PURPOSE
To describe the chest radiographic appearance of the Amplatzer septal occluder (ASO) (AGA Medical Corporation, Golden Valley, Minn) for atrial septal defects (ASDs) in pediatric patients.

MATERIALS AND METHODS
Two radiologists independently reviewed frontal and lateral chest radiographs obtained in young patients 24 hours after transcatheter ASD closure with the ASO. The appearance (flat disks or dots) and location of the ASO were recorded. The location was related to that of a thoracic vertebral body on frontal and lateral chest radiographs and to a line drawn between the anterior margin of the right hilum and the posterior margin of the inferior vena cava (hilar-caval line) on lateral radiographs; this line corresponded to the expected position of the interatrial septum. The relationship between ASO appearance and patient age was assessed with logistic regression and cumulative probability plots.

RESULTS
Sixty-eight pediatric patients (age range, 1 month to 18 years; mean age, 4.2 years; 24 boys and 44 girls) were included. On frontal radiographs, the ASO center projected between T7 and T9, either to the right of or over the spinous processes of the vertebral body. On lateral radiographs, the ASO projected over (n = 66) or anterior to (n = 2) the hilar-caval line. On frontal radiographs, it appeared as one or two flat disks (n = 61) or as two metallic dots (n = 7). On lateral radiographs, it appeared as two flat disks (n = 54) or as two metallic dots (n = 14). The relationship between increasing patient age and the metallic dot appearance on frontal and lateral radiographs and on the combination of frontal and lateral radiographs was highly significant in each case (P < .001, likelihood ratio chi(2) test), with r(2) values of 0.35, 0.20, and 0.28, respectively. ASDs were successfully occluded with the ASO in all patients except one, in whom trivial shunting was seen at 12-month follow-up.

CONCLUSION
The ASO in pediatric patients has a characteristic radiographic appearance when properly positioned.


The long, north-south-trending Front Range in Colorado is a complex mosaic of Precambrian crystalline rocks bordered on the eastern flank by a narrow eastward-dipping foothills belt. The sedimentary formations have a total thickness of nearly 3 miles. The Precambrian consists of high-rank metasedimentary formations, quartzites, and layered meta-igneous rocks. About one third of the area is composed of folded and faulted metamorphic formations and nearly two-thirds is occupied by at least six generations of competent granitic rocks. Small batholiths, stocks, and innumerable plutons intrude the metamorphics, constituting major, fairly rigid bulwarks of the anticlinal structure of the Range. The sedimentary formations are of every geologic age except Silurian and possibly Devonian. There are four major lithologic units: (1) older Paleozoic marine limestones and sandstones, (2) Paleozoic and Mesozoic dominantly terrestrial and littoral redbed and arkosic formations, (3) marine Cretaceous formations, and (4) Tertiary formations of continental type. Five fault-bounded, northwest-trending segments extend across the range and involve the foothills belt of the eastern flank. The segments follow structural trends established in Precambrian time and reactivated during the Laramide. The eastern margin of the Range and foothills belt is underthrust and upthrust for about 90 miles along general north-south trends. Cross folds, tear faults, grabens, horsts, en echelon faulted folds, and drape folds dislocate the foothills formations and the Precambrian rocks adjacent to the foothills belt. Fifteen structural units within the eastern foothills belt and associated Precambrian formations are described. The distinctive units are the result of strong horizontal compression from east to west during subsidence and underthrusting of the bordering basins in Laramide time, compensating uplift of the body of the Range, and minor deformation of the more plastic foothills formations.


A scenario based model is developed for Indus River System which addresses the problem related issues and applicability under a complex system network. We apply this model considering the current and future storage capabilities. We conduct an analysis under stochastic hydrologic regime (stochastic inflow and rainfall) if these capabilities considered effective. We note that wheat gain the major rise in its area i.e. from 5.428 million hectares to 6.227 million hectares. We also provide some analysis according to current storages. A cropping pattern is presented consistent with system infrastructure and land resources in multiple canal areas.


California ranchers in urban Alameda and Contra Costa Counties, and in rural Tehama County, were surveyed to examine effects of increasing development, land use change, and attrition of the ranching community on their commitment to ranching, and to assess land conservation program acceptability. Questions were about practices, reasons for ranching, and what influences ranching's future. Ranchers share much in common. Most enjoy ranching, "feeling close to the earth," living in a "good place for family life," and the camaraderie in the ranching community. They regularly carry out range improvements. Most believe that society is becoming "hostile to ranching." A dislike for outsider intervention and land use control prevails. Urban ranchers cared significantly less about the fate of their ranch if sold, and feared local land use planning much more. Rural ranchers overwhelmingly wanted their ranch to remain a productive ranch even if sold. No new ranchers appeared in the urban sample for the last 10 years. As urbanization proceeds, we suggest that a point is reached where ranchers recognize the social, ecological, and economic landscape as urban and see it as no longer suitable for ranching. Expecting to sell for development, and/or expecting zoning to change to allow it, becomes the rational view. Land conservation efforts, including relatively acceptable though as yet not widespread conservation easement programs, should begin before that happens. DOI:10.2458/azu_jrm_v53i4_liffmann


Taking a new steel tube rotating mechanism as the research object, the model is simplified and the virtual prototyping model of the mechanism is established. The mechanism kinematics simulation is carried out with ADAMS simulation software. The motion law and state in two conditions are comparatively analyzed. Analysis results show that, in steel tube clamping stage the motion of the clip rod is of variable deceleration; And in rotating stage, mechanism is of accelerated rotation with variable acceleration when the cylinder input, while mechanism is of uniform rotation when the crank input; And then the cylinder is with positive and reverse swings throughout the movement process. The analysis results provide the basis for institution parameter selection and structure optimization design.


In this paper, measurements of small scale electron density fluctuations in low confinement (L)-mode and high confinement (H)-mode plasmas obtained by collective scattering of infrared light are presented. A single discharge in the Wendelstein 7-AS (W7-AS) stellarator (Renner H et al 1989 Plasma Phys. Control. Fusion 31 1579) was studied. The plasma developed from steady-state L-mode to a dithering mode and finally became an edge localized mode (ELM)-free H-mode. These three phases are separately characterized. Autopower spectra of density fluctuations measured in the dithering and ELM-free H-modes are limited to lower frequencies than those in the dithering and steady-state L-modes. Correlations between the density fluctuations, an Hα-signal and magnetic fluctuations as measured by Mirnov coils were analysed. The correlation calculations made for time windows of tens of milliseconds with time lag steps of 100 μs show that all the fluctuating quantities are highly correlated during the L-mode and dithering states, but that no correlation exists in the ELM-free H-mode. Evaluating correlations on a 20 μs timescale between magnetic and density fluctuations leads to the result that the minimum correlation timescale in steady-state and dithering L-modes is of order 100 μs, while no correlation exists for ELM-free and dithering H-modes. Finally, the time derivative of the phase of the measured complex density fluctuation signal allows us to study the structure of turbulent bursts in L- and H-mode.


It has been proven that smoking boosts the symptoms of allergy; the smokers have higher bronchial responsiveness and tobacco smoking provokes a strong immunological imbalance to those exposed. The aim of our study was to evaluate reactivity and sensitivity of respiratory tract in persons with the symptoms of allergic rhinitis and proven tobacco smoke allergy who are active smokers or passively exposed to tobacco smoke. Materials and methods: We evaluated 40 patients, average age 34 years divided into two groups: group I - active smokers (with average 16.4±8.7 package years) and group II – passive smokers. All subjects had symptoms of allergic rhinitis, local ORL findings that confirms excluded vasomotor rhinitis, positive Prick test on inhalation allergens of tobacco smoke and normal basal spirometry findings. Non-specific bronchoprovocative testing was done by intermittent inhalation of histamine in progressive grooving doze and result was expressed by the value of provocative doze by which the value of FEV1 was reduced by 20% of basal FEV1. Histamine responsiveness was analyzed using dose-response slope to describe each subject9s responsiveness (positive results were considered to be if reactivity was between 520-2000mcg). Results: Bronchial activity was confirmed in 58.2% in smoking group and 39.5% in non-smoking group. The degree of bronchial hypereactivity didn9t differ between groups, although provocative doze was in lower concentrations in smoking group, but difference wasn9t significant. Conclusion: Although we confirmed that smokers have higher degree of hypereactivity than non-smokers, our results in passive smokers group may implicate on significance of passive smoking.


Introduction: Orthopaedic surgery is one of the most cited specialties among legal claims. Malpractice lawsuits are financially burdensome, increase defensive practices, and incur a notable emotional toll on defendants. We sought to determine the effect of malpractice lawsuits on professional well-being and self-reported medical errors among orthopaedic surgeons. Methods: We surveyed 305 members of the American Orthopaedic Association to collect information on experiences with medical malpractice lawsuits, demographic and practice characteristics, professional well-being on the Professional Fulfillment Index, and self-reported medical errors. Multivariable logistic regression identified predictors of malpractice lawsuits, professional well-being, and self-reported medical errors. Results: Seventy-three percent (224 of 305) respondents had been involved in a medical malpractice lawsuit. The odds of experiencing a malpractice lawsuit increased by seven percent with each year in practice (OR = 1.07, 95% CI: 1.04 to 1.10, P < 0.001) and with specialization in spine surgery. Respondents with a lawsuit in 2 years before the survey reported comparable professional well-being and medical error rates with those without a lawsuit. However, compared with respondents without a lawsuit, respondents with a lawsuit more than 2 years in the past were less likely to report burnout (OR = 0.43, 95% CI: 0.20 to 0.90, P = 0.03) and more likely to report a medical error in the past year, which resulted in patient harm (OR = 3.51, 95% CI: 1.39 to 8.91, P = 0.008). Discussion: While malpractice lawsuits negatively affect professional well-being, this effect resolves with time. The effect on medical errors may be more permanent; orthopaedic surgeons who have experienced a lawsuit reported greater rates of medical errors even after these legal issues have been settled. Among orthopaedic surgeons dealing with lawsuits, supportive interventions to protect professional well-being and mitigate the factors which lead to greater medical errors are needed. Level of Evidence: Prognostic Level III.


Abstract:This essay examines the effects of the critique of religion on the critique of capital and how the former confines the latter. It asks: What remains of the concepts of alienation or fetishism if they all stem from an anthropology of religion that seems to be criticized? If religion ceases to refer to an anthropological essence and is criticized as a European colonial concept, then what happens to the critique of capital? It argues that what Marx considers the condition for critique seems to be the blind spot ofWestern Marxism. Without a critical analysis of how the concept of religion is constructed and how religion is thus described as a human invention, Marxism cannot know itself. If Marx is a "critic of the critique of religion," this gesture must apply to Marx as well as to Marxism itself. The critique of capitalism might need an alternative foundation if the anthropological concept of religion that supported it collapses. It is therefore impossible to maintain the critique of capital as it is while refusing the critique of religion that lies at its foundation.


Coronavirus disease 2019 (COVID-19) typically presents with fever and respiratory symptoms in children. Most children develop an asymptomatic and mild illness, with a minority requiring specialist medical care. Gastrointestinal manifestations and liver injury can also occur in children following infection. The mechanisms of liver injury may include infection following direct viral hepatic tissue invasion, immune response, or medication effects. Affected children might develop mild liver dysfunction which has a benign course in most children with no pre-existing liver disease. However, the presence of non-alcoholic fatty liver disease or other pre-existing chronic liver disorders is associated with a higher risk of developing severe COVID-19 illness with poor outcomes. On the other hand, the presence of liver manifestations is associated with the severity of COVID-19 disease and is considered an independent prognostic factor. Respiratory, hemodynamic, and nutritional supportive therapies are the mainstay of management. Vaccination of children at increased risk of developing severe COVID-19 disease is indicated. This review describes the liver manifestations in children with COVID-19, detailing its epidemiology, basic mechanisms, clinical expression, management, and prognosis in those with and without pre-existing liver disease and also children who have had earlier liver transplantation.


Assessment of human cancer risk from animal carcinogen studies is severely limited by inadequate experimental data at environmentally relevant exposures and by procedures requiring modeled extrapolations many orders of magnitude below observable data. We used rainbow trout, an animal model well-suited to ultralow-dose carcinogenesis research, to explore dose-response down to a targeted 10 excess liver tumors per 10000 animals (ED(001)). A total of 40800 trout were fed 0-225 ppm dibenzo[a,l]pyrene (DBP) for 4 weeks, sampled for biomarker analyses, and returned to control diet for 9 months prior to gross and histologic examination. Suspect tumors were confirmed by pathology, and resulting incidences were modeled and compared to the default EPA LED(10) linear extrapolation method. The study provided observed incidence data down to two above-background liver tumors per 10000 animals at the lowest dose (that is, an unmodeled ED(0002) measurement). Among nine statistical models explored, three were determined to fit the liver data well-linear probit, quadratic logit, and Ryzin-Rai. None of these fitted models is compatible with the LED(10) default assumption, and all fell increasingly below the default extrapolation with decreasing DBP dose. Low-dose tumor response was also not predictable from hepatic DBP-DNA adduct biomarkers, which accumulated as a power function of dose (adducts = 100 x DBP(1.31)). Two-order extrapolations below the modeled tumor data predicted DBP doses producing one excess cancer per million individuals (ED(10)(-6)) that were 500-1500-fold higher than that predicted by the five-order LED(10) extrapolation. These results are considered specific to the animal model, carcinogen, and protocol used. They provide the first experimental estimation in any model of the degree of conservatism that may exist for the EPA default linear assumption for a genotoxic carcinogen.


This thesis proposed a new way of conceptualising financing of pro-poor innovation in rural areas by focusing on pro-poor entrepreneur-based innovation (PEBI) and by considering the knowledge flows in different parts of the financial system. Empirically, the thesis found that the Indian banking system does not efficiently support rural PEBI. Instead an alternative financing sector has emerged recently, in which there are three broad categories of organisations: micro venture capital firms, small-scale finance providers, and grassroots innovators and incubators. They are complementary, forming an ecosystem of finance for different types of rural PEBI. What these organisations have in common is an integrated approach to support; an emphasis on partnerships and networks to provide better services and acquire expertise; continuous involvement in the investees; and a dual bottom line. This thesis argues that there is a need to partially shift the focus of financial support and livelihood creation in rural areas away from microfinance, to more productive entrepreneurship and innovation that hold potential for indirectly providing more livelihoods and poverty alleviation opportunities. Three broad Government policies to achieve an enabling environment in which the PEBI support organisations can flourish include: 1) supportive regulations and an overarching PEBI Agency to coordinate departmental, national and state efforts; 2) a PEBI Fund investing in PEBI support organisations; and 3) capacity building programmes in entrepreneurship, especially for MFIs, NGOs and Banks.


This paper sets out an approach using a revised Bloom's taxonomy of learning
objectives for the careful design of objective questions to assist in the assessment of
higher learning outcomes (HLO's) and details the creation and evaluation of a
variety of such questions. This has been done within the context of two constraints;
the use of popular, commercially available computer-aided assessment (CAA)
software, specifically Question Mark Perception and Half-Baked Hot Potatoes, and
the assumption of limited learning technologist support. It examines the problems
inherent in the design of objective questions for HLO's (specifically at the levels of
Application, Analysis and Evaluation) and introduces a framework by which
systematic design may be carried out. It examines the mode of design, construction
and evaluation of 22 such objective questions devised for formative assessment for
two post-graduate course units in Information Systems, involving two groups of
students, 37 in total. The results from the trialing of these questions raises issues of
crucial differences in CAA software for feedback, scoring and delivery. The paper
examines key statistical indicators of question quality (facility and discrimination
indices), as well as the results of interviews with students, to drawn conclusions
about the best use of question types, student preparation for tests, and discusses
key issues in question preparation. It concludes with an examination of the main
advantages and disadvantages of using CAA for HLO's referring to the resource
overheads needed and the problems inherent in the process.


Background: Obesity is an increasing burden affecting developed and emerging societies since it is associated with an increased risk of diabetes and consequent cardiovascular complications. Increasing evidence points towards a pivotal role of inflammation in the etiology of vascular dysfunction. Our study aimed to investigate signs of inflammation and their relation to vascular dysfunction in rats receiving a high fat diet. Methods: Diet-induced obese (DIO) rats were used as a model since these rats exhibit a human pre-diabetic pathology. Oral glucose and insulin tolerance tests were conducted on DIO rats and their controls prior to the development of insulin resistance. Furthermore, the plasma contents of selected cytokines [macrophage chemoattractant protein (MCP-1), interleukin-6 (IL-6), and interleukin-1 (IL-1)] and the concentration of adiponectin were measured. Using wire myography, we tested the vascular function of isolated small mesenteric arteries. Results: DIO animals had significantly (p < 0.05) increased body weight (721.2 ± 6.3 g) compared to age- and sex-matched controls (643.4 ± 14.6 g), as well as a significant increase (p < 0.01) in body fat percentage (29.7 ± 1.7% and 22.7 ± 0.97%, respectively). No significant difference in fasting plasma insulin levels could be detected between the two groups (chow-fed group 141.5 ± 15.1 pmol/l; high fat-fed group 125.9 ± 18.8 pmol/l). However, the levels of MCP-1 (89.7 ± 4.2 pg/ml vs. 60.8 ± 7.7 pg/ml) and IL-6 (61.6 ± 3.1 pg/ml vs. 41.6 ± 7.4 pg/ml) were significantly elevated in DIO animals (p < 0.05) as compared to controls. Adiponectin levels were also significantly increased (p < 0.01) in DIO rats (10.8 ± 0.7 ng/ml) versus controls (6.9 ± 0.5 ng/ml). No difference in vascular or endothelial function was evident as determined by responses to acetylcholine, sodium nitroprusside, endothelin-1, and calcitonin gene-related peptide. Conclusion: In DIO rats, which have not yet developed hyperinsulinaemia or glucose intolerance, the levels of inflammatory mediators MCP-1 and Il-6 are significantly increased without concomitant vascular dysfunction. The results show that inflammation and obesity are tightly associated, and that inflammation is manifested prior to significant insulin resistance and vascular dysfunction.


The quality of life of 17-year-olds reared in lesbian-parent families did not differ from that of a matched group of adolescents who grew up in heterosexual-parent families. The study, also found, among teens with lesbian mothers, no difference in quality of life based on donor status (whether they had been conceived by known or unknown donors), experienced stigmatization (whether or not they had experienced discrimination), or maternal relationship continuity (whether their mothers were still together or had separated). The data in the new report comes from adolescents whose families are participants in the National Longitudinal Lesbian Family Study (NLLFS), the longest-running and largest prospective investigation of lesbian mothers and their children in the United States. Initiated in 1986, the NLLFS examines the social, psychological, and emotional development of the children as well as the dynamics of planned lesbian families.


With the disadvantages of complex structure, complicated operation and power control, the application of existing high-building escape device are restricted. A novel high-building escape device is designed based on TRIZ theory, which has the advantages of simple structure, easy operation and without electric or other energy. With the transformation of closed-loop mechanism, the gravity of escape person generate the resistance preventing the rapid drop of escape person. The closed-loop mechanism consists of driving shaft, feedback shaft, drving gear, feedback gear and rope. One end of the rope is winded around the driving shaft, and another end is tied with escape person. With the reduction of layers number of rope, the pressure angle between feedback shaft and rope increase, which cause the raise of resistance and the decrease of landing velocity of escape person. Simulation and experiment show that the designed escape device is effective and safety.


Through the life-time of a production field in the offshore petroleum industry it is normal to drill several new wells for both production and injection purposes. The initial well template, either at the platform or at a subsea installation, has space for a fixed total number of wells. When this limit is reached an old well needs to be plugged and the well slot reused to allow new wells to be drilled.
 In order to re-use well slots and benefit from full diameter when constructing the new well, it is required to remove the tubulars in the upper part of the plugged well. The outside of these tubulars are normally in contact with cement or settled particles from shut-in drilling fluids. Removing the tubular through the cement or settled particle is always challenging and there is need for using new techniques.
 In order to address the dominating effects in these operations, down-scaled laboratory tests are performed. The experiments reported here are performed by pulling steel pipes out of a cemented annulus. The pipes used in the tests are down-scaled from typical casing sizes. They are either normal pipes, grooved pipes or pipes with and without collars. Two setups with different geometries are used. The first is selected to study the de-bonding effect from the cemented annulus and the mechanical friction that must be overcome to remove the pipe. The other setup is designed to show the effect of collars when pulling out the tubulars. Since most tubulars in wells have collars between each stand with extended diameter, this effect is important to consider when comparing laboratory results to field operations.
 Results show that the loosening force (de-bonding) and pulling force can be significantly reduced by manipulating the pipes with grooves prior to pulling them out. Further, the results show that the most significant resistance when pulling the tubulars are caused by the collars outside the pipe. It is also observed that the effect of collar is significantly reduced when the pipe is grooved between the collars. In total these results provide improved understanding on the dominating effects when pulling pipes from packed wellbore annulus.


The development objectives of the Electricity and Gas Improvement Project for Nigeria are to: (i) improve the availability and reliability of gas supply to increase power generation in existing public sector power plants; and (ii) improve the power networks capacity and efficiency to transmit and distribute quality electricity to the consumers. Some of the negative impacts and mitigation measures include: i) encroachment, damage to historically or culturally significant areas; ii) air pollution due to elevated levels of dust and gaseous emissions; iii) elevated noise and vibration levels that could cause nuisance and damage to properties; iv) improper handling of wastes could cause odor, vermin problems, pollution and obstruction of nearby water courses; v) pollution and safety risks due to use of hazardous materials and disposal of hazardous wastes; vi) damage to community utilities such as water supply pipes, irrigation canals, drainage, etc.may occur during construction activities; vii) traffic disruption and obstruction of access to roadside properties; viii) health and safety risks to workers and the public


An adaptive protocol based on minimizing a tight approximate symbol-error-rate (SER) significantly improves a performance of full-rate cooperative communication systems in comparison with existing protocols. This protocol crucially requires a short-term channel variance for computing such approximate SER, used in an adaptation process. In this paper, we propose a least square (LS) approach to estimate that of short-term channel variance, and the pilot transmission strategy. A mean square error (MSE) for such estimation is also derived. Simulation results indicate that the adaptive protocol employing the LS channel variance estimation performs essentially similar to an ideal adaptive protocol for quasi-static fading channels, where a lower SER compared with existing protocols is achieved. For nonquasistatic fading channels, the proposed scheme is still able to work acceptably with a SER penalty in high signal-to-noise ration (SNR) regimes. In addition, the analytical MSE is close to the simulated MSE as well.


This report is a Terminal Evaluation of the UNEP/GEF project 'Technology Needs Assessment Phase II' implemented between 2014 and 2018.The project's overall development goal was to provide targeted financial and technical support to self-selecting developing countries to carry out Technology Needs Assessments (TNAs) and develop national Technology Action Plans (TAPs) for prioritized technologies that reduce GHG emissions, support adaptation to climate, and are consistent with national sustainable development goals. The evaluation sought to assess project performance (in terms of relevance, effectiveness and efficiency), and determine outcomes and impacts (actual and potential) stemming from the project, including their sustainability. The evaluation has two primary purposes: (i) to provide evidence of results to meet accountability requirements, and (ii) to promote learning, feedback, and knowledge sharing through results and lessons learned among UNEP, and the relevant agencies of the project participating countries.


The aim of this study was to compare the morphometry of the entire sperm of Holstein Friesian and Murrah buffalo bull and also to compare various staining techniques for the evaluation of sperm morphology by light microscopy. For this research work, twelve semen samples, six from Holstein Friesian and six from Murrah buffalo were collected. Smears of neat semen were stained with Hematoxylin Eosin, Toluidine Blue, Silver Nitrate and Eosin Nigrosin dyes. Seven measurements were made including the head length, head width, head base length, acrosomal cap length, acrosomal cap width, mid piece length and total tail length for two hundred spermatozoa with normal morphology. In the present study the mature spermatozoon consisted of head, neck, middle piece, principal piece and end piece. These morphometric measurements were almost similar for the various stains used. In addition, it indicate that Haematoxylin Eosin and Eosin Nigrosin are the suitable staining methods for evaluation of sperm head, Toluidine Blue is suitable stain for the evaluation of mid piece and Eosin Nigrosin is a effective stain for the evaluation of acrosomal cap. Appreciable evaluation was not possible in smears stained with Silver nitrate. Holstein Friesian sperm was longer in length than Murrah buffalo sperm length. The measurements for head length, head width, mid piece length and total tail length were significant (P<0.01) whereas the measurements for head base length, acrosomal cap length and acrosomal cap width were non significant (P<0.01).


One of the greatest challenges for people with disabilities is the lack
 of accessibility to information, and communication, in addition, to learning
 processes, which results in few possibilities for labor and social
 inclusion. Currently, in this sense, research and projects are carried out
 to promote strategies that allow greater use of ICTs in the acquisition and
 exchange of knowledge to reduce inequalities in terms of accessibility,
 especially for people with disabilities and, in general, for priority care
 groups. However, sustained processes are required that allow comprehensive
 accessibility to people with disabilities.According to studies carried out
 by the World Health Organization (WHO), it is estimated that 5% of the
 world's population has a hearing impairment (World Health Organization,
 2018). This community generally presents learning problems given the low
 effectiveness in the transmission of messages between listeners and
 non-listeners, and, regarding information and communication technologies,
 there are not enough computerized educational materials that facilitate
 communication and Autonomous Learning.It is important to mention that ICT
 plays a decisive role in teaching-learning in various educational
 environments. Undoubtedly, new technologies can supply means for improving
 teaching and learning processes, and managing educational environments in
 general, since they facilitate cooperation and collaboration between
 students. In addition, they contribute to overcoming social inequalities.
 Because sign language is the first language of the deaf community, and since
 it is expressed spatially and visually, it is necessary to produce
 multimedia content for the generation of computerized educational tools to
 properly transmit these messages. The present work is oriented toward
 facilitating sign language learning in people with hearing impairment, which
 contributes to their coexistence and interaction.We cannot fail to mention
 that the approach to nature is mediated by language. Without sufficient
 lexical background, any formative action is limited. It is essential to have
 a sufficient repertoire of terms that help the speaker understand and know
 her environment. Under regular conditions, vocabulary acquisition may be
 conditioned by diverse, but drawing events or conditions: access to physical
 or digital bibliography, limited educational experience, family environment
 little related to reading, etc. The increase in vocabulary in a speaker
 facilitates learning. Many reading comprehension problems begin with the
 impossibility of properly decoding words.The problem of access to vocabulary
 improvement is exacerbated for the deaf community and people with visual
 disabilities. The aggravation is because they do not exist in the Ecuadorian
 environment, dictionaries that offer information from the Ecuadorian lexicon
 not defined in general dictionaries and that, at the same time, contribute
 to the interpretation of sign language for the deaf community or that meets
 the standards of inclusion necessary to facilitate reading in users with
 visual disabilities.In this context, part of our work will be focused on
 determining which is the lexicon of Ecuadorian speech that deaf people do
 not know. We consider as a hypothesis that the lexicon unknown by deaf
 people mostly comprises terms with abstract or very localized references.In
 addition, we propose to propose the structure of the design of a
 technological platform of the dictionary. This web application would present
 the set of lexical entries defined in Spanish and expanded with an author
 appointment, accompanied by an image of the referent and a video with sign
 language interpretation of both the definition and the appointment. Each
 dictionary entry will offer automatic reading on the screen for the
 accessibility of no seers. The dictionary macrostructure will be composed of
 basic words and expressions of sign language to promote educational interest
 and facilitate and energize learning.The work will also be based on a
 methodology specialized in web applications such as OOHDM (Object Oriented
 Hypermedia Desing Methodology), on free tools for the manipulation of
 multimedia audio, video, and images such as Avidemux, Audacy, and Gimp
 respectively, in the Netbeans 14.0 development tool with JSF 2.0 framework.
 For integration with the database, PostgreSQL will be used.


The time-harmonic dynamical stress field in the system comprising two axially pre-stressed covering layer and two axially pre-stressed half space was studied under the action of uniformly distributed forces on free face plane of the covering layer. It is assumed that the forces are distributed within the rectangular area. The study was conducted within the scope of the piecewise homogeneous body model with the use of three-dimensional theory of elastic waves in an initially stressed bodies. The materials of the layer and half-space were assumed to be isotropic and homogeneous. The corresponding three-dimensional boundaryvalue-contact problem was solved by applying double Fourier exponential integral transformation. The numerical results were presented and discussed for the case where the material of the layer and half space were aluminum and steel, respectively. In this case, the main focus was the dependencies between the interfacial normal stress and frequency of the external forces. It was established that under the action of the statically equivalent forces in rectangular area the influence of the size of the area on the prescribed dependencies increased with increasing frequency of the forces. At the same time, it was shown that the influence of the pre-stretching of the covering layer on the stress was dependent on the frequency of the external forces. In particular, it was found that the influence became more significant as the frequency of the external forces approached the "resonance" frequency.


Abstract : This report summarizes the development of an Aircraft Fire Sentry (AFS) system. The AFS is designed to automatically detect a fire in the cargo bay of large cargo aircraft, provide an audio and visual alarm locally, and remotely notify the nearest fire department by radio frequency link. The basic design philosophy in developing the AFS was to use commercially available fire detection hardware and radio transmitters/receivers. The finished assembly is to be lightweight and portable. The AFS is to be deployed onboard parked aircraft and left to sense fire stimulus for up to 60 continuous hours in the self- powered mode. A prototype model was designed, built, and tested for performance and reliability.... Unattended/parked cargo aircraft, Aircraft fire detection, Fire department notification, Portable, Modular, Radio frequency operation


Abstract The upper Viséan–lower Serpukhovian Roque Redonde Formation in the southern part of the Montagne Noire, SW France, contains carbonate mounds with predominant micropeloidal facies tens of meters thick representing paleotopographic highs. Calcareous green algae, including representatives of the Dasycladales and Bryopsidales, are relatively common within the mounds (varying in percentages from 1% to 15% of the components, exceptionally reaching up to 40%). Six morphological types of algal remains are recognized within the mounds, and represented by (1) fragmented material, (2) discrete segments, (3) semi-articulated elements, (4) articulated elements, (5) stacked blades, and (6) bushes. Analysis of their preservation state suggests that they mostly constitute autochthonous or parautochthonous assemblages, which were living during the growth of the predominant micropeloidal/clotted fabrics of the carbonate mounds. As such, the carbonate mounds in the Roque Redonde Formation would have developed in an outer platform setting under dysphotic-euphotic conditions. Green algae in the carbonate mounds of the Mississippian confirm that they do not have analogs within the modern deep-water/bathyal carbonate mounds. The abundant green algae in the Montagne Noire is an exceptional case for any geological time period.


The Song of Deborah (Jud 5:2-31a) is one of the Biblical texts that has been most thoroughly analyzed. In this article I wish to present a new solution to some of the basic issues relating to the song. My hypothesis is based on exegetical and historical insights that can shed light on the process of editing and sculpting that the song underwent. A distinction between the original poem and editorial additions may, in my opinion, help solve some of the major problems in our understanding of the poem and its thematic coherence. Once the kernel of the text is isolated and the editorial additions are peeled away, the original song text is revealed, which is based on a clear and elaborate numerical structure.


Using three different methods, the activity of neuraminidase was studied in the promesenteron, postmesenteron, rectal ampulla, haemolymph and salivary glands in 600 Rhodnius prolixus experimentally infected with Trypanosoma rangeli stock San Agustín. The haemagglutination method with peanut lectin, and the fluorescence test with peanut lectin conjugated with fluorescein isothiocyanate, and the fluorescence emitted by 4-methylumbelliferone showed in all cases the presence of neuraminidase in the supernatant culture of T. rangeli in Tobie's medium between 8 to 15 days growth. None of the three methods was able to detect the presence of neuraminidase in R. prolixus infected with T. Rangeli, thus suggesting that this enzyme is not produced in vivo, and consecutively is not implicated in the pathogenicity that this trypanosome has to its vector.


The usability of a statewide curriculum website was evaluated involving 876 participants. Site usage differed based on user group and overall site content and relevance was found to be good along with high levels of satisfaction with graphic design. Usability problems with ease-of-use, however, were identified leading to the suggestion that many potential users do not use the site because of difficulty finding the information they are looking for. Implications of the research center on the articulation of a usability evaluation framework that could be generalized for testing the usability of other websites as well as redesign considerations for the site examined for the study.


Nova Scotia duck tolling retrievers (Tollers) have been shown to be strongly predisposed to immune-mediated diseases, including steroid-responsive meningitis-arteritis (SRMA) and an immune-mediated rheumatic disease (IMRD) (Anfinsen and others 2008, Hansson-Hamlin and Lilliehook 2009). SRMA has been described in several canine breeds, where the typical, acute form of SRMA is characterised by cervical rigidity, pain, pyrexia and a polymorphonuclear pleocytosis of the cerebrospinal fluid (CSF) (Tipold and others 1995, Tipold and Schatzberg 2010). SRMA has been described as occasionally occurring concurrently with immune-mediated polyarthritis (Webb and others 2002, Tipold and Schatzberg 2010). Genetic studies have indicated an inherited connection between the diseases, IMRD and SRMA, in Tollers (Wilbe and others 2009, 2010).

The aim of this study was to describe 23 Tollers with probable SRMA, including history, clinical signs, CSF, haematological and serum biochemical findings, antinuclear antibody (ANA) reactivity and C-reactive protein (CRP). Treatment and progress of the disease were also studied.

The 23 Tollers (unrelated at the grandparental level), were privately owned and diagnosed with suspected acute SRMA during 2005–2012. They showed clinical signs of meningitis with acute severe pain from the neck, fever, depression, anorexia and stiffness. The diagnosis was made by different clinicians at different veterinary clinics in Sweden. Haematological analyses were performed with the instruments at the clinics where the dogs were examined. The different clinicians and laboratory methods was a disadvantage of the study. However, all clinicians contacted the main author of this manuscript (who was known to be in charge of the …


The United Liberation Front of Asom (ULFA) was founded in the spring of 1979, guided by a desire to liberate the north-eastern state of Assam from the "neglectful" and "exploitative" tendencies of Indian control. The group's objectives dovetailed with the nationalist fervour of the Assam Movement (1979-85), which sought to resist the perceived influx into Assam of illegal immigrants, and opposed what it considered a state-sanctioned policy of enfranchising these (mostly Bengali) "foreigners." While the Indian state succeeded in absorbing the majority of agitators into the political mainstream through the Assam Accord of 1985, ULFA persisted with a militant struggle aimed at secession from the Indian union. Towards this end, the group was able to capitalise on a critical mass of individuals dissatisfied with the terms of the Accord. A quantitative indicator of the group's salience resides in the assortment of statistics capturing the impact of militancy in Assam. Official and unofficial data sources suggest that more than 4,000 civilians, and approximately 800 security personnel succumbed to militant activity in the state during the two decades spanning 1992 through 2011. In absence of a continuous record of ULFA-specific incidents, scattered repositories place the group's relative responsibility for this death toll between 20 and 26 percent of civilian fatalities, and between 32 and 43 percent of fatalities in the case of security personnel. In absolute terms, these estimates suggest that between 800 and 1,040 civilians and between 250 and 350 security personnel died in the context of ULFA activity during this period. But ULFA's assault has not been unilateral. Deploying the combined strength of its military, paramilitary, and police forces, the Indian state has achieved considerable success in its effort to weaken the group. According to one source, as many as 855 ULFA operatives were killed in the period from 1992 through 2001. Coupled with these coercive measures, the state's provision of financial incentives to surrendering militants has induced a great many to disengage.


In the traditional Medical and Allied Health science courses in UK and in Ireland students attend human dissection sessions on a regular basis for at least four hours each week through their entire semester to gain knowledge and understanding of Human Anatomy. At the University of Limerick Human Anatomy curriculum is delivered without involving the dissection of cadavers or human prosections. To meet this major but an exciting challenge and to achieve the learning outcomes; Anatomy curriculum was delivered using innovative teaching strategies in 1st and 2nd year human anatomy modules. The objective of this study is to describe the design, usage, and the impact of these teaching strategies on: students' knowledge of anatomy, on student class experiences and on their practical skills. An educational strategy based on role-playing was developed to engage all students. In role playing students (therapists) used each other as live models (patients) to get hands-on experience for identifying, localising and labelling body structures. Student opinions were sought on the appropriateness of these strategies to the subject content and to their future practise. The findings of this study are based on data gathered from 3 undergraduate anatomy modules; and relates to quantitative analysis of student results, content analysis of learner messages to module feedback questionnaires and two recent in-class observation sessions. The new teaching approaches were found to result in a substantial increase in student-student interaction, leading to observable improvements in the achievement of learning outcomes. The findings highlight the pedagogical value of these strategies and also suggest possible ways in which their benefits can be maintained while still meeting the formal assessment requirements of the course. This study highlights that real interactive learning from the start is needed for students, in order to prepare them appropriately for their future clinical interactions.


In this paper a frequency quadrupler circuit, integrated with a commercially available SiGe HBT technology (fT/fmax¿80/90 GHz) is presented. The quadrupler consists of two Gilbert cell mixers stacked as squarers. The measured maximum conversion gain is 0.6 dB for an input level of -9 dBm. The circuit is optimized for M-QAM carrier recovery, and the performance was tested by applying QPSK and 16QAM modulated signals with 4 Gbit/s data rate at the input. Both experimental and simulated results are presented. The fully integrated chip is operated from a single 2.5V DC supply and draws 22.3 mA current.


TRPM8 mRNA is expressed in a subset of cold-responsive trigeminal neurons from rat Abstract Recent electrophysiological studies of cultured dorsal root and trigeminal ganglion neurons have suggested that multiple ionic mechanisms underlie the peripheral detection of cold temperatures. Several candidate " cold receptors " , all of them ion channel proteins, have been implicated in this process. One of the most promising candidates is TRPM8, a non-selective cationic channel expressed in a subpopulation of sensory neurons that is activated both by decreases in temperature and the cooling compound menthol. However, evidence for the expression of TRPM8 in functionally defined cold-sensitive neurons has been lacking. Here, we combine fluorometric calcium imaging of cultured rat trigeminal neurons with single-cell RT-PCR to demonstrate that there are distinct subpopulations of cold responsive neurons, and that TRPM8 likely contributes to cold transduction in one of them. TRPM8 is preferentially expressed within a subset of rapidly responsive, low-threshold (~30°C), cold-sensitive neurons. A distinct class of slowly responsive cold-sensitive neurons that is activated at lower temperatures (~20°C) generally lacks detectable TRPM8 mRNA. Together with previous findings, our data support the notion that cold responsive neurons are functionally heterogeneous.


In the 19th century, new methods were developed with oxalic acid (Chappel 1887) and super-peroxide, which is thus the first documented use of hydrogen peroxide (H2O2; Harlan 1884). In 1918, Abbot discovered a fundamental formula for tooth bleaching, entailing a combination of light, heat production and the chemical interactions of stabilised H2O2at 35 % (superoxol). Since then, the formula has been refined continuously, but not changed in essence.


SUMMARY Throughout evolution, enzymes and their metabolites have been highly conserved. Parasites are no exception to this and differ most markedly by the absence of metabolic pathways that are present in the mammalian host. In general, parasites are metabolically lazy and rely on the metabolism of the host both for a supply of prefabricated components such as purines, fatty acids, sterols and amino acids and for the removal of end-products. Nonetheless, parasites are metabolically highly sophisticated in that (1) they retain the genetic capacity to induce many pathways, when needed, and (2) they have developed complex mechanisms for their survival in the host. Certain unique features of the metabolism of trypanosomes, leishmania, malaria and anaerobic protozoa will be discussed. This will include (1) glycolysis and electron transport with reference to the unique organelles: the glycosome and the hydrogenosome, (2) purine salvage, pyrimidine biosynthesis and folic acid metabolism and (3) polyamine and thiol metabolism with special reference to the role of the unique metabolite of trypanosomes and leishmanias, trypanothione.


General Lagrangian theory of discrete one-dimensional integrable systems is illustrated by a detailed study of Bäcklund transformations for Toda-type systems. Commutativity of Bäcklund transformations is shown to be equivalent to the consistency of the system of discrete multi-time Euler–Lagrange equations. The precise meaning of the commutativity in the periodic case, when all maps are double-valued, is established. It is shown that the gluing of different branches is governed by the so-called superposition formulas. The closure relation for the multi-time Lagrangian 1-form on solutions of the variational equations is proved for all Toda-type systems. Superposition formulas are instrumental for this proof. The closure relation was previously shown to be equivalent to the spectrality property of Bäcklund transformations, i.e., to the fact that the derivative of the Lagrangian with respect to the spectral parameter is a common integral of motion of the family of Bäcklund transformations. We relate this integral of motion to the monodromy matrix of the zero curvature representation which is derived directly from equations of motion in an algorithmic way. This serves as further evidence in favor of the idea that Bäcklund transformations serve as zero curvature representations for themselves.


RATIONALE, AIMS AND OBJECTIVES
A positive and strong safety culture underpins effective learning from patient safety incidents in health care, including the community pharmacy (CP) setting. To build this culture, perceptions of safety climate must be measured with context-specific and reliable instruments. No pre-existing instruments were specifically designed or suitable for CP within Scotland. We therefore aimed to develop a psychometrically sound instrument to measure perceptions of safety climate within Scottish CPs.

METHODS
The first stage, development of a preliminary instrument, comprised three steps: (i) a literature review; (ii) focus group feedback; and (iii) content validation. The second stage, psychometric testing, consisted of three further steps: (iv) a pilot survey; (v) a survey of all CP staff within a single health board in NHS Scotland; and (vi) application of statistical methods, including principal components analysis and calculation of Cronbach's reliability coefficients, to derive the final instrument.

RESULTS
The preliminary questionnaire was developed through a process of literature review and feedback. This questionnaire was completed by staff in 50 CPs from the 131 (38%) sampled. 250 completed questionnaires were suitable for analysis. Psychometric evaluation resulted in a 30-item instrument with five positively correlated safety climate factors: leadership, teamwork, safety systems, communication and working conditions. Reliability coefficients were satisfactory for the safety climate factors (α > 0.7) and overall (α = 0.93).

CONCLUSIONS
The robust nature of the technical design and testing process has resulted in the development of an instrument with sufficient psychometric properties, which can be implemented in the community pharmacy setting in NHS Scotland.


The paper is the first part of a broader empirical study that considers the entry timing of accession economies into the eurozone and their exchange-rate regimes between the EU entry and prior to the eurozone entry. The presented empirical analysis is based on model simulations and on the outcomes of previous work related to panel estimates of model equations for five accession economies. The first conclusion is that is not possible to search for one-for-all answers as to timing and exchange-rate regimes. Each of the accession countries should decide in accordance with specific country characteristics. According to our analysis, Poland could benefit most from entering the eurozone relatively quickly, while the Czech Republic and Hungary may benefit from a more cautious approach. This diversity reflects different characteristics such as openness, flexibility, and financial wealth. Postponing entry after 2009 would likely carry fewer additional benefits, however.


. A decentralization of electronic currency would allow business activity and development of a single network to be independent of other different business networks. Cost of a decentralized currency of the network can become stable as long as participants of that network are still active. We propose a solution for such a big problem of traditional economy as a "direct dependency of local prices on global ones". We also propose an innovative mechanism that allows participants of NCN to get any service of one business network for money (hours) earned in other network ('s). The currency is implemented by usage of two innovative technologies, "Proof of Participation protocol" (PoP) [3] and "Smart Transactions" [2].


Deep convolutional neural networks achieve remarkable visual recognition performance, at the cost of high computational complexity. In this paper, we have a new design of efficient convolutional layers based on three schemes. The 3D convolution operation in a convolutional layer can be considered as performing spatial convolution in each channel and linear projection across channels simultaneously. By unravelling them and arranging the spatial convolution sequentially, the proposed layer is composed of a single intra-channel convolution, of which the computation is negligible, and a linear channel projection. A topological subdivisioning is adopted to reduce the connection between the input channels and output channels. Additionally, we also introduce a spatial "bottleneck" structure that utilizes a convolution-projection-deconvolution pipeline to take advantage of the correlation between adjacent pixels in the input. Our experiments demonstrate that the proposed layers remarkably outperform the standard convolutional layers with regard to accuracy/complexity ratio. Our models achieve similar accuracy to VGG, ResNet-50, ResNet-101 while requiring 42, 4.5, 6.5 times less computation respectively.


Outlines the development of the construction sector in the period 1980-2001, e.g. the employment in collective-owned vs. state-owned enterprises, the influx of rural workers, role of labour contractors, and the impact of using pre-fabricated concrete and interior fittings such as doors, flooring and pipes.


chair is deficient; it may have 11 inch pneumatic tyred rear wheels but if the front wheels are not swivel castors propulsion by the attendant is very difficult. Also model 9L chairs do not have detachable sides, making sideways transfer difficult. Fourthly, the use of polyurethane foam and its hazards have been highlighted recently in the national press. Dr Malcolm Ellis in his article on easy chairs (5 March, p 701) considered the use of fire resistant materials desirable. Fifthly, mention is made of the use of a plywood base board to improve the cushioning effect; plywood is too hard a substance; chip foam is far more suitable. Finally, Dr Young says that electric wheelchairs are heavy, do not fold, and require space. But both models 109 and 103 will fold easily once the batteries have been removed. The same applies to the powered carter's chair, but removing the batteries is more difficult. It was disappointing to find in the references no mention of the booklet on wheelchairs produced by Mary Marlborough Lodge, which covers both DHSS chairs and those which may be bought privately. ' Rookwood Hospital and the Royal Hospital and Home, Putney, have both produced excellent booklets aimed at the professionals and disabled people. M A TUDOR Royal Hospital and Home, Putney, London SW15 3SW


In a superconductor that lacks inversion symmetry, the spatial part of the Cooper pair wave function has a reduced symmetry, allowing for the mixing of spin-singlet and spin-triplet Cooper pairing channels and thus providing a pathway to a non-trivial superconducting state. Materials with a non-centrosymmetric crystal structure and with strong spin–orbit coupling are a platform to realize these possibilities. Here, we report the synthesis and characterisation of high quality crystals of Sn4As3, with non-centrosymmetric unit cell (R3m). We have characterised the normal and superconducting states using a range of methods. Angle-resolved photoemission spectroscopy shows a multiband Fermi surface and the presence of two surface states, confirmed by density-functional theory calculations. Specific heat measurements reveal a superconducting critical temperature of Tc ∼ 1.14 K and an upper critical magnetic field of μ0Hc ≳ 7 mT, which are both confirmed by ultra-low temperature scanning tunneling microscopy and spectroscopy. Scanning tunneling spectroscopy shows a fully formed superconducting gap, consistent with conventional s-wave superconductivity.


Fatigue damage behavior under repeated electric loading was investigated on two kinds of PZT ceramics with discontinuous electrodes. Intergranular cracking was observed at the electrode edge in soft PZT under electric fields greater than ±400 V/mm. However, under the same loading conditions, no damage was observed in hard PZT. When cracking occurred, permittivity of specimens decreased with the number of cycles corresponding to the amount of mechanical damage. FEM analyses of the electroelastic field of the specimens showed that cracking due to cyclic electric loading was related to 180˚ domain switching caused by concentrated electroelastic field.


The behavior of non-Newtonian fluids is considered as an important subject in micro scale and microfluidic flow researches. Because of the complexity and cost in the numerical works and the experimental set-ups in some instances, the analytical approach can be taken into account as a robust alternative tool to solve the non-Newtonian microfluidic flows in some special cases benefiting from a few simplified assumptions. In this work, we analyze the flow of two non-Newtonian fluids including the power-law and grade-fluid models in microchannels. For the grade-fluid, the stress tensors are defined considering the Rivlin-Ericksen tensor definitions. To avoid the complexities in the entrance region, the flow is assumed to be hydrodynamically developed. The flow is steady and laminar and the fluid has constant properties independent of its temperature. We treat three different relations between slip velocity and wall shear stress as the slip boundary condition in our analysis. The Homotopy perturbation method is applied to solve the Navier-Stokes equations in case of grade fluid. To achieve the best slip coefficient, our power-law model solution is compared with available experimental data. Moreover, we compare the results of our Homotopy perturbation method with the numerical solutions. The current results show that the best slip relation is the one with a square of wall shear stress dependency.Copyright © 2009 by ASME


Neutrophils have been reported to acquire surface expression of MHC class II and co-stimulatory molecules as well as T-cell stimulatory activities when cultured with selected cytokines. However, cellular identity of those unusual neutrophils showing antigen presenting cell (APC)-like features still remains elusive. Here we show that both immature and mature neutrophils purified from mouse bone marrow differentiate into a previously unrecognized "hybrid" population showing dual properties of both neutrophils and dendritic cells (DCs) when cultured with granulocyte macrophage-colony-stimulating factor but not with other tested growth factors. The resulting hybrid cells express markers of both neutrophils (Ly6G, CXCR2, and 7/4) and DCs (CD11c, MHC II, CD80, and CD86). They also exhibit several properties typically reserved for DCs, including dendritic morphology, probing motion, podosome formation, production of interleukin-12 and other cytokines, and presentation of various forms of foreign protein antigens to naïve CD4 T cells. Importantly, they retain intrinsic abilities of neutrophils to capture exogenous material, extrude neutrophil extracellular traps, and kill bacteria via cathelicidin production. Not only do our results reinforce the notion that neutrophils can acquire APC-like properties, they also unveil a unique differentiation pathway of neutrophils into neutrophil-DC hybrids that can participate in both innate and adaptive immune responses.


As technology develops, dictionaries have changed from paper to electronic. Electronic dictionaries can be an alternative medium for language learning because they combine sound, visuals and text that make learning foreign languages easier. One example of using an electronic dictionary is in reading subjects. Users can learn about how to pronounce a vocabulary and sound tones correctly by utilizing the audio feature in an electronic dictionary. Vocabulary recall through mobile device applications is far more effective than through other media. The electronic dictionary application that is widely used by Chinese Literature students in learning Mandarin is the Pleco and Google Translate application. Therefore, the authors are interested in making comparisons of the similarities and differences between the two applications for the recommendation of Mandarin learning aids. This study uses a comparison method by comparing the functions of the two e-dictionaries. From the results of the comparison, both applications have keyboard features, handwriting features, voice record features and scanning features for translating words. The difference is in the radical features, stroke, number words and sentences sample


To understand how metabolism changes during fruit ripening in Jatropha curcas L., we performed a non-targeted analysis of metabolites in fruit (the pericarp and developing young seeds) from each maturation stage by means of liquid chromatography-Orbitrap-mass spectrometry, which provides m/z data with approximately 2 ppm precision. The chromatographic data were processed using bioinformatics tools. The total number of metabolites detected decreased substantially with fruit maturation. Self-organizing map (SOM) analysis and metabolite annotation of the ions detected suggested that dynamic metabolic changes occur during fruit maturation. All chromatographic data were deposited in databases accessible by the public.


The developmental stage at which Dictyostelium discoideum strain v12/M2 cells was inhibited in resuming cell division was monitored by a Coulter counter. Neither vegetative nor pre-aggregating v12/M2 amoebae used as inocula in liquid growth cultures exhibited a delay in recommencing cell division. Inocula prepared from aggregates were delayed for 3 h before the onset of division. Although cyclic AMP had no effect upon vegetative or preaggregating stages the aggregating amoebae were inhibited for 9 h before resuming division. Following the onset of division by both controls and cyclic AMP-treated cells the normal growth rate of vegetative amoebae (3.2 h/generation) was attained. Aggregateless mutant vegetative amoebae and those of comparable ages to vas/M2 aggregates were not inhibited in the rate of cell division by cyclic AMP. Cyclic AMP sustains the delay in cell division only among amoebae derived from aggregates. Cyclic AMP induces structural components in the plasma membranes which may be necessary in cell adhesion and interactions. Consequently interactions between the membranes of apposing cells may transmit stimuli intracellularly to inhibit cell division.


This review reports on the competition/collaboration among intertwined base-catalyzed acyl cleavage bimolecular mechanism (BAc2)/base-catalyzed alkyl cleavage bimolecular mechanism (BAl2) or the related acid catalyzed mechanisms AAc2/AAl2 and AAl1 concerning Carbonates chemistry also in comparison with Esters reactivity. A consistent analysis of the experimental data so far available in the literature led to proposing a Model outlining the differences in energy profiles among the above-mentioned reaction mechanisms. The reactions involving Carbonates are so tightly interconnected that the formation of the final product is driven by a precise not interfering sequence of BAc2-BAl2 (or AAl2-AAc2) mechanisms. When entropic effect (in cyclizations) or an anchimneric effect (mustard carbonates, isosorbide methylation) are involved, the difference in Gibbs activation energy is reduced allowing chemical transformations that would normally require higher temperatures. In these cases (intramolecular alkylation, cyclisation reaction, and alkylation by mustard carbonates) only a catalytic amount of base is required as the leaving group CH3OCOO- decomposes restoring the base. As Green Chemistry is concerned, syntheses with much lower environmental impact are achieved with Carbonates when compared with the corresponding ones involving Chlorine chemistry.


The aim of the research is to examine the innovation process followed by Siemens. Two segments of Siemens were investigated and compared namely: Siemens Information and Communication Network ( ICN) Germanay and Siemens Information and Communication Network ( ICN) Malaysia. The study examined the following: the historical backgrounds and financial performance achieved, the types of innovations implemented, the stages of innovation process followed, the actual problems faced, the factors perceived to be favourable to the success of iinovation implementation, the key people perceived to be most influential in innovation, the strategies adopted, the training programs introduced, the extent of interactions with its environment, and the working climates of the firms. This research adopted a field study approach with hypotheses testing; data were obtained through the use of questionnaires, interviews and secondary sources. The study showed that both firms were innovation active in the sense that they innovated in multiple ways in response to a changing environment. However, Germany was more innovation active as its implemented more types of incremental innovation and technological innovations, perceived more types of innovations needed for its upcoming future, initiated more innovative programs, had more interactions with the environments, and had a better creative climate. The study demostrated that each innovations is unique in its requirement and no specific strategies were universally successful in all types of innovation. Despite that both firms shared similar innovation processes, each was found to have different critical success factors and different people to influence its innovation peoject. Further, Germany had more technical types of problems while Malaysia had more behavioural types of problems while implementing innovations. Since few innovation studies have been conducted in Malaysia, this research provides a better understanding of innovation practice across cultures, particularly for multinationals operating in manufacturing industry. Finally, the study confirmed Zain's( 1995) findings from a quantitative viewpoints.


The objective of this study is to fabricate lightweight structural panels and pressurized tanks by blow forming of solid-state bonded Ti-6Al-4V sheets. The solid-state bonding process was conducted in selective areas of the sheets and gas pressure was applied to the core sheet in order to form center cells. The microstructure of bonded region shows no indication of any discontinuous or heterogeneous microstructure at interface. It is shown that the blow forming of a lightweight sandwich structural panel and a sphere vessel was successfully performed with solid-state bonded multiple sheets of titanium alloy. The result of configuration and thickness distribution measurement indicate that the FEM analysis can predict the forming behavior during blow forming process of solid-state bonded sheets.


NEUROCHEMISTRYNew evidence is indicating that, along with dopamine, another neurotransmitter, glutamate, may contribute to the learning of addictive behavior by producing long-term, stable changes in the brain that lead to compulsive drug-seeking. Researchers have found, for example, that blocking glutamate transmission in rats prevents behavioral sensitization, in which repeated doses of amphetamine or cocaine make the animals increasingly frantic and more likely to engage in purposeless motions; this may parallel the increasing anxiety and drug craving that humans feel after repeated hits of amphetamine or cocaine. Scientists have also identified lasting cellular and molecular changes that seem to increase activity in the brain's glutamate circuitry in animals given cocaine; brain imaging studies in humans have buttressed the theory that these circuits may be reactivated during drug cravings. If the notion that glutamate plays such a critical role in addiction holds true, drugs that block glutamate activity could one day help addicts kick their habit.


Letters must be no longer than 400 words ere must include a wor d cou nt. All le tters are subject to edi ting . Proofs will not normally be supplied, Th ere should be no more th an 4 a utho rs per reue r. EaCh author should provide curren t qualifications and posi tion . Co ntact telephone and facs imi le num be rs should be supplied. Letters fro m 8 si ngle author may be submut ed by e-mail (ampco @magna.com.au). but mus t include lull delails 01pos tal address and te lephone oumber. There should be no more lhan 5 references. The reterence list sho uld not mcroce aoyth ing tha t has not been publ ished or accepted for publicaliOO. Bete rence detai ls m ust be comple te, irlCludin g: names and initials 10' up to 4 authors, 0' 3 autho,s. et ar. if there are more than 4; places and date s lor confer· enoos and publiS hers , places and yea' 01 publi<:alion lor thei' p roce edings; pu bliShers, p laces , year of pub lication and page numbers lor monographS; volume numbers and page numbers for journal articles, Letters


Currently much attention is given to strategic measurement systems with the balanced scorecard as the far most high profiled. This US-born approach has not been very warmly welcome in France where tableau de bord, a French strategic measurement system, has been used for at least 50 years. The differences between both approaches have been variously discussed. This paper investigates the cultural and ideological hypotheses founding both methods, which may explain their differences as well as the climate surrounding the debate. This broadens up the usual perspective regarding performance measurement systems, which are usually implemented with respect to their strategic and organizational relevance - their cultural and ideological backgrounds being generally disregarded. In addition, this analysis provides some insight into the more general question of the transferability of management methods.


Diversifying household activiies is essential to household food security in Southern Malawi. Farms are extremely small; many farms are less than half a hectare. With these small landholdings, food security cannot be achieved by subsistence farming alone. Cash crops and off-farm income are key to these livelihood systems. This paper presents the findings of research conducted in 1998 as a part of a study to examine options for improving household food security in Southern Malawi. The researcher used linear programming to model household farming systems. These models were used to test different options for improving food security. The following options were tested: a maize safety net, a fertilizer safety net, introducing credit for tobacco, increasing off-farm work opportunities, and introducing a loan to start a small business. This study also considered differences between female-headed households (FHHs) and male-headed households (MHHs) to discover if there were differences between the two household types, and if so, to find out how the differences affect the households' situations.


Abstract For over 100 years, Eugène Simon's system of pholcid classification has been used with only minor modifications. Phylogenetic research over the last decade has shown that some fundamental changes are necessary if the formal system is to reflect putative evolutionary relationships. Based on cladistic analyses of morphological and molecular data and on qualitative character assessment, the family is here divided into five subfamilies: Ninetinae, Arteminae, Modisiminae, Smeringopinae, and Pholcinae. All currently valid genera are placed in a cladogram. Even though the evidence supporting some of the nodes and assignments is weak, the cladogram generates numerous testable hypotheses and provides an improved framework for the mapping of 'new' characters like those from sperm ultrastructure and chromosome analysis.


In wireless sensor networks (WSN) location awareness is required to use the communication advantages of adaptive antenna arrays (AAA) and use energy efficiency location based routing protocols. In this work, we introduce a simple and practical location estimation technique which uses AAAs at the central node in WSNs. This localization technique can be used at the setup phase in the location based routing protocol. This technique is based on scanning the desired region in azimuth and radial directions by changing parameters of downlink beam. This sweeping process can activate the nodes in the desired region which is specified by antenna beam width and beam direction of the localization beam and also by minimum and maximum thresholds (Rmin and Rmax) for the received signal strength indicator (RSSI). Active nodes in the desired region transmit their IDs and RSSI levels via multi hop communication to the central node. Unlike GPS-based or beacon based localization techniques, the proposed technique does not require any modification in the sensor nodes. We demonstrate different scenarios for performance analysis of this localization technique. The results show that by carefully adjusting these parameters, desired performance can be achieved. The accuracy of location estimation depends on beam direction, beam width and transmitting power for downlink beams.


Buckling and postbuckling behaviors of moderately thick composite plates reinforced by single-walled carbon nanotubes (SWCNTs), rested on elastic foundations and subjected to two types of thermal loading are investigated in this article. Carbon nanotubes (CNTs) are reinforced into isotropic polymer matrix according to functional rules in which volume fractions of constituents are graded in the thickness direction. Material properties of constituents are assumed to be temperature-dependent and effective properties of nanocomposite are estimated by extended rule of mixture. Formulations are based on first-order shear deformation theory taking von Karman nonlinearity, initial geometrical imperfection, tangential constraints of edges, and two-parameter elastic foundation into consideration. Approximate solutions are assumed to satisfy simply supported boundary conditions and Galerkin method is applied to derive nonlinear temperature–deflection relations from which buckling temperatures and postbuckling equilibrium paths are determined by an iteration algorithm. Novel findings of the present study are that deteriorative influences of temperature-dependent properties on the postbuckling behavior become more serious as plate edges are partially movable, CNT volume fraction is higher, elastic foundations are stiffer, plates are thicker, and/or temperature linearly changed across the thickness.


Collectively, small and medium-sized enterprises (SMEs) make a significant contribution to carbon emissions. Transformative changes are needed to achieve Net Zero amongst the SME community, presenting policymakers and practitioners with a complex and largely unresolved set of challenges. In this paper, we investigate the unexploited potential of human values in facilitating these changes, with a particular focus on the role and experiences of specialist intermediaries, such as business advisors, as agents of change. The paper reports on four linked, transdisciplinary research projects, which tested and validated a values-based intervention in collaboration with businesses and advisors, designed to promote more effective, long-term journeys towards Net Zero. Our study connects research evidence on SME support with key insights from values literature, including the emerging concepts of values practices and values work. We discuss outcomes from the four projects, and the broader implications for research, policy, and practice.


Abstract UVA exposure causes skin photoaging by singlet oxygen (1O2)-mediated induction of matrix metalloproteases (MMPs). We assessed whether β-carotene, a carotenoid known as 1O2 quencher and retinoic acid (RA) precursor, interferes with UVA-induced gene regulation and prevents UVA-induced gene regulation in HaCaT human keratinocytes. HaCaT cells accumulated β-carotene in a time- and dose-dependent manner. UVA irradiation massively reduced the cellular β-carotene contents. β-Carotene suppressed UVA induction of MMP-1, MMP-3, and MMP-10 - three major MMPs involved in photoaging. HaCaT cells produced weak retinoid activity from β-carotene, as demonstrated by mild up-regulation of retinoid receptor RARβ and activation of an RARE-dependent reporter gene. Of the 568 UVA-regulated genes, β-carotene reduced the UVA effect for 143, enhanced it for 180, and did not interact with UVA for 245 genes. The pathways regulated β-carotene in interaction with UVA were characterized by genes involved in growth factor signaling, stress response, apoptosis, cell cycle, extracellular matrix (ECM) degradation, tanning, and inflammation. In conclusion, β-carotene at physiological concentrations interacted with UVA effects by multiple mechanisms that included, but were not restricted to, 1O2 quenching. With our results, we provide a mechanistic basis for the long-known and clinically established photoprotective effects of β-carotene in human skin.


Abstract. One of the most important freely available digital elevation models (DEMs) for Amazonia is the one obtained by the Shuttle Radar Topography Mission (SRTM). However, since SRTM tends to represent the vegetation surface instead of the ground surface, the broad use of SRTM DEM as a framework for terrain description in Amazonia is hampered by the presence of deforested areas. We present here two data sets: (1) a deforestation-corrected SRTM DEM for the interfluve between the Purus and Madeira rivers, in central Amazonia, which passed through a careful identification of different environments and has deforestation features corrected by a new method of increasing pixel values of the DEM (Renno, 2009); and (2) a set of 18 hydrological-topographic descriptors based on the corrected SRTM DEM. Deforestation features are related with the opening of an 800 km road in the central part of the interfluve and occupancy of its vicinity. We used topographic profiles from the pristine forest to the deforested feature to evaluate the recovery of the original canopy coverage by minimizing canopy height variation (corrections ranged from 1 to 38 m). The hydrological–topographic description was obtained by the Height Above the Nearest Drainage (HAND) algorithm, which normalizes the terrain elevation (above sea level) by the elevation of the nearest hydrologically connected drainage. The validation of the HAND data set was done by in situ hydrological description of 110 km of walking trails also available in this data set. The new SRTM DEM expands the applicability of SRTM data for landscape modelling; the data sets of hydrological features based on topographic modelling are undoubtedly appropriate for ecological modelling and an important contribution to environmental mapping of Amazonia. The deforestation-corrected SRTM DEM is available at http://ppbio.inpa.gov.br/knb/metacat/naman.318.3/ppbio ; the polygons selected for deforestation correction are available at http://ppbio.inpa.gov.br/knb/metacat/naman.317.3/ppbio ; the set of hydrological–topographic descriptors is available at http://ppbio.inpa.gov.br/knb/metacat/naman.544.2/ppbio ; the environmental description of access trails is available at http://ppbio.inpa.gov.br/knb/metacat/naman.541.2/ppbio ; and the limits of deforestation corrections and drainage validation are available at http://ppbio.inpa.gov.br/knb/metacat/liliandias.38.1/ppbio .


The roots of labor process begins with Marx analyses of how the labor process shifted from simple cooperation to manufacture and modern industrial stage, which resulted in the elimination of the skilled craft workers ability to exercise his judgment and authority over their labor power. Braverman take a new look at the skill, technology and work organization. He argued there is a greater possibility for managerial control which resulted in the wide-range deskilling of the workers. The Labor process debate in late 1970s attempts to include into discussion the important changes in the labor process. The debate over the development of the labor process led to a developing body of theoretical and empirical literature in the sociology of work. The present paper reviews the theoretical contribution of various thinkers to the labor process and to analyze the roots of deskilling or Upskilling of the workers in the labor process.


This manuscript summarizes a total of 12 peer-reviewed studies, published from 1981 to 2001, reporting 28 separate estimates for the disaggregate2 value of water quality services provided by coastal and non-coastal wetlands. Estimates ranged across three orders of magnitude and are highly dependent on the specific geographic site providing the service, the type of water quality service provided, the measurement technique, and whether locally derived benefits were calculated to extend across all existing wetlands. Considering only coastal zone wetlands across all study categories, the value of water quality services ranged from $2.85/acre/year to $5,673.80/acre/year, with a mean and median of $825.04/acre/year and $210.93/acre/year, respectively. The large difference between the mean and median value reflects the non-normal distribution of the estimates, and in particular the influence of a few very high values. Eliminating the most extreme outliers from the calculations generated mean and median values of $323.05/acre/year and $178.64/acre/year, respectively. By comparison, reported estimates of willingness-to-pay (WTP) values for wetland water quality services were relatively consistent across studies, ranging from $41.71 to $101.81, with a mean and median of $66.59 and $63.19, respectively. The apparent importance of geographic location, and the specific use demand, on water quality service value suggests that this facet of coastal wetland benefits needs to be carefully examined within a spatially disaggregated context.


Vascular anomalies of the large bowel, commonly known as vascular malformations of the colon (VMC), constitute a rare but important condition, potentially causing significant morbidity and mortality. Our aim is to provide an up-to-date, practical summary evaluating this disease entity, focussing on pathogenesis, as well as diagnostic and therapeutic modalities. We reviewed available data in the literature, and discussed it in the form of a narrative, readily applicable review. Most VMC (over 70%) are detected in the caecum and ascending colon, and affect people aged over 50 years. VMC are almost always symptomatic, presenting with lower bleeding. Endoscopy is crucial to identify and locate VMC, and to treat the lesions. In patients who fail or do not fit endoscopic treatment, aggressive approaches (interventional angiology or surgery) are mandatory. Up to 40% of patients may have relapse in the long term. VMC are rare but potentially life-threatening. Advances in endoscopic imaging and therapy have improved the results of treatment. Long-term follow-up after treatment is recommended.


Background:  Midazolam is one of the most frequently used agents for sedation in pediatric dentistry. The injectable form of midazolam can also be given orally. However, its bad taste has negative effects on ingestion of the drug. In this study, we aimed to evaluate the effect of drinks which were added to mask the bitter taste of midazolam for drug acceptance and sedation.


Background

Life expectancy and the number of ultra-octogenarians increased significantly, thus making crucial the appropriateness of several endoscopic procedures in elderly patients. The aim of our study was to provide a retrospective analysis of the efficacy and safety of capsule endoscopy in patients aged over 80 years.
Patients and Methods

In this single-centre study, 900 patients underwent capsule endoscopy between 2002 and 2015 for different indications; of these 106 patients aged ≥ 80 years (group A) and 99 patients aged 40–60 years (control group B) were randomly selected.
Results

Occult gastrointestinal bleeding accounted for 62.1% of all indications for capsule endoscopy in group B, compared to 95.2% in group A (p < 0.001). Although not statistically significant, the diagnostic yield was higher in group A (71%) vs. group B (62%). The percentages of reaching the cecum and the median gastric transit time were uniform within the two groups. In contrast, small bowel transit time was longer in group A vs. B. Small bowel preparation was similar in the two groups. The exam was generally well tolerated in both groups, with capsule aspiration being one of the main adverse events, which occurred in two elderly patients.
Conclusions

Our data expand previous findings confirming that capsule endoscopy can be performed safely even in very old patients and show that the diagnostic yield is similar to that of younger patients.


Problem of lateral driving stability of the automobiles passing by the vicinity of pylons of cable-supported bridges in condition of strong cross wind exists obviously because of the alternative wind environment above the deck due to complex flow fluid around the pylon and the deck. Based on numerical wind tunnel technology, the numerical simulation investigation of alternating wind environment above the girder near A-shaped pylon for main span of the steel truss girder cable-stayed bridge of Zhengxin Yellow River Highway-railway Bridge is carried out, considering wind barrier set up on the deck or not. The result shows that the original program has significant effect on wind speed amplification and mutation near the pylon domain in cross wind. Further investigation on wind barrier set up on both sides of the girder section or near the A-shaped pylon along the bridge gives that wind barrier near the A-shaped pylon is useful for reducing wind speed above the leeward deck near the pylon and weakening its mutation. Deeply, taken a medium-size commercial bus as an example, lateral driving stability of the automobiles passing by the leeward lane near A-shaped pylon is discussed through the dynamic response simulation of the vehicle controlled by ideal-driver under cross wind. The results confirms again that the wind barrier near the A-shaped pylon is good for driving safety of vehicles passing by the leeward lanes in vicinity of A-shaped pylon. In all, above work provides technical support for the final implementation of the wind barrier as an engineering measure.


To solve problems of bodies of revolution (BoR) using the method of moments, the modal Green's function is used, which is defined as the radiation field of a circular loop antenna with sinusoidal current distribution. It is a group of oscillating integrals that forms the bottleneck for further accelerating the computation of BoR problems. In this paper, we propose closed-form expressions for near-axis far-distance modal Green's functions, which can be used to accelerate the computation of BoR problems especially when the object is slim. A criterion is presented based on a rigorous error analysis to guarantee its range of applications. Both the scattering and radiation examples are presented to demonstrate the validity and efficiency of the proposed expressions.


The US Space Resource Exploration and Utilization Act 2015 aroused heated discussions. The international community has not yet reached consensus on the application of the concept of "common heritage of mankind" in the Moon Agreement. In accordance with the non-appropriation principle in the Outer Space Treaty, outer space is not subject to national appropriation. However, there is a need to balance the common interests of the international society and the interests of the States and private entities which invest heavily in the space resource exploration. The unilateral approach of the US by adopting a national law is not an ideal way to deal with space resource exploration. As a major space-faring nation, China should take a proactive approach in both national legislation and international cooperation in this field. At the international level, China should consider establishing an appropriate international regime for space resource management.


BACKGROUND
The aim of the study was to evaluate plasma natriuretic peptides (NPs): atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) concentrations in patients with paroxysmal, persistent and permanent atrial fibrillation (AF).

METHODS AND RESULTS
The study groups consisted of 23 patients with paroxysmal AF, 42 patients with permanent AF and 77 patients with persistent AF with normal left ventricular function. The mean ANP level was increased in AF patients in the paroxysmal, persistent and permanent groups: 249 +/- 88.3 pg/mL; 258 +/- 89.7 pg/mL; 208 +/- 76.7 pg/mL, respectively, vs. 67 +/- 21.2 pg/mL in the control subjects (p < 0.001). The mean BNP level was increased in AF patients in the paroxysmal, persistent and permanent groups: 99.6 +/- 29.8 pg/mL; 82.3 +/- 33 pg/mL; 95.6 +/- 46.4 pg/mL, respectively, vs. 37.5 +/- 13 pg/mL in the control group. Multivariate logistic regression analysis revealed a positive correlation between ANP levels, maximal left atrial volume, heart rate and New York Heart Association (NYHA) classification, in the persistent AF patients. A positive correlation between plasma BNP levels and heart failure stage according to NYHA classification in this group was found. Baseline ANP concentrations were positively correlated with baseline BNP concentrations in AF patients.

CONCLUSIONS
Plasma NPs levels are increased in patients with paroxysmal, persistent and permanent AF and normal left ventricle function, and positively correlated with left atrial volume, heart rate and heart failure stage according to NYHA classification. Neurohormonal assessment does not distinguish the type of arrhythmia.


A 67-year-old man experienced acute inferior myocardial infarction. Echocardiography and computed tomography showed massive pericardial effusion. He underwent emergency operation for ischemic ventricular free wall rupture. During the operation, an oozing type rupture was found on the inferior wall and the bleeding was completely controlled by applying fibrin glue sheets. On the 5th day after the operation, ventricular tachycardia appeared with hemodynamic deterioration. Echocardiography showed a ruptured posteromedial papillary muscle with massive mitral regurgitation. Intra-aortic balloon pumping was introduced and emergency repair operation was performed. The mitral valve was replaced with a bioprosthetic valve. The postoperative course was uneventful.


Clinicians' Perceptions of Trauma Treatment for People with Intellectual Disabilities by Katherine E. Schoech M.A., Regis University, 2002 B.S., University of Northern Colorado, 1982 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Clinical Psychology Walden University August 2017 Abstract People with intellectual disabilities (ID) experience trauma and posttraumatic stress disorder (PTSD) in similar ways as individuals in the general population. The purpose of this phenomenological study was to explore and describe clinicians perceptions of trauma treatment for people with ID. Theories of trauma, PTSD, and stigma were part of the conceptual framework from which interview questions were developed. Purposive and snowball sampling were used to recruit 8 participants in thePeople with intellectual disabilities (ID) experience trauma and posttraumatic stress disorder (PTSD) in similar ways as individuals in the general population. The purpose of this phenomenological study was to explore and describe clinicians perceptions of trauma treatment for people with ID. Theories of trauma, PTSD, and stigma were part of the conceptual framework from which interview questions were developed. Purposive and snowball sampling were used to recruit 8 participants in the Denver, Colorado area. Four participants had experience working with people with ID, and 4 participants did not have this experience. Participants sat for semi structured openended recorded interviews, which were used to gather data for interpretation. Eight essential themes were identified: (a) chosen field, (b) lack of training, (c) stigma and stereotypes, (d) they're just folks like us, (e) preying on their vulnerabilities, (f) PTSD and trauma symptoms are the same with people with ID, (g) EMDR and the adaptive information processing theory, and (h) mindfulness interventions. The participants dispelled myths such as people with ID do not experience trauma and PTSD, and people with ID cannot participate in trauma therapy such as EMDR. Participants who had experience working with people with ID wanted more training on adaptations for treatment interventions, and participants without this experience welcomed advanced training on trauma treatment for people with ID. This study adds to the research on trauma treatment for people with ID and may affect social change by inspiring more conversations among clinicians on appropriate trauma treatment for people with ID. Clinicians with experience can build stronger relationships with community mental health centers, and continue to educate, clients, families, direct care providers, and agency personnel on trauma-informed care. Clinicians' Perceptions of Trauma Treatment for People with Intellectual Disabilities A Qualitative Study by Katherine E. Schoech M.A., Regis University, 2002 B.S., University of Northern Colorado, 1982 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Clinical Psychology


In September 2004 the American Thoracic Society released a revised set of guidelines for the clinical diagnosis of nonmalignant asbestos-related disease (Am J Resp Crit Care Med. 2004;170:691–715). The conditions of concern are asbestosis, pleural disorders, and chronic airways obstruction. The criteria are evidence of structural lesion consistent with asbestos-related disease, evidence of causation by asbestos, and exclusion of alternative diagnoses. Findings that satisfy each are described. These guidelines are an extension of the 1986 ATS criteria and expand on them by establishing three explicit criteria, accommodating newer diagnostic modalities, recommending evaluation of impairment appropriate to the diagnosis, and outlining initial management measures following diagnosis. A history of significant asbestos exposure obligates the responsible physician to provide a management plan for the patient that takes into consideration current disease, impairment, and future risk. Persons identified as having asbestos-related disease or having significant exposure histories may benefit from management directed at preserving lung function, preventing complications, reducing the risk of lung cancer, and screening for potentially treatable asbestos-related disease including malignancies. Various issues arising since the publication of the guidelines are addressed, including evidence for pleural plaques being a marker of risk for lung disease apart from history of asbestos exposure; evidence against smoking being associated with a greater frequency of pleural plaques; an association between asbestos exposure and colon cancer; the diagnostic sensitivity of the chest film in smokers; and affirming the adequacy of findings on plain chest films as sufficient for the diagnosis of nonmalignant asbestos-related disease but not always sufficient to rule it out.