addressed the following research questions using multiple methods in a pragmatic and reflexive way:
1. How does a clinical team identified as being in difficulty experience a change process directed at changing team culture?
2. How do collaborative change processes engender culture change in the context of teams in difficulty?
Conventional problem-solving approaches to team development were found to reinforce existing patterns of deficit relating leading to a critique of organization development practice. The project found that different contextualized experiences had different effects on the learning behaviour of the team and on the leadership-followership relationship. A critical appreciative approach and narrative methods were found to create psychological safety for a collaborative inquiry to take place. Building on previous theoretical research, the study proposes a reconceptualization of experiences of teamwork as emergent states of "knotworking" and "not working".
The project offers a framework for realist evaluation with clinical teams in difficulty. It recommends that intervention and evaluation are collapsed into a single approach of collaborative inquiry, and has provided easy to use resources for clinical teams to evaluate and improve their team culture in a climate of psychological safety. A practice model of creating a critically appreciative space is proposed and described. Narratives of patient care emerged as a source of generativity for team development, which led to reflections about how patient experience and involvement might support future team development interventions and directions for research.


Ishophloroglucin A (IPA), a component of Ishige okamurae (IO), was previously evaluated to standardize the antidiabetic potency of IO. However, the potential of IPA as a functional food for diabetes prevention has not yet been evaluated. Here, we investigated if 1.35 mg/kg IPA, which is the equivalent content of IPA in 75 mg/kg IO, improved glucose homeostasis in high-fat diet (HFD)-induced diabetes after 12 weeks of treatment. IPA significantly ameliorated glucose intolerance, reducing fasting glucose levels as well as 2 h glucose levels in HFD mice. In addition, IPA exerted a protective effect on the pancreatic function in HFD mice via pancreatic β-cells and C-peptide. The level of glucose transporter 4 (GLUT4) in the muscles of HFD mice was stimulated by IPA intake. Our results suggested that IPA, which is a component of IO, can improve glucose homeostasis via GLUT4 in the muscles of HFD mice. IO may be used as a functional food for the prevention of diabetes.


1. A relation between toxicity, resistance, and time of survival has been derived on the basis of the assumption that the time is a function of a parameter which is the difference between the toxicity and the resistance. Toxicity and resistance act like forces which can maintain an equilibrium-like (or stationary) state. If the equilibrium is upset, the time at which the event (death) occurs is proportional to the logarithm of the difference between toxicity and resistance. 2. It was found that if values proportional to the resistance are calculated with the proposed equation and the percentage mortality plotted against them (instead of against the time as is usual) symmetrical curves are obtained even though the corresponding mortality-time curves are asymmetrical. Assuming that the resistance varies like an error, that is, according to probability rules, theoretical mortality-time curves, similar to the experimental curves, can be constructed from the proposed equations. 3. In the case of a toxic agent acting on a unicellular organism suspended in solution, the toxicity is proportional to the adsorbed amount of the agent, as calculated with the aid of the Langmuir equation. In small concentration ranges the toxicity can be taken as approximately proportional to the concentration. 4. The variation of the temperature affects mainly the constant a which is a function of the temperature similar to that of the velocity constant of a chemical reaction (Arrhenius' law). 5. The proposed equation has been tested in four different combinations of the variables, concentration, resistance, time, and temperature. The agreement with the experiments is satisfactory. 6. Any noxious agent acting on a unicellular organism may be characterized by three constants: r, the resistance, which is the threshold value at which the agent is still fatally toxic for the organism; a, the reciprocal of the rate constant determining the specific rate (that is, the time corresponding to a difference of 1 between the toxicity and the resistance); and finally the constant γ of the function representing the relation between toxicity and concentration.


Small and Medium-sized Enterprises (SMEs) in logistics experience practical barriers when trying to use, exchange, share, and exploit real-time data in their operational processes. Such barriers include the abundance of proprietary data formats and schemes, the cost of implementing standards, the lack of trust among partners, the lack of IT expertise, and the uncertainty about benefits and return on investments. This position paper introduces the goal and proposed approach of a recently started research project that aims at lowering these barriers. The core proposition revolves around the application of a federated approach based on the concepts of the International Data Space (IDS). In this paper we present a high level architecture underlying this goal and approach. Two main components of the architecture are discussed in more detail: (1) a connector store, offering connectors to realize data exchange between heterogeneous ICT environments, and (2) an interoperability simulator, to explore collaboration opportunities prior to implementation.


Food preferences and tastes are among the fundamentals affecting human existence; the sociocultural, physiological and neurological factors involved have therefore been widely researched and are well documented. However, information and debate on these factors are scattered across the academic literature of different disciplines. In this volume cross-disciplinary perspectives are brought together by an international team of contributors that includes socialand biological anthropologists, ethologists and ethnologists, psychologists, neurologists and zoologists in order to provide access to the different specialisms on the topic. Helen Macbeth is chair of ICAF (Europe) and Honorary Research Fellow of the Anthropology Department, Oxford Brookes University.


An approach to simultaneous recursive weight adaptation and node creation in multilayer perceptron neural networks is presented. The method uses time and order update formulations in the orthogonal projection method to arrive at a recursive weight updating procedure for the training process of the neural network and a recursive node creation algorithm for weight adjustment of a layer with added nodes during the training process. The approach allows optimal dynamic node creation in the sense that the mean-squared error is minimized for each new topology. The effectiveness of the algorithm was demonstrated on a real world application for detecting and classifying underground dielectric anomalies.<<ETX>>


Soil bacteria, Sinorhizobium meliloti is of great agricultural importance because of its ability to fix atmospheric nitrogen in symbiosis with alfalfa very valuable forage crop. The main aim of this study was to evaluate tolerance of indigenous S. meliloti strains to stress environmental conditions. Twenty rhizobial strains, isolated from different regions in Croatia, were genotipically characterized to assess diversity amongst natural population. Stress tolerance assays were performed in order to select indigenous rhizobia with tolerance to unfavorable soil conditions. The growth of the strains was studied at different pH values, temperatures, NaCl and heavy metals concentrations. The results of 16S rDNA genotyping using PCR/RFLP analysis showed that 17 isolates could be assigned to S. meliloti while RAPD and ERIC-PCR fingerprints revealed significant genetic diversity among indigenous rhizobial strains. In comparison to the reference strain, higher resistance to adverse growth conditions of indigenous S. meliloti strains was determined. Most of the strains grew at temperatures higher than optimal and tolerated both acidic and alkaline environment. It was found that indigenous strains tolerate extremely high NaCl concentrations. Better understanding of rhizobial response to adverse environmental conditions is of potential value for improving rhizobial inoculants and efficiency of symbiotic nitrogen fixation.


In the present study, influences of pleural adhesions on thoracoscopic lung surgeries were investigated. A total of 666 consecutive patients who had undergone thoracoscopic surgeries for lung malignant tumors were retrospectively analyzed. Pleural adhesions were present intraoperatively in 289 cases, of which 6 required conversion to thoracotomy due to the adhesions. The influences of pleural adhesions on the perioperative period were comparatively large under following conditions (level-A); the adhesion-type was tight which meant lung and pleural wall sticked closely even if lung collapse was encouraged, the strength was middle( required sharp-dissection) or strong( hard to dissect between visceral and parietal pleura), and the range was more than 10% of total pleural surface. Significant influences of the level-A of pleural adhesions were as follows;prolonged operation time in all procedures, frequent intraoperative lung fistula and prolonged pleural drainage period in wedge resections, and increased blood loss, intraoperative and postoperative lung fistula with prolonged pleural drainage time and postoperative hospitalization period in lobectomy. Other postoperative complications (pneumonia, empyema, exacerbation of interstitial pneumonitis, and arrhythmias) were not associated with pleural adhesions. Careful dissection procedure for pleural adhesions that minimize damage of visceral pleura would be the most important.


Transfer learning has been demonstrated to be successful and essential in diverse applications, which transfers knowledge from related but different source domains to the target domain. Online transfer learning(OTL) is a more challenging problem where the target data arrive in an online manner. Most OTL methods combine source classifier and target classifier directly by assigning a weight to each classifier, and adjust the weights constantly. However, these methods pay little attention to reducing the distribution discrepancy between domains. In this paper, we propose a novel online transfer learning method which seeks to find a new feature representation, so that the marginal distribution and conditional distribution discrepancy can be online reduced simultaneously. We focus on online transfer learning with multiple source domains and use the Hedge strategy to leverage knowledge from source domains. We analyze the theoretical properties of the proposed algorithm and provide an upper mistake bound. Comprehensive experiments on two real-world datasets show that our method outperforms state-of-the-art methods by a large margin.


Extracellular vesicles (EVs) are essential intercellular communication tools, but the regulatory mechanisms governing heterogeneous EV secretion are still unclear due to the lack of methods for precise analysis. Monitoring the dynamics of secretion from individually isolated cells is crucial because, in bulk analysis, secretion activity can be perturbed by cell–cell interactions, and a cell population rarely performs secretion in a magnitude- or duration-synchronized manner. Although various microfluidic techniques have been adopted to evaluate the abundance of single-cell-derived EVs, none can track their secretion dynamics continually for extended periods. Here, we have developed a droplet array-based method that allowed us to optically quantify the EV secretion dynamics of >300 single cells every 2 hours for 36 hours, which covers the cell doubling time of many cell types. The experimental results clearly show the highly heterogeneous nature of single-cell EV secretion and suggest that cell division facilitates EV secretion, showing the usefulness of this platform for discovering EV regulation machinery.


In this thesis I have combined cognitive metaphor theory, based mostly on the theories of the book Metaphors we live by by Lakoff & Johnson, with translation theory in order to try and show how the former can contribute with useful analytical tools within me- taphor translation. More specifically, my objective is to try and show how the knowled- ge of how metaphor works according to the cognitive perspective can help translating metaphors in a way that corresponds to the recommendations established by Peter Newmark (1992), i.e. try to maintain, in as much as posible, both grammatical structure and semantics. Through a qualitative analysis I considered gramatical structure and se- mantics of three original literary metaphors taken from the swedish book "Gosta Ber- lings saga" by Selma Lagerlof, and their translations to spanish made by Slaby (1955). I identified how well the translations corresponded to the recommendations of Newmark, as well as suggested new translations based on the results of the cognitive analysis. As a result we could see the importance, not only of maintaining both source domain and tar- get domain of the original metaphor, or at least the epistemical correspondences in case the source domain changed, but also the ontological correspondences, the specific con- tact, that the original metaphor establishes between these two domains, for a translation that better follows the norms defined by Newmark. In other words, limited to these th- ree examples, I managed to confirm that a cognitive approach to metaphor can be very useful within translation.


Public policies in many diverse fields have implications for the transfer of resources between sectors. Administered agricultural prices, taxes, subsidies, an overvalued currency and protection provided to producers are examples of some of the policies that have been used by many governments in mobilizing resources for development. From the vantage point of assessing the past performance and development prospects of the agricultural sector, it is useful to have an idea about the direction and extent of the resource transfer from this sector. The knowledge of the policy instruments used to bring about the transfer is also important. While the size of the transfer is a measure of the overall incentives being provided, the tools used for the transfer have unique implications for efficiency, equity and growth outcomes. The purpose of the paper is confined to: (i) an estimation of the magnitude of the transfer for the period 1972-73 to 1986-87; and (ii) identification, in broad terms, of the direction that the restructured public policies may take.


Objectives Exposure to family medicine (FM) can serve to promote students' interest in this field. This study aimed at identifying clerkship characteristics which decrease or increase students' interest in FM. Design This cross-sectional questionnaire study analysed students' clerkship evaluations between the years 2004 and 2014. Descriptive statistics were used to compare four predefined groups: (1) high interest in FM before and after the clerkship (Remained high), (2) poor interest before and after the clerkship (Remained low), (3) poor interest before the clerkship which improved (Increased) and (4) high interest before the clerkship which decreased (Decreased). Setting Students' evaluations of FM clerkships in the fourth of 6 years of medical school. Participants All questionnaires with complete answers on students' interest in FM and its change as a result of the clerkship (2382 of 3963; 60.1%). The students' mean age was 26 years (± 3.9), 62.7% (n=1505) were female. Outcome measure The outcome was a change in students' interest in FM after completing the clerkship. Results Interest in FM after the clerkship was as follows: 40.1% (n=954) Remained high, 5.5% (n=134) Remained low, 42.1% (n=1002) Increased and 12.3% (n=292) Decreased. Students with decreased interest had performed a below-average number of learning activities (4 vs 6 activities). A total of 45.9% (n=134 of 292) of the students with decreased interest reported that the difficulty of the challenge was inadequate for their educational level: 81.3% (n=109) felt underchallenged and 18.7% (n=25) overchallenged. Conclusions In more than 50% of cases, the clerkship changed the students' interest in FM. Those with decreased interest were more frequently underchallenged. We observed an increase in FM if at least six learning activities were trained. Our findings stress the importance of well-designed FM clerkships. There is a need for standardised educational strategies which enable teaching physicians to operationalise educational requirements.


period. Variables of maternal and fetal characteristics including gestational age, six parameters of fetal facial expression (grimacing, eye blinking, yawning, tongue expulsion, swallowing, mouthing) patterns were recorded. All observed facial expressions were presented collectively with maximum, minimum, and median frequencies during observation. We analyzed data using multiple regression. Results: Statistically significant changes were noted in grimacing (P < 0.05), eye blinking (P < 0.05), tongue expulsion (P < 0.05) and swallowing (P < 0.05) during the second half of normal pregnancy. There were no significant changes in yawning and mouthing. A tendency towards decreased frequency of facial expressions (except for eye blinking) with increasing gestational age was found. Conclusions: With four-dimensional ultrasonography, it is possible to quantitatively assess normal fetal behavior during the second half of pregnancy to identify abnormal behavior before birth.


Abstract  Spotted wing drosophila, Drosophila suzukii (Matsumura), is a major agricultural pest throughout most of the fruit growing regions of the United States, with high reproductive rates and short generation times resulting in exponential population growth in berry crops across the country. Fruit suitability research has been conducted for some small fruit species such as raspberries, strawberries, cherries, and blackberries; however, there is a paucity of data regarding the role of previous injury on host susceptibility and suitability for D. suzukii. This study examined the role of previous fruit injury on adult D. suzukii survival, adult production, and host susceptibility, with injury referring to physiological splitting, disease, and vertebrate feeding. Results indicate that intact raspberries, blueberries, and table grapes are susceptible to oviposition by D. suzukii and the presence of injury increases survival of both male and female flies. When fruit was injured, berry infestation levels increases, but this did not always translate into increased adult populations. We found that the proportions of D. suzukii–infested fruit were significantly higher for injured versus intact fruit. When comparing adult emergence for intact and injured fruit, only table grape and cherry tomato had significantly higher adult counts for injured berries. Overall, adult emergence per injured fruit for raspberries of 19.77 was significantly higher than all other fruit types tested, with 2.87, 3.57, and 3.43 adults for cherry tomatoes, grapes, and blueberries, respectively. Results suggest reducing previous injury in ripe fruit may facilitate more effective management of D. suzukii populations.


Background: Irritable bowel syndrome (IBS) is considered one of the most common functional gastrointestinal disorders. The pathogenesis of IBS is still unknown, as it has both physiological and psychological factors. Being a multifactorial disorder, the treatment of IBS is thereby challenging and also conflicting. Conventional therapy might have an effect in mild and recently diagnosed cases but for some while and some extent. So, antidepressant medications were proposed to treat IBS with long lasting effect. This study aimed to compare effect of sertraline to placebo in treatment of IBS and its comorbid anxiety and/or depressive symptoms.
Methods: 55 patients were recruited from outpatient clinics at Assiut University Hospitals and were diagnosed as irritable bowel syndrome according to Rome III criteria. Patients underwent Hamilton rating scale for anxiety and depression to assess their level of anxiety and depression respectively. Patients were divided into two groups, one group of patients received sertraline and the second group received placebo. Blinding was concealed throughout the clinical trial. Assessment of patients was done after four weeks regarding their bowel symptoms, anxiety, and depressive symptoms.
Results: Sertraline group showed significant reduction of bowel symptoms in 20 patients (66.67%) versus 8 patients (32%) who received placebo (P=0.001). Also, there was significant reduction in anxiety and depressive scores in Hamilton rating scale for anxiety and depression respectively (P=0.001).
Conclusion: Sertraline is superior to placebo in treatment of irritable bowel syndrome especially in those who have comorbid anxiety and depression.


This hard-hitting research report presents a rigorous critique of the most widely used trade models based on computable general equilibrium (or CGE) models. The authors present concise analytical arguments explaining the fundamental weaknesses of typical CGE models. They show that these models tend to make unrealistic assumptions about the macro-economy and do not allow an accurate estimation of the welfare gains that trade liberalisation is supposed to induce. The report appeals for honest simulation strategies showing a variety of possible outcomes, which would enable policy-makers to assess the different scenarios for themselves.


Many legal writings on investor-state dispute settlement (ISDS) consider the State primarily in its practical dimension as a respondent or treaty negotiator. International lawyers certainly work with a concept of the State, but it often consists of little more than the criteria of statehood (population, territory, government and independence) expressed in the Montevideo Convention on Rights and Duties of States. These criteria say little to nothing about how modern administrative States should or do interact with economic and political actors within their territories. Certainly, some arbitrators and treaties defer to States' regulatory prerogatives in greater or lesser degree. But absent a consistent theory of appropriate State behavior vis-à-vis other economic actors, there is a risk that some State-society interactions that promote long-run development may also trigger treaty liability under international investment agreements in the short-term. This chapter has two goals. First, it hopes to introduce readers in the legal community to some of the ways in which social scientists study the State and various judicial processes. Second, it shows that investment arbitrators are already working with concepts of the State, even if these do not constitute full-blown theories.


The General
 Agreement on Trade in Services (GATS) is a set of multilateral,
 legally enforceable rules governing international trade in services.
 These rules are aimed at enhancing international trade in services
 including through promotion of progressive liberalization, free
 competition among service providers, and open access to national
 markets with out any prejudice or any pre-conditionality. The
 agreement regulates the cross-border flow of trade and investment in
 services and provides important opportunities and threats for
 developing countries especially in higher education field. However,
 the potential impact of GATS is still unknown as it is a new
 agreement yet to be implemented fully. With out examining the
 purpose, motivations, content, thrust and tone of GATS and specific
 threats and promises it holds for the economy, society and cultural
 enfoldments of signatories, they would be grouping into dark.
 Instead of being positive impacted, negative fallout may be in store
 for them. Considering the role and importance of higher education
 for sustainable social, political and economic development in
 Pakistan it is imperative for the appropriate quarters to
 investigate pros and cons attached to this new set of globalization
 process. To better understand this ongoing process the research
 explores the viability of options for our own institutions to avail
 the opportunities being offered by foreign market like Middle East,
 Central Asia, and South Asia etc for performing an efficient role as
 educational providers across border and vise versa.
 The research is based on the belief that insightful evaluation of
 consequence of opening education at various levels of GATS is
 essential for the formulation of rational, prudential and
 internationally acceptable policy and response mechanism on the part
 of Pakistan. Therefore, the dissertation aims to furnish helpful
 inputs to the authorities managing higher education in Pakistan so
 as to enable them to articulate realistic proposals, preempt the
 impact of negative effects attached with the agreement, execute
 necessary safeguards and reap benefits if any at appropriate stage.
 The resultant awareness is likely to smoothen higher education
 system in Pakistan compatible with the dictates of ongoing
 globalization and to withstand the competitive environment shaped by
 the developed world. Depending on the sagacity of policy and
 organizational intervention the intended expansion in trade and
 promotion of development can be realized and perils of disposed
 trade rise by foreign owned and controlled academic institutions can
 be avoided. Research endeavours to highlight the stakes and the
 pearls of intended participation of the third world in the
 forthcoming round of negotiations of GATS and the future of
 competitiveness of Pakistan higher education system hinges upon
 the reduction of prospective risks and maximization of our
 competencies.


A new antilog-sum algorithm for decoding error-correcting codes is described. The soft-input, soft-output (SISO) algorithm uses squared Euclidean distance as the metric, does not require knowledge of the signal-to-noise ratio of the received signal and is less complex to implement than other SISO algorithms. The results of simulations show that the performance is very close to that of the log-sum-product algorithm.


We use the non-tidal Passaic River Watershed as a case study to investigate the size of potential cost savings associated with allowing phosphorus emissions trading amongst Waste Water Treatment Plants (WWTP) to achieve a significant reduction in ambient phosphorus levels. To measure the cost saving, we specify a trading-ratio system similar to that proposed recently by Hung and Shaw (JEEM, 2005) that minimizes the abatement cost of meeting environmental standards. Because there are relatively few potential traders and abatement costs are relatively homogeneous across firms, the cost savings to the 22 municipal waste water treatment plants relative to the base case will be on the order of 7%. We believe that these results fail to support efforts to establish a permit exchange market structure in the Passaic Watershed such as the one celebrated with the success of the U.S. acid rain trading program. Rather, our results suggest quite a different strategy for water quality trading in small watersheds such as the Passaic, where there are relatively few potential traders and abatement costs are relatively homogeneous across firms. In these situations, trading programs should instead be designed to identify the subset of firms that will gain substantially from trade in pollution permits and to nurture trade amongst these firms. Furthermore, because markets in such watersheds are relatively thin and investments in pollution abatement capacity are costly and lumpy and must be framed within five-year permit cycles, it is likely that these structured bilateral opportunities for trade will need to take the form of multiyear contracts.


Striving for flawlessness in all aspects of life is one of the most simple definitions of perfectionism (Flett i Hewitt, 2002.). Researches clearly indicate relation of this multidimensional construct with negative outcomes and even with psychopathology. Distinction between positive and negative aspects of perfectionism is becoming more present recently. This research attempts to investigate the differential connection of perfectionism with positive and negative aspects of life, which also represents a contribution to validation of the positive and negative perfectionism model. A correlation research has been conducted for this purpose in order to check the relation of perfectionism dimensions with academic achievement and depression. It is expected that out of three perfectionism dimensions (high standards, order and discrepancy) setting high standards would represent positive perfectionism, and thus correlate positively with student achievement, while discrepancy would represent negative perfectionism, and thus be negatively related to academic achievement, and positively with depression. 246 students of Law and Medical faculty at University of Zagreb completed APS-R for perfectionism, BDI questionnaire of depression, and evaluated their achievement on four measures of academic performance, as well as their self-satisfaction as a student. Results have confirmed the hypothesis. Discrepancy correlated positively with depression, and negatively with academic achievement and self-satisfaction, while high standards correlated positively with academic performance. These two dimensions have proved to be significant academic achievement predictors while only discrepancy has shown to be a significant depression predictor. The present findings consistently suggest that setting high standards represents the positive aspect of perfectionism, while discrepancy represents the negative one.


A large number of youth in the United States suffer from a severe emotional disturbance (SED). Due to a number of factors (e.g., lack of access to services, siloed service providers), many of these children have unmet severe emotional and behavioral health needs. Wraparound has been identified as a care philosophy and intervention to meet the needs of these youth. Wraparound programs aim to provide individualized, comprehensive, community-based care for children and their families. Although this intervention is widely spread across the United States, research findings on the efficacy of the approach are mixed. Previous research aimed to identify and understand the most beneficial components of wraparound, while noting how contextual and regional factors can impact the delivery of these components. Some explorations have utilized a qualitative methodology; however, to date, most of the qualitative research focuses on the perspectives of service providers while neglecting the essential perspectives of caregivers and youth served by wraparound programs. This dissertation aimed to better understand a wraparound program in New Hampshire from the perspective of the caregiver. This phenomenological study used semi-structured interviews to explore the perspective of eight caregivers. Interpretive Phenomenological Analysis (IPA) of the data resulted in six main themes: (a) Initiating wraparound services, (b) FAST Forward Coordinator (FFC) and Family Support Specialist (FSS), (c) Wraparound Team, (d) Supports and Services, (e) Family Engagement, and (f) Program Outcomes. Implications, limitations, and future research suggestions are explored.


Prehospital care has developed dramatically the last decades with the implementation of new devices and educational concepts. Clinical decisions and treatments have moved out from the hospitals to the prehospital setting. In Sweden this has been accompanied by an increase in the level of competence, i.e. by introducing nurses in the ambulances. With some exceptions the scientific support for these changes is poor. This thesis deals with such changes in three different subsets of prehospital care: Cardiopulmonary resuscitation (CPR), the stroke chain of survival and trauma care. We assessed the performance of ambulance crews during CPR, using a mechanical compression device, as compared to CPR using manual compressions. There was a strikingly poor quality of compressions using the mechanical device compared to CPR with manual compressions. The result calls for caution when implementing a chest compression device in clinical practice and reinforce the importance of randomised controlled trials to evaluate new interventions. Careful attention should be given to the assurance of correct application of the device. Further implementation without evaluation of the quality of mechanical compressions in a clinical setting is discouraged. Among patients with a prehospital suspicion of stroke we analysed the ambulance nurses' ability to select the correct patient subset eligible for a CT scan as a preparation for potential thrombolysis. The results do not support an implementation of a bypass of the emergency department, using ambulance nurse competence to select patients eligible and suitable for a CT scan without a preceding assessment by a physician. The association between the Prehospital Trauma Life Support (PHTLS) course and the outcome in victims of trauma was analysed in two observational studies. A study covering one county gave some support for a protective effect from PHTLS, but the estimate had a low precision. A nationwide study, covering all of Sweden, could not confirm those results. Although there was a reduction in mortality over time coinciding with the implementation of PHTLS, it did not appear to be associated with the implementation of PHTLS. Thus, we could not detect any clear beneficial impact of the PHTLS course on the outcome of trauma patients. " As honest as possible " Shinya Yamanaka List of Papers This thesis is based on the following papers, which are referred to in the text by their Roman numerals. I Poor chest compression quality with mechanical compressions in simulated cardiopulmonary resuscitation: a randomized, crossover manikin study. II Agreement between …


Constitutive rules are developed to include three-dimensional dislocation mechanisms, such as line tension and dynamic junction formation, within a two-dimensional dislocation dynamics formulation. Some of the junctions that form dynamically can operate as Frank–Read sources. Boundary value problems are solved by using superposition to represent the solution in terms of the infinite medium fields for discrete dislocations and non-singular complementary fields that enforce the boundary conditions. This framework is used to analyse the plane strain tension of a single crystal. Calculations are carried out to strains of 3–8%, and the transition from stage I to II hardening is exhibited. The dependence of this transition and of the stage II hardening on constitutive parameters is explored. A variety of stress–strain responses are obtained and compared with available experimental results. The emergence of dislocation cells is seen and the structure of the cells is described.


Abstract Title: PR consultants and bloggers; a win-win situation? - A study of PR consultants' new adaptations in the labour market due to the emergence of fashion bloggers. Authors: Cecilia Girell, Sandra Kjellstrom Tutor: Ylva EkstromPurpose: With the expansion of the Internet, fashion bloggers have gotten more power. A few companies have understood this powerful and reasonable cheap marketing channel. Despite this, most companies still feel powerless, but what has happened to the work of PR consultants in this constant changing media environment? The ones whos purpose is to act as intermediaries between companies and various media channels. That is our purpose for this essay; to look at PR consultants new adaptations in their extern marketing communication in phase with the ever- growing blogosphere.Method: In this study a qualitative method in terms of personal interviews has been used in the collection of data. Four interviews have been held; whereas two with PR consultants working with fashion, and two with fashion bloggers. These interviews together with literature and theories regarding our topic have later on been used as the base for our results and analysis.Main results: Overall, PR consultants have gotten a more stressful environment since the entrance of the bloggers. More and different strategies must nowadays be planned, since the bloggers work differently compared to traditional media. They offer a more personal connection towards their readers, which also have made it easier for the PR consultant to reach their target groups faster. Both bloggers and PR-consultants have nowadays become dependent on each other, and the factors leading up to this can be explained through technological, economic and cultural perspectives.Number of pages: 50 Course: Media and Communications Studies C Department: Division of Media and Communication, Department of Information University: Uppsala University Period: Fall 2014Keywords: PR consultant, blogger, fashion, communication, Jenkins, convergence, marketing communication, Bourdieu.