The evaluation of hydrogenic retention in present tokamaks is of crucial importance to estimate the expected tritium (T) vessel inventory in ITER, limited from safety considerations to 350 g. In the framework of the European Task Force on Plasma Wall Interaction (EU TF on PWI) efforts are underway to investigate gas balance and fuel retention during discharges, and to compare the data obtained with those from post-mortem analysis of in-vessel components exposed over whole experimental campaigns. This paper summarizes the principal findings from coordinated studies on gas balance and fuel retention from a number of European tokamaks, namely, ASDEX-Upgrade (AUG), JET, TEXTOR and Tore Supra (TS). For most devices, the long-term retention fraction deduced from integrated particle balance is ∼10–20%. This is larger than the ∼3–4% deduced from post-mortem analysis of plasma facing components (PFCs). However, from the database available for tokamaks with their main PFCs made of carbon, the important conclusion is that the T inventory limit (set by the working guideline for operations) could be reached in ITER within fewer than 100 discharges. This, therefore, would seriously impact on operation of the device unless efficient T removal processes are developed.


Background is key to HIV transmission, monitoring trends in groups of men from the general population, especially those whose mobility features and difficult access to sexual health services specialised transit routes is a constant Methods From November 2012 - January 2013, men were recruited long-haul drivers as part of the Survey of Prevalence of HIV, syphilis and sexual behaviours in key populations of HIV in Guatemala. We used a convenience sample. All participants fulfilled the eligibility criteria and signed an informed consent, a questionnaire was face to face. All participants had been testing for HIV and syphilis. Data were analysed using STATA 11.1 Results 609 men long-distance drivers participated in the study, the median age was 37 years (IQR 31–46). The Guatemalans were 86.54%, 98% married or living with a woman and more than half (56%) had completed primary education. Only 9.2% had participated in activities about HIV in the past year, 22.8% correctly recognised ways of preventing HIV transmission, a 11.35% underwent an HIV test in the last 12 months, higher than that found in the general population (4.0%), but lower than in FSW´s clients (23.5%). Prevalence in HIV were found in 0.50% (0.10–1.44) and 1.98% (1.02–3.43) in syphilis Conclusions The low prevalence of HIV is similar to that found in the general population of Guatemala (0.8%). Based on the results of this study primarily: the lack of correct knowledge about HIV and the little assistance to get tested for HIV diagnosis in addition with the UNAIDS recommendations in textbooks on population mobility and AIDS interventions are required to establish this special population is a priority under the bridge populations, for their constant mobility.


We present a new interface for minimally invasive surgery (MIS) training that incorporates novel broadband sensory modalities that include visual, force, and thermal technology, into the evolution of the next generation of surgical robotics and simulators. A new haptic device is designed to provide high force and torque capabilities for a better touch feedback. Part of the surgical tool is kept to be the real grasper (i.e., the handle) of the haptic interface. Yet, our main novel contribution is in integrating thermal feedback in MIS applied perspectives; indeed, thermal sensing finds particular utility in detecting and isolating unstable arterial plaque and tumors. In addition, thermal energy is used in several therapeutic procedures such as tumor ablation or tissue welding. We propose several thermal exchange models based on the Pennes' bioheat transfer equation. The overall haptic interface (force and thermal display) is interfaced with an open source virtual reality simulator (the SOFA framework). We added in SOFA the necessary models dealing with thermal simulation using built-in data structure and methods. The integration is successful, and realistic simulation scenarios combining visual, thermal, and force feedback were achieved. Results using the overall simulation are presented and evaluated.


The present study aimed to visualize human motor neuronal activation in the brain using fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET), and to develop an FDG-PET procedure for imaging neuronal activation. A male volunteer underwent 20 min periods of rest and motor activation, whilst being assessed using FDG-PET on two consecutive days. The motor task, which involved repetitively grasping and releasing the right hand, was performed during the initial 5 min of the activation period. Subtraction of the rest period signal from the activation PET images was performed using the subtraction ictal single-photon emission computed tomography co-registered to magnetic resonance imaging method. The subtracted image detected activation of the contralateral (left) primary motor cortex, supplementary motor area, and ipsilateral (right) cerebellum. In the present study, FDG-PET detected significantly increased motor-associated activation of the brain in a subject performing a motor task.


John F. Kennedy holds a unique position in American public memory and opinion polls continuously rank Kennedy among the best presidents. The scholarly assessment of Kennedy, however, has changed considerably over time and holds a decisively less celebratory appraisal of Kennedy today. This dissonance between public opinion and scholarly assessment is closely connected to the so-called Kennedy Myth, which presents an idealized mythological image of Kennedy. Existing scholarship has demonstrated that Kennedy was immensely popular among Danes up until his assassination in 1963. However, little is known about how Danish perceptions of Kennedy developed over time. This article traces the portrayal of Kennedy in four major Danish newspapers from 1963 to the end of the Cold War. The article finds a clear manifestation of the Kennedy Myth throughout the period. Moreover, the article demonstrates that exposure to scholarly criticism and increased awareness of the existence of the Kennedy Myth does little to damage positive appraisals of Kennedy. The article thus testifies to the resilience of the Kennedy Myth across both space and time.


To understand the stress regime in the shallow portion of the Nankai Trough seismogenic zone, we carefully investigated the resistivity image logs at IODP Site C0009 that penetrated to 1600 meters below the sea floor (mbsf) in the central Kumano forearc basin. During the riser drilling, several downhole measurements were run including image logs, caliper and comprehensive geophysical logs sets. Borehole resistivity images obtained by a wireline‐logging tool were reprocessed in order to eliminate image artifacts generated by sticky tool movements, etc. The constraints on the possible magnitude and orientation of horizontal principal stresses are provided from the borehole images, rock strength, and logging data. The absence of borehole breakouts above 1285 mbsf represents a small difference (<10 MPa) between horizontal principal stresses and reflects the normal faulting and strike–slip faulting stress regimes. A stable, continuous breakout was observed in the resistivity image logs suggest that the stress state is in a strike–slip faulting and tending to reverse faulting regime below 1285 mbsf. The differential horizontal stress (up to 15 MPa) is significantly larger than in the shallow portion of the borehole (SHAMX ≫ Sv > Shmin).


For over two decades no attempt has been made to update the checklist of Ferns and Lycophytes (hereafter only referred to as pteridophytes) of Honduras. In 1996 Nelson-Sutherland and co-workers published the first fully annotated checklist for the country, which included 651 named species (680 taxa including varieties and hybrids). However, phylogenetic relationships have changed substantially since then. There have also been many taxonomic revisions for several groups and a considerable number of new records have since been published. Our work aimed to provide a comprehensive updated and fully annotated checklist of Honduran ferns. We undertook a comprehensive literature review of new records for Honduras and verified each individual record for the country. We followed PPGI for our taxonomic species revisions. We excluded a total of 81 taxa from the original 1996 checklist due to synonymy or lack of evidence of the species occurrence in Honduras. A total of 114 new species records were added, including four previously unpublished records. Our new updated checklist includes 713 taxa (including 8 varieties and 7 hybrids) which represents a 19% increase to the number of pteridophytes known from Honduras. Our work provides updated information regarding the pteridophytes diversity of Honduras. These data provide a crucial first step towards the first Honduran pteridophytes flora.


Abstract As with most agricultural industries, the U.S. dairy industry has evolved into a structure including fewer yet larger firms. In Louisiana, total milk production has declined along with dairy farm numbers since 1972. This study addresses the impact of alternative policies, macroeconomic factors, and technology on the structure of the Louisiana dairy industry using a micro-data non-stationary Markov chain analysis. Results indicate that a number of factors have affected the structure of the industry in Louisiana, including but not limited to prices, milk supply reduction programs, technology and interest rates.


The six- and four-quark systems are studied in the framework of constituent quark models. It is emphasized that the color confinement used in multiquark system should be different from the one used in two- or three-quark system. For six-quark system, we look for △△ and N△ dibaryon resonances by calculating NN scattering phase shifts with explicit coupling to these dibaryon channels in quark delocalization and color screening model. The model gives a good description of low-energy NN properties and predicts IJP = 03+ and 01+ △△ resonances, which can be promising candidates for the isoscalar ABC structure reported by the CELSIUS-WASA Collaboration. For tetraquark system, a flux-tube quark model with multi-body confinement interaction is employed to study Y(2175) as a tetraquark state. The Y(2175) with diquark-antidiquark structure has energy 2174 MeV which is very consistent with experimental data. The calculation shows that multi-body confinement potential may play a vital role in the multiquark system.


Peste des Petits ruminants (PPR) is a highly contagious trans-boundary animal disease associated with 100% morbidity and 80-90% mortality in goat herds. The study was carried out to assess the immune status against PPRV in unvaccinated and post vaccinated flock as well as immune response as it relates to age, sex and breed using a homologous tissue culture PPR vaccine produced by National Vaccine Production Laboratory, Kathmandu, Nepal. A total 276 blood samples were randomly collected from different regions of Parbat, Baglung and Myagdi districts with a population of 0.0189 million goats. Out of these, 214 goats were vaccinated one month earlier and 62 were unvaccinated. PPR antibody was detected by using competitive enzyme linked immunosorbent assay (c-ELISA) (ID Screen, PPR competition test kit, IDvet France). Of the unvaccinated goats, 25.8% (16/62) were sero-positive suggesting prior exposure to PPRV. In the vaccinated goats, 75.2% (161/214) were sero-positive and 2.8% (6/214) animals were doubtful, suggesting a significant proportion failed to respond to vaccination. The competition percentage (S/N%±SD) of post-immunization (49.19±32.19) were significantly (p<0.01) lower in comparison to the respective unvaccinated mean titre (75.76±35.51). There is no significant effect of age, sex or breed on the antibody titre value in PPR vaccinated animals. The sero-prevalence of PPR in unvaccinated animals suggested that these flocks are in high susceptibility to PPR outbreak and needs an implementation of control measures to reduce economic losses. Vaccination will increase the proportion of animals with a protective antibody level, however more investigation needs to be done to determine why almost one-quarter of animals failed to seroconvert to vaccination. Further detailed study is needed to find out the risk factors responsible for low prevalence of antibody against PPRV in the immunized flock.


Science and technology have become increasingly intertwined in the twentieth century. However, little attention has been paid to the forces that have brought about this condition. Indeed, many scholars have taken it simply for granted that causality always runs from science to technology. In this groundbreaking book, Rosenberg's research suggests that history and extensive empirical evidence lead to a reality that is far more complex as well as far more interesting. Here, Rosenberg's papers explore a wide range of pertinent issues, especially those connected with the innovative process, including the realms of electric power, electronics, chemicals, aircraft, medicine, instrumentation and, in particular, higher education and the organization of research activities.


Iodine is a crucial nutrient for public health, and its presence in the terrestrial atmosphere is a key factor in determining the prevalence of iodine deficiency disorders. While oceanic iodine emissions decrease at lower sea surface temperatures, the primary contributors to atmospheric iodine can vary from oceanic sources in the summer to other sources in winter. However, the specific sources and their respective contributions have remained unexplored. Fortunately, the atomic ratio of 129I to 127I significantly differs between nuclear activity and fossil fuels like coal and petroleum, which formed millions to billions of years ago. This distinction makes 129I a valuable tool for identifying iodine sources. In our study, we analyzed iodine isotopes and incorporated additional indicators such as element content in PM2.5 samples. Our findings reveal, for the first time, that in winter inland areas, fuel oil, alongside coal combustion, is a significant source of atmospheric iodine. This research enhances our comprehension of the impact of human activities on iodine levels in the environment. This understanding is crucial not only for addressing iodine deficiency-related health concerns but also for comprehending stratospheric ozone depletion, a phenomenon closely associated with atmospheric iodine.


How WW-II era radio and personal histories have shaped the development of "From the Diary of Eve", a narrative series of poems set in Southern Appalachia.


Nature is perceived and valued in many different ways. Often, the types of values that are the most important to people depend on how they cognitively frame desirable human-nature relations. For instance, the value of nature can be seen through a utilitarian lens, e.g., as providing ecosystem services for humans. Alternatively, it can also be considered valuable for non-instrumental reasons, e.g., for its sacred or spiritual significance. In this paper we use a framed field experiment to test how people belonging to three distinct communities in Colombia (Indigenous, Afro-Colombian, and Campesino) respond to different ways of framing payments for ecosystem services (PES) schemes, so as to assess potential motivational crowding effects of pro-social/intrinsic motivations for forest conservation. The experimental results indicate that crowding-in of intrinsic motivations for forest conservation occurred in participants from the Indigenous community when the PES scheme was framed in a way that highlighted relational values of the forest. By contrast, motivational crowding-in took place for participants in the framed field experiment from the Campesino community when the PES scheme was introduced in a way that highlighted instrumental values instead. Participants from the Afro-Colombian community did not show evidence of motivational crowding under either framing. Together, these results suggest that PES schemes that are framed in a way that harmonizes with locally salient human-nature relational models and associated values are more likely to cause motivational crowding-in, and thus encourage higher rates of environmental conservation, even after payments are discontinued.


Intercultural communication and education are important topics that are gaining prominence in many fields of study. In this article, a multimedia and hypermedia tool is presented that has demonstrated important successes in promoting intercultural education and an appreciation for pedagogical and student diversity. The article begins with an introduction to the need for this type of research with overview questions provided from a reading of Clifford Geertz. The technological tool is then presented and research data is provided to support its integration. The article ends with a call for more research.


The development of a Performance Index (P.I.) for traffic signal controlled intersections, i.e. of an index which would give a measure of the performance of a signalized junction, seems to be a necessary tool for evaluating traffic signal operation. On the basis of such a P.I., the traffic engineer could be assisted to: (i) define which of the various traffic signal controlled junctions of an area present problematic operation, and to rate these junctions accordingly; (ii) identify the interventions, which ought to be carried out for the specific signalized junctions, in order to improve their operation; (iii) program the series of traffic signal maintenance actions, in the area under consideration. Such a Performance Index is developed in this paper as a combination of various parameters- "symptoms" of operation, to each of which a weight is allocated; the combined outcome of these parameters gives then the P.I. The potential "symptoms" of performance, which are taken into account as parameters, are described in detail. The reasons for the consideration of each of these parameters are also outlined. The cases of both the isolated and coordinated traffic signaled intersections are treated accordingly. An amount of data is collected from two different cities in Greece, i.e. Athens and Patras, and case-study applications take place, which produce reasonable and interesting results. For the covering abstract see ITRD E129315.


Objectives: Iodine is an essential
nutrient needed for
the synthesis of hormone thyroxin. Hormone thyroxin is involved in the metabolism
of several nutrients, the regulation of enzymes and differentiation of cells,
tissues and organs. Iodine deficiency (ID) impairs the development of the brain
and nervous system. It affects cognitive capacity, educability, productivity
and child mortality. ID hinders physical strength and causes reproductive failure. The objective of this paper is to explore if the
health impacts of ID are more common and severe among women. Design:
Using primary data (notes from a visit) and secondary data, this paper
examines if the effects of ID are more common and severe among Oromo women inEthiopia.
Findings:
The health impacts of ID are more common and severe among women. Conclusions: ID is an easily preventable nutritional
problem. In Oromia, the persistence of ID is explained by the Ethiopian government's colonial social policies. Preventing ID should be seen as part
of the efforts we make to enhance
capacity building, promote health, gender equity and social justice. Implications:
Iodine deficiency has a wide range of biological, social, economic and
cultural impacts. Preventing ID can be
instrumental in bringing about gender equity and building the capacity of people.


South Africa's informal backyard rental sector contributes significantly to the country's housing needs by presenting affordable informal rental options within serviced areas. This paper relates the informal backyard rental sector not only to urban sustainability, but also urban resilience against internal urbanisation pressures, specifically related to an ever-increasing low-cost housing demand. This paper reflects the need to establish flexible and sustainable planning practices which capitalise on an existing informal development culture in order to improve living conditions and urban functions by celebrating informality's innately flexible nature. Thus, this research aims to provide evidence for the value of the informal backyard rental sector in the context of socio-economic, environmental and spatial viability, for sustainable and resilient urban environments which deliver settlements in which all tenure options and housing needs are equally met. Research navigates through existing theories on the informal city and incorporates new theoretical and empirical work on SA's informal backyard rental sector. Oudtshoorn in the Western Cape Province is used as a case study to answer the question: How do informal backyard rentals contribute to urban resilience and sustainability and how can this contribution be amplified? This paper finds that the informal backyard rental sector, through its instinctive ability to adapt, increase residential densities and support life sustaining practices may significantly contribute to urban resilience and sustainability, if recognised and supported by those who wield the power to influence South Africa's urban (r)evolution.


This article argues that, to be truly understood, South Africa's new Language in Education Policy (LiEP) must be examined in the context of both historical and recent developments. It provides this background discussion and focuses on the LiEP as it presently affects curricula, classroom practices, institutional restructuring, subject choices in South African schools, and the rights of South African parents and students. It also addresses the educational and extra-educational tensions associated with the LiEP, inhibiting factors impeding its implementation, initiatives and activities deserving of priority consideration, and models for effecting meaningful change in this policy area. INTRODUCTION Although there are many languages in South Africa, official and nonofficial, two major language battles, with two competing language groups in each case, loom most prominently. On one side are the nine local languages of the African majority that were recently granted official status: isiNdebele, isiXhosa, isiZulu, Sepedi, Sesotho, Setswana, siSwati, Tshivenda, and Xitsonga. On the other are English and Afrikaans, the two former official and privileged languages. One contention is whether, with the advent of Black majority rule in the recently democratized nation, the African languages "deserve" their newly elevated status. Contesting this are Afrikaans speakers, who also rage against what they perceive as the diminished position of their language and the superior position that seems to have been given to English by South Africans of British descent and Africans alike. It should be noted, however, that statements alleging that the status of Afrikaans has receded are typically more an expression of fear than fact, depending on which side of the political fence one sits. Additionally, resistance to the official use of African languages as languages of instruction has surfaced among South Africa's African majority, many of whom contend that their children should be exposed to and immersed in English, which is rapidly becoming the language of commerce and politics in South Africa, as early as possible. Other observers have pointed out the unchanging status of the nation's minority and majority language groups from the previous regime to the present, noting that the South African economy remains in the hands of the powerful White minority. They argue that it has not been possible to level the playing field insofar as African languages are concerned because written texts in some languages, like isiXhosa, have been available since the early 19th century, while other languages such as isiNdebele have existed in written form for fewer than 15 years. Into this fray in 1997 stepped the Language in Education Policy (LiEP)-or the Language Policy in Education, as it is known in some quarters-part of contemporary South African society's efforts to distance itself from its apartheid origins and spirit (Republic of South Africa Department of Education [RSADE], 1997b). The present article argues that, to be truly understood, the LiEP must be examined in the context of both historical and recent developments in South African society. Included among these developments are the following: (1) the first democratic elections in South Africa, held in 1994, and the subsequent installation of a more truly representative Black-majority government, a Black President, a Black Minister of Education, and a Black Director-General of Education, along with the integration of the nation's previously segregated education departments; (2) the country's 1996 adoption of a new Constitution (RSA, 1996b), its founding provisions, and Bill of Rights, along with the passage that same year of the omnibus South African Schools Act (SASA), which provides a "uniform system for the organisation, governance and funding of schools" and amended and repealed laws relating to schools (RSA, 1996a, p. 2); (3) the generation of national educational policy documents such as the 1995 White Paper on Education and Training (RSADE, 1995a) and the 1996 Education White Paper 2: The Organisation, Governance and Funding of Schools (RSADE, 1996a), both of which document the new government's intentions and proposals for the education and training in the democratic era; (4) the creation in October 1995 of the Pan-South African Language Board, whose mission includes promoting and creating conditions for the development, use of, and respect for all official languages, nonofficial languages of native inhabitants, and sign language; (5) the exodus, since 1991, of Black students from exclusively African township schools, where African languages are the primary languages of instruction; to the formerly allWhite, Indian, and Colored city schools, where English or Afrikaans is the language of instruction; (6) the increasing acceptance and promotion in recent years, in both the Constitution and recent education policy documents, of multiculturalism and multilingualism as assets and valuable resources in the educational process; (7) the 1995 institution of a uniform senior high school national examination system that prescribes the same examination procedures, dates, times, and questions for all learners at the school exit level (grade 12); (8) the creation in February 1995 of the National Commission on Higher Education, which in December 1996 released its Green Paper on Higher Education Transformation (RSADE, 1996d) which served as the basis for the Higher Education Act (RSA, 1997) (passed in December 1997) and which challenged South African colleges' and universities' resistance to broadening the number of official languages of instruction used at institutions of higher education; (9) the return to South Africa's schools of large numbers of exiled citizens and other learners who do not speak any African languages; and (10) other corrective developments in the country, both educational and noneducational, such as name changes of rivers, suburbs, and airports to reflect and honor the multicultural and multilingual heritage of the nation; removal of apartheid-stigmatized statues and pictures from government properties; changes in the governance and programming of the South African Broadcasting Corporation; the growth and spread of adult basic education and training; and the establishment of the National Qualifications Framework (NQF), the new Department of Education's integrated approach to education and training that "[links] one level of learning to another and [enables] successful learners to progress to higher levels without restriction from any starting point in the education and training system" (RSADE, 1995a, p. …


In this paper, we study the Cabibbo favored nonleptonic D0 decays into K-π+ decays. First we show that, within the Standard Model (SM), the corresponding charge conjugation and parity (CP) asymmetry is strongly suppressed and out of the experimental range, even taking into account the large strong phases coming from final state interactions. We show also that although new physics models with extra sequential generation can enhance the CP asymmetry by a few orders of magnitude, the resulting CP asymmetry is still far from the experimental range. The most sensitive new physics models to this CP asymmetry come from nonmanifest left-right models, where a CP asymmetry up to 10% can be reached, and the general two-Higgs model extension of the SM, where a CP asymmetry of order 10-2 can be obtained without being in contradiction with the experimental constraints on these models.


In this paper, we introduce a LMS (least mean square) algorithm with a modified step size for adaptive filtering. An adaptive feedback constant step size in the LMS algorithm controls the convergence rate of the filter coefficients but also determines the final mean-square error. Since the convergence time is inversely proportional to step size, a large step size is often selected for fast convergence. This selection, however, results in an increased mean square error. The proposed detector uses the LMS algorithm with three different step size to obtain low mean square error and fast convergence. In this structure, errors which are obtained from each group are compared, and a minimum error is chosen to the selection block. In several step size LMS algorithms, filter coefficients for each group are upgraded using the output information of the selection block respectively. The advantages of this detector are that convergence time is fast, and that mean square error is low. However this detector has a defect that hardware complexity is increased.


This guide will lead you through the process of identifying image collections (searching for images in licensed and Emory-built image collections and finding images on the open web) and then using them (understanding permissions and citing images correctl


admitted to a general hospital and associated factors. The objective of the study was to evaluate the nutritional status of the hospitalised elderly patients using the Mini Nutritional Assessment (MNA) and nutritional classic parameters, to estimate the prevalence of undernutrition among them and to value the correlation of undemutrition with epidemiological characteristics of the sample for determine the highest risk's group among the malnourished patients. A cross sectional survey was done among a sample of 200 elderly patients admitted to the USP San Carlos Hospital (Murcia, Spain) during a period of 3 months. Patients answered a questionnaire including demographic data and the MNA clinical tool. Lymphocyte concentration and albumin and transferrin serum levels were also collected. Statistical analyses were performed with the Student t and chi 2 tests. For the MNA, the Spearman's coefficient was employed. Mean age of the 200 patients was 80.72 SD 7.43 years. Mean weight was 63.41 SD 19.57 kg and mean height was 160.93 SD 8.36 cm, with a mean Body Mass Index of 24.27 SD 7.31. The serum values of albumin and transferrin and total lymphocytes in blood were 3.09 SD 0.5 g/l, 1.69 SD 0.37 mg/dl and 1412 mm3 respectively. Average score of the MNA was 15.9 SD 6.21 arid, according to this scale, 50% (n=100) of the patients were malnourished. Correlation analyses resulted in significant association (p<0.001) between values of undernutrition in the MNA and measurements under normality of the biochemical and immunological parameters. The patients who presents chronic diseases, advanced physical or mental deterioration and minor self-sufficiency are either malnourished or at high risk of being. The individualized nutritional evaluation must be performed routinely when the patient is admitted to the hospital for detect and treat early signs of malnutrition.


This thesis investigates the relationship between the State and destitute, neglected children, and youthful offenders in the period 1895 to 1920 in Tasmania.
 The thesis, using a wide range of primary source material which until recently has been overlooked by historians, reveals how the State penetrates the private sphere in prescriptive and proscriptive ways in structuring the lives of people. Further, the documents clearly illustrate the class nature of Tasmanian society at Federation and reveal structures and practices of oppression which were the basis of the interaction between privileged men and women and working class children and their families.
The thesis aims to investigate children in a way which places children back into history rather than creating a history of children. Children have always been of concern to the State; with women they have constituted the largest group of welfare recipients since the beginning of settlement. Special agencies have been established in every State, which have the right to assume guardianship over certain children. The continued existence of 'State' children is ample evidence of the need to record their trials and tribulations. In 1981 there were over 20,000 children under state guardianship in Australia. The experiences of this group of children will provide a further dimension to the social history of Tasmania at Federation.
Because the thesis aims to bring to centre stage the experiences of 'welfare' children set in a broad landscape of social history, it explores a number of other questions which lead to a more complete understanding of the nature of Tasmanian society in the period under scrutiny.
During the debate on the care of 'welfare' children contemporary ideologies reveal the way in which children and childhood are perceived in this period and how these ideas are translated into social policy and its institutions. The documents reveal a complex of ideas about children's sexuality which in turn determine the way children were managed when they entered the care of the State. The documents reveal the intimate relationship between the Church and the State as mutual agents of the moralizing of the working class and show how both are mutually involved with philanthropic groups which are an integral part of the services dealing with 'welfare' children and which attempt to influence the legislative wing of the State.
The high status which is accorded to influential women in the voluntary philanthropic groups throughout colonial times is also observed in Tasmania around the turn of the century. The implications of this activity for these women and their relationship to women and children in other social classes is explored.
The period under investigation is one during which the provision of public services became increasingly sophisticated. This period saw the growth of a more professional bureaucracy but it will be shown however that within the State bureaucracy the welfare of children was accorded a low priority reflected in both the changing organizational structures experienced by the Neglected Children Department and in the very limited commitment by successive governments in funding the Department's work.
Finally the files of the children who came under the care of the State are a window onto the lives of working class families both through the judgmental language of the inspecting officers, departmental officers and police and through the correspondence of children, their families, and carers. These documents reveal the conditions under which many families attempted to survive, the work they undertook, the way children were seen in working class families and the resistance individuals mounted against the intrusion of the State and its agents into their lives.


We have designed an SFQ pipeline multiplier using a cell-based design method. The cell-based design method enables us to expand the circuit-scale easily and is essential for the design of large-scale circuits. In the construction of the multiplier, a serial-parallel type was adopted. This type performs the partial products and the summation of the products in a bit-serial form. The multiplier designed here is a 3-bit serial-parallel structure with a seven-stage pipeline and is composed of destructive read-out (DRO) gates, nondestructive read-out (NDRO) gates and carry save serial adders (CSSA's). This circuit was fabricated by the NEC standard process. The number of Josephson Junctions is 1150. We have successfully tested the full operation with a bias margin of /spl plusmn/5.5%.


The developmental aspects of sleep and breathing are rarely treated as one subject. This report attempts to link the fields of sleep research and developmental pulmonology in a comprehensive description of development and control of sleep and breathing from gestation to adulthood. Unfortunately, much of the investigation in this area is basic physiology and was done some time ago. Although this subject matter need not be updated, some of these references are older; however, this may be new information for the pulmonologist. The second part of this report details the pathophysiologic mechanisms behind the development of sleep-disordered breathing in children and adults. In fact, developmental abnormalities that occur in childhood may recrudesce in adulthood. We conclude with a discussion of the familial and genetic aspects of sleep-disordered breathing and consider the place of sudden infant death syndrome in the spectrum of these disorders.


Intraguild predation combines two fundamental interactions between species: predation and competition, and is very common in nature. The intraguild predation module contains an intraguild predator, an intraguild prey and their shared resource. Both predation and competition occur between the intraguild predator and intraguild prey since the intraguild predator preys on the intraguild prey, and they both compete for their shared resource. It has been recognized that intraguild predation has significant impacts on the distribution, abundance, persistence and evolution of the species involved. In this dissertation, the dynamics of three intraguild predation models are investigated. I show that intraguild predation models can undergo a new global bifurcation, basin boundary bifurcation, and a torus bifurcation. I also show that the time delay in interguild predation models can induce stability switches and chaos. A review of the existing work on intraguild predation is given in Chapter 1. For convenience, some basic mathematical concepts and results on dynamic systems are also given in Chapter 1.


We investigated the role of host sex in parasite transmission and questioned: 'Is host sex important in influencing the dynamics of infection in free living animal populations?' We experimentally reduced the helminth community of either males or females in a yellownecked mice (Apodemus flavicollis) population using an anthelmintic, in replicated trapping areas, and subsequently monitored the prevalence and intensity of macroparasites in the untreated sex. We focussed on the dominant parasite Heligmosomoides polygyrus and found that reducing parasites in males caused a consistent reduction of parasitic intensity in females, estimated through faecal egg counts, but the removal of parasites in females had no significant influence on the parasites in males. This finding suggests that males are responsible for driving the parasite infection in the host population and females may play a relatively trivial role. The possible mechanisms promoting such patterns are discussed.


A dilution sampler was used to examine the effects of dilution ratio and residence time on fine-particle emissions from a pilot-scale pulverized coal combustor. Measurements include the particle size distribution from 0.003 to 2.5 μm, PM2.5 mass, and PM2.5 composition (OC/EC, major ions, and elemental). Heated filter samples were also collected simultaneously at stack temperatures in order to compare the dilution sampler measurements with standard stack sampling methodologies. Measurements were made both before and after the bag house, the particle control device used on the coal combustor, and while firing three different coal types and one coal–biomass blend. The PM2.5 mass emission rates measured using the dilution sampler agreed to within experimental uncertainty with those measured with the hot-filter sampler. Relative to the heated filter sample, dilution did increase the PM2.5 mass fraction of selenium for all fuels tested, as well as ammonium and sulfate for selected fuels. However, the additional particulate mass created by gas-to-particle conversion of these species is within the uncertainty of the gravimetric analysis used to determine the overall mass emission rate. The enrichment of PM2.5 selenium caused by dilution did not vary with dilution ratio and residence time. The enrichment of PM2.5 sulfate and ammonium varied with fuel composition and dilution ratio but not residence time. For example, ammonium was only enriched in diluted acidic aerosol samples. A comparison of the PM2.5 emission profiles for each of the fuels tested underscores how differences in PM2.5 composition are related to the fuel ash composition. When sampling after the bag house, the particle size distribution and total particle number emission rate did not depend on residence time and dilution ratio because of the much lower particle number concentrations in diluted sample and the absence of nucleation. These results provide new insight into the effects of dilution sampling on measurements of fine particle emissions, providing important data for the ongoing effort of the EPA and ASTM to define a standardized dilution sampling methodology for characterizing emissions from stationary combustion sources.


Phase separated polymer nanocomposite (PNC) bilayer films consisting of poly(vinyl alcohol) (PVA) and poly(methyl methacrylate) (PMMA) matrices (PVA/PMMA = 50/50 wt %) dispersed with 5 wt % amount of inorganic nanoparticles (i.e., Al 2 O 3 , SiO 2 , ZnO and SnO 2 ) have been prepared by solution-cast method using the polymer blend binary solutions. Complex dielectric permittivity, electric modulus, alternating current (AC) electrical conductivity and impedance spectra of the PNC bilayer films have been investigated in the frequency range from 20 Hz to 1 MHz, at 27°C, by employing the dielectric relaxation spectroscopy. The values of real part of dielectric permittivity of all these films are found less than 2.5, and their dielectric loss part values are significantly low confirming the suitability of these PNC materials as high performance low-permittivity nanodielectrics. The complex dielectric permittivity values of these PNC bilayer films vary with the nanoparticles in the order SnO 2 > ZnO > SiO 2 > Al 2 O 3 . The complex dielectric permittivity values of Al 2 O 3 and SiO 2 dispersed films are found less than 1.33– j 0.035 and also remain almost stable over the entire frequency range of measurements. The AC electrical conductivity and impedance values of these films have linear increase and decrease, respectively, with the increase of frequency which confirms their Ohmic behaviour. The direct current (DC) electrical conductivity values of the PNC bilayer films are found of the order of 10 –14 S/cm, and these values have variation of about one order of magnitude with different nanofillers. The dependence of dielectric and electrical properties of the PNC films on the structural and dielectric permittivity of the nanofillers has been explored. The feasibility of these PNC bilayer films as polymer dielectrics, electrical insulator and dielectric substrate in the development of advanced microelectronic devices has been confirmed.


Cytogenetic analyses of bone marrow and gonadal cells in a male mouse, which appeared to be normal, revealed mosaicism in both tissues. Three chromosome complements, 39,X, 40,XY, and 41,XYY, were found in both bone marrow and spermatogonia, while only the last two complements were found in spermatocytes. In this mouse, unlike in the human, the XYY cells showed a proliferative advantage over the XY cells. In XYY cells at diakinesis/metaphase I the gonosomes showed all possible types of association, and a pairing advantage of the X chromosome was clearly demonstrated. The fertility of the mouse was not determined. However, since the epididymal sperm count was reduced by only 55% and the incidence of sperm head abnormality was near normal, it is not evident that the mouse was sterile.


This book deals with Solzhenitsyn and Sakharov as political philosophers, presenting their philosophies in a comparative framework. He sets their dissident activities within the larger framework of the emergence of dissent in contemporary Soviet society. Both men are recognized as the products of their life experiences, their occupations as author and scientist respectively, their views of the social and political legitimacy of the current Soviet regime, and their hopes for the future as expressed in their images of the ideal Soviet society. This work also compares the Solzhenitsyn-Sakharov dialogue to the ongoing debate in western nations about the nature and future of industrial society, and clarifies the ideologies of two key figures in the modern-day Russian dissident movement.


"Looking for things" is a mundane but critical task we repeatedly carry on in our daily life. We introduce a method to develop a human character capable of searching for a randomly located target object in a detailed 3D scene using its locomotion capability and egocentric vision perception represented as RGBD images. By depriving the privileged 3D information from the human character, it is forced to move and look around simultaneously to account for the restricted sensing capability, resulting in natural navigation and search behaviors. Our method consists of two components: 1) a search control policy based on an abstract character model, and 2) an online replanning control module for synthesizing detailed kinematic motion based on the trajectories planned by the search policy. We demonstrate that the combined techniques enable the character to effectively find often occluded household items in indoor environments. The same search policy can be applied to different full body characters without the need of retraining. We evaluate our method quantitatively by testing it on randomly generated scenarios. Our work is a first step toward creating intelligent virtual agents with human‐like behaviors driven by onboard sensors, paving the road toward future robotic applications.


Background: Breast cancer is second most important cancer among Indian women. In India, the number of new breast cancer cases is about 115,000 per year. Although risk factors are not much prevalent as in western countries, incidence rate is increasing in India. Breast cancer awareness is an effort to raise awareness and reduce the stigma of breast cancer through education on symptoms and treatment. Objectives: Present study has the objective to assess the level of awareness about Carcinoma Breast and to study the knowledge and practice regarding screening methods of breast   carcinoma Material & Methods: A cross sectional study was conducted among 160 women aged 15 years & above by simple random sampling. Pretested preformed questionnaire was used. Verbal consent was taken prior to interview. Data analysis was done by SPSS version 20 & MS Office Excel 2007. Results: 58.7% women had no knowledge regarding breast carcinoma. 93.12% women had no knowledge regarding risk factors of it. Only 8 women had knowledge about Breast Self Examination and amongst them only 2 practice it. Only 2 women had knowledge about mammography and MRI as screening method. Conclusion: Majority of women had no knowledge regarding Risk factors & Screening methods of Breast Ca. Education has positive impact on knowledge of symptoms of breast carcinoma.  Keywords: breast carcinoma, breast self examination, screening methods


The Entropy™ module and bispectral index (BIS) depth-of-anesthesia monitors have been shown to be influenced by electromyographic (EMG) activity. The increase in entropy and BIS values is most likely caused by increased EMG activity and a higher level of consciousness. A strong EMG activity can increase entropy and BIS values because it is impossible to separate electroencephalography (EEG) from EMG, and this results from their overlapping power spectra. Thus, the entropy module may be more affected by EMG compared with the BIS module because it has more overlap with the power spectra of EEG and EMG. Several studies have suggested that EMG activity is most likely to increase, especially as it relates to the level of total intravenous anesthesia without a muscle relaxant or an insufficient analgesic level, which results in falsely increased entropy values. We present the case of a patient whose entropy values were falsely elevated by increased EMG activity resulting from light neuromuscular block or nociceptive stimuli during surgery even when undergoing desflurane anesthesia. This was closely related to the change in the neuromuscular block level and it was influenced by the degree of analgesia and the remifentanil infusion rate.


The coordinate converter-equipped radionavigation receiver is now commonplace. Is its ease of use an unmitigated blessing?

Most U.S. civil charts are printed using North American Datum—1927, while coordinate converters are based on World Geodetic System—1972. The variations between these two common descriptions of the shape of the Earth range from zero to nearly 200 meters in U.S. waters. It is fortunate that the majority of precise navigation in the U.S. is performed utilizing systems (usually Loran-C) in their repeatable mode. Those systems employed in an "absolute" accuracy sense are generally not accurate enough to be affected by problems with coordinate conversion (although differences between WGS-72 and local chart datums can be as much as 1/2 kilometer). The presence and growth of the Global Positioning System, a system with civil accuracies of 15 to 30 meters, will reveal the coordinate conversion problems heretofore disguised by use of less accurate systems.

For several years, military and numerous foreign charts have offered published corrections from WGS-72 to the chart datum. This far from ideal solution requires mental arithmetic or entry of corrections into the coordinate converter before positions can be plotted. It is still better than the situation on the vast majority of charts available to the civil mariner which carry no means of effecting corrections. National Ocean Service has proposed a plan which will convert, over a five-year period, most of their large-scale charts to NAD-1983, a description of the Earth which closely approximates WGS-84—soon to be the basis for GPS positions.

The marine electronics manufacturer, and ultimately the mariner, is thus faced for the next 5–10 years with an "alphabet soup" of conflicting chart and coordinate converter datum/ellipsoid combinations. With no brilliant solution to offer, this paper relies on "education of the consumer" as the only way out of this multi-variable problem.


Early detection of breast cancer is essential for improving patient survival. However, non-invasive imaging test have different diagnostic value. This study aimed to assess the diagnostic accuracy of mammography and ultrasound to detect breast malignancy in Albania. The 234 patients suspected with breast lesions in Albania during 2018-2022 were subjected to both mammograph and ultrasound and then to core needle biopsy (CNB). The BI-RADS classification was used to evaluate breast lesions. The diagnostic value of ultrasound, mammography and their combination were assessed. Mean age of participants was 55.97 years (96.2% females). Ultrasound detected higher proportions of high-risk patients compared to mammography (79.1% vs. 52.6%, respectively) but the combination of the two increased this figure even further (88.9%). The sensitivity of mammography increased quickly with age, peaking to 93.2% among patients >60 years old, whereas ultrasound has better sensitivity among younger participants (<45 years and 45-60 years); overall, the combined tests had the highest sensitivity (95.1%), followed by ultrasound (87.4%) and mammography (59.3%). In conclusion, the sensitivity of mammography is best among older patients whereas ultrasound seems to be more accurate among younger patients. The combination of mammography and ultrasound seems to increase the diagnostic accuracy of breast tumors among Albanian patients.


This thesis examines the size-growth relationship for banking and manufacturing firms. In particular it
tests the Law of Proportionate Effect (LPE) which suggests that there is no relationship between firm
size and growth. Tests of the LPE are carried out for eight European banking markets (Belgium,
Denmark, France, Germany, Italy, Netherlands, Spain and the United Kingdom) and for three bank
types (commercial, co-operative and savings) over the period 1990 to 1994. Employing three
measures of size (total assets, equity and off balance sheet business) models are estimated that test
for size effects on growth, and the influences of previous growth, bank type and country membership. In the majority of cases, bank growth is independent of bank size, so the LPE holds. However, small
banks grew faster than their larger counterparts (in terms of assets and equity) in France, Italy and
Spain.
The LPE is also investigated for a sample of European manufacturing firms drawn from five countries
and eleven industry groups. In contrast to the banking industry there is less evidence that the LPE
holds. In most cases small firms grew proportionately faster than their larger counterparts.
Using stochastic simulation techniques, the effects of firm growth, entry, exit and merger activity on
the evolution of bank sizes and market concentration is examined. Using a simulated industry in
which the LPE holds as the benchmark, the implications of various alternative assumptions regarding bank growth were examined. Superimposition of entry leads to a lower mean bank size and lower
levels of concentration. Exit leads to higher mean bank size and increased concentration. Mergers
lead to increases in mean bank size and concentration in all simulated industries.
Using the simulations methodology, hypothetical projections as to the future structure of the banking
markets in France, Germany, Italy, Spain and the UK are carried out. Overall, the simulations
suggest that bank numbers are likely to decrease in all countries. The market shares of the largest
banks are also projected to decline in all countries with the exception of the UK.


Significant efforts are being made to minimize aflatoxin contamination in peanut seeds and one possible strategy is to understand and exploit the mechanisms of plant defense against fungal infection. In this study we have identified and characterized, at biochemical and molecular levels, plant protease inhibitors (PPIs) produced in peanut seeds of the resistant PI 337394 and the susceptible Forman cultivar during Aspergillus parasiticus colonization. With chromatographic methods and 2D-electrophoresis-mass spectrometry we have isolated and identified four variants of Bowman-Birk trypsin inhibitor (BBTI) and a novel Kunitz-type protease inhibitor (KPI) produced in response to A. parasiticus colonization. KPI was detected only in the resistant cultivar, while BBTI was produced in the resistant cultivar in a higher concentration than susceptible cultivar and with different isoforms. The kinetic expression of KPI and BBTI genes along with trypsin inhibitory activity was analyzed in both cultivars during infection. In the susceptible cultivar an early PPI activity response was associated with BBTI occurrence. Meanwhile, in the resistant cultivar a later response with a larger increase in PPI activity was associated with BBTI and KPI occurrence. The biological significance of PPI in seed defense against fungal infection was analyzed and linked to inhibitory properties on enzymes released by the fungus during infection, and to the antifungal effect of KPI.


Is cognition a collection of loosely connected functions tuned to different tasks, or is it more like a general learning algorithm? If such an hypothetical general algorithm did exist, tuned to our world, could it adapt seamlessly to a world with different laws of nature? We consider the theory that predictive coding is such a general rule, and falsify it for one specific neural architecture known for high-performance predictions on natural videos and replication of human visual illusions: PredNet. Our results show that PredNet's high performance generalizes without retraining on a completely different natural video dataset. Yet PredNet cannot be trained to reach even mediocre accuracy on an artificial video dataset created with the rules of the Game of Life (GoL). We also find that a submodule of PredNet, a Convolutional Neural Network trained alone, has excellent accuracy on the GoL while having mediocre accuracy on natural videos, showing that PredNet's architecture itself might be responsible for both the high performance on natural videos and the loss of performance on the GoL. Just as humans cannot predict the dynamics of the GoL, our results suggest that there could be a trade-off between high performance on sensory inputs with different sets of rules.


Introduction: Enhancing health and wellbeing of employees is becoming a growing concern for researchers, employers, policy makers and practitioners in today's society. The promotion of employees' psychological wellbeing can be mutually beneficial for individuals and organisations (Wright, 2010). Research has found that psychological wellbeing in a workforce is associated with a range of positive outcomes, including increased work performance (Ford, Cerasoli, Higgins & Decesare, 2011), enhanced job satisfaction (Wright & Cropanzano, 2000) and reduced voluntary staff turnover (Wright & Bonett, 2007). Given the desirability of these outcomes for employers, employees and broader society, this highlights the importance of understanding how psychological wellbeing can be enhanced and maintained in the workplace. Policing is becoming an increasingly complex and demanding work environment (e.g., Hesketh, Cooper & Ivy, 2015), and police can be exposed to a variety of stressors that can have a detrimental impact on health and wellbeing (Juniper, White & Bellamy, 2010). Higher levels of perceived organisational support have been associated with increased psychological wellbeing (Pannaccio & Vandenbergh, 2009), while an individual's personality has also been identified as an important predictor of wellbeing (DeNeve & Cooper, 1998). To date, little research appears to have examined links between psychological wellbeing, social support and personality characteristics in policing. Therefore, the primary aim of the study was to examine the relationship between psychological wellbeing with received and perceived support from colleagues and personality characteristics in police.

Design: The present study utilised a cross-sectional design. The variables assessed were psychological wellbeing, received social support, perceived social support and five personality characteristics, comprising agreeableness, openness to experience, emotional stability, conscientiousness and extraversion. Methods Participants: All operational and non-operational employees of a police force in the Midlands region of England were invited to participate in the study, with a total of 381 employees (M age = 42.49, SD = 9.85; female n = 187; male n = 183; unspecified gender n = 11) agreeing to take part (17.8% response rate). Ethical approval was obtained from a school ethics committee at a British university.

Measures: Participants completed an online questionnaire via Qualtrics. The questionnaire comprised the Warwick-Edinburgh Mental Well-being Scale (WEMWBS; Tennant et al., 2007), an adapted version of the shortened Inventory of Socially Supportive Behaviours (ISSB; Barrerra, Sandler & Ramsay, 1981), Social Provisions Scale (SPS; Russell & Cutrona, 1987), and Ten-Item Personality Inventory (Gosling, Renfrow & Swann, 2003). Responses for the WEMWBS and ISSB reflected a four-week period prior to completing the questionnaire. Data analysis Data were analysed in SPSS 22. Initially, data were examined to establish whether the assumptions required to run parametric tests were satisfied. Visual inspection of scatterplots and results of normality tests revealed that data for psychological wellbeing, perceived support, received support, and personality characteristics were not normally distributed. As a result, the median, interquartile range, and standard deviations of these measures were calculated, and non-parametric analyses undertaken. A Spearman's rank order correlation analysis was conducted to examine relationships between the study variables. A multiple logistical regression analysis was used to examine whether perceived support, received support, and personality characteristics predicted psychological wellbeing.

Results: Results of the Spearman's rank correlational analysis showed that psychological wellbeing was significantly (p < .05) and positively associated with perceived support, received support, extraversion, agreeableness, conscientiousness, emotional stability and openness to experience. The multiple logistical regression analysis indicated the likelihood of each variable predicting psychological wellbeing. In terms of social support, psychological wellbeing was significantly (p < .05) predicted by received support and perceived support. With regards to the predictive capacity of the personality characteristics, only extraversion and emotional stability significantly predicted psychological wellbeing. The remaining variables in the model, openness to experience, agreeableness and conscientiousness, were not significant predictors of psychological wellbeing.

Discussion and Conclusions: The current findings advance understanding of the association between psychological wellbeing and received and perceived support, and personality in police employees. Both received and perceived support significantly predicted psychological wellbeing, demonstrating that employees that received more support from colleagues, and perceived support to be more readily available from colleagues, had elevated psychological wellbeing. Furthermore, the personality traits of extraversion and emotional stability significantly predicted psychological wellbeing, such that employees characterized by greater levels of these traits reported enhanced psychological wellbeing. These findings emphasise the important role that both received and perceived support, and certain personality traits, could have with respect to psychological wellbeing in police employees. These findings add to the organsational psychology literature, provide recommendations for employers of emergency service workers, and could help to inform the design of tailored psychosocial interventions.


Members of the Society and guests, it is my pleasure and privilege to introduce Dr. Jacob Karl Frenkel, the President of the American Society of Tropical Medicine and Hygiene. Jack Frenkel is the fifth President of this Society to ask me to introduce him, and this must be a record. However, it happens that I have known him since 1940 which is longer than I have known any of the previous Presidents. Let me review Jack's history briefly, including both personal and scientific aspects of his life.
When Jack arrived in Berkeley, California, in 1940 he was a 19-year-old fresh from the educational rigors of a gymnasium education in Germany. His father, Karl, a physician, and mother, Anne Marie, a nurse, believed that the political pressures of national socialism and the onset of war in Europe made it a desirable time to leave Germany. We thank them for this wise decision, as it gave us Jack as a future leader in our field.


Background Plaque neovascularization accompanies local inflammation and critically contributes to plaque instability. Correct identification of intraplaque neovascularization by contrast–enhanced ultrasound (CEUS) may provide an additional risk marker in carotid stenosis. This pilot study investigates the correlation between histological evaluation of carotid plaque specimens and pre-surgery CEUS to identify neovascularization. Methods 17 patients with high-grade internal carotid artery (ICA) stenosis were studied. CEUS was performed in all patients shortly before carotid endarterectomy. Neovascularization, infiltration of T cells and macrophages along with intraplaque hemorrhage were studied in excised plaques by immunohistochemistry. Ultrasound-based four-level and two-level classification systems for neovascularization were used. CEUS findings were compared with histological findings. Results Scores on the CEUS-based four-level and two-level classifications were robustly correlated with the density of intraplaque vessels (r = 0.635, p = 0.006 and r = 0.578, p = 0.015, respectively). Histological evaluation of regions with strong and prolonged intraplaque enhancement typically showed strong intraplaque neovascularization in conjunction with acute intraplaque hemorrhage. Moreover, higher grades of intraplaque neovascularization as determined by ultrasound were associated with a higher percentage of macrophage-rich areas. Conclusion CEUS is a technique well suited to gauge the degree of neovascularization of carotid plaques. Future research will have to define the reliability and validity of CEUS in everyday clinical practice. Further, our study suggests that CEUS may also be useful to pick up features of vulnerable plaques such as acute intraplaque hemorrhages.


Lactose biosensor based on surfactant doped polypyrrole (PPy) was developed. Galactose oxidase and b-galactosidase was coimmobilized in PPy matrix during electropolymerization process with the presence of sodium dodecylbenzene sulphonic acid as surfactant. Bi-enzyme entrapped PPy was characterized with Fourier transform infrared spectroscopy (FTIR), cyclic voltammetry (CV), and scanning electron microscopy (SEM). The response of the enzyme electrode was measured by CV in the range of 20.1 to 1.0 V versus Ag/AgCl which was due to the electrooxidation of enzymatically produced H2O2. The effect of lactose concentration was investigated. Response time of biosensor was found to be 8-10 s (the time required to obtain the maximum peak current) and upper limit of the linear working portions was found to be 1.22 mM lactose concentration with a detection limit of (2.6 3 10 26 M). The apparent Michaelis-Menten constant was found to be 0.117 mM lactose. The effects of interferents (ascorbic acid and uric acid) were determined. V C 2013 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2014, 131, 40200.


As forest is of great significance for our whole development and the sustainable plan is so focus on it. It is very urgent for us to have the whole distribution, stock volume and other related information about that. So the forest inventory program is on our schedule. Aiming at dealing with the problem in extraction of dominant tree species, we tested the highly hot method—object-based analysis. Based on the ALOS image data, we combined multi-resolution in eCognition software and fuzzy classification algorithm. Through analyzing the segmentation results, we basically extract the spruce, the pine, the birch and the oak of the study area. Both the spectral and spatial characteristics were derived from those objects, and with the help of GLCM, we got the differences of each species. We use confusion matrix to do the Classification accuracy assessment compared with the actual ground data and this method showed a comparatively good precision as 87% with the kappa coefficient 0.837.


In Machine Learning scenarios, privacy is a crucial concern when models have to be trained with private data coming from users of a service, such as a recommender system, a location-based mobile service, a mobile phone text messaging service providing next word prediction, or a face image classification system. The main issue is that, often, data are collected, transferred, and processed by third parties. These transactions violate new regulations, such as GDPR. Furthermore, users usually are not willing to share private data such as their visited locations, the text messages they wrote, or the photo they took with a third party. On the other hand, users appreciate services that work based on their behaviors and preferences. In order to address these issues, Federated Learning (FL) has been recently proposed as a means to build ML models based on private datasets distributed over a large number of clients, while preventing data leakage. A federation of users is asked to train a same global model on their private data, while a central coordinating server receives locally computed updates by clients and aggregate them to obtain a better global model, without the need to use clients' actual data. In this work, we extend the FL approach by pushing forward the state-of-the-art approaches in the aggregation step of FL, which we deem crucial for building a high-quality global model. Specifically, we propose an approach that takes into account a suite of client-specific criteria that constitute the basis for assigning a score to each client based on a priority of criteria defined by the service provider. Extensive experiments on two publicly available datasets indicate the merits of the proposed approach compared to standard FL baseline.


In the last decade, Intelligent Transportation Systems (ITS) have increasingly been deployed in work zones by state departments of transportation. Also known as smart work zone systems they improve traffic operations and safety by providing real-time information to travelers, monitoring traffic conditions, and managing incidents. Although there have been numerous ITS deployments in work zones, a framework for evaluating the effectiveness of these deployments does not exist. To justify the continued development and implementation of smart work zone systems, this study developed a framework to determine ITS effectiveness for specific work zone projects. The framework recommends using one or more of five performance measures: diversion rate, delay time, queue length, crash frequency, and speed. The monetary benefits and costs of ITS deployment in a work zone can then be computed using the performance measure values. Such ITS computations include additional considerations that are typically not present in standard benefit-cost computations. The proposed framework will allow for consistency in performance measures across different ITS studies thus allowing for comparisons across studies or for meta analysis. In addition, guidance on the circumstances under which ITS deployment is recommended for a work zone is provided. The framework was illustrated using two case studies: one urban work zone on I-70 and one rural work zone on I-44, in Missouri. The goals of the two ITS deployments were different – the I-70 ITS deployment was targeted at improving mobility whereas the I-44 deployment was targeted at improving safety. For the I-70 site, only permanent ITS equipment that was already in place was used for the project and no temporary ITS equipment was deployed. The permanent dynamic message signs (DMS) equipment serves multiple purposes, and it is arguable whether that cost should be attributed to the work zone project. The data collection effort for the I-70 site was very significant as portable surveillance captured the actual diversion flows to alternative routes. The benefit-cost ratio for the I-70 site was 2.1 to 1 if adjusted equipment costs were included and 6.9 to 1 without equipment costs. The safety-focused I-44 ITS deployment had an estimated benefit-cost ratio of 3.2 to 1.


In 1866, at the C. Ludwig's laboratory, E. F. Cyon discovered n. depressor, and after C. Bernard's presentation he was awarded with the Montion Prize of the Paris Academy of Sciences. In 1867, together with his brother M. Cyon, he discovered nn. accelerantes of heart, which increase the heart rate when being stimulated. From 1868 to 1874 he was a privatdocent an professor of physiology at Saint-Petersburg University, where under his guidance I.P. Pavlov mastered the brilliant technique of vivisection experiment and accomplished his first works on the physiology of circulation and digestion. From 1872 to 1874 E. F. Cyon was physiology professor at Saint-Petersburg Medical-Surgical Academy. He published "Course of Physiology" in 2 volumes, the official speech "Heart and Brain" and others, proposed an original theory of inhibition, improved the reflex theory. He published 197 works, including 151 in German and French. I. P. Pavlov paid a worthy tribute to his teacher and continued the main direction of his investigations.


The Maasai of northern Tanzania, a semi-nomadic ethnic group predominantly reliant on pastoralism, face a number of challenges anticipated to have negative impacts on child health, including marginalisation, vulnerabilities to drought, substandard service provision and on-going land grabbing conflicts. Yet, stemming from a lack of appropriate national survey data, no large-scale comparative study of Maasai child health has been conducted. Savannas Forever Tanzania surveyed the health of over 3500 children from 56 villages in northern Tanzania between 2009 and 2011. The major ethnic groups sampled were the Maasai, Sukuma, Rangi, and the Meru. Using multilevel regression we compare each ethnic group on the basis of (i) measurements of child health, including anthropometric indicators of nutritional status and self-reported incidence of disease; and (ii) important proximate determinants of child health, including food insecurity, diet, breastfeeding behaviour and vaccination coverage. We then (iii) contrast households among the Maasai by the extent to which subsistence is reliant on livestock herding. Measures of both child nutritional status and disease confirm that the Maasai are substantially disadvantaged compared to neighbouring ethnic groups, Meru are relatively advantaged, and Rangi and Sukuma intermediate in most comparisons. However, Maasai children were less likely to report malaria and worm infections. Food insecurity was high throughout the study site, but particularly severe for the Maasai, and reflected in lower dietary intake of carbohydrate-rich staple foods, and fruits and vegetables. Breastfeeding was extended in the Maasai, despite higher reported consumption of cow's milk, a potential weaning food. Vaccination coverage was lowest in Maasai and Sukuma. Maasai who rely primarily on livestock herding showed signs of further disadvantage compared to Maasai relying primarily on agriculture. We discuss the potential ecological, socioeconomic, demographic and cultural factors responsible for these differences and the implications for population health research and policy.


Neurons are specialized cells for information transmission and information processing. In fact, many neurologic disorders are directly linked not to cellular viability/homeostasis issues but rather to specific anomalies in electrical activity dynamics. Consequently, therapeutic strategies based on the direct modulation of neuronal electrical activity have been producing remarkable results, with successful examples ranging from cochlear implants to deep brain stimulation. Developments in these implantable devices are hindered, however, by important challenges such as power requirements, size factor, signal transduction, and adaptability/computational capabilities. Memristors, neuromorphic nanoscale electronic components able to emulate natural synapses, provide unique properties to address these constraints, and their use in neuroprosthetic devices is being actively explored. Here, we demonstrate, for the first time, the use of memristive devices in a clinically relevant setting where communication between two neuronal populations is conditioned to specific activity patterns in the source population. In our approach, the memristor device performs a pattern detection computation and acts as an artificial synapse capable of reversible short-term plasticity. Using in vitro hippocampal neuronal cultures, we show real-time adaptive control with a high degree of reproducibility using our monitor-compute-actuate paradigm. We envision very similar systems being used for the automatic detection and suppression of seizures in epileptic patients.


Cancer risk assessment necessarily involves the use of mathematical models. Although risk estimates can be extremely sensitive to underlying assumptions in such models, the assumptions are frequently overlooked when a particular model is used. This paper presents four examples to illustrate how the alteration of assumptions can have a large effect on risk estimates. Ways of avoiding undue model dependence are discussed.


Automotive systems are being developed to increase positive driver experiences and traffic safety. As these new technologies are being adapted into the automotive environment, i.e. safety systems and multimedia applications, are the drivers additionally taking with them nomad devices, i.e. mobile phones, media players, GPS devices, etc., into this environment making it more and more complex. This complexity does not help the driver and in some cases distracts the driver too. The number of information sources has escalated to new heights and this trend does not seem to be slowing down. To be able to keep up with the advances in information technology, which also includes advances in display technology, automobile manufacturers are seeking for new and/or different ways to attract potential customers without bending the traffic safety. In this thesis this phenomena is looked upon by studying how drivers could use the information presented to them in the automobile. What do drivers perceive as important information, how should it be presented, and where? To obtain this several studies were conducted to gain a more complete picture of a driver's perception, behavior, and preferences. First, a questionnaire was administered to three different culture groups; China (167), Sweden (142), and United States of America (89) to learn how they perceive the information's importance and placement. The results showed that the drivers preferred the locations used in their own automobiles, but could think of using the HUD for more advanced driving helps. Based upon those responses a second study was conducted in a fixed-based high fidelity driving simulator. Forty participants drove a baseline and a experiment block (ca 20 min each) in which they where given either 10 warnings or 10 messages from four locations found in automobiles; the Head-Up Display (HUD), Head Down Display (HDD), Infotainment Display (IF), and Center-Stack Display (CS). The measurements were time to respond, time to notice, glance time, fixation time, number offixations, and their driving performance via lane deviation and average speed during in each particular situation. All the drivers preferred information being presented in the HUD and the data showed that their performance was just as good as in the IF location and significantly better than in the CS and HDD locations. Redundant information in the HUD and HDD were not preferred and the participants the HUD exclusively. These results gave support to test HUD in traffic and in the drivers own vehicles. Therefore 30 drivers were recruited to test a HUD during three around the clock days, which showed the automobiles actual speed in their own automobiles on the windscreen. The on-road test showed that HUD was significantly preferred over the HDD for speed information. The majority of the drivers also wanted important warnings to be made available there along with directional helps for navigation. In conclusion the HUD was seen as the "next step" in automobile development. To reduce time away from road, increase traffic awareness, and to "lift" necessary information from more difficult to notice, and attend to, locations to the traffic scene the HUD could be the solution to enhance traffic safety, while speedometer and warning areas could be "freed up" and used for other functions and systems, leaving the locations furthest away for non-critical information.


The paper estimates the benefits of low speed autonomous vehicle braking technologies (e.g. City Safety from Volvo) on reducing whiplash injuries, and whether driver adaptation is likely. Potential UK whiplash injury reduction and cost savings associated with autonomous braking systems are calculated. Assuming standard fleet wide fitment, predictions show autonomous braking systems (City Safety) could annually prevent 263,250 crashes, mitigate 87,750, and prevent 151,848 injuries, equalling nearly 2 billion Euro savings in repair costs and whiplash compensation. In driver adaptation testing participants drove toward an inflatable target car at 15km/h without braking. Responses were collected from 99 driver tests, where the vehicle autonomously brakes preventing impact. 11% of drivers braked instinctively when approaching targets, and 95% of drivers stated they would not rely on City Safety for normal driving, and understood that it was for emergency braking only. Feedback was also gathered from 11 drivers experiencing the system on thousands of kilometres of normal UK roads. None reported either positive interventions or false interventions. City Safety, an example of low speed autonomous braking systems, shows huge potential for reducing crashes and whiplash injuries valued at nearly 2 billion Euro in insurance claim savings. Other current autonomous braking systems operating at higher speeds require driver activation, and can only mitigate impact speeds. City Safety operates autonomously at low speeds and can prevent collisions occurring completely, so no risk compensation issues are expected. The full text of this paper may be found at: http://www-nrd.nhtsa.dot.gov/pdf/esv/esv21/09-0328.pdf For the covering abstract see ITRD E145407.


ABSTRACT Objective: To evaluate the short and medium-term outcomes of patients undergoing robotic-assisted minimally invasive cardiac surgery. Methods: From March 2010 to March 2013, 21 patients underwent robotic-assisted cardiac surgery. The procedures performed were: mitral valve repair, mitral valve replacement, surgical correction of atrial fibrillation, surgical correction of atrial septal defect, intracardiac tumor resection, totally endoscopic coronary artery bypass surgery and pericardiectomy. Results: The mean age was 48.39±18.05 years. The mean cardiopulmonary bypass time was 151.7±99.97 minutes, and the mean aortic cross-clamp time was 109.94±81.34 minutes. The mean duration of intubation was 7.52±15.2 hours, and 16 (76.2%) patients were extubated in the operating room immediately after the procedure. The mean length of intensive care unit stay was 1.67±1.46 days. There were no conversions to sternotomy. There was no in-hospital death or deaths during the medium-term follow-up. Patients mean follow up time was 684±346 days, ranging from 28 to 1096 days. Conclusion: Robotic-assisted cardiac surgery proved to be feasible, safe and effective and can be applied in the correction of various intra and extracardiac pathologies.


Abstract In the face of a generalized Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Virus (AIDS) epidemic in Southern Africa, children's education is viewed increasingly as a key area of concern as well as a potential opportunity for HIV intervention. However, the relationship between HIV and AIDS and education is a complex one, as the epidemic may influence educational indicators negatively through multiple pathways. This paper focuses upon one of these potential pathways: caregivers' attitudes to and perceptions of formal education. We argue that this area has not been afforded adequate attention among researchers and practitioners in Southern Africa despite evidence, from both the developed and developing world, that parental attitudes are important influencers of children's attitudes to education and educational outcomes. A review of recent empirical literature, and findings of a 2006–07 exploratory study we conducted across three sites in Southern Africa, suggest that economic factors or considerations – rather than health and objective life expectancy – are central in influencing the value caregivers attribute to children's formal education, even in a context of generalized HIV/AIDS. Further integrated qualitative and quantitative investigation is clearly needed in our region to explore determinants of parental attitudes to education among communities highly affected by the epidemic, and how these attitudes affect education-related decisions and outcomes. Interventions have a greater possibility of succeeding if they aim to support income-generating opportunities and include efforts to bridge schooling and health education with economic opportunities. Moreover, conditional transfers and school-based interventions or services are more likely to be effective at ensuring school attendance than unconditional transfers, particularly where the value caregivers attribute to education is low.


The forest landscapes of the Greater Mekong Subregion (GMS) are changing dramatically, with a multitude of impacts from local to global levels. These changes invariably have their foundations in forest governance. The aim of this paper is to assess perceptions of key stakeholders regarding the state of forest governance in the countries of the GMS. The work is based on a quantitative and qualitative analysis of the perceptions of forest governance in the five GMS countries, involving 762 representatives from government, civil society, news media, and rural communities. The work identified many challenges to good forest governance in the countries in the region, as well as noting reasons for optimism. Generally speaking, there was a feeling that the policies, legislation, and institutional frameworks were supportive, but there are numerous challenges in terms of implementation, enforcement, and compliance. The work also presents a program of activities recommended by the research participants to address governance challenges and opportunities in the GMS countries. These include the development of a forest governance monitoring system, and initiatives that support informed decision-making by forest product consumers in the region as well as the implementation of a capacity development program for non-state actors (e.g., civil society, news media) to ensure they are more able to support the diverse, and often demanding, forest governance initiatives.


In this paper, the topology of power electronic transformer based on modular multilevel converter (MMC) structure was studied firstly. And a new topology was proposed that combines the power electronic transformer with energy storage system. Then, the control strategy of power electronic transformer was introduced. Finally, the simulation model of power electronic transformer based on MMC structure was built in PSCAD simulation environment. The simulation results showed that the power electronic transformer is able to ensure the voltage and current waveform of the input and output side in sinusoidal, resist load disturbance, isolate fault and isolate harmonic propagation. In addition, the battery model was also studied in PSCAD simulation environment, followed with the analysis of the influence of battery energy storage on load. The power electronic transformer topology with energy storage system proposed in this paper can guarantee both the quality and the reliability of power supply.


OBJECTIVE
Recent reports suggest a trend of increasing prevalence of psychotropic drug prescriptions among children with attention-deficit/hyperactivity disorder (ADHD); however, reasons for the increased use of such medications is unclear. The objectives of this study were to examine differences in nonstimulant psychotropic medication fills between children with and without identified ADHD and to assess associations with non-ADHD neurobehavioral disorders.

METHODS
A population-based retrospective matched cohort study was conducted of a large group model health maintenance organization located in western Washington State. Eligible patients were children who were ages 3 to 17 years and were continuously enrolled and used services from January 1 to December 31, 1997 (N = 57 216). Children with ADHD were identified by a diagnosis of ADHD or a pharmacy fill for a stimulant medication using automated patient files. Children without ADHD were randomly selected and matched 4:1 to children with ADHD on age and gender. Neurobehavioral disorders and pharmacy fills for psychotropic medications were measured.

RESULTS
During 1997, 2992 children were identified as having ADHD (5.2%). These children were more likely to have a diagnosis of a non-ADHD neurobehavioral disorders (adjusted odds ratio: 6.3; 95% confidence interval: 5.4-7.3) than children without ADHD. Although most (78%) were treated with stimulant medications, children who were identified as having ADHD were also more likely to receive pharmacy fills for nonstimulant medications than were children without ADHD. Nonstimulant medications were more often used along with stimulant medications and were frequently prescribed in association with ADHD after controlling for other disorders.

CONCLUSIONS
Children who were identified as having ADHD were more likely to have a diagnosis of other neurobehavioral disorders and to receive nonstimulant psychotropic medications than were children without ADHD. Because many of these drugs have little or no empirical basis in the treatment of ADHD, the rationale for their use is less clear. Future research to examine the use, effectiveness, and safety of these medications alone and in combination in children with ADHD is urgently needed.


In this paper we analyse the role of superior bargaining power in competition law and policy in the agri-food value chain. Conventional approaches to competition law based on a neoclassical price theory perspective tend to neglect or to stay opaque on the role of bargaining power in competition law. However, national competition authorities and national legislators seem to be less biased by specific theoretical approaches and have increasingly engaged with the application of the concept of bargaining power in competition law. In this paper we discuss both positions and set a general theoretical framework, the global value chain approach, to better understand the interactions between suppliers and retailers in the food sector. Finally, we observe the framing of new tools of competition law intervention at national level, in order to deal with situations of superior bargaining power in specific settings related to the food value chain.


Objective: Infection is a significant problem associated with increased morbidity and mortality in intensive care units (ICU). This study aimed to examine the effect of infectious agents obtained from Medical ICU on the resistance pattern and the patient outcomes in a 3 year period retrospectively. Material and Method: The patients with positive culture results while hospitalized in a tertiary level medical ICU between January 2016 and April 2019 were included in the study. The patients were grouped as survivors and non-survivors. These groups were compared for infection foci, infectious agents, mortality, and the sensitivity of the infectious pathogens to the antibiotics. Results: From a total of 426 patients admitted to ICU with the diagnosis of infection, culture positivity was determined in 212 samples. The highest rates of positivity were determined from the urinary tract specimens (n:90, 42.4%), followed by bloodstream specimens (n:62, 29.2%) and then lower respiratory tract specimens (n:47, 22.1%). The most frequently isolated micro-organisms were gram-negative bacteria (n.152, 70.6%) and within these, the most common micro-organism was Escherichia coli (n:59, 27.8%). When the microorganisms evaluated according their antibiotic susceptibility it was found that, A. baumanii strains were sensitive to colistin, and K. pneumonia, E.coli, and Pseudomonas aeruginosa (P. aeruginosa) strains were sensitive to aminoglycosides and colistin. The mortality rate of the hospitalized patients because of infection was found to be 51.8% (n:112). Conclusion: When selecting empirical antibiotics in the treatment of infection in critically ill patients, the intensive care unit flora and the antibiotic resistance patterns must be known. Therefore, it is important to periodically determine the infectious agents and antibiotic sensitivity.


The Invar phenomenon (very small thermal expansion in some iron alloys or compounds) is usually explained by the thermally induced transitions between different spin states of Fe, having different atomic volumes. We consider these processes taking into account elastic interaction between Fe atoms in different spin states. Inclusion of these interactions explains why thermal expansion may be close to zero in a broad temperature interval and thus gives rise to the Invar effect.


"The framework of this contribution is the nexus between scientific and popular knowledge, and their importance assessing diagnostical expressions when studying death causes in times prior to the setting of a standard for the definition of illness. By means of a particular example, the expression teething, we shall show some nuances concerning the loanwords and equivalences between popular and academic knowledge, and their deep, if sometimes hidden, influence upon the diagnostical expressions informing us about the death causes as shown in the records of life and death statistics." The geographical focus is on Spain. (SUMMARY IN ENG AND FRE)


Rabbi Marc D. Angel is the author of an acclaimed study of his ancestral Sephardic Jewish community of Rhodes. His new book Voices in Exile (Ktav [1991], $25.00, pp.237, ISBN 0-88125-370-7) implicitly serves two masters. On the one hand, it is a defence of the 'normative Jewish' credentials of the Sephardi community; on the other, it is a celebration of the unique Sephardi cultural heritage. Though its subtitle is 'a study in Sephardic intellectual history', the book is more a compact summary of Sephardi personalities and writings from the time of the Jewish expulsion from Spain (1492) to the establishment of the State of Israel. It contains a great deal of material, some of it from unpublished sources, about Jewish reactions to the expulsion, the 'conversos', messianic aspirations, the 'folk mind', pietistic ethics (musar), and orthodox responses to modernity. There is little attempt at real historical analysis, and


Objective— The diagnostic boundaries of sleep disorders are under considerable debate. The main sleep disorders are partly heritable; therefore, defining heritable pathophysiologic mechanisms could delineate diagnoses and suggest treatment. We collected clinical data and DNA from consenting patients scheduled to undergo clinical polysomnograms, to expand our understanding of the polymorphisms associated with the phenotypes of particular sleep disorders. Methods— Patients at least 21 years of age were recruited to contribute research questionnaires, and to provide access to their medical records, saliva for deoxyribonucleic acid (DNA), and polysomnographic data. From these complex data, 38 partly overlapping phenotypes were derived indicating complaints, subjective and objective sleep timing, and polysomnographic disturbances. A custom chip was used to genotype 768 single-nucleotide polymorphisms (SNPs). Additional assays derived ancestry-informative markers (eg, 751 participants of European ancestry). Linear regressions controlling for age, gender, and ancestry were used to assess the associations of each phenotype with each of the SNPs, highlighting those with Bonferroni-corrected significance. Results— In peroxisome proliferator-activated receptor gamma, coactivator polysomnographic sleep duration. The association of rs3923809 in BTBD9 with periodic limb movements in sleep was confirmed. SNPs in casein kinase 1 delta ( CSNK1D rs11552085), cryptochrome 1 ( CRY1 rs4964515), and retinoic acid receptor-related orphan receptor A ( ROR A rs11071547) were less persuasively associated with sleep latency and time of falling asleep. Conclusions— SNPs associated with several sleep phenotypes were suggested, but due to risks of false discovery, independent replications are needed before the importance of these associations can be assessed, followed by investigation of molecular mechanisms.


The structural features of the G·U wobble pair in Escherichia coli alanine transfer RNA (tRNAAla) that are associated with aminoacylation by alanyl-tRNA synthetase (AlaRS) were investigated in vivo for wild-type tRNAAla and mutant tRNAs with G·U substitutions. tRNAAla with G·U, C·A, or G·A gave similar amounts of charged tRNAAla and supported viability of E. coli lacking chromosomal tRNAAla genes. tRNAAla with G·C was inactive. Recognition of G·U by AlaRS thus requires more than the functional groups on G·U in a regular helix and may involve detection of a helical distortion.


The purpose of this research was to examined the influence of job stressors perceived by nurses, nurse's level of spirituality to work stress and performance of nurses who work in Pirngadi General Hospital of Medan and construct a theoretical model that can describe the influence of endogenous variables to exogenous variables. This research was conducted in January 2014 until July 2015, which starts from a preliminary survey to the making of research reports. The number of samples in this study as many as 150 people. Methods of data collection using questionnaires. Data were analyzed by descriptive and inferential, hypothesis testing is done with path analysis, to test the suitability of the model used goodness of fit test. Structural Equation Modeling Analysis of the model is done by using AMOS 21.0. Results showed that: job stressors and spirituality have significant effect on work stress and performance of nurses, as seen from the suitability of Goodness of Fit (GoF ) on Structural Equation Modeling.