In this study, effect of temperature (4, 10, 25, and 35°C) on microstructural and rheological properties of royal jelly (RJ) was investigated. Our results indicated that pH and proximate composition of RJ was insignificantly affected by temperature, but °Brix values increased. Microstructural images showed that RJ particles were homogeneous at 10 and 25°C, but swelled at 35°C. RJ samples showed shear thinning behavior with yield stress. The increasing temperature caused the increase of yield stress due to swelling of particles. All samples were characterized as weak gel‐like behavior because G′ > G″ at up to 100 rad/s. Three interval thixotropic test (3ITT) showed that RJ samples could partially recover after high shear deformation, but increasing temperature decreased recovery percentage of samples. This study revealed that the temperature of RJ should never exceed to 10°C to obtain better recovery during the processing. PRACTICAL APPLICATIONS: Apicultural products such as royal jelly (RJ) have become very important nutritional products in recent times due to bioactive properties and are increasingly attracted by consumers. Bioactive properties of RJ can highly be deteriorated by process temperature and storage conditions. RJ has creamy and milk‐like structure and contains high amounts of proteins and carbohydrates. Therefore, the rheological characterization of RJ can provide significant information about structure, freshness, end product quality for consumers, as well as process equipment design and energy consumption for manufacturers. The freshness of RJ is determined with the analysis of 10‐HDA, furosine, superoxide dismutase and 57 kDa proteins. This study revealed that the rheological characterization of RJ at different temperatures may be helpful to estimate freshness and process conditions easier than analytical methods.


Rett syndrome (RTT) is an incurable neurodevelopmental disorder caused by mutations in the gene encoding for methyl-CpG binding-protein 2 (MeCP2). Gene therapy for this disease presents inherent hurdles since MECP2 is expressed throughout the brain and its duplication leads to severe neurological conditions as well. However, the recent introduction of AAV-PHP.eB, an engineered capsid with an unprecedented efficiency in crossing the blood-brain barrier upon intravenous injection, has provided an invaluable vehicle for gene transfer in the mouse nervous system. Herein, we use AAV-PHP.eB to deliver an instability-prone Mecp2 (iMecp2) transgene cassette which, increasing RNA destabilization and inefficient protein translation of the viral Mecp2 transgene, limits supraphysiological Mecp2 protein levels in transduced neural tissues. Intravenous injections of the PHP.eB-iMecp2 virus in symptomatic male and female Mecp2 mutant mice significantly ameliorated the disease progression with improved locomotor activity, coordination, lifespan and normalization of altered gene expression and mTOR signaling. Remarkably, PHP.eB-iMecp2 administration did not result in severe toxicity effects either in female Mecp2 mutant or in wild-type animals. In contrast, we observed a strong immune response to the transgene in treated male Mecp2 mutant mice that was overcome by immunosuppression. Overall, PHP.eB-mediated delivery of the iMecp2 cassette provided widespread and efficient gene transfer maintaining physiological Mecp2 protein levels in the brain. This combination defines a novel viral system with significant therapeutic efficacy and increased safety which can contribute to overcome the hurdles that are delaying clinical applications of gene therapy for RTT. One Sentence Summary Global brain transduction of the instability-prone Mecp2 transgene by systemic AAV-PHP.eB administration is both safe and effective in protecting male and female Mecp2 mutant mice from the RTT disease phenotype.


It is widely known that the vibration characteristics of blade integrated discs can dramatically change in the presence of manufacturing tolerances and wear. In this context, an increasing number of publications discuss the influence of the geometrical variability of blades on phenomena like frequency splitting and mode localization. This contribution is investigating the validity of a stiffness modified reduced order model for predicting the modal parameters of a geometrically mistuned compressor stage. In detail, the natural frequencies and mode shapes, as well as the corresponding mistuning patterns, are experimentally determined for an exemplary rotor. Furthermore, a blue light fringe projector is used to identify the geometrical differences between the actual rotor and the nominal blisk design. With the help of these digitization results, a realistic finite element model of the whole compressor stage is generated. Beyond that, a reduced order model is implemented based on the nominal design intention. Finally, the numerical predictions of the geometrically updated finite element model and the stiffness modified reduced order model are compared to the vibration measurement results. The investigation is completed by pointing out the benefits and limitations of the SNM-approach in the context of geometrically induced mistuning effects.


Modern mechatronic systems include a network of microcontroller on which real-time control algorithms and comfort functions are executed. To provide additional resources for stress situations (dealing with emergencies, overload of comfort functions) without deactivation comfort functions, these comfort functions should be reallocated to other nodes of the network. For this purpose a local operating resource manager is combined with an approach to manage heterogenic resources in a network. With a virtual emergency node additional resources for the comfort functions will be provided.


'B-29!' No other term struck such terror in the hearts of the Japanese public during World War 2 than this single, most-hated name. It was then only natural that the pilots who attempted to shoot these high-flying Boeing bombers out of the skies over Tokyo, Nagasaki, Hiroshima and Kobe should become known as the elite of the Japanese Army Air Force. This book details the exploits of the 'Dragon Slayers' who, flying the very latest single- and twin-engined fighters, exacted a heavy toll on the AAF Boeing bombers, using a range of tactics including ramming.


ABSTRACT In this paper, we analyse the model of pure carving turns in alpine skiing and snowboarding based on the usual assumption of approximate balance between forces and torques acting on the skier during the turn. The approximation of torque balance yields both lower and upper limits on the skier speed, which depend only on the sidecut radius of skis and the slope gradient. We use the model to simulate carving runs on slopes of constant gradient and find that pure carving is possible only on slopes of relatively small gradient, with the critical slope angle in the range of . The exact value depends mostly on the coefficient of snow friction and to a lesser degree on the sidecut radius of skis. Comparison with the practice of ski racing shows that the upper speed limit and the related upper limit on the slope gradient set by the model are too restrictive and so must be the assumption of torque balance used in the model. A more advanced theory is needed.


"Big-Game" consists of the Belgian Elric Petit, the Swiss Gregoire Jeanmonod and the Frenchman Augustin Scott de Martinville. Having met up at the ECAL (Cantonal School of Art of Lausanne) and given their shared passion for the aesthetics of industrial design, in 2004 they decided to join forces and found a design studio, based in Brussels as well as Lausanne. In this relatively short time they have collaborated with, amongst others, Ligne Roset, Galerie Kreo, Vlaemsch and Inout Designers. Their work is minimalist, with a humourous, sometimes slightly subversive touch. In October 2008, Grand Hornu Images (attached to the MAC) brings an exhibition about the work of the threesome, on the occasion of which this book is published. With texts by Lise Coirier and Pierre Keller, it sneaks behind the scenes and offers a visual exploration of the journey of a design object from the conception and drawings to the finalised product.


Epitaxial layers of aluminum nitride (AlN)less than or equal to 80 mum thick have been grown at the temperatures 1900 and 2100 degreesC on 10x10mm(2) 4H-SiC substrates via sublimation recondensation in a RF heated graphite furnace. The source material was polyerystalline sintered AlN. A maximum growth rate of 80 mum/h was achieved at 2100degreesC and seed to source separation of I mm. The surface morphology reflects the hexagonal symmetry of the seed that suggesting an epitaxial growth. All crystals show strong and well defined single crystalline XRD patterns. Only the (002) reflection positioned at around 36.04 was observed in symmetric Theta-2Theta scan. The rocking curves FWHM (full width half maximum) and peak positions arc reported.


During growth Van der Waals forces between the incident atoms and the substrate lead to steering with sometimes important implications for the morphology of the molecular-beam-epitaxy- or sputter grown films. Deterministic classical trajectory calculations, modelling the atom-substrate interaction with a Lennard Jones potential, have been run to provide insight in the influence of the polar angle of incidence and the energy of the atoms on steering for 1 and 3 monolayer high islands. For low energies (10?100 meV) substantial flux redistribution has been found. A major part of the flux directed to the ascending steps is transferred on top of the protrusion, while even reversal of the lateral velocity at the descending steps occurs. At grazing incidence strong deviations from geometric shadowing behavior is observed even for energies as high as 1 to 10 eV.


This volume contributes to the growing body of literature on religion and globalization and specifically global Pentecostal movements. While Pentecostalism worldwide shares a cultural resemblance, it is also localized and expressed in different ways. The variety of Pentecostalisms throughout the world are illustrated through important themes of mission, migration, and public religion. The global flows of Pentecostal practices, beliefs, and cultures, brings into contrast these variations. Negotiating what it means to be Pentecostal often leads to conflict and questions of identity. Interaction with other religions like Islam in Africa, mission work in Asia, and migration to Europe and North America is problematized. Regional coverage includes Africa, Asia, Latin America, Europe, and North America.


Background Several decellularisation techniques have been developed to produce acellular matrix scaff olds for the purpose of tissue engineering, mostly comprising (non-)ionic detergents or enzymatic extraction methods. However, the eff ect of chemically induced decellularisation on the major structural and adhesion molecules as well as glycosaminoglycans, and the possible replenishment of lost compounds has escaped attention. Methods Porcine aortic valves were treated with two diff erent methods: detergent Triton X-100 and enzymatic Trypsine cell extraction. (Immuno-) histochemistry was used to address changes in extracellular matrix constitution (elastin, collagen, glycosaminoglycans, chondroitin sulfate, fi bronectin and laminin) and the production of extracellular matrix components by seeded endothelial cells. Results The Trypsine treated group showed a fragmentation and distortion of elastic fi bers. Changes in collagen distribution were observed in both groups. An almost complete washout of glycosaminoglycans and chondroitin sulfate was observed in the Triton and Trypsin treated group, but the latter with a smaller glycosaminoglycans reduction. Both treatments resulted in a considerable washout of the adhesion molecules laminin and fi bronectin. Furthermore, seeded endothelial cells were capable of synthesizing laminin, fi bronectin and chondroitin sulfate. Conclusions Chemically induced decellularisation by Triton or Trypsine resulted in changes in the extracellular matrix constitution, which could lead to problems in valve functionality and cell growth and migration. Seeded endothelial cells were capable of synthesizing extracellular matrix components lost by cell extraction. Further studies on tissue engineering should focus more on the eff ect of chemically induced cell extraction on the extracellular matrix of the remaining scaff old and the in vitro or in vivo replenishment of lost compounds.


The purpose of this paper is to estimate the output cost associated with lowering inflation for Australia. The paper is particularly motivated by a strand of theoretical and empirical evidence in the literature suggesting nonlinearity in the output-inflation relationship, namely, a nonlinear Phillips curve. To accommodate this potentially important departure from linearity, a vector autoregression (VAR) model of output, inflation, and the terms of trade is augmented with logistic smooth transition autoregression specifications. My empirical results indicate that the model captures the nonlinear features present in the data well. Based on this nonlinear approximation, the output costs for reducing inflation are found to vary, depending critically on the state of the economy, the size of intended inflation change, and whether policymakers seek to disinflate or prevent inflation from rising. This implies that inferences based on the conventional linear Phillips curve may provide misleading signals about the cost of lowering inflation and thus the appropriate policy stance.


This Research Support Library guide provides a general resource on research information and will be updated regularly. The Library Subject Guides provide subject specific information and should be used alongside this guide.


Rationale: Iron deficiency, in the absence of anemia, is common in patients with idiopathic and heritable pulmonary arterial hypertension (PAH) and is associated with a worse clinical outcome. Oral iron absorption may be impeded by elevated circulating hepcidin concentrations. The safety and benefit of parenteral iron replacement in this patient population is unclear. Objectives: To evaluate the safety and efficacy of parenteral iron replacement in PAH. Methods: In two randomized, double-blind, placebo-controlled 12-week crossover studies, 39 patients in Europe received a single infusion of ferric carboxymaltose (Ferinject) (1,000 mg or 15 mg/kg if weight <66.7 kg) or saline as placebo, and 17 patients in China received iron dextran (Cosmofer) (20 mg iron/kg body weight) or saline placebo. All patients had idiopathic or heritable PAH and iron deficiency at entry as defined by a serum ferritin <37 μg/L or iron <10.3 μmol/L or transferrin saturations <16.4%. Results: Both iron treatments were well tolerated and improved iron status. Analyzed separately and combined, there was no effect on any measure of exercise capacity (using cardiopulmonary exercise testing or 6-minute walk test) or cardiopulmonary hemodynamics, as assessed by right heart catheterization, cardiac magnetic resonance, or plasma NT-proBNP (N-terminal–pro hormone brain natriuretic peptide) at 12 weeks. Conclusions: Iron repletion by administration of a slow-release iron preparation as a single infusion to patients with PAH with iron deficiency without overt anemia was well tolerated but provided no significant clinical benefit at 12 weeks. Clinical trial registered with ClinicalTrials.gov (NCT01447628).


This paper perceives Romania as an integral part of the Balkan sub-regional security complex and attempts to evaluate the implications of its participation in Balkan affairs on its security. More precisely, the article discusses the effects that the Yugoslav (Croat-Serbian, Bosnian and Kosovar) wars had on Romanian security and presents Bucharest's endeavor to manage its insecurity. The research demonstrates that Romania envisaged the management of its insecurity by upholding its application for membership in Western security structures (NATO, WEU) rather than by institutionalizing Balkan cooperation. Considering that NATO and Yugoslavia were adversaries throughout the 1990s, the paper discusses Bucharest's dilemma of how best to show solidarity with the Atlantic Alliance without impairing its bilateral relations with Belgrade.


Pathology laboratory services are dependent on the laboratory information system (LIS) to organize the work, manage the operation, and communicate the results for effective laboratory medicine. For maximum efficiency, staffing for the LIS should be an integral component of laboratory operations and is facilitated by a two-tier structure. A core LIS staff provides system support and continuous services. A group of bench medical technologists have multitasking responsibilities, including LIS support for a specific laboratory work area. The two components form a team that uses staff efficiently to provide ongoing operational services and flexibility for problem solving and new functionality implementation.


Background and Purpose : Intrapartum period is defined as the period from the diagnosis of labour to one hour after the delivery of the placenta, also known as fourth stage of labour. Information communication during intrapartum management is vital for the continuation of care.  This paper focuses on how the Activity Analysis and Development (ActAD) framework and the Activity-Driven Information Systems Development (AD-ISD) model can be practically used in the analysis of the information communication processes. The practical application for work-oriented information communication research in practice is discussed. The dimensions, levels and phases of the AD-ISD model are elaborated on their application in analysis as a theoretical framework, for information communication by skilled birth attendants during the intrapartum period of pregnancy. Method : The ActAD framework views work activities as an integration of systems with its elements and activity networks forming information communication. Within these levels there are barriers of communication and enablers which require identification in order to enhance work activities. The AD-ISD model then provides methods and techniques for 1) understanding the present state of an activity; 2) describing the goal state of the activity; and 3) planning for the transformation to the goal state through planned changes. Results : We provide an ActAD analysis of the current state of activities during the intrapartum period in a case Maternal and Obstetrics Unit (MOU) in Cape Town, South Africa, focusing particularly on the information communication within the MOU and between the MOU and its referral hospital. We then describe the goal state of the intrapartum activities by applying AD-ISD. The plans of change and the practical application of the model will be elaborated on after the completion of the research data collection. Conclusion : The current engagement results and pilot study experiences have been very reassuring on the applicability of the ActAD framework and the AD-ISD model to analysing the current state and drafting the goal state of information communication in healthcare activities in an African context. Keywords : Activity Theory, Information systems, Intrapartum period, Meaning


Background: Italy is characterized by high prevalence of goiter. To date, only limited data about the prevalence of goiter in the Italian adult population are available. Aim: To investigate the prevalence of thyroid ultrasound abnormalities in adults unaware of any thyroid disease and evaluate the rate of differentiated thyroid cancer (DTC) obtained by this intervention. Methods: Ultrasound (US) thyroid scan was performed in adult volunteers recruited by advertisement in Modena, Italy. One hundred and thirty-five women and 66 men (no.= 201), unaware of any thyroid disease (mean age of 46±10.7 yr) underwent their first thyroid US scan. Results: US thyroid abnormalities were found in 101 subjects (50.3%): 91 nodular goiters (45.2%) and 13 US-thyroiditis (6.5%) associated with positive auto-antibodies in 11 of them. Seventeen subjects (18%) with nodules underwent US-fine needle aspiration biopsy with the following cytological class (C) outcome: 14 patients C2 (82%), 1 patient C3 (6%), 2 patients had C4 (12%), the latter received histological confirmation. Conclusions: The prevalence of thyroid abnormalities is very high in subjects unaware of any thyroid disease. DTC was found in 1% of subjects and in 2% of those affected by nodular goiter. Compared to the detection rate of the well-established screening programs for breast (0.45%) and colorectal (0.27%) cancer, the prevalence of DTC seems to be much higher. Thyroid US screening could allow the detection of DTC in asymptomatic subjects and this diagnosis often includes DTC at an advanced stage. Thus, US screening not necessarily results in the over-diagnosis of clinically not relevant thyroid diseases.


Many countries have established disaster risk management (DRM) systems to reduce disaster risks and improve societal safety. Risk assessment in the DRM system is not only an important tool to identify potential risks, but also promotes DRM through conversations among stakeholders from different functional sectors and administrative levels. The municipal risk assessment, produced at the lowest administrative level of the system, is often expected to fulfill two purposes. One is to meet municipalities' own, local DRM needs, while the other is to contribute to regional and national-level work. This article takes the multi-level, multi-stakeholder, bottom-up Swedish DRM system as a representative example to investigate the perceived challenges and opportunities emerging from the preparation of these dual-purpose assessments. Empirical data were collected through 42 semi-structured interviews and related documentation from 18 local municipalities and six regional authorities in Sweden. The findings, representing perceived challenges and opportunities were categorized into six themes: the focus of municipal RVA work; the template and evaluation criteria for municipal RVAs; municipal RVA work as a continuous process; the dissemination of municipal RVAs; feedback from the county administrative board; and the benefits and drawbacks of municipal RVA work. (Less)


Promotion of products has become an increasingly important component in the new digital age, mostly thanks to digital marketing. The traditional form of marketing is lagging behind digital marketing, which offers users new opportunities like personalized messages or answers to a search query. There are several ways to advertise on the internet, and in this paper, ways and tools will be presented that allow digital advertising as well as their advantages and disadvantages. Specifically, search engine optimization, search engine marketing, display advertising, social networking marketing and e-mail marketing will be discussed. Also, the goal of the paper is to enable more efficient creation and implementation of similar contents in new business environments through an insight into internet advertising, social and business networks.


This article analyzes the impact of social capital on regional economic growth in Spain during the 1985-2005 period. The literature in this context is virtually nonexistent and, in addition, whereas most studies, regardless of their context, have used survey data in order to measure social capital, we use a measure whose construction is based on similar criteria to other measures of capital stock. Compared with more standard measures of social capital and trust, our measure is available with a high level of disaggregation, and with annual frequency for a long time period. Following a panel data approach, our findings indicate that social capital has a positive impact on GDP per capita growth in the context of Spanish provinces, implying that "social features" are important for explaining the differences in wealth one might find across Spanish provinces. We also explore the transmission mechanisms from social capital to growth, finding a highly positive relation between social capital and private physical investment.


Background: The Post-Concussion Symptom Scale (PCSS) is a self-report questionnaire measuring symptoms that commonly occur after a concussion; however, these symptoms are nonspecific and can be related to co-occurring orthopaedic injuries (eg, cervical strain) or patient characteristics and preexisting conditions, even in the absence of a recent injury. As such, clinicians may have difficulty determining whether symptom elevations are attributable to a recent concussion as opposed to a confounding injury or a preexisting condition, which may be especially difficult when preinjury baseline symptom data are unavailable. Purpose: This study aimed to further validate the 4-factor model of the PCSS (ie, cognitive, sleep-arousal, physical, and affective symptoms) with adolescent student-athletes and provide normative reference data for each factor and the total score, stratified by gender and preexisting health conditions. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Participants were 9358 adolescent student-athletes who completed the PCSS during a preseason baseline evaluation (mean age, 14.9 years; SD, 1.3 years [range, 13-18 years]; 49.3% boys). The 4-factor model of the PCSS was tested for the full sample and separately for boys and girls using confirmatory factor analysis. Symptom severity percentiles were created for the PCSS total score and each factor, stratified by gender and preexisting conditions (ie, attention-deficit/hyperactivity disorder, mental health history, headache/migraine history, learning disability/dyslexia, academic problems, and concussion history). Results: The 4-factor model of the PCSS replicated in the full sample (comparative fit index [CFI] = 0.959) and in both gender groups (boys: CFI = 0.961; girls: CFI = 0.960). The total PCSS score at the 84th percentile varied by preexisting conditions as follows: healthy participants = 8, attention-deficit/hyperactivity disorder = 18, mental health history = 26, headache/migraine history = 18, learning disability = 19, and academic problems = 17. On all PCSS subscales, participants with a mental health history had the highest scores, and high scores were associated with having >1 preexisting condition. Girls had higher scores than boys for each stratification. Conclusion: The 4-factor model of the PCSS replicates for adolescent student-athletes. Gender, number of preexisting conditions, and mental health history are important factors to account for when interpreting PCSS symptom severity. The normative data provided herein could assist clinicians in determining whether an adolescent student-athlete is presenting with persistent postconcussion symptoms or a typical symptom experience based on their gender and personal health history.


In Northwestern and Central Spitsbergen geomorphological and botanical data were collected on slope deposits associated with infrequent meteorological events. In hillslope debris flows triggered by heavy rainfall, compact volumes of debris range from 1 to 600 m 3 . Recurrence intervals of major episodes are tentatively estimated from lichenometry at 80 to 500 years. Such debris flows are widespread in Spitsbergen and induce conspicuous geomorphological effects. Nevertheless, typical levees and lobes are small-sized because of the thinness of permafrost and they rarely survive more than one century. In contrast, catastrophic slush avalanches mobil ize 1300 to 7000 m 3 of rock debris every 500 years, forming long boulder tongues and fans. Such accumulations can been observed in much more restricted sites. In Central Spitsbergen at least three generations of slush avalanche deposits have been identified and lichenometry suggests that such boulder tongues survive for at least 2000 years. So the geomorphic impact of sporadic slush avalanches appears much more important than the effects of recurrent spring snow avalanches which d o not generate original and long-lasting landforms. Botanical studies show that investigations of saxicolous l ichen communit ies allow more reliable chronological reconstructions than observations of phanerogamic and bryophytic vegetation cover. Rhizocarpon diameters are partly interpreted from growth curves from Baffin Island and North Alaska. The results will be refined when a curve is published for Spitsbergen. Nevertheless, recurrence intervals proposed here seem to be consistent and are fruitfully compared with previous evaluations from Swedish Lappland and Colorado. K e y w o r d s : Arctic, Spitsbergen, geomorphology , l ichenometry.


The aim of this research is to study the behavior of flexible pavement under wheel and thermal loading conditions using the finite element program ANSYS V (5.4). The stress states distribution within the asphalt concrete pavement that influence the direction of crack propagation have been investigated. The obtained results from ANSYS finite element program show that a maximum stress intensity factor value obtained at surface and then decrease with depth about (0.75 of asphalt layer thickness) due to reduction in temperature in asphalt layer, which indicates that crack will initiate at surface and extend throughout asphalt layer. The horizontal stress for both top and bottom layers increase with the variation of thermal coefficient expansion factor. High values of stresses at top surface of asphalt layer due to high contact stress were induced under wheel and thermal load conditions. As a result the highway pavement exhibited propagation of surface -initiated cracks. Field observation of cores extracted from asphalt concrete pavement confirmed the obtained results.


Air quality networks need revision and optimisation as instruments and network requirements, both scientific and societal, evolve over time. Assessing and optimising the information content of a monitoring network is a non-trivial problem. Here, we introduce a methodology formulated in a variational framework using an air quality model to simulate the dispersion of carbon monoxide (CO) as a passive tracer at the city scale. We address the specific case of adding or removing stations, and the more general situation of optimally distributing a given number of stations in a domain taking into account transport patterns and spatial factors such as population density and emission patterns. We consider three quality indicators: precision gain, information gain and degrees of freedom for a signal. These metrics are all functions of the singular values of the sensitivity matrix that links emissions and observations in the variational framework. We illustrate the application of the methodology in the case of Santiago (33.5°S, 70.5°W, 500 m a.s.l.), a city of ca. 7 million inhabitants with significant pollution levels. We deem information gain as the best of the above indicators for this case. We then quantify the actual evolution of Santiago's network and compare it with the optimal configuration suggested by our methodology and with results previously obtained using a statistical approach. The application is restricted to diurnal and summer conditions, for which the dispersion model shows a good agreement with observations. The current method offers advantages in that it allows extending a network to include new sites, and it explicitly considers the effects of dispersion patterns, and desired weighting functions such as emission fluxes and population density. We find that Santiago's air quality has improved two-fold since 1988, regarding CO under diurnal summer conditions. Still, according to our results, the current configuration could be improved by integrating more suburban stations in the southwest of the basin.


We present a new general-equilibrium behavioural microsimulation model designed to assess long-run macroeconomic and fiscal consequences of reforms to the tax and transfer system. General-equilibrium feedback effects are simulated by embedding microsimulation in a parsimonious macro model of a small open economy. We estimate and calibrate the model to Hungary, and then perform three sets of simulations. The first one explores the impact of personal income tax rate reductions which are identical in cost but different in structure. The second one compares three different tax shift scenarios, while the third one evaluates actual policy measures between 2008 and 2013. The results suggest that while a cut in the marginal tax rate of high-income individuals may boost output, it does not have a significant employment effect. On the other hand, programs like the Employee Tax Credit do have a significant employment effect. We find that policy measures since 2008 substantially increase income inequality in the long run; the contribution of the changes after 2010 are about three times that of the changes before 2010. Our results highlight that taking account of household heterogeneity is crucial in the analysis of the macroeconomic effects of tax and transfer reforms.


This research project examines the nature of pictorial space
within contemporary painting. It proposes, through the use of a
studio-based investigation, a new condition of spatial
construction that has been interpreted through the
representational methodologies of the screen. It argues that the
screen has become a dominant paradigm in the creation and
articulation of an ambivalent condition of spatiality. This
ambivalent condition is suggested in a body of painterly works as
a closed cycle of movement in which objects and detail are
dislocated within/on the pictorial plane whilst concurrently
grounded in an illusion of reality. This project also establishes a
perception of anxiety and spatial unease as being indicative of
contemporary experience. This is instituted through the concept
of something being a guise for "Nothing" and "Nothing" being a
comment on contemporary experience. It argues that the
something of "Nothing" is also a context for "otherness". The
principle vehicle for this investigation is the inanimate figurine
(toy soldier). It is used, within this context, as a paradoxical
object from popular culture; it alludes to the current climate of
unrest and quotes from propaganda imagery and other military
representations within visual culture. The analysis of pictorial space
 was initiated through observation
and interpretation of painting practices and it was within this
examination that a definition of the screen was located. The
screen is defined as a methodology of literal and metaphorical
representations that are part of an on-going evolution in pictorial
construction. These practices are discussed under the related
areas of the flat/deep space of the screen; the screen as a literal
painterly boundary; and the screen as a metaphorical barrier.
Other issues that are considered here are a re-definition of
flatness; the allusion to "otherness" ; and the perception of anxiety
and unease in contemporary painting. This research has
developed practical strategies that contextualize these issues by
subverting traditional notations of figure/ground relationships.
They include both technical and conceptual applications such as
the concurrent use of a variety of spatial paradigms, decoration
(camouflage patterning), the cut-out silhouette, an original paint
surface (the mica glaze/ pearl surface) and an overall sense of
spatial compression within the pictorial plane.


Floods and droughts—the most frequent water-related hazards are negatively impacting livelihoods across the world, particularly in Sub-Saharan African countries, where poverty remains endemic. Naturally, victims adopt different coping strategies against burgeoning hydro-meteorological hazards. Contemporary research on determinants for coping decisions in SSA has been largely driven by isolated case studies, of little relevance for broad-based policy making. We analyze the determinants for coping with floods and droughts across multiple geo-eco-logical zones in Cameroon. Quantitative data primarily obtained from 2024 flood and drought household victims in the Western Highlands and Sudano-Sahelian Upland geo-ecological zones are analyzed alongside qualitative data obtained through 31 FGDs and 99 IDIs using descriptive statistics and regression analysis in MS Excel 2013 and SPSS 20 for the questionnaires and content analysis in Nvivo 11 for the unstructured interviews. Results reveal government policy, socio-cultural, economic and educational factors, and hazard experience as major shapers of coping decisions, irrespective of hazard type, timing and geo-ecology ( P = 0.05). In contrast to the state-of-the-art, we observed livelihoods improvement after some hazardous events. The policy implications for long-term coping and resilience building are then discussed.


Objective To assess body shape trajectories in early and middle life in relation to risk of mortality. Design Prospective cohort study. Setting Nurses' Health Study and Health Professionals Follow-up Study. Population 80 266 women and 36 622 men who recalled their body shape at ages 5, 10, 20, 30, and 40 years and provided body mass index at age 50, followed from age 60 over a median of 15-16 years for death. Main outcome measures All cause and cause specific mortality. Results Using a group based modeling approach, five distinct trajectories of body shape from age 5 to 50 were identified: lean-stable, lean-moderate increase, lean-marked increase, medium-stable/increase, and heavy-stable/increase. The lean-stable group was used as the reference. Among never smokers, the multivariable adjusted hazard ratio for death from any cause was 1.08 (95% confidence interval 1.02 to 1.14) for women and 0.95 (0.88 to 1.03) for men in the lean-moderate increase group, 1.43 (1.33 to 1.54) for women and 1.11 (1.02 to 1.20) for men in the lean-marked increase group, 1.04 (0.97 to 1.12) for women and 1.01 (0.94 to 1.09) for men in the medium-stable/increase group, and 1.64 (1.49 to 1.81) for women and 1.19 (1.08 to 1.32) for men in the heavy-stable/increase group. For cause specific mortality, participants in the heavy-stable/increase group had the highest risk, with a hazard ratio among never smokers of 2.30 (1.88 to 2.81) in women and 1.45 (1.23 to 1.72) in men for cardiovascular disease, 1.37 (1.14 to 1.65) in women and 1.07 (0.89 to 1.30) in men for cancer, and 1.59 (1.38 to 1.82) in women and 1.10 (0.95 to 1.29) in men for other causes. The trajectory-mortality association was generally weaker among ever smokers than among never smokers (for all cause mortality: P for interaction <0.001 in women and 0.06 in men). When participants were classified jointly according to trajectories and history of type 2 diabetes, the increased risk of death associated with heavier body shape trajectories was more pronounced among participants with type 2 diabetes than those without diabetes, and those in the heavy-stable/increase trajectory and with a history of diabetes had the highest risk of death. Conclusions Using the trajectory approach, we found that heavy body shape from age 5 up to 50, especially the increase in middle life, was associated with higher mortality. In contrast, people who maintained a stably lean body shape had the lowest mortality. These results indicate the importance of weight management across the lifespan.


Atherosclerosis is a disease with a chronic-progressive course. We report on the statistic prevalence of vascular lesions in 1,500 asymptomatic patients with vascular diseases examined with Computed Tomography (CT) for different reasons. The aortoiliac arterial district was involved in 934/1,500 patients (62.3%), with simple or calcified plaques, thrombosis or dilatations. We investigated the involvement of other arterial vessels (47%) whenever feasible (57.7% of cases). The aorta was thrombosed in 107 patients (2.8%) and the thrombus associated with a calcification and a dilated vessel in 45 of them (42.1%). The aorta or the iliac arteries were enlarged in 62 patients (4.1%) and arterial diameter exceeded 4 cm in 20 patients (1.3%). Finally, the statistical significance was analyzed considering risk factors-i.e., smoking, arterial hypertension, diabetes and hypolipoproteinemia. All the patients with 2 or more risk factors had positive CT findings; the prevalence was 75% in cigarette smokers, 83% in hypertensive, 81.3% in dislipidemic and 93.5% in diabetic patients. These data demonstrate that, in agreement with international literature reports, it is possible to single out the groups of patients that, because of their age, risk factors and sex, should be considered for color Doppler screening programs and the selected cases to be submitted to CT.


Author(s): Chen, Linchun | Abstract: My doctoral dissertation aims to study several issues on identification and weak identification, with applications in linear instrumental variables (IV) models and transformation models. Chapter 1 is joint with Patrik Guggenberger, Frank Kleibergen and Sophocles Mavroeidis, which considers tests of a simple null hypothesis on a subset of the coefficients of the exogenous and endogenous regressors in a single-equation linear IV model with potentially weak identification. Existing methods of subset inference (i) rely on the assumption that the parameters not under test are strongly identified, or (ii) are based on projection-type arguments. We show that under homoskedasticity the subset Anderson and Rubin (1949) test, which replaces unknown parameters by limited information maximum likelihood (LIML) estimates has correct asymptotic size without imposing additional identification assumptions, but that the corresponding subset Lagrange multiplier (LM) test is size distorted asymptotically. Subsequently, Chapter 2, joint with Qihui Chen and Patrik Guggenberger, derives the asymptotic size of the corresponding subset LM test, and shows it is size distorted. We provide the smallest nonrandom size corrected (SC) critical value that ensures that the resulting "SC subset LM test" has correct asymptotic size. We introduce an easy to implement generalized moment selection plug-in SC subset LM test ("GMS-PSC subset LM test" from now on) that uses a data-dependent critical value that gives correct asymptotic size. Chapter 3 focuses on transformation models. It provides sufficient conditions for transformation models with endogenous regressors H(Y) =X[beta]+U to be identified under conditional moment restrictions, E(U/Z)=0, where Z is the IV for X. Allowing observables (X, Y, Z) and unobservable U to be high-dimensional, we show that the assumption of completeness suffices for identification. Based on the identification results, we propose to apply the penalized sieve minimum distance estimator (ĥ[beta] in Chen and Pouzo (2009) with possible shape constraints to estimate (ĥ[beta]. Demand model of differentiated products markets is considered as an application of transformation models, and we provide the identification and PSMD estimation results for its parameters


The respiratory activity of quiet and sleeping healthy infants has been studied by pneumographic tracings and by clinical observations. Four successive stages of respiration have been described through which all healthy, full term newborn infants pass.
 The first stage is concerned with the establishment of postnatal respirations and lasts for a few minutes following birth.
 The second stage lasts from several hours to a day or more. Respiratory activity is characterized by a wide range of rates, a regular rhythm and a single respiratory pattern, to which the term "synchronous" has been given. The term is based on the fact that all parts of the chest and abdomen expand and contract together in an easy, smooth and regular fashion. Any signs of chest retraction indicate that the infant either is not well or has passed into the third stage.
 The third stage lasts several days or weeks. Infants in this stage exhibit rapidly fluctuating rates, variable rhythms and a wide variety of respiratory patterns. Two of the common patterns seen in this stage have been given the terms "simple retraction" and "see-saw." In simple retraction the lower end of the sternum and adjacent costal margins are pulled inwards as the abdomen and upper chest expand. In "see-saw" breathing the whole anterior chest wall is pulled inwards and downwards as the abdomen expands. There is much shifting back and forth from one pattern to another.
 The fourth stage begins several weeks after birth and is characterized by a return to more stable rhythms and respiratory patterns. All previous bizarre patterns have disappeared leaving "synchronous" and "simple retraction" as the only patterns of breathing.
 The same four stages of respiration have been identified in a small group of surviving premature infants.
 Knowledge of these stages has made it possible to give a more accurate prognosis during the first 24 hours of life on the infant's chances for survival The absence of retraction during stage 2 has been associated with an excellent prognosis for the infant. The presence of any degree of retraction in the first 24 hours of life, except as it may occur in the first few minutes after birth, has been associated with serious illnesses in the infants in the small series of cases observed to date.
 Factors which might explain the presence of stages 2, 3 and 4 have been explored only partially. One of the factors involved in the change from stages 2 to 3 is the increasing vigor of diaphragmatic contractions.


Internet Distributed Denial of Service (DDoS) at- tacks are prevalent but hard to defend against, partially due to the volatility of the attacking methods and patterns used by attackers. Understanding the latest DDoS attacks can provide new insights for effective defense. But most of existing understandings are based on indirect traffic measures (e.g., backscatters) or traffic seen locally. In this study, we present an in-depth analysis based on 50,704 different Internet DDoS attacks directly observed in a seven-month period. These attacks were launched by 674 botnets from 23 different botnet families with a total of 9,026 victim IPs belonging to 1,074 organizations in 186 countries. Our analysis reveals several interesting findings about today's Internet DDoS attacks. Some highlights include: (1) geolocation analysis shows that the geospatial distribution of the attacking sources follows certain patterns, which enables very accurate source prediction of future attacks for most active botnet families, (2) from the target perspective, multiple attacks to the same target also exhibit strong patterns of inter-attack time interval, allowing accurate start time prediction of the next anticipated attacks from certain botnet families, (3) there is a trend for different botnets to launch DDoS attacks targeting the same victim, simultaneously or in turn. These findings add to the existing literature on the understanding of today's Internet DDoS attacks, and offer new insights for designing new defense schemes at different levels.


This study evaluates the effect of the long acting somatostatin analogue octreotide on biochemical and clinical parameters of endoscopic retrograde cholangiopancreatography (ERCP) induced pancreatitis. Altogether 245 patients were randomised to receive either octreotide or isotonic saline. Octreotide (100 micrograms) was administered intravenously five minutes before ERCP and subcutaneously 45 minutes after ERCP. There were no significant differences in the median serum amylase and lipase activities at baseline, eight, and 24 hours after ERCP. Five patients (2%) developed clinical pancreatitis--three in the octreotide and two in the placebo groups. Excluding patients who developed pancreatitis, 43 (18%) developed abdominal pain after ERCP--21 in the octreotide and 23 in the placebo groups. There were no significant differences in the median serum amylase and lipase values between the treatment groups. None of the 52 patients who had therapeutic interventions developed pancreatitis. This study suggests that octreotide may not protect against ERCP induced pancreatitis.


This quality improvement project implemented bedside handover in nursing. Using Lewin's 3-Step Model for Change, three wards in one Australian hospital changed from verbal reporting in an isolated room to bedside handover. Practice guidelines and a competency standard were developed. The change was received positively by both staff and patients. Staff members reported that bedside handover improved safety, efficiency, teamwork and the level of support from senior staff members.


ABSTRACT White terns (Gygis alba) are common on many islands in the tropical and subtropical Pacific, Atlantic, and Indian oceans, but in the southeastern Hawaiian Islands they are found only on Oahu, where they are listed as threatened by the State of Hawaii. In 2016, we censused the White Tern population on Oahu, mapped their distribution, and investigated their breeding biology. The total White Tern population on Oahu was 2,308 birds, including 1,408 breeders and ∼900 nonbreeders. The number of White Terns on Oahu has increased 282% since the previous census in 2002, for an average annual population growth rate of 7.7%. We observed White Terns only in urban and suburban areas of Honolulu and not in other parts of the island. Breeding occurred year-round, with 2 peaks in egg-laying in March and October. Hatching success was 69%, fledging success was 83%, and overall breeding success was 57%. Pairs made an average of 1.75 (SE 0.09) breeding attempts per year and produced an average of 1.08 (0.09) offspring per year (range 0–3). Terns used >58 tree species for breeding and roosting, most of which were large (>45 cm diameter). Average height in trees of breeding attempts was 9.1 (0.2) m. White Terns are thriving in urban Honolulu and are not seriously affected by numerous potential sources of human disturbance or predation from nonnative mammals, but some efforts will help to ensure their status remains secure. Received 7 July 2017. Accepted 6 January 2018.


Fire is a fundamental disturbance process in ecology and has been a powerful agent of change in terrestrial ecosystems for millions of years. Understanding the role of fire on a landscape is critical for managing fire and forests for biodiversity, ecosystem function, and resilience to changes in climate. To better understand the role fire can play in forests today, researchers and managers have found it useful to reconstruct attributes of historical fire regimes before the onset of fire exclusion. Fire exclusion in the southwestern United States often occurred in the late 1800s, when activities such as grazing of domestic animals, logging, and fire suppression began on a widespread scale. Information about past fire regimes can be a helpful reference to guide and inform land managers about current and future fire regime characteristics, patterns, and forest structure characteristics. Management activities that benefit from understanding past fire regimes include prescribed fire, managed wildfires for resource benefit, and mechanical treatments to reduce fire risk. Six fire regime attributes are often considered: - Frequency: how often fires occur in a given area or region (see Box 1 for more detailed frequency terminology) - Seasonality: time of year - Severity: ecological effects of fire - Type: surface or crown fire - Size: area burned - Spatial complexity: pattern of severity within fire perimeter Fire intensity, which is a measure of the heat of a fire, is a seventh fire regime attribute that cannot be reconstructed directly but is inferred from fire severity. Fire severity refers to the ecological effects of fire and is often quantified by overstory tree mortality. Each fire regime attribute can be characterized by an average condition (for example, an average fire frequency of 8 years) as well as a measure of variation (for example, a range in fire frequency of 2 to 20 years). This working paper discusses several methods for reconstructing historical fire regimes: - Historical documents and photos - Dendrochronology: re-scar data - Dendrochronology: tree age, death and growth data - Forest structure data - Plant traits - Charcoal Each of these methods will be discussed in terms of advantages, disadvantages, inherent uncertainties, and assumptions as well as temporal and spatial precision. The potential value and limitations for reconstructing historical forest structure and composition with each method are also briefly covered.


Traditional geometry-based approach can maintain the characteristics of vector data. However, complex interpolation calculations limit its applications in high resolution and multi-source spatial data integration at spherical scale in digital earth systems. To overcome this deficiency, an adaptive integration model of vector polyline and spherical DEM is presented. Firstly, Degenerate Quadtree Grid (DQG) which is one of the partition models for global discrete grids, is selected as a basic framework for the adaptive integration model. Secondly, a novel shift algorithm is put forward based on DQG proximity search. The main idea of shift algorithm is that the vector node in a DQG cell moves to the cell corner-point when the displayed area of the cell is smaller or equal to a pixel of screen in order to find a new vector polyline approximate to the original one, which avoids lots of interpolation calculations and achieves seamless integration. Detailed operation steps are elaborated and the complexity of algorithm is analyzed. Thirdly, a prototype system has been developed by using VC++ language and OpenGL 3D API. ASTER GDEM data and DCW roads data sets of Jiangxi province in China are selected to evaluate the performance. The result shows that time consumption of shift algorithm decreased about 76% than that of geometry-based approach. Analysis on the mean shift error from different dimensions has been implemented. In the end, the conclusions and future works in the integration of vector data and DEM based on discrete global grids are also given.


This thesis uses an empirically informed Marxist analysis to investigate the role of interests, consciousness and unpaid activity of refugees and asylum seekers in shaping their relationships with the British state, including case studies from the city of Newcastle upon Tyne. I argue that antagonism between the British state and refugees from economically underdeveloped countries is rooted in capitalist relations of production, with Britain occupying an imperialist position. The thesis advances a novel perspective on 'social capital', understood as purposive and sustained forms of non-contractual engagement, with implicit norms and values. Social capital is 'unmasked' as a way of understanding and intervening in relations at an individual level, in order to influence change at a social level. I argue that the tendency of recent Labour governments' policy has been to break up social capital formations among refugees which are seen as threatening, whilst actively cultivating formations which engage refugees on an individual basis, as part of managing their oppression. The thesis identifies contradictions and possibilities for resistance within this process, such as simultaneous tendencies for volunteering to contribute to more collective forms of identity and more individualised forms of action.

The multi-level research design explores processes connecting the individual to the global. Empirical data is used to interrogate and develop a theoretical framework which is rooted in classical Marxism, draws on insights developed within qualitative social research methods and anti-oppressive practice, and engages creatively with challenges from post-modernism and feminism. The methodology combines: theoretical research; secondary statistics and literature at an international level; interviews with key participants and archival research on local histories of migration and settlement, including three organisational case studies; four contemporary organisational case studies; and individual volunteer case studies based on semi-structured interviews and focus groups with eighteen refugees and asylum seekers.


Genetic diseases remain an important cause of ailment, morbidity and death for children and adults. Despite the recent advances of tools for molecular diagnosis such as DNA chips and protein arrays which are capable of analyzing many genes, SNPs and proteins, few of these systems have been applied in clinical diagnosis because the apparatus are still expensive and many of the genetic tests are less likely to be developed commercially. Hence most genetic tests are still being performed through conventional methods such as Dot-Blot hybridization and Slot-blot hybridization in clinical laboratories worldwide. The expensive, time consuming and labor-intensive nature of these tests make them unaffordable for popular use. The availability of a low-cost diagnostic system will make molecular testing cost efficient and become readily available worldwide. In this report, we evaluated the Flow-through hybridization system. Our results show that Flow-through hybridization method produces higher sensitivity in 5 to 15 minutes compared to those obtained through conventional hybridization in hours to overnight respectively without sacrificing specificity. An apparatus can also be readily adopted for membrane-based home-brew tests, R&D development as well as other commercially available diag- nostic kits, hence making the Flow-through method a useful tool for molecular diagnosis.


Abstract Objectives: Quarantine lockdown enforced for a long duration of time during the Corona pandemic added strain upon families; the educational system has been closed, children were forced to remain at home, and many parents lost their jobs. The aim of the study was to find out the impact of lockdown periods on middle-class parent-child relationship in terms of parental aggressive behaviors. Method: The convenient sample consisted of 236 parents to children (age ranged from 3- to 16). Recruitment was conducted through social media. Following signing a consent form, participants filled a self-report anonymous questionnaire that included demographics, Center for Epidemiologic Studies Depression Scale, The Conflict Tactics Scale pre and during lockdown periods, and, The Parent Strain Scale during lockdown period. Results: Findings indicated an increase of depression level among parents who had higher levels of depression pre- Corona. Additionally, secular parents younger than 36 years old, who lost their jobs, had more than two children, and, had higher levels of depression, showed increase in emotional aggressive tactics behaviors towards their children.


In this paper, TOPAS-a new parallel programming environment for distributed systems-is presented. TOPAS automatically analyzes data dependence among tasks and synchronizes data, which reduces the time needed for parallel program developments. TOPAS also provides supports for scheduling, dynamic load balancing and fault tolerance. Experiments show simplicity and efficiency of parallel programming in TOPAS environment with fault-tolerant integration, which provides graceful performance degradation and quick reconfiguration time for application recovery.


This paper is concerned with the detection of bone fragments embedded in de-boned skinless chicken breast fillets by modeling images made by back-lighting and embedded bone fragments. Imaging of chicken fillets is often dominated by strongly multiple scattering properties of the fillets. Thus, resulting images from multiple scattering are diffused, scattered and low contrast. In this study, both transmittance and reflectance hyperspectral imaging, which is a nonionized and non-destructive imaging modality, is investigated as an alternative method to the conventional transmittance X-ray imaging technique which is an ionizing imaging modality. As a way of reducing the influence of light scattering on images and thus increasing the image contrast, the use of a structured line light is examined along with an image formation model that separates undesirable lighting effects from an image. The image formation model based on an illumination-transmittance model is applied for correcting non-uniform illumination effects so that embedded bones are more easily detected by a global threshold. An automated image processing algorithm to detect bones is also proposed. Experimental results with chicken breast fillets and bone fragments are provided.


Background: An increasing numbers of studies show low diversity of the gut microbiome in those with chronic diseases such as obesity, inflammatory bowel disease, and allergy. Manipulation of the microbiota may promote health. However, the adult microbiota is stable and may be difficult to change. Understanding the fixed and modifiable factors which determine colonisation in early life may provide strategies for acquisition of a healthpromoting microbiome. Summary: Not enough is known about the long-term effects of established determinants of gut colonisation, including delivery mode, perinatal antibiotics and infant diet. It has been suggested that weaning onto solid diet containing non-digestible carbohydrates and cessation of breastfeeding are key stages in the colonisation process. In addition, the microbiome of the placenta, amniotic fluid and breast milk, alongside vaginal and faecal bacteria, may aid the transfer of maternal bacteria to the infant. However, methodological issues such as contamination during collection and/or analysis should be considered. Key messages: The factors determining early colonisation are becoming more evident. However, longitudinal studies of microbiome maturation into late childhood and adulthood are required. The nutrition and health status of the mother before, during and after birth may be major factors in the early colonisation of the infant.


Methacrylic Acid is an organic acid used at concentrations between 50 and 88 percent to pretreat the nail and maximize the adhesion between the nail and artificial nail extender. Methacrylic Acid is readily absorbed through mucous membranes of the lungs, the gastrointestinal tract, and the skin; and is distributed to all major tissues. Oral LD50 values for rats ranged from 277 to 2260 mg/kg; acute toxicity symptoms included severe gastric irritation, gasping, labored respiration, prostration and hematuria. In a short-term inhalation study, rats exposed to Methacrylic Acid at 1300 ppm showed nose and eye irritation and weight loss, while necropsy results and blood and urine tests were normal. Methacrylic Acid is an ocular toxicant in animals. Undiluted Methacrylic Acid is corrosive to the skin of rabbits and guinea pigs. Exposure as limited as 3 minutes can cause severe erythema and slight to moderate edema. Exposure from 15 minutes to 24 hours under occlusive patches can cause marked to severe discoloration, slight to severe subcutaneous hemorrhages, necrosis, ulcerations, severe erythema, edema and concave eschar. Methacrylic Acid was irritating and caused strong rubefaction and scab formation in a guinea pig maximization test at challenge concentrations from 10 to 100 percent. It was difficult to determine if the results were type IV hypersensitivity reactions or simple irritation. In three other studies, guinea pigs were not sensitized. Methacrylic Acid was not a reproductive/developmental toxicant in rats or mice. Methacrylic Acid was negative in Salmonella typhimurium mutagenicity tests using strains TA98, TA100, TA1535 and TA1537 both with and without metabolic activation, but was positive in a DNA-cell-binding assay. Case reports involving Methacrylic Acid often involve children. Effects from ingestion include drooling, gagging, and vomiting. Children exposed to Methacrylic Acid as a result of accidental spills caused first and second degree burns to the eyes, face, hands, arms, and chest. The Consumer Product Safety Commission has required child-resistant packaging for liquid household products containing more than 5 percent Methacrylic Acid (weight-to-volume) in a single package. Since Methacrylic Acid is an extremely corrosive chemical, a primary concern about its use as a cosmetic ingredient was the ability to limit exposure to the nail when pretreating the nail prior to application of an artificial nail extender. A videotape presentation demonstrated that a trained professional could use a small applicator brush to dab a limited volume of Methacrylic Acid only to the center of the nail, allowing the monomer liquid to diffuse down the nail without any exposure to the skin. There were no available data to demonstrate that an individual consumer could apply Methacrylic Acid and avoid inadvertent skin contact. In order to minimize any exposure to the acid, the Expert Panel concluded that nail primers containing Methacrylic Acid could be


Introduction: Timing of atrial, right (RV), and left ventricular (LV) stimulation in cardiac resynchronization therapy (CRT) is known to affect electrical activation and pump function of the LV. In this study, we used computer simulations, with input from animal experiments, to investigate the effect of varying pacing delays on both LV and RV electrical dyssynchrony and contractile function. Methods: A pacing protocol was performed in dogs with atrioventricular block (N = 6), using 100 different combinations of atrial (A)-LV and A-RV pacing delays. Regional LV and RV electrical activation times were measured using 112 electrodes and LV and RV pressures were measured with catheter-tip micromanometers. Contractile response to a pacing delay was defined as relative change of the maximum rate of LV and RV pressure rise (dP/dtmax) compared to RV pacing with an A-RV delay of 125 ms. The pacing protocol was simulated in the CircAdapt model of cardiovascular system dynamics, using the experimentally acquired electrical mapping data as input. Results: Ventricular electrical activation changed with changes in the amount of LV or RV pre-excitation. The resulting changes in dP/dtmax differed markedly between the LV and RV. Pacing the LV 10–50 ms before the RV led to the largest increases in LV dP/dtmax. In contrast, RV dP/dtmax was highest with RV pre-excitation and decreased up to 33% with LV pre-excitation. These opposite patterns of changes in RV and LV dP/dtmax were reproduced by the simulations. The simulations extended these observations by showing that changes in steady-state biventricular cardiac output differed from changes in both LV and RV dP/dtmax. The model allowed to explain the discrepant changes in dP/dtmax and cardiac output by coupling between atria and ventricles as well as between the ventricles. Conclusion: The LV and the RV respond in a opposite manner to variation in the amount of LV or RV pre-excitation. Computer simulations capture LV and RV behavior during pacing delay variation and may be used in the design of new CRT optimization studies.


The open-ended, coaxial-line probe technique can be used to obtain estimates of the permittivities of some solid dielectrics over broad ranges of frequency by measurements on powdered or pulverized samples, but certain limitations must be recognized. Such a probe was used with a network analyzer to estimate the permittivities of coal and limestone from reflection coefficients measured on pulverized samples. The bulk density of the pulverized samples for the coaxial probe measurements was determined from auxiliary, single-frequency permittivity measurements on the samples at known bulk densities, and the permittivities of the solid materials over the frequency range from 0.2 GHz to 20 GHz were then estimated by computations based on the Landau and Lifshitz, Looyenga dielectric mixture equation and solid material densities.


AbstractThis paper reports on the link between Navajo Police Officers' feelings of spirituality and the manner in which they tend to enforce European-based law. The enforcement behavior of Navajo Police Officers is used as indicators of the intensity of their feelings concerning the usefulness of traditional versus European-based forces of social control. The underlying assumption being tested is that self-determination is not only a state of law but a state of psychological being. Previous research suggests that a link exists between the Navajo Officers' depth of feeling of spirituality and the officers' attitude toward the effectiveness of the traditional methods of social control, particularly peacemaking as it has been reintroduced to the Navajo Nation. A snowball method of sample development was used to select officers for intensive interviews. The findings suggest that the officers' feelings of spiritual connectedness to their culture is inversely related to the strictness of their enforcement of Eu...


BACKGROUND
Visceral leishmaniasis is potentially fatal protozoan diseases caused by Leishmania donovani. Nepal is an endemic region in which visceral leishmaniasis causes a major public health problem in the lowland areas that border the endemic areas of Bihar state in India. Accurate diagnosis to inform treatment is a first step in achieving the goal of visceral leishmaniasis elimination from South East Asian regions by 2020.

OBJECTIVE
The objective of the present study was to compare between the Microcopy and polymerase chain reaction for diagnosis of visceral leishmaniasis.

METHODS
In the present study, 236 bone marrow aspirations were collected from suspected visceral leishmaniasis patients in Janakpur Zonal Hospital, Dhanusa district, Terai region of Nepal in between 2003-2007. We evaluated bone marrow samples by microscopic examination with subsequent testing of the same sample by polymerase chain reaction and sequence analysis.

RESULTS
Giemsa's solution stained bone marrow slides stored for over five years were used for polymerase chain reaction amplification. The result showed that 71% were polymerase chain reaction positive and 56% were microscopic positive. Out of 104 microscopic negative bone marrow samples, 15% of samples were positive by polymerase chain reaction.

CONCLUSION
Polymerase chain reaction could make a very good option for diagnosis by using less or non-invasive material from visceral leishmaniasis patients in endemic areas of Nepal.


In Brazil, homeopathic medicines are prepared according to the Homeopathic Pharmacopeia, regulated by ANVISA. Among several categories of medicines, there is the biotherapic group, which is prepared from etiologic agents. In this study, we developed a biotherapic from influenza A virus, aiming the influenza infection prevention. Influenza is a disease that affects thousands of people worldwide every year, with an important economic impact, what motivates the development of new low cost therapies. The H3N2 biotherapic developed in this study was administered to Balb/c mice to evaluate their immune response to viral specific antigens and behavior (homeopathic proving). Sixty-two 4 weeks old Balb/c mice were divided into five experimental groups (n=14 per group), after approval by the Ethics Committee of Animal Use (Protocol DFBCICB 037) and stimulated daily, blindly, with 1% (v/v) different homeopathic medicines, for a maximum period of 42 days. The tested medicines were: biotherapic 30x prepared from inactivated influenza A virus; biotherapic 30x prepared with infectious influenza A virus; and thymulin 5cH, a thymus hormone. The two control groups were treated with water 30x and nothing (baseline group). After 21 days of treatment, half of the animals from each group was challenged subcutaneously with the viral hemagglutinin antigen (7 mg / 200 mL) and monitored by 21 days further, to evaluate the humoral immune response and general behavior, using an open field device. The remaining animals were evaluated by the same behavioral tests at the end of the first 21 days, as an attempt to define the proving features. After euthanasia, all animals were autopsied and the spleen, lungs, heart and mediastine lymph nodes were weighed. Histometry of the spleen follicles was also made. Histopathological and behavioral analyses showed absence of behavioral effects, however, there was increase of spleen lymphoid follicles diameter in immunized animals treated with thymulin and with the biotherapic prepared from infectious influenza A, when compared to the control group. This experiment is being repeated using flow cytometry to complete the analysis and confirm the results.


IgA nephropathy, the most prevalent form of primary glomerular disease, usually portends a favourable outcome. Antineutrophil cytoplasmic autoantibodies (ANCAs) have been reported in association with IgA nephropathy in a small subset of patients, mostly presenting with rapidly progressive glomerulonephritis and necrotising crescentic lesions. Herein, we describe a case of IgA nephropathy, positive serum cytoplasmic and perinuclear ANCAs with anti-myeloperoxidase antibody, and preserved renal function without any histological evidence of necrotising or crescentic glomerulonephritis. Based on available mechanistic and clinical data, we opine that such patients could benefit from close monitoring of renal function.


Concerns about a global decline in pollinators have called for more knowledge about the drivers of wild pollinator abundance and diversity. In this study we observed pollinator foraging activity in 27 field margins, from 2014-2016, in order to investigate the role of native weeds in supporting wild pollinators in Mediterranean cereal agroecosystems. In total, 175 different plant species were identified and 1,959 wild pollinators were observed foraging on margin flora. The most visited floral species were Papaver rhoeas L. (251 pollinator visits), Torilis arvensis (Huds.) (229 visits) and Malva sylvestris L. (141 visits). Pollinator abundance increased with flower abundance, vegetation height and floral diversity. Pollinator visits increased initially with open flower richness, but began to decrease when high richness likely resulted in lower densities of individual species.


Purpose: DNA methylation plays major regulatory roles in gene transcription. Our previous studies con fi rmed that Ki-67 promoter is hypomethylated and Sp1 is a transcriptional activator of Ki-67 gene in cancer cells. However, whether Sp1-mediated transcriptional activation of Ki-67 is related to its methylation has not been studied yet. Materials and methods: In this study, we con fi rmed that methylated CpG binding protein 2 (MBD2) binding to methylated DNA hindered the binding of Sp1 to Ki-67 promoter and then repressed Ki-67 transcription through chromatin immunoprecipitation (ChIP) and quantitative real-time PCR (qRT-PCR). Co-immunoprecipitation (Co-IP), ChIP, methylation-speci fi c PCR (MS-PCR) and Western blot were utilized to analyze the effects of Sp1 binding to Ki-67 promoter on its methylation status. Less DNA methyltransferase 1 (DNMT1) bound to the Ki-67 promoter in MKN45 cells than in HK-2 cells. Histone acetyltransferase p300 that was recruited by Sp1 to Ki-67 promoter could attenuate the methylation level of Ki-67 promoter. Furthermore, higher expression of Sp1 and Ki-67 was related to the overall survival (OS), fi rst progression (FP) and post-progression survival (PPS) in gastric cancer by scrutinizing bioinformatics datasets. Conclusion: Taken together, our fi ndings suggested that hypomethylation of Ki-67 promoter enhanced the binding of Sp1, which in turn maintained hypomethylation of promoter, leading to increase Ki-67 expression in cancer cells. Sp1 and Ki-67 could act promising prognostic biomarkers for clinical diagnosis and treatment of cancer.


Due to a rapid increase in aging population, demand for personalized health care increases proportionally. Personalized patient data can be a helpful way of catering the needs and requirements of elderly people staying at home. Indirectly, it can be a manner of providing better eHealth services according to their needs. Another interesting aspect of providing better personalized eHealth services is to make patient information systems interoperable. Interoperability of eHealth systems is an issue of great concern to current research and development but in this study, we focus on patient information systems. Like in some other European countries, introduction of open source platform to achieve interoperability and personalization of patient information system could save money for health care organizations and make the procedure easier in Sweden also. The purpose of this study is to identify what standards are available for interoperability and what are the benefits and challenges of introducing open source systems for achieving personalized interoperable patient information systems (PIPIS). In light of this investigation, author has identified the benefits and challenges of introducing OSS for achieving PIPIS. Author has also made several recommendations regarding the challenges identified.


The electric power grid has been developed over last century and it is facing many problems. The electric grid lacks the ability to adapt and integrate intermittent energy sources and active customer participation. Numbers of architecture have been proposed by various agencies for smart grid. Micro-grid is the lowest node in the hierarchy of smart grid that has to be developed efficiently for optimal performance. Smart grid, which will involve multidirectional energy and information flows, may be susceptible to cyber attack due to involvement of ICT in managing the smart grid. Multiagent based public key infrastructure (PKI) is proposed for the authentication of participating devises in micro-grid. The agents utilize information exchanges from neighboring agents to construct knowledge base that can be used in making efficient decision support system. The studies suggest that multi-agent perform better under the given circumstance and pressure providing the real-time communication.


A system and methodology were developed for the nondestructive qualitative and quantitative analysis of volatile emissions from hydroponically grown 'Waldmann's Green' leaf lettuce (Lactuca sativa L.). Photosynthetic photon flux (PPF), photoperiod, and temperature were automatically controlled and monitored in a growth chamber modified for the collection of plant volatiles. The lipoxygenase pathway products (Z)-3-hexenal, (Z)-3-hexenol, and (Z)-3-hexenyl acetate were emitted by lettuce plants after the transition from the light period to the dark period. The volatile collection system developed in this study enabled measurements of volatiles emitted by intact plants, from planting to harvest, under controlled environmental conditions.


Idea sets—the complete stock of entrepreneurial ideas an individual has accessible within his or her memory at any given time—are proposed as a new unit of analysis through which the antecedents, processes, and outcomes of entrepreneurial opportunity recognition may be more fully understood. A number of dimensions are identified along which one person's idea set may be compared with that of another person. These comprise the novelty, volume, content, stage of development, strategic value logic, and composite knowledge configuration of ideas within the idea set. The idea set construct and the methods advocated for its empirical operationalization provide a differentiated, comprehensive approach to investigating entrepreneurial opportunities. They also help to overcome sample selection and survival biases characterizing empirical research in this domain. A questionnaire-based idea set instrument, designed and tested in the corporate context, demonstrates good evidence of content, convergent and divergent validities.


Through silicon vias (TSVs) are used e.g. to create electrical connections through MEMS wafers or through silicon interposers used in 2.5D packaging. Currently available technologies do not address situations in which TSVs through unthinned wafers have to withstand large temperature variations. We propose using ferromagnetic Invar metal alloy for this purpose due to its low mismatch in heat induced strain in comparison to silicon. We demonstrate the suitability of a magnetic assembly process for Invar TSV fabrication and the use of spin-on glass as a TSV insulator. We demonstrate TSVs, with contact pads, that tolerate temperature cycling between -50 °C and 190 °C and can withstand elevated temperatures of at least up to 365 °C.


Inhibin is a glycoprotein hormone composed of an alpha-subunit and a beta-subunit. It suppresses pituitary FSH secretion. Activin is a dimer of beta-subunits of inhibin, which stimulates pituitary FSH secretion. This review is a survey of recent research progress in gene expression and regulation of inhibin/activin, particularly pointing out some questions in studying gene expression of inhibin.


There are many different approaches to the problem of the relation between science and religion. It is often claimed that there exists a conflict between those two domains. However, S. J. Gould cannot see neither how the two enterprises can stay in any conflict nor how they can be reconciled or unified. He developed a concept of two Non-Overlapping Magisteria (NOMA). Gould claims that science and religion are characterized by completely different areas of investigation. The two magisteria ask different questions and provide different explanations. Science investigates the factual character of the natural world while religion explores the world of values, meanings and purposes of human life. One could say that this is a reasonable point of view, but at a closer glance it does not seem to be a satisfactory solution.


This paper considers a redundancy optimization problem in which multiple-choice and resource constraints are incorporated. The problem is expressed as a nonlinear integer programming problem and is characterized as an NP-hard problem. The purpose of the paper is to develop a SSRP (solution space reduction procedure). Therefore, the problem is analyzed first to characterize some solution properties. An iterative SSRP is then derived using those solution properties. Finally, the iterative SSRP is used to define an efficient B&BP (branch-and-bound procedure) algorithm. Experimental tests show how dramatically the SSRP can work on removing any intermediately-found unnecessary decision variables from further consideration in solution search, and how efficient this B&BP is.


With the aim of advancing the literature on impression management in physical activity settings, we developed a theoretically derived 2 by 2 instrument that was designed to measure different types of context-specific self-presentation motives. Following item generation and expert review (Study 1), the instrument was completed by 206 group exercise class attendees (Study 2) and 463 high school physical education students (Study 3). Our analyses supported the intended factor structure (i.e., reflecting acquisitive-agentic, acquisitive-communal, protective-agentic, and protective-communal motives). We found some support for construct validity, and the self-presentation motives were associated with variables of theoretical and applied interest (e.g., impression motivation and construction, social anxiety, social and achievement goals, efficacy beliefs, engagement). Taken together, the results indicate that the Self-presentation Motives for Physical Activity Questionnaire (SMPAQ) may be useful for measuring various types of self-presentation motives in physical activity settings.


Understanding the architecture of tree roots is an important component of urban forestry management practice. Tree roots are structurally and functionally important to the survival of trees, and this can be even more so in urban environments where underground space for roots is limited. Tree root architecture models can provide a complementary approach to traditional on-site field investigation methods. Root architecture models are unique in that they can simulate the spatial arrangements of root system structure explicitly, and allow investigators to create hypothetical simulations to test their assumptions about what may be driving root growth. The use of root architecture models in the literature is extensive and may be applied in diverse streams of investigation, but their application to tree root systems is less common. This research demonstrates a root architecture model, Rootbox, as a case study in the application of plant architecture models to simulate tree root growth in urban conditions. Model parameterization was based on conformity of root simulations to tree root architecture reported in the literature. The model is deployed in four hypothetical urban soil scenarios, which are representative of planting sites commonly observed in urban settings. The analysis demonstrates that plausible tree root system architectures – specifically, commonly observed growth attributes - can be produced by Rootbox, but only after several adaptive changes to both the source code/model design are made. Custom soil models can integrate with the simulation to represent urban conditions by modifying both the growth direction and elongation of portions of the root architecture, and thus offer greater control over the output architecture. Rootbox offers a flexible method of simulating the architecture of tree root systems, but further research should focus on optimizing the model's parameters and functions to enable greater user control over model output.


The zero angle production of light nuclei has been studied in CC-interactions at beam energy 20.5 GeV/n on accelerator U-70. The measurements were performed with employing of the beamline no. 22 as spectrometer of secondary particles with verying its rigidity from 10 to 70 GeV/c. We observed secondary protons and deuterons with momenta above kinematic limit of NN-interactions. The measured dependence of forward yields on momentum are compared with the model predictions in the framework of Geant4. The models more or less correctly give positions of maxima of the distributions and their general qualitative dependence on the momentum. But in the quantitative predictions of the yields there are significant differences with the experiment which grow with increase of atomic mass number A.


Despite the fact that Thailand is a non-signatory of the 1951Refugee Convention relating to the Status of Refugee and its 1967 protocol, it has become a home to many and still provides basic protection for many refugees and those who seek asylum. In principle with lack of some legal framework that recognizes and provides documents for asylum seekers and refugees, these subjects are treated as illegal migrants under the Thai Law article 12 of Immigration act. The focus of the study is to understand and examine the challenges and the livelihood strategies faced by Pakistan urban women refugees on access to health and education on their children and how they cope with it in the absence of assistance in order to survive, and the given role played by international organization, local organization and religious institutions in helping provide assistance to women refugees. Through in-depth interviews of open ended questions and non-participant methodology, provided the account of their experience in accessing there social services. This research examines a broad view of the available literature on insecurity, women urban refugees and asylum seekers? access to health services as well as education for their children, in order to form the development of policy work and further research in this area. The study found that the difficulty with access to health situations and conditions faced by refugees and asylum-seekers awareness was vital; as well as understand the ways in which these refugees and Asylum Seekers provide for and protected themselves and their families in this hostile precarious environment. In addition, the study found that urban refugees had little access to education for their children. The study gave avenues for a better understanding of the ways in which refugees and asylum-seekers develop their strengths and agency to contend with traumatic events and daily challenges to better support and strengthen these coping mechanisms The significance of this paper is to help improve and make a difference in the lives of women urban refugees through coping strategies with access to education and health, finding alternative for assisting and providing them with sustainable opportunities.


Psychological studies have shown adolescents to be the most highly associated with risk-taking behaviours (RTB) which lead to increased risks of accidents and untimely deaths. Studies have also linked psychoticism (P), extraversion (E) and neuroticism (N) to predict RTB to some extent but not on the moderation effects of self-esteem (SE) and gender on RTB bringing about inconsistencies hence the need for this study. The study used a cross-sectional research design with 491 randomly selected participants at a Secondary school in North West Province, South Africa. The sample consisted of 252 male and 239 female adolescents between 16 to 18 years of learners from grades 10 to 12. Data was collected using the EPQ-R short, Y-RTB and the Rosenberg SE scales which measured PEN, RTBs and SE respectively. Results showed a significant positive relationship between E (r= .14, p= 05); N (r= .013, p= .05) and RTB. P was not significant. Moderation results showed that SE (p<.04, β= .121) and gender (p<.001, β= .342) independently moderated PEN and RTB and as such making all PEN factors insignificant. Results further showed a significant interaction between N and SE (p< .05, β= -.382) and P (p< .001, β = .188), E (p< .022, β= .193), N (p< .000, β= .285) with gender. In line with the findings of the study, recommendations such as ways of enhancing SE programmes and emotion regulation of learners into school programme amongst others were recommended Keywords: Personality/PEN/Risk-taking behaviour/Adolescents/School Learners/Self-Esteem/Gender


Economists are frequently faced with the task of valuing commodity package components. The valuation of specific impacts of public policies is a case in point. Two contingent market bid elicitation procedures were tested for valuing changes in single components of multicomponent government program. Results of the test suggested that respondents provided more accurate component to piecewise valuation when a two-step bidding approach, rather than a one-step approach was used. Thus, there is evidence that a two-step approach which helps respondents to isolate valuations for package components is perhaps a preferable bid elicitation procedure for piecewise valuation.


Study Abstract:
Context: The UK Nepali community is a unique migrant population, with recent expansion and presence in the UK following the approval of settlement rights to Gurkha veterans and their dependents granted from 2004 to 2008. The community is heterogeneous in relation to caste and religion, with Ghurkha military ties the principal denominator to bind this newly arrived population. Many in the community have settled close to military institutions, with a new migrant population that has emerged as a result around the Aldershot area in Hampshire and Surrey.
The health awareness and needs of the UK Nepali community is poorly understood, including in chronic viral hepatitis (CVH), with increased hepatitis B and C (HBV and HCV) risks that are well described in migrant groups from the neighbouring countries of India and China, but with no previous studies in the UK Nepali population.
HBV and HCV is a global disease, and carries a higher death toll than that seen in comparison to HIV or tuberculosis. CVH disproportionately affects some migrant groups, with case-finding to test at-risk groups part of national guidance by the National Institute of Health and Care Excellence (NICE), as well as the World Health Organisation (WHO), with WHO goals that look to eradicate HBV and HCV by 2030.
At the same time, migrant groups such as the recently arrived Nepali community face growing political and social pressures, with rising nationalism and anti-migrant sentiment seen across Europe, and with blood borne virus rates that have been specifically targeted by right-wing political groups in the UK.
CVH is typically asymptomatic until advanced and severe complications develop; but with highly effective and well-tolerated treatments available if disease is identified at the right time. Effective case-finding to identify CVH in at-risk groups is therefore a priority, and a key aim of national (NICE) CVH testing guidance. The awareness and implementation of this policy is however largely unknown, with particular deficits in our understanding of testing activity in primary care, which remains crucial to delivering CVH testing in migrant communities nationally.
The following study therefore presents a comprehensive exploration of the potential barriers and facilitators that exist towards CVH testing in migrant groups, taking the Nepali community as the focus of this thesis. It explores the factors that exist at the policy level towards effective testing delivery in migrant groups, and at the local (community) level towards CVH testing in primary care, and compares the understanding and perception of the newly arrived Nepali community towards liver disease, and the development of a community based study to identify the CVH risks in the local Nepali population.

Intervention: At the macro-level a policy prioritisation framework was utilised to look at the factors that influence how CVH testing policy can achieve political attention and resources for its implementation. At the community (micro) level, focus group studies were undertaken with members of the Nepali population to explore the awareness, knowledge and perception of liver disease, as well as the potential risks and barriers that may exist towards health engagement strategies. Qualitative focus studies were also conducted with General Practitioners (GPs) from 3 local GP practices who serve the recently arrived Nepali community, to understand the awareness, knowledge and perception of CVH testing in migrant groups. A dedicated community-based testing intervention was then developed to directly assess HBV and HCV prevalence in the local Nepali community, building on the findings from local focus group studies.

Outcome: At the policy level, the National Institute for Health and Care Excellence has produced CVH testing recommendations that are far-reaching, and would have a positive impact on CVH testing in migrant communities, including the UK Nepali population. However, policy has been developed in a top-down approach, without clear leadership to coordinate testing activity, and without community level cohesion that is evident at the Local Authority, local health service (currently Clinical Commissioning Groups (CCG)) or primary care level.
At the micro-level, focus group studies in the Nepali community identified high-levels of awareness of liver disease, and although understood principally as "jaundice", liver disease is viewed as a disease to be feared. Whilst perceptions of stigma are evident, with associations to extrinsic agents such as Spirits and Witch Doctors in disease and cure, there is an overwhelming desire to engage with modern healthcare approaches in the UK, with primary care a trusted and well sought counsel to learn about liver disease. Focus group studies in primary care though suggest significant barriers to CVH testing in migrant groups, with low levels of awareness and knowledge towards existing policy, and with active perceptions of prejudice and harm if they were to engage in CVH testing activity in migrant communities.
As part of a dedicated testing study, HBV and HCV testing was undertaken in 1005 participants (984 unique individuals) from the local Nepali population, with the close and integral involvement of a specially developed Nepali research committee. DBS (Dry-blood spot) testing was used to deliver testing at centrally located community sites. Significant anti-migrant sentiment was expressed during the study, limiting the ability for formal study advertising through written or visual media. Despite this, we were able to recruit close to 1000 members of the local community, with word-of-mouth a powerful route to disseminate testing information in the Nepali community. Absolute rates of active CVH were low, with HBsAg detected in just 3 (0.3%) of individuals and HCV Ab detected in 4 individuals(0.4%), although none of these participants had detectable RNA levels on subsequent testing. Evidence of previous HBV exposure was however raised, with 9.25% (91) of participants demonstrating HBcAb positivity. Associated risk factors for HBcAb positivity were lower educational status and male gender.

Conclusion: Overall, the absolute rates of active CVH appear low in Nepali community, but with higher rates of previous hepatitis B exposure that warrant the need to understand disease risks in the wider Nepali community. At the policy level, there are gaps in the effectiveness of policy across the policy prioritisation framework, with a lack of leadership and direction to facilitate testing at the community level. Members of the Nepali community view CVH as a disease to be feared, and whilst stigma arises as a perception towards liver disease, the overwhelming emphasis is a wish to engage with health care professionals, with good levels of engagement demonstrated in our subsequent community-based testing studies. The perceptions raised in primary care though demonstrate a reluctance to engage in CVH testing activity in migrant groups, with the need for further interventions to modify testing behaviour if we are to reach global and national CVH eradication goals.