Nausea and vomiting are ranked as the most severe side effects to chemotherapy by cancer patients. Twenty years ago, treatment of nausea and vomiting from chemotherapy only had moderate effect and often unpleasant side effects. The drugs used included dopamine(2)-receptor antagonists and corticosteroids alone or combined. This review summarizes the development of anti-emetic therapy, but will focus on the importance of two new classes of anti-emetics: the serotonin(3)- and the neurokinin(1)-receptor antagonists. Furthermore, evidence-based guidelines for the treatment of chemotherapy-induced nausea and vomiting will be given. The serotonin(3)-receptor antagonists, the first group of drugs developed specifically as anti-emetics, have significantly improved the prophylaxis of chemotherapy-induced emesis especially in combination with a corticosteroid. The improvement in the prophylaxis of nausea with this combination is however modest. A new group of anti-emetics, the neurokinin(1)-receptor antagonists, has now been developed, and the first drug, aprepitant, was marketed in 2003. Aprepitant increases the effect of a serotonin(3)-receptor antagonist plus a corticosteroid against acute emesis induced by highly or moderately emetogenic chemotherapy and aprepitant is also active in the protection against delayed emesis. The importance of drug-drug interactions with anti-emetics and other drugs, especially cytotoxins, through their competition for cytochrome P450 enzymes, have been studied. At present, there is no evidence that such interactions are of major clinical importance. Evidence-based clinical guidelines are now available and regularly updated, but unfortunately clinical implementation is slow. Recommendations for some types of chemotherapy-induced emesis such as delayed emesis, is based on a low level of evidence. Furthermore, the majority of clinical trials include highly selected groups of patients not permitting definite conclusions for other and more heterogeneous patient groups. Development of new anti-emetics with other mechanisms of action is awaited with interest.


Sexually transmitted diseases have once again become an area of medical interest. In the era before antibiotics, these diseases, primarily syphilis, attracted the attention and the efforts of the best clinical and academic minds. The availability of penicillin, with its almost miraculous efficacy against syphilis and gonorrhea, led to the general belief that all of the problems of sexually transmitted diseases had been solved. The clinicians and investigators of the day turned their attention to more pressing problems. An entire generation of physicians—those who began their careers between 1950 and 1970—ignored the sexually transmitted conditions. Although this era corresponded with a spectacular growth in academic medicine, virtually none of the new investigators chose sexually transmitted diseases as their area of concentration. It was not until about 1970 that sexually transmitted diseases began to attract some attention, due mainly to a dramatic increase in the number of cases of gonorrhea. The


Many empirical researches on urban growth have been carried out in megapolitan cities like Jakarta, and Surabaya. Most theoretical studies in this particular problem have been concerned about the expanding urban areas. This study differs firstly, concerning urban growth in a coastal city named Semarang, and secondly using superimposed and descriptive analysis based on old city-map and field survey data. Base on mapping analysis and field survey, Semarang urban fringe areas indicated dualistic characteristics, a mixing of formal and informal, planned and un-planned settlements. Most of them are incrementally spreading, mixed and growth simultaneously. Semarang as a port and exDutch colonial city just has been on the earlier stages of spatial and structural evolution. This stage has been characterized as "spill over and specialization" occurred in fringe areas and it would lead to poly-centric metropolis. New urban infrastructure network has a contribution to the mono-centric fragmenting and metamorphosing into a polycentric metropolis. The main activities at urban core have been move sporadically and incrementally to fringe area. Middle class migrated out of the city centre into sprawl settlements on the fringe areas. The role of central city decline while fringe areas increase. These conditions raise complicated social problems. Keyword : Fringe area, Poly-centric, dualistic characteristics, coastal city Correspondence : Phone : +62-24-7470690; +62-24-747069 ; E-mail: email@example.com


We consider the two matrix model with an even quartic potential W(y) = y^4/4 + αy^2/2 and an even polynomial potential V(x). The main result of the paper is the formulation of a vector equilibrium problem for the limiting mean density for the eigenvalues of one of the matrices M_1. The vector equilibrium problem is defined for three measures, with external fields on the first and third measures and an upper constraint on the second measure. The proof is based on a steepest descent analysis of a 4 x 4 matrix valued Riemann-Hilbert problem that characterizes the correlation kernel for the eigenvalues of M_1. Our results generalize earlier results for the case α = 0, where the external field on the third measure was not present.


Nature and landscape goals are increasingly receiving a prominent place in the political debate within the EU. Governments all over the world are more and more aware that international agreements influence their national policy-making processes. The focus of this study was particularly on the manner that the Netherlands operates in the European arena. Four policy dossiers were selected, namely the Reform of the Common Agricultural Policy and the dairy sector, the Common Fishery Policy, Natura 2000 and the Water Framework Directive. An influence analysis was done with the aid of key informants in Great Britain, Denmark and Spain, as well as EU officials.


Receptor (type II) taste bud cells secrete ATP during taste stimulation. In turn, ATP activates adjacent presynaptic (type III) cells to release serotonin (5-hydroxytryptamine, or 5-HT) and norepinephrine (NE). The roles of these neurotransmitters in taste buds have not been fully elucidated. Here we tested whether ATP or 5-HT exert feedback onto receptor (type II) cells during taste stimulation. Our previous studies showed NE does not appear to act on adjacent taste bud cells, or at least on receptor cells. Our data show that 5-HT released from presynaptic (type III) cells provides negative paracrine feedback onto receptor cells by activating 5-HT1A receptors, inhibiting taste-evoked Ca2+ mobilization in receptor cells, and reducing ATP secretion. The findings also demonstrate that ATP exerts positive autocrine feedback onto receptor (type II) cells by activating P2Y1 receptors and enhancing ATP secretion. These results begin to sort out how purinergic and aminergic transmitters function within the taste bud to modulate gustatory signaling in these peripheral sensory organs.


This study aims to interpret Lives of Christian saints as examples of religious literature. Hagiography is commonly studied as an historical artefact indicative of the politics or linguistics of the time in which a text was composed, but few theorists have attempted to interpret its religious content. As these texts were composed within monastic environments I argue that the religious content may be illumined by a methodology which identifies an implicit theology of sanctity within the narrative.
The biblical hermeneutic method proposed by Paul Ricoeur in the mid-twentieth century is applied to the earliest Lives of Samson, Cuthbert, and Brigit. These three date from the mid- to late-seventh century, a time of secular and ecclesiastical change, in some cases profound turmoil. Historical context for the composition of each text is presented; texts are analysed for biblical allusions and literary sources, and submitted to structural analysis. Motifs of religious and archetypal significance are derived from the work of theorists in folklore, anthropology, Bible, and the History of Religions. Each text is examined for motifs and patterns that disclose the structural framework used to organize the work. The structural analysis is then used to highlight central themes in the text.
This interpretive process imagines a dynamic encounter between text and reader which combines historical inquiry with biblical hermeneutic, fulfilling Ricoeur's expectation that the encounter would expand the reader's horizon of meaning. Samson's encounters with serpents and sorceress function as an initiatory pattern drawing monastics into a dynamic of spiritual growth. Cuthbert's time on Farne Island includes echoes of the Desert Saints as well as the crucifixion of Christ and results in a brief but powerfully kenotic episcopal ministry. Brigit's Kildare becomes the locus of the New Jerusalem, City of Refuge and Peaceable Kingdom


BACKGROUND
The acute care surgery model has gained favour in general surgery, but has yet to be widely adopted in other specialties. An Acute Care Plastic Surgery (ACS) Service was recently implemented in the Saskatoon Health Region in an effort to improve trauma care.

OBJECTIVE
To evaluate the impact of ACS on the management of flexor tendon lacerations. The authors hypothesize that ACS has resulted in more timely intervention, improved outcomes and decreased 'after hours' surgery.

METHODS
A retrospective review of patients treated for flexor tendon lacerations from 2007 to 2013 was performed. Patients were stratified into two groups based on whether they received treatment before (group A) or after (group B) ACS implementation. Variables included dates and times of patient referral, consultation and tendon repair; postoperative complications; and admissions. A surgeon survey was administered on the perceived impact of ACS.

RESULTS
Group A was more likely to have surgery performed after hours (P=0.0019) and be admitted to hospital (P=0.0211) compared with group B. Time from referral to consultation and injury-to-surgery interval were slightly increased post-ACS (Group B). Surgeons were highly satisfied with the new system, citing benefits to patients and surgeons.

CONCLUSION
ACS was designed to improve trauma care, while favourably impacting surgeon workload. Surprisingly, the injury-to-surgery interval was slightly increased. However, this was not clinically significant and did not lead to increased postoperative complications. This finding was likely due to a favourable change in practice patterns observed after ACS implementation. ACS has resulted in fewer hospital admissions, decreased after-hours surgeries and improved surgeon satisfaction.


Shallow multi-arch tunnel under unsymmetrical pressure has complex mechanical behavior to which further study is lacking at present. The existing design methods are thoughtless about the features of shallow and partial pressure. The phenomena of cracks, collapse or other diseases in tunnel lining structure are often seen during the construction or after the completion. Combining one tunnel example, this paper presented scientific feedback design method that suited for Shallow multi-arch tunnel under unsymmetrical pressure: made load back analysis with collected information during construction, then averaged the above load and field monitoring load to make forward analysis and internal force calculation, which was used as reference of reinforcement and sectional design for lining structure.


Active and passive control of leading-edge vortices over a 70°/50° double delta wing by means of jet blowing and bleed were studied experimentally in a closed-loop water tunnel using particle image velocimetry (PIV) measurements. Depending on the jet location and yaw angle, the strake vortices and the wing vortices could be separated further away from each other thus resulting in weak interactions or the interactions between the strake and wing vortices could be intensified thus leading to an earlier merge. Ingestion of jet turbulence into the vortices appears to promote merging. Evidence suggests that significant forces/moments could be produced even at low momentum coefficients. Passive bleed with estimated momentum coefficients of the order of 0.1% can also promote vortex merging. Secondary vortex can be strengthened and alter the vortical flow structure over the delta wing. It was found that bleed is more effective at lower wing incidences.


The objective of the present study was to determine if the generally accepted phylogenetic relationships in the tribe Bovini correspond to a phylogenetic scheme derived from polymorphisms at 20 bovine microsatellite loci. This study comprises 17 representative populations: eight Bos taurus, two Bos indicus, one Poëphagus, one Bibos, one Bison, three Bubalus and one Syncerus. Phylogenetic analyses using (delta mu)2 and chord (DC) distances revealed substantial divergence among species. Neighbor-joining trees with both distance measures showed only minor differences. Bos taurus and Bos indicus grouped first, followed by Bos frontalis (Mithan) and Bos grunniens (Yak), Bison bison branched off next and Bubalus bubalis and Syncerus caffer emerged as the two most divergent species from the Bos clade. These findings would suggest that Bos, Poëphagus, and Bibos should be integrated into the Bos genus with each group classified as a subgenus. On the other hand, Bison, Bubalus and Syncerus should each be considered a separate genus. Direct estimates of the divergence times were calculated using the (delta mu)2 genetic distance. Bos taurus and Bos indicus were estimated to have diverged 0.31-0.82 MYA, Bos and Poëphagus: 0.57-1.53 MYA, Bos and Bibos: 0.57-1.52 MYA, Bos and Bison: 0.46-1.23 MYA, Bos and Bubalus: 1.85-4.93 MYA and Bos and Syncerus: 0.98-2.61 MYA.


The development of electricity technology from the environmental aspect has become the key factor for competitiveness, i.e., environmental friendliness is one of the most important considerations for technology development. Under the monopolised electric industry of the past, there was little motivation for individual companies to actually manage their company. However, because of the increasing demand for energy and the concerns for the environment, energy policies are shifting towards a sustainable development, which considers both the economics and environmental protection. According to the paradigm shift of the energy policy, it is necessary to compare two major electricity sources from the view of environmental management issues. It is effective with the common dimensionless unit concerning the various environmental categories including the radiological and non-radiological points of view, which can be realized by the new environmental impact assessment methodology such as the Life Cycle Assessment (LCA). This study aims at a comparison of the environmental impacts of the nuclear and coal power generation systems using the LCA methodology. These results are very preliminary ones, however, this study will be helpful in making a decision on a long term electricity plan and the energy mix optimization when considering the environmental aspect in Korea and also the power generation companies could enhance their images by showing off their willingness to improve the environmental quality.


The purpose of this paper is to find out the determinants that are significantly influencing Telkomsel's customer's perception. The study surveyed 100 Telkomsel users to determine the key influential factors that significantly influence on their perception. The data analyses were conducted by exploratory factor analysis, confirmatory factor analysis and structural equation modeling to test the hypothesis. The results of the statistical analysis reflected that most of the Telkomsel's customers are highly concerned about service quality. The researcher hoped that the findings may assist the mobile phone operators in production of their services and promotion of their services.


Abstract Background: Delusions are usually considered core symptoms of schizophrenia, but they are in fact associated with a wide range of psychiatric disorders. The content of a delusion is often related to stressful life experiences that preceded the delusion. Objective: The aim of this study is to detect whether there is a link—specifically, a thematic link—between past experiences and delusion content that connects the two events via thematic analogy. Method: The sample population evaluated for this study consisted of 16 consecutive patients with delusions between the ages of 9.9 and 16.5 years. All patients were experiencing their first psychotic episodes and were not taking any medications. Data were obtained from transcribed clinical sessions. Results: The data suggested the presence of a thematic link between previous experiences and the contents of delusions for 15 patients (93%). Humiliating events, including bullying, are more likely to be linked to persecutory delusions (p = .004). Conclusions: If a thematic link between past experiences and delusion content does exist, this may provide a means of greater psychotherapeutic understanding.


The current study explores the roles offenders see themselves playing during an offence and their relationship to different crime types. One hundred and twenty incarcerated offenders indicated the narrative roles they acted out whilst committing a specific crime they remembered well. The data were subjected to Smallest Space Analysis (SSA) and four themes were identified: Hero, Professional, Revenger and Victim in line with the recent theoretical framework posited for Narrative Offence Roles (Youngs & Canter, 2012). Further analysis showed that different subsets of crimes were more like to be associated with different narrative offence roles. Hero and Professional were found to be associated with property offences (theft, burglary and shoplifting), drug offences and robbery and Revenger and Victim were found to be associated with violence, sexual offences and murder. The theoretical implications for understanding crime on the basis of offenders' narrative roles as well as practical implications are discussed.


Microfinance has shown to be an effective tool for combating poverty, creating jobs, and improving the poor peoples. Poverty alleviation is the main objective of improving the socioeconomic. It has becomes main targets and attention at many developing and developed countries. The objective of this research is to find out the contributing factors in alleviating poverty for women entrepreneurship. A total of 97 samples were collected from women entrepreneurship in Terengganu. Data analyses were conducted using SPSS 20.0.


The incidence of atrial fibrillation increases with age, but it is unknown whether there are changes in the intrinsic function of Na+ currents in cells of the aged atria. Thus, we studied right (RA) and left (LA) atrial cells from two groups of dogs, adult and aged (>8 yr), to determine the change in Na+ currents with age. In this study all dogs were in normal sinus rhythm. Whole cell voltage clamp techniques were used to compare the Na+ currents in the two cell groups. Immunocytochemical studies were completed for the Na+ channel protein Na(v)1.5 to determine whether there was structural remodeling of this protein with age. In cells from aged animals, we found that Na+ currents are similar to those we measured in adult atria. However, Na+ current (I(Na)) density of the aged atria differed depending on the atrial chamber with LA cell currents being larger than RA cell currents. Thus with age, the difference in I(Na) density between atrial chambers remains. I(Na) kinetic differences between aged and adult cells included a significant acceleration into the inactivated state and an enhanced use-dependent decrease in peak current in aged RA cells. Finally, there is no structural remodeling of the cardiac Na+ channel protein Na(v)1.5 in the aged atrial cell. In conclusion, with age there is no change in I(Na) density, but there are subtle kinetic differences contributing to slight enhancement of use dependence. There is no structural remodeling of the fast Na+ current protein with age.


The teleost fish hippocampal pallium, like the hippocampus of tetrapods, is essential for relational map-like spatial memories. In mammals, these relational memories involve the dynamic interactions among different hippocampal subregions and between the hippocampus-neocortex network, which performs specialized operations such as memory encoding and retrieval. However, how the teleost hippocampal homologue operates to achieve comparably sophisticated spatial cognition capabilities is largely unknown. In the present study, the progressive changes in the metabolic activity of the pallial regions that have been proposed as possible homologues of the mammalian hippocampus were monitored in goldfish. Quantitative cytochrome oxidase histochemistry was used to measure the level of activation along the rostrocaudal axis of the ventral (Dlv) and dorsal parts of the dorsolateral division (Dld) and in the dorsoposterior division (Dp) of the goldfish telencephalic pallium throughout the time course of the learning process of a spatial memory task. The results revealed a significant increase in spatial memory-related metabolic activity in the Dlv, but not in the Dld, suggesting that the Dlv, but not the Dld, is comparable to the amniote hippocampus. Regarding the Dlv, the level of activation of the precommissural Dlv significantly increased at training onset but progressively declined to finally return to the basal pretraining level when the animals mastered the spatial task. In contrast, the commissural Dlv activation persisted even when the acquisition phase was completed and the animal's performance reached an asymptotic level. These results suggest that, like the dentate gyrus of mammals, the goldfish precommissural Dlv seems to respond nonlinearly to increments of change in sensory input, performing pattern separation under highly dissimilar input patterns. In addition, like the CA3 of mammals, the commissural Dlv likely operates in a continuum between two modes, a pattern separation or storage operation mode at early acquisition when the change in the sensory input is high, probably driven by the precommissural Dlv output, and a pattern completion or recall operation mode when the animals have mastered the task and the change in sensory input is small. Finally, an unexpected result of the present study is the persistent activation of the area Dp throughout the complete spatial task training period, which suggests that the Dp could be an important component of the pallial network involved in spatial memory in goldfish, and supports the hypothesis proposing that the Dp is a specialized part of the hippocampal pallium network.


We continue a line of work on extracting random bits from weak sources that are generated by simple processes. We focus on the model of locally samplable sources, where each bit in the source depends on a small number of (hidden) uniformly random input bits. Also known as local sources, this model was introduced by De and Watson (TOCT 2012) and Viola (SICOMP 2014), and is closely related to sources generated by $\mathsf{AC}^0$ circuits and bounded-width branching programs. In particular, extractors for local sources also work for sources generated by these classical computational models. Despite being introduced a decade ago, little progress has been made on improving the entropy requirement for extracting from local sources. The current best explicit extractors require entropy $n^{1/2}$, and follow via a reduction to affine extractors. To start, we prove a barrier showing that one cannot hope to improve this entropy requirement via a black-box reduction of this form. In particular, new techniques are needed. In our main result, we seek to answer whether low-degree polynomials (over $\mathbb{F}_2$) hold potential for breaking this barrier. We answer this question in the positive, and fully characterize the power of low-degree polynomials as extractors for local sources. More precisely, we show that a random degree $r$ polynomial is a low-error extractor for $n$-bit local sources with min-entropy $\Omega(r(n\log n)^{1/r})$, and we show that this is tight. Our result leverages several new ingredients, which may be of independent interest. Our existential result relies on a new reduction from local sources to a more structured family, known as local non-oblivious bit-fixing sources. To show its tightness, we prove a"local version"of a structural result by Cohen and Tal (RANDOM 2015), which relies on a new"low-weight"Chevalley-Warning theorem.


This volume is an expose of building archaeological research works and building restorations. It is well known that buildings and their restorations mirror the dynamics of societies. Whether as a single monument, clustered in villages, towns, or cities, or even as single rooms or spaces, buildings and restorations result from socio-economic, political, or ideological power or expressions. But there are many different ways of looking at buildings and restorations in this respect, as the authors of this volume show. The 10 papers are presented in chronological order from ancient to modern times and the sites and areas under discussion include Crete, Mycenae, Pompeii, Scandinavia, Jamaica (Spanish Town) and Tongaat, South Africa.


Fiscal constitutions comprise the set of rules and frameworks guiding fiscal policy that are enshrined in a country's fundamental laws. This paper compares empirically the fiscal constitutions of 15 federal countries with the arrangements that shape fiscal relations between the European Union (EU) and its member countries. Fiscal constitutions can be ranked along two indicators, namely constitutionally guaranteed decentralisation and institutional coherence, which measures the extent to which the elements of the institutional arrangements fit together. The fiscal constitution of the EU is decentralised yet quite incoherent. This incoherence derives from an unusual mix of the models of competitive and collaborative federalism with large fiscal autonomy of the Member States combined with strict EU budget oversight. Simple correlations imply that institutional incoherence is associated with higher deficits, higher debt or vulnerability to crises, suggesting that the current European fiscal framework is structurally prone to economic and fiscal imbalances. Since incoherence is a feature of the fiscal constitution as a whole, institutional reform requires a holistic approach.


This paper presents the results of fast user trial of multimedia services that are enabled when a mobile terminal has access to converged services over digital broadcast and mobile telecommunications networks. It first describes the motivations behind developing this system and describes the service scenarios that benefit most from it. It then provides an overview of the service components of the test case scenario. Finally, it presents the results of fast user trials on end users of the services that were developed. This work was conducted as part of the EU-funded CISMUNDUS project.


Depletion effects on the structure and interactions between polymers induced by the presence of small depleting spheres are investigated by computer simulations. As the separation between two polymers decreases, the polymers repel each other due to the loss of conformational entropy. When the polymers are immersed in a medium crowded with small depleting spheres, however, depletion attractions between the polymer segments are induced. The resulting repulsive interaction is significantly reduced when the polymer segments approach one another closer than the size of the depleting spheres. The distance-dependent potential of mean force shows a highly nonmonotonic behavior reflecting the packing of the small depleting spheres around the polymer segments. We show that the depletion potential, that is, the component of the interactions arising from the presence of the small depleting spheres, between flexible polymers is qualitatively similar to that between two large spheres. However, there are small numerical differences that arise from the connectivity of the polymer chains. We also show that Brownian dynamics simulations of a single polymer chain with depletion potential can predict polymer statistical properties in good agreement with those from molecular dynamics simulations in which depleting spheres are explicitly accounted for. Therefore, we suggest the use of the depletion potentials for computational study of crowding effects on large biopolymers such as chromatin fibers.


Many species in the animal kingdom are characterized by alternative mating tactics (AMTs) within a sex. In males, such tactics include mate guarding versus sneaking behaviours, or territorial versus female mimicry. Although AMTs can occur in either sex, they have been most commonly described in males. This sex bias may, in part, reflect the increased opportunity for sexual selection that typically exists in males, which can result in a higher probability that AMTs evolve in that sex. Consequently, females and polyandry can play a pivotal role in governing the reproductive success associated with male AMTs and in the evolutionary dynamics of the tactics. In this review, we discuss polyandry and the evolution of AMTs. First, we define AMTs and review game theoretical and quantitative genetic approaches used to model their evolution. Second, we review several examples of AMTs, highlighting the roles that genes and environment play in phenotype expression and development of the tactics, as well as empirical approaches to differentiating among the mechanisms. Third, ecological and genetic constraints to the evolution of AMTs are discussed. Fourth, we speculate on why female AMTs are less reported on in the literature than male tactics. Fifth, we examine the effects of AMTs on breeding outcomes and female fitness, and as a source, and possibly also a consequence, of sexual conflict. We conclude by suggesting a new model for the evolution of AMTs that incorporates both environmental and genetic effects, and discuss some future avenues of research.


Category management (CM) is a widely practiced supplier–retailer process for managing entire product categories as strategic business units and for customizing them on a store-by-store basis to produce enhanced business results through a focus on delivering consumer value. A particular form of CM involves "category captain" (CC) arrangements, in which a supplier, often the category leader, takes on a significant role in the retail management of the category, including the brands of competing suppliers. Although CC arrangements are capable of yielding benefits to competition, they may also enable a CC to take advantage of its role in ways that restrict competition and harm consumers. Recent antitrust litigation that targets CC arrangements illustrates the nature and magnitude of competitive issues that can arise in the arrangements. Competitive concerns about CC arrangements have also attracted the attention of public policymakers in the United States and abroad. In response to public policy developments and in recognition of the significance of CM and CC arrangements in the marketing field, Journal of Public Policy & Marketing recently collaborated with the American Antitrust Institute to convene the Roundtable on Antitrust and Category Captains. This article assembles and archives the findings, analysis, and commentary from the roundtable, and it examines antitrust issues that may attend CC arrangements.


We investigate the number of samples required for testing the monotonicity of a distribution with respect to an arbitrary underlying partially ordered set. Our first result is a nearly linear lower bound for the sample complexity of testing monotonicity with respect to the poset consisting of a directed perfect matching. This is the first nearly linear lower bound known for a natural non-symmetric property of distributions. Testing monotonicity with respect to the matching reduces to testing monotonicity with respect to various other natural posets, showing corresponding lower bounds for these posets also. Next, we show that whenever a poset has a linear-sized matching in the transitive closure of its Hasse digraph, testing monotonicity with respect to it requires Ω( √ n) samples. Previous such lower bounds applied only to the total order. We also give upper bounds to the sample complexity in terms of the chain decomposition of the poset. Our results simplify the known tester for the two dimensional grid and give the first sublinear bounds for higher dimensional grids and the Boolean cube.


Diversity is employed to improve the performance of a communication system in a fading environment. A novel form of diversity which is useful especially in situations where frequency diversity is not available is proposed. This technique uses multiple transmit antennas and the antennas are weighted by suitably determined time-varying phase offsets. It is shown that with this technique, M transmit antennas and an L-branch RAKE receiver gives rise to diversity of order LM.<<ETX>>


CONTEXT: The failure and complications of central venous access devices (CVADs) result in interrupted medical treatment, morbidity, and mortality for the patient. The resulting insertion of a new CVAD further contributes to risk and consumes extra resources. OBJECTIVE: To systematically review existing evidence of the incidence of CVAD failure and complications across CVAD types within pediatrics. DATA SOURCES: Central Register of Controlled Trials, PubMed, and Cumulative Index to Nursing and Allied Health databases were systematically searched up to January 2015. STUDY SELECTION: Included studies were of cohort design and examined the incidence of CVAD failure and complications across CVAD type in pediatrics within the last 10 years. CVAD failure was defined as CVAD loss of function before the completion of necessary treatment, and complications were defined as CVAD-associated bloodstream infection, CVAD local infection, dislodgement, occlusion, thrombosis, and breakage. DATA EXTRACTION: Data were independently extracted and critiqued for quality by 2 authors. RESULTS: Seventy-four cohort studies met the inclusion criteria, with mixed quality of reporting and methods. Overall, 25% of CVADs failed before completion of therapy (95% confidence interval [CI] 20.9%–29.2%) at a rate of 1.97 per 1000 catheter days (95% CI 1.71–2.23). The failure per CVAD device was highest proportionally in hemodialysis catheters (46.4% [95% CI 29.6%–63.6%]) and per 1000 catheter days in umbilical catheters (28.6 per 1000 catheter days [95% CI 17.4–39.8]). Totally implanted devices had the lowest rate of failure per 1000 catheter days (0.15 [95% CI 0.09–0.20]). LIMITATIONS: The inclusion of nonrandomized and noncomparator studies may have affected the robustness of the research. CONCLUSIONS: CVAD failure and complications in pediatrics are a significant burden on the health care system internationally.


At the onset of the COVID-19 pandemic, the WHO recommended the prioritisation of risk communication and community engagement as part of response activities in countries. This was related to the increasing spread of misinformation and its associated risks, as well as the need to promote non-pharmaceutical interventions (NPIs) in the absence of an approved vaccine for disease prevention. The Nigeria Centre for Disease Control, the national public health institute with the mandate to prevent and detect infectious disease outbreaks, constituted a multidisciplinary Emergency Operations Centre (EOC), which included NCDC staff and partners to respond to the COVID-19 outbreak. Risk communication, which also comprised crisis communication, was a pillar in the EOC. As the number of cases in Nigeria increased, the increasing spread of misinformation and poor compliance to NPIs inspired the development of the #TakeResponsibility campaign, to encourage individual and collective behavioural change and to foster a shared ownership of the COVID-19 outbreak response. Mass media, social media platforms and community engagement measures were used as part of the campaign. This contributed to the spread of messages using diverse platforms and voices, collaboration with community leaders to contextualise communication materials and empowerment of communication officers at local levels through training, for increased impact. Despite the challenges faced in implementing the campaign, lessons such as the use of data and a participatory approach in developing communications campaigns for disease outbreaks were documented. This paper describes how a unique communication campaign was developed to support the response to the COVID-19 pandemic.


ABSTRACT The influence of electronic word of mouth (eWOM) has been heavily investigated in relation to online ratings. However, only a few studies examined the content of eWOM. From the perspective of the consideration sets model, consumers formulate an awareness set, a consideration set and a choice set before making a purchase. We argue that the formulation of these sets is influenced by eWOM based on its volume, valance and content relating to product attributes such as value for money, product sophistication and experiential feeling. In this study, the content of posts relating to Shure professional earphones in the online forum Mingo (www.mingo-hmw.com/forum) was captured and annotated. During the data collection period, Mingo was the sole online forum relating to professional earphones. Without much interference from other online forums, the circumstances of this study closely approximate a laboratory setting. In addition, we collected the actual sales, marketing costs, fault rates and number of retail stores selling the Shure professional earphones for 126 weeks. Our findings show that the weekly volume of posts, their relative number of positive (negative) comments, especially regarding value for money and sound quality, and those posts from the earlier week impinged strongly on weekly sales of Shure products. From the regression models, the explained variance in sales jumps from 0.236 to 0.732 due to the influence of eWOM.


Forest degradation, forest fires, and wildlife poaching have devastated biodiversity in Indonesia. To assess the impact of forest degradation and the potential for recovery, we used birds as a proxy for biodiversity and assessed density estimates (hereafter density) in the degraded lowland forest of Harapan Rainforest Ecosystem Restoration Concession (HRF) in Sumatra. In this study, a total of 149 bird species (from 5,317 individuals) were recorded. Of the 103 species for which densities could be calculated, 45% were lowland bird specialists (i.e. species occurring below 200 m above sea level in Sumatra), including three globally threatened and 41 Near-Threatened species. Comparison with bird densities in degraded forest of Borneo revealed that there was broad similarity across taxa but three species had significantly higher density, and four had significantly lower density, in HRF. The mosaic of degraded forest habitats in different stages of regeneration in HRF appears to support more individuals of some species, especially woodpeckers, than the Bornean sites, but fewer individuals of other species. Determining bird densities is essential to establish population baselines, allowing comparisons between sites and over time. The present study fills one gap, but we urge others to conduct similar studies to provide a better understanding of the temporal and spatial variation in bird density in Southeast Asia's degraded forests. (Less)


Language learning is a prerequisite for successful intercultural communication. Learning the official language of a country is of significant importance for this process as well as for learning English, which is a globally accepted language in the international community. The training of students, prospective teachers, to work in an intercultural environment includes a complex development of linguistic, pedagogical and intercultural competence. This article is dedicated to developing student teachers' pedagogical skills in teaching the official language of a country (Bulgarian language in this case) as part of their overall training in intercultural education. The theoretical part contains a brief analysis of specialized linguistic, pedagogical and methodological literature as well as an analysis of preschool education programs in the Republic of Bulgaria.


These thoughts about an ethic of international health can be summarized in a very free revision of the Hippocratic Oath: I will share the science and art by precept, by demonstration, and by every mode of teaching with other physicians regardless of their national origin. I will try to help secure for the physicians in each country the esteem of their own people, and in collaborative work see that they get full credit. I will strive to eliminate sources of disease everywhere in the world and not merely set up barriers to the spread of disease to my own people. I will work for understanding of the diverse causes of disease, including the social, economic, and environmental. I will promote the well-being of mankind in all its aspects, not merely the bodily, with sympathy and consideration for a people's culture and beliefs. I will strive to prevent painful and untimely death, and also to help parents to achieve a family size conforming to their desires and to their ability to care for their children. In my concern with whole communities I will never forget the needs of its individual members.


Bio-accessibility increase soil nutrients and other natural sources and increase productive use of nutrients in crops, accompanied by decrease the impact of pollutant chemical fertilization on the environment, are major goals of modern agriculture and organic farming by default. The research carried out in the last years on the unconventional fertilization methods and means puts the problem on some new methods to prevent chemical pollution of vegetal production environment. Globally, application of nutrients in the form of dilute solutions by foliar spraying has become a current practice in many cultures, the absorption and translocation of nutrients from the skin of the plant in different plant organs is an undeniable reality. This paper refers to tomatoes grown, Dacia cultivar, in greenhouse (R.I.S.S.A., Bucharest) by an unconventional fertilization method. Tomato represents a basic product in human food, being consumed under both fresh and canned condition. The great number of bell pepper cultivars and varieties constitutes the raw material for producing a large range of culinary products. In this context the main objectives in research carried out were complex agrochemical testing of ecological liquid compositions approved for use in Romania agriculture, two with effect by incorporation in soil (Neb 26 and Stimusoil) and two with foliar applied on plant (Kelpak and Bionat) and quantifying the effect of fertilization of the fertilizers applied on different topsoils of fertilization. Experimentation was conducted in greenhouse of R.I.S.S.A. Bucharest (2004-2007), experiences were placed in Mitscherlich pots, which were introduced 20 kg soil. According to the testing methodology for each experimental combination of factors has ensured a number of 3 repetitions. The analysis of experimental data obtained can be observed that the tested foliar fertilizers were provided, in most cases examined, provided statistical yield increases compared to unfertilized ecological control.


Background: Vaccines capable of eliciting cellular and humoral immune responses in tandem could provide prophylactic and therapeutic responses against infectious diseases and cancer. These responses can be induced systemically and at mucosal surfaces by activating the mucosal immune system, but rarely successfully due to challenges associated with mucosal delivery. Objective: To investigate delivery strategies to improve the effectiveness of mucosal vaccines. Methods: Different challenges are associated with different types of vaccines. We consider administration routes, schedules, carrier systems and adjuvants that can be used to overcome these challenges to enhance mucosal vaccination. Results/conclusions: The use of particle-mediated delivery systems is an effective strategy to enhance mucosal vaccination by protecting immunogenic material during delivery, providing targeted delivery systems, and allowing incorporation of adjuvant material.


INTRODUCTION
Internalized stigma is prevalent among patients diagnosed with schizophrenia. Their family caregivers (FGs) also suffer from internalized stigma, but limited studies have addressed the issue.

AIM
The aim of this study was to determine the severity of internalized stigma and its correlates among FGs of patients diagnosed with schizophrenia in Changsha, Hunan, China.

METHODS
A consecutive sample of 299 FGs was recruited at the psychiatric outpatient department of a tertiary hospital in Changsha. This study explored the relationships between internalized stigma and potential factors.

RESULTS
Nearly 50% of the FGs perceived mild internalized stigma, 24% of the FGs reported moderate level and 6% had a severe level. Internalized stigma was associated with patients' characteristics (severity of illness), and FGs' characteristics (hope, social support, passive coping, age, education background, residence with the patient, caring for a male or a young patient, and difficulty in supervising medication).

DISCUSSION AND IMPLICATIONS FOR PRACTICE
Informative and psychosocial interventions based on education and contact for FGs such as enhancing mental health literacy programs, cognitive therapies, and group psychoeducation can provide FGs with a better understanding of schizophrenia and to promote hope, active coping, and social support.


Blood vessels anastomosis is one of the most challenging and delicate tasks to learn in many surgical specialties, especially for vascular and abdominal surgeons. Such a critical skill implies a learning curve that goes beyond technical execution. The surgeon needs to gain proficiency in adapting gestures and the amount of force expressed according to the type of tissue he/she is dealing with. In this context, surgical simulation is gaining a pivotal role in the training of surgeons, but currently available simulators can provide only standard or simplified anatomies, without the chance of presenting specific pathological conditions and rare cases. 3D printing technology, allowing the manufacturing of extremely complex geometries, find a perfect application in the production of realistic replica of patient-specific anatomies. According to available technologies and materials, morphological aspects can be easily handled, while the reproduction of tissues mechanical properties still poses major problems, especially when dealing with soft tissues. The present work focuses on blood vessels, with the aim of identifying – by means of both qualitative and quantitative tests - materials combinations able to best mimic the behavior of the biological tissue during anastomoses, by means of J750™ Digital Anatomy™ technology and commercial photopolymers from Stratasys. Puncture tests and stitch traction tests are used to quantify the performance of the various formulations. Surgical simulations involving anastomoses are performed on selected clinical cases by surgeons to validate the results. A total of 37 experimental materials were tested and 2 formulations were identified as the most promising solutions to be used for anastomoses simulation. Clinical applicative tests, specifically selected to challenge the new materials, raised additional issues on the performance of the materials to be considered for future developments.


The ade6-M26 mutation of Schizosaccharomyces pombe has previously been reported to stimulate ade6 intragenic meiotic recombination. We report here that the ade6-M26 mutation is a single G----T nucleotide change, that M26 stimulated recombination within ade6 but not at other distinct loci, and that M26 stimulated meiotic but not mitotic recombination. In addition, M26 stimulated recombination within ade6 when M26 is homozygous; this result demonstrates that a base-pair mismatch at the M26 site was not required for the stimulation. These results are consistent with the ade6-M26 mutation creating a meiotic recombination initiation site.


Vast changes in the world of work spurred by rapid technological growth and globalization have called for a more inclusive, progressive, and forward thinking conceptualization of vocational theory, practice, training, and policy. Discussions across 8 discussion groups at the 2007 joint symposium of the International Association for Educational and Vocational Guidance, Society for Vocational Psychology, and National Career Development Association addressed various topics in the field of vocational psychology and career guidance. Several themes emerged that have captured the attention of career scholars and practitioners across the globe: culture and context in theory and practice, research as a process within a contextual system, partnership and collaboration, and social responsibility and public policy.


ABSTRACT Research Findings: The current study explored the ethnotheories of 6 Chinese families regarding their young children's play in Shanghai, the most Westernized metropolis in China. A triangulation of multiple data sources was established through in-depth interviews, home visit observations, and 1-week recordings of child's daily play activities. The empirical evidence revealed that the 6 families practiced eduplay (Rao & Li, 2009) with their young children, a Chinese version of play-based learning or a compromise between contemporary Western notions of child-centered play and the Chinese tradition of adult-directed academic training. Albeit with individual differences and varieties, parents' ethnotheories were instantiated in the child's daily settings for the provision of toys, the use of time in play and learning, and parents' roles in the child's play. However, some contextual constraints and barriers prevented the parents from fully putting the imported progressive educational beliefs into action. Practice or Policy: The changing and varying parental ethnotheories of play may reflect a paradigm shift in the early childhood education system, which has been jointly shaped by traditional Chinese beliefs and contemporary Western notions of appropriate practice. More implications of these findings are discussed against the backdrop of sociocultural changes in contemporary Chinese society.


Detached residential wooden houses are a common type of housing in Japan. Decay of wooden components within the walls is easily caused by condensation or defective flushing. To solve this problem, a double-skin system with a room-side air gap was developed. In this system, during winter, the airflow in the ventilated wall circulates freely around the whole house. Therefore, during daytime, the airflow moves solar heat to base, and releases heat to the house at night which can increase indoor temperature. The purpose of this study is to evaluate the flow rate in the ventilated wall and evaluate indoor temperature increase and reduction of heating load in winter. Therefore, it is important to develop an expression for flow rate in the wall. An airflow-energy simulation program was used to predict flow rates in the ventilated wall, and the performance of air-flows in several exterior walls of the house was investigated. The results verify that the flow rate in the ventilated walls increase with solar radiation. By using the double-skin system with a room-side air gap, the heating load in winter was reduced by 5%.


A study on shape memory alloy materials as vibration dampers is reported. An important component is the strain rate–dependent and temperature-dependent constitutive behavior of shape memory alloy, which can significantly change its energy dissipation capacity under cyclic loading. The constitutive model used accounts for the thermo-mechanical strain rate–dependent behavior and phase transformation. With increasing structural flexibility, the hysteretic loop size of shape memory alloy dampers increases due to increasing strain rates, thus further decreasing the response of the structure to cyclic excitation. The structure examined is a beam, and its behavior with shape memory alloy dampers is compared to the same beam with conventional dampers. Parametric studies reveal the superior performance of the shape memory alloy over the conventional dampers even at the resonance frequency of the beam-damper system. An important behavior of the shape memory alloy dampers is discovered, in that they absorb energy from the fundamental and higher vibration modes. In contrast, the conventional dampers transfer energy to higher modes. For the same beam control, the stiffness requirement for the shape memory alloy dampers is significantly less than that of the conventional dampers. Response quantities of interest show improved performance of the shape memory alloy over the conventional dampers under varying excitation intensity, frequency, temperature, and strain rate.


Collisional complexes, which are formed as intermediate states in molecular collisions, are typically short-lived and decay within picoseconds. However, in ultracold collisions involving bialkali molecules, complexes can live for milliseconds, completely changing the collision dynamics. This can lead to unexpected two-body loss in samples of nonreactive molecules. During the past decade, such "sticky" collisions have been a major hindrance in the preparation of dense and stable molecular samples, especially in the quantum-degenerate regime. Currently, the behavior of the complexes is not fully understood. For example, in some cases, their lifetime has been measured to be many orders of magnitude longer than recent models predict. This is not only an intriguing problem in itself but also practically relevant, since understanding molecular complexes may help to mitigate their detrimental effects. Here, we review the recent experimental and theoretical progress in this field. We treat the case of molecule–molecule as well as molecule–atom collisions.


Machine learning algorithms and artificial intelligence influence many aspects of life today and have gained an aura of objectivity and infallibility. The use of these tools introduces a new level of risk and complexity in policy. This report illustrates some of the shortcomings of algorithmic decisionmaking, identifies key themes around the problem of algorithmic errors and bias, and examines some approaches for combating these problems.


Oil price fluctuations have been prominent in economy since World War II. Researchers have been busy exploring the possible transmission mechanisms from these fluctuations to the economy, with their task being complicated over the years by a changing economic environment and transforming dynamics in the oil industry.

This thesis uniquely brings on board the study of three topical research areas pertaining to the oil market that have attracted attention both in academic and industrial circles. The first chapter explores the role of financial participants in the oil futures market by applying Markov-switching vector autoregressions. A popular view has been that significant oil price changes cannot be explained solely by fundamentals. Investigating whether oil prices convey information about supply-demand forces, or they are a result of `speculative effects', can be of importance for the economy as their information content constitutes a key input in a variety of decisions, from businesses to governments and regulators. The second chapter studies the relationship between public debt and economic growth for hydrocarbon-rich developing economies. The dependence of these countries on oil and gas revenues can raise serious concerns about their fiscal sustainability, especially during the oil industry's bust cycles. By employing threshold analysis, this work examines whether a common threshold debt level exists for these countries beyond which debt can adversely affect the economic performance. The third chapter is a case study for Saudi Arabia, the largest exporter of crude oil in the world. The internal economic and social conditions of Saudi Arabia are, indirectly, important for the world as the Kingdom has the ability to decrease or increase oil production levels during supply interruptions or high demand growth, which in turn can affect global oil prices. While the natural resource endowment has been translated into more financial wealth for the Kingdom, placing the Saudi economy to the 19th position of the global rank, it remains questionable to what extent this wealth has further been translated into economic development and social progress for the Saudi population.

Our findings suggest that oil prices are driven by the forces of demand and supply, with trader positions having little impact on oil prices. The Markov-switching model with two regimes proves to be a good description of the behaviour for the majority of the futures market participants. Next, the results of the debt-growth relationship confirm existing empirical evidence that debt can stimulate growth, with the impact turning negative and having a detrimental effect on the country's economic activity when debt crosses a certain tipping point. Finally, the case study analysis on Saudi Arabia shows that oil prices have had significant repercussions on the economic development and social progress of the country. Saudi Arabia, heavily reliant on hydrocarbon revenues, has failed to successfully utilise its oil wealth and convert it into development and welfare levels equivalent to those economies with similar-sourced incomes.


Few methods are available to regenerate articular cartilage defects in patients with osteoarthritis. We aimed to assess the safety and efficacy of articular cartilage regeneration by a novel medicinal product composed of allogeneic human umbilical cord blood‐derived mesenchymal stem cells (hUCB‐MSCs). Patients with Kellgren‐Lawrence grade 3 osteoarthritis and International Cartilage Repair Society (ICRS) grade 4 cartilage defects were enrolled in this clinical trial. The stem cell‐based medicinal product (a composite of culture‐expanded allogeneic hUCB‐MSCs and hyaluronic acid hydrogel [Cartistem]) was applied to the lesion site. Safety was assessed by the World Health Organization common toxicity criteria. The primary efficacy outcome was ICRS cartilage repair assessed by arthroscopy at 12 weeks. The secondary efficacy outcome was visual analog scale (VAS) score for pain on walking. During a 7‐year extended follow‐up, we evaluated safety, VAS score, International Knee Documentation Committee (IKDC) subjective score, magnetic resonance imaging (MRI) findings, and histological evaluations. Seven participants were enrolled. Maturing repair tissue was observed at the 12‐week arthroscopic evaluation. The VAS and IKDC scores were improved at 24 weeks. The improved clinical outcomes were stable over 7 years of follow‐up. The histological findings at 1 year showed hyaline‐like cartilage. MRI at 3 years showed persistence of the regenerated cartilage. Only five mild to moderate treatment‐emergent adverse events were observed. There were no cases of osteogenesis or tumorigenesis over 7 years. The application of this novel stem cell‐based medicinal product appears to be safe and effective for the regeneration of durable articular cartilage in osteoarthritic knees. Stem Cells Translational Medicine 2017;6:613–621


This paper proposes a novel design procedure of proportional and integral (Pl)-like fuzzy logic controller (FLC) for DC-DC converters that integrates linear control techniques with fuzzy logic. The design procedure allows the small signal model of the converter and linear control design techniques to be used in the initial stages of FLC design. This simplifies the small signal design and the stability assessment of the FLC. By exploiting the fuzzy logic structure of the controller, heuristic knowledge is incorporated in the design, which results in a nonlinear controller with improved performance over linear PI controllers.


No matter what the era is, history lesson is one of the leading of the courses that will provide the nations to comprehend the awareness of being a nation. For that reason, history education and teaching is permanently essential. History is the lesson that provide the nations to adapt the values they have, sustain these values through the awareness of protection and provide nations not to lose these, and help people understand the past and present. History has constantly protected its significance due to providing people to make inferences from the experiences, obtain some values, transfer the human values, and proving the negative behaviors such as injustice, malignancy, and wrong and positive behaviors such as justice, honesty, correct and goodness. For that reason, in this study, history lesson curriculums in Turkey were investigated in terms of the values, and the values required to be provided to the students in these programs were determined. Although the history lesson was taught through a program understanding without a specific purpose until 1971, some of these values were noticed to be provided during this period. Since 1971, it could be noticed that the values expected for the students to acquire have been included in purposes section of the history lesson in all history curriculums and program changes. National unity and solidarity is the leading of the values required to be provided, and the values related to a human model constitutional order aims to be raised has also been noticed to be included in all these curriculums.


A new reactive power compensation method is developed to reduce the negative and zero sequence components of load currents and to improve the load bus power factor of unbalanced three-phase four-wire distribution feeders. Negative and zero sequence currents may cause additional losses and damage to power systems. Load compensation at the load bus is an effective method to eliminate those undesired sequence currents. The compensation technique uses a Y-connected and a Delta -connected static reactive power compensators (SVCs) to give a different amount of reactive power compensation to each phase. The compensation formulas are very suitable for on-line control by measurement of phase voltages and currents in real time. The compensation effect can also be achieved even if one leg of the SVCs is out of service. In addition to balancing effect and power factor improvement at the load bus, the SVCs can also be used to support the load bus voltage and to maintain the substation feeder at unity power factor. Digital simulations are made with the load data measured from an 11.4 kV secondary substation feeder. >


No one doubts that prosecutors may sometimes decline prosecution notwithstanding factual guilt. Everyone expects prosecutors to prioritize enforcement based on resource limitation and, occasionally, to decline prosecution on a case-by-case basis when they deem justice requires it. Recently, however, some state prosecutors have tested the boundaries of this power by asserting the right to refuse categorically to enforce certain state laws. Examples include refusals to seek the death penalty and refusals to prosecute prostitution or recreational drug use.

There is thus a burgeoning need for a pertinent evaluative framework. To answer that call, this Article offers the first extended analysis of the normative import of the locally elected status of the state prosecutors who make such pledges. In so doing, it finds that local elections make all the difference. There may well be something suspect about unilateral prosecutorial negation of democratically enacted law. Yet there is something distinctly democratic, and thus justifiable, about an elected prosecutor who can claim popular sanction for the exact same act.

This Article first unspools a once-robust American tradition of localized, populist criminal-law non-enforcement, best seen in jury nullification. It then applies democratic theory to construct a normative basis for reviving that tradition in the context of state prosecutors' categorical non-enforcement. These moves uncover a before-now unappreciated connection: at least where the prosecutor ties her categorical nullification to the polity's electorally expressed will, she accomplishes wholesale what nullifying juries could once do retail. Appreciating that relationship helps uncover a phenomenon best thought of as populist prosecutorial nullification. Building upon that finding, I set out a novel framework for evaluation of state prosecutors' categorical non-enforcement that is keyed to the concept of localized popular will.


We measured levels of antibodies to Giardia lamblia by age in serum specimens from persons in Denver, Colorado, and Soongnern, Thailand. Serum levels of immunoglobulin (Ig) G, IgM, and IgA G lamblia-specific antibodies measured by enzyme-linked immunosorbent assay increased substantially during childhood in both geographic areas, although children in Soongnern showed significantly higher mean levels of each antibody class (P less than .05). After adolescence, levels of G lamblia-specific IgM fell steadily with age in both populations. In contrast, specific IgA levels remained elevated throughout life among the Thai but decreased to low levels among adults in Denver. Similarly, rates of carriage of G lamblia were high among children aged 1 to 4 years in Denver and Soongnern (14.3% versus 26.5%, respectively) but were much lower among adults in Denver (0% versus 14%; P less than .01). These data suggest that levels of G lamblia-specific IgM may reflect exposure to the parasite early in life in both areas. Levels of parasite-specific IgA may reflect recurrent exposure to G lamblia in Soongnern, where G lamblia is endemic, but less frequent exposure to the parasite in Denver, where exposure is often episodic.


Wearable antennas are an integral part of Body Area Networks (BAN). Antenna design for BAN applications is a challenging task since the antennas have to be small, efficient and must not be affected by the wearer's body. This makes isolation of antenna a matter of importance. Ferrites form an opaque media for microwave at the ISM frequencies and hence it could be used for the isolation of antenna from surroundings. Thin polymeric ferrite sheets are used to reduce body influence in BAN perspective.


In this field note, I explore the community coalition model Creative Associates International and its partners employed to provide nonformal education to out-of-school displaced children and youth in northern Nigeria under the USAID-funded Education Crisis Response project. While there is no evidence directly linking community involvement to improved education outcomes in crisis- and conflict-affected contexts, the existing literature and final project results point to its importance in the education in emergencies field. In this field note, I briefly shed light on the education landscape in northern Nigeria, offer global evidence on the impact of community participation in education in low-income and crisis- and conflict-affected contexts, and describe the promise a community-led model employed by the Education Crisis Response project holds for improving education access for out-of-school internally displaced children and youth. I also describe the community mobilization and capacity-building approach adopted for the project and its success in providing access to education for more than 80,000 learners in a volatile region.


Glucose causes a rapid increase in the proportion (%) of glycogen synthase in the active (I) form and a rapid decrease in the proportion of phosphorylase in the active (a) form in both fed and fasted rats. The changes in synthase I and phosphorylase a are more rapid in fasted animals. With graded doses of glucose, the maximal decrease in phosphorylase a occurred at a dose that was considerably smaller than that required to maximally stimulate an increase in % synthase I. Thus, in the intact animal a dissociation between the effects of glucose on the synthase and phosphorylase systems was observed. Sorbitol, mannose, galactose, and arabinose all stimulated an increase in synthase I but did not significantly affect the proportion of phosphorylase in the a form. The % synthase I was not significantly affected by a number of other glucose homologues, pentoses, or three-carbon gluconeogenic substrates. The ketoses fructose and mannoheptulose both caused a striking increase in % phosphorylase a and a decrease in % synthase I, i.e., results opposite to those of glucose. The mechanism by which fructose induces these changes is not known, but the mannoheptulose effects may be accounted for by a rise in liver cAMP concentration.


The aim of this article is to carry out a study on the theory of otherness in three essays from the book El arco y la lira by Octavio Paz: "La otra orilla", "La inspiracion" and "Los signos en rotacion". Given that the otherness is a philosophical problem that dates back to ancient times, a theoretical frame was included in order to expose a background, adopt a methodology and formulate a hypothesis regarding the characteristics of Paz' theory. The hypothesis suggests that a certain affinity can be found with Hegel's dialectics in that for Paz the search for otherness is a dialectical process between being and non-being, between the self and the non-self (the other), and later on this supposition was confirmed in the analysis. Furthermore, three different and complementary visions on otherness were found in the three essays: In "La otra orilla", Paz argues that the poetic revelation is similar to the religious one insofar as it entails an act of "plunging into the other"; in "La inspiracion", he adopts a surrealist perspective, according to which the poetic experience implies a "fusion with the other"; and, finally, in "Los signos de rotacion", most similarities with Hegel were disclosed, especially when Paz suggests that the other should be associated with "being as change", rejecting the traditional idea of "death".


This study observes how a math day-based intervention in master level research methodology education affects students' thinking about mathematics and also about mathematical methods in science. The experiment was constructed in three phases: short instruction, group work, and instant communication to the whole learning group. Utilization of the Learning material portal (LMP) and presence of two teacher coaches implemented our student-centric learning approach.
Standard student evaluation of teaching questionnaires were used for data collection. With minor limitations, the SET data was useful. The gathered feedback revealed that the concept was accepted. Even though the students observed some inconsistencies, they felt that the theme day was an inspirational and thought-provoking event.
With this approach, a highly theoretical subject like mathematical research appearing as sample articles did motivate our students to think in a new way. So the goal to encourage officer students to utilize math-related scientific knowledge in their thesis came closer to becoming reality


Pan stage operations have a major influence on the quality of shipment sugar production, the processing efficiency of the centrifugal and dryer stations, the sugar recovery from final molasses and the steam consumption of raw sugar factories. As well, for many factories, the production capacity of the pan stage is often the rate limiting station of the factory. Several Australian factories now operate with only one pan stage operator and a management tool such as a smart supervisory control system (SSCS) would assist the operator in making better decisions for managing the stage. The SSCS integrates the projected boil-on rates for syrup and molasses to each pan on the stage with the forecast production of syrup based on cane receivel data and molasses from the centrifugals. By using the phase of each pan into an operational model the levels of syrup, A molasses and B molasses in the respective stock tanks are forecast and the information used to forewarn of potential problems or inefficiencies if current operating strategies are maintained. A hybrid fuzzy logic based expert system is employed to advise corrective procedures. While the system is not yet adopted commercially each phase of the development plan has been undertaken. Forecast tank levels have been found to compare favourably with actual tank levels. The SSCS should result in improved use of the installed equipment on the pan stage to achieve increased sugar recovery, improved sugar quality and reduced steam consumption while fulfilling the production rate requirements. One of the important benefits of the control system should be reduced variability in the steam consumption on the pan stage, leading to improved steam economy for the factory.


MultiChord is a new variant of the Chord namespace management algorithm [7] that includes lightweight mechanisms for accommodating a limited rate of change, specifically, process joins and failures. This paper describes the algorithm formally and evaluates its performance, using both simulation and analysis. Our main result is that lookups are provably correct—that is, each lookup returns results that are consistent with a hypothetical ideal system that differs from the actual system only in entries corresponding to recent joins and failures—in the presence of a limited rate of change. In particular, if the number of joins and failures that occur during a given time interval in a given region of system are bounded, then all lookups are correct. A second result is a guaranteed upper bound for the latency of a lookup operation in the absence of any other lookups in the system. Finally, we establish a relationship between the deterministic assumptions of bounded joins and failures and the probabilistic assumptions (which are often used to model large scale networks). In particular, we derive a lower bound for the mean time between two violations of the deterministic assumptions in a steady state system where joins and failures are modeled by Poisson processes.


Instrumented research aircraft data quality during Project SESAME '79 is examined in a series of tower fly-bys designed to compare temperature and static pressure measurements with reference values obtained from sensors located on the towers. Aircraft studied included an NCAR Queen Air and Sabreliner, and the South Dakota T-28. Measurements indicate that the quality of data was within acceptable limits. A discussion of data quality assessment philosophy is given, along with specific means of identifying real and potential sources of error.


Summary The behavior of 125I-labeled recombinant hirudin towards the uninjured and de-endothelialized rabbit aorta wall has been studied in vitro and in vivo to determine its usefulness as an indicator of thrombin activity associated with the aorta wall. Thrombin adsorbed to either sulfopropyl-Sephadex or heparin-Sepharose bound >95% of 125I-r-hirudin and the complex remained bound to the matrix. Binding of 125I-r-hirudin to the exposed aorta subendothelium (intima-media) in vitro was increased substantially if the tissue was pre-treated with thrombin; the quantity of l25I-r-hirudin bound to the de-endothelialized intima-media (i.e. balloon-injured in vitro) correlated positively with the quantity of bound 131I-thrombin (p <0.01). Aortas balloon-injured in vivo were measured for thrombin release from, and binding of 125I-r-hirudin to, the de-endothelialized intimal surface in vitro; 125I-r-hirudin binding correlated with the amount of active thrombin released (p <0.001). Uptake of 125I-r-hirudin by the aorta wall in vivo was proportional to the uptake of 131I-fibrinogen (as an indicator of thrombin activity) before and after balloon injury. After 30 min in the circulation, specific 125I-r-hirudin binding to the uninjured and de-endo- thelialized (at 1.5 h after injury) aorta wall was equivalent to 3.4 (± 2.5) and 25.6 (±18.1) fmol of thrombin/cm2 of intima-media, respectively. Possibly, only hirudin-accessible, glycosaminoglycan-bound thrombin is measured in this way.


Signaling initiation by receptor-like kinases (RLKs) at the plasma membrane of plant cells often requires regulatory leucine-rich repeat (LRR) RLK proteins such as SERK or BIR proteins. The present work examined how the microbe-associated molecular pattern (MAMP) receptor FLS2 builds signaling complexes with BAK1 (SERK3). We first, using in vivo methods that validate separate findings by others, demonstrated that flg22 (flagellin epitope) ligand-initiated FLS2-BAK1 extracellular domain interactions can proceed independent of intracellular domain interactions. We then explored a candidate SERK protein interaction site in the extracellular domains (ectodomains; ECDs) of the significantly different receptors FLS2, EFR (MAMP receptors), PEPR1 (damage-associated molecular pattern (DAMP) receptor), and BRI1 (hormone receptor). Repeat conservation mapping revealed a cluster of conserved solvent-exposed residues near the C-terminus of models of the folded LRR domains. However, site-directed mutagenesis of this conserved site in FLS2 did not impair FLS2-BAK1 ECD interactions, and mutations in the analogous site of EFR caused receptor maturation defects. Hence this conserved LRR C-terminal region apparently has functions other than mediating interactions with BAK1. In vivo tests of the subsequently published FLS2-flg22-BAK1 ECD co-crystal structure were then performed to functionally evaluate some of the unexpected configurations predicted by that crystal structure. In support of the crystal structure data, FLS2-BAK1 ECD interactions were no longer detected in in vivo co-immunoprecipitation experiments after site-directed mutagenesis of the FLS2 BAK1-interaction residues S554, Q530, Q627 or N674. In contrast, in vivo FLS2-mediated signaling persisted and was only minimally reduced, suggesting residual FLS2-BAK1 interaction and the limited sensitivity of co-immunoprecipitation data relative to in vivo assays for signaling outputs. However, Arabidopsis plants expressing FLS2 with the Q530A+Q627A double mutation were impaired both in detectable interaction with BAK1 and in FLS2-mediated responses, lending overall support to current models of FLS2 structure and function.


In a process called photoreactivation, blue light reverses the chemical damage done to DNA by ultraviolet light. One mediator of this effect is the enzyme CPD photolyase; a second photolyase, (6-4)photolyase, is now reported from Drosophila in a paper in this week's issue (Todo et al., p. 109). In his Perspective, Sancar describes how this discovery defines a family of light-sensitive enzymes that also includes the blue-light receptors of plants and why it represents a reawakening of the photolyase field.


Following the idea of performing tests in environmental conditions as similar as possible to the real working ones, many sets of partial discharge tests carried out on an epoxy resin within a broad environmental temperature range are reported on. Life tests were carried out on specimens with a calibrated, enclosed cavity and with embedded electrodes. In the tests performed at temperatures higher than ambient, an interesting strong decrease of data scattering resulted and emphasis on the subject is given. Actually, a strong and unexpected effect was found of the residual mechanical casting stress inside the resin on time-to-breakdown, depending on the difference between the material glass transition temperature and the temperature used in the test. Further data such as discharge amplitude distributions, discharge repetition rate and inception and extinction voltages at the investigated temperatures are also reported and commented upon. >


Household water insecurity is a complex socioecological challenge with a range of consequences for health and wellbeing. Understanding individual and household‐level coping strategies, i.e., responses or adaptations to manage water insecurity, can shape future research and development practice. We therefore (a) systematically describe the characteristics and contexts of 173 studies documenting coping strategies and (b) classify the types of strategies within four domains of water insecurity: access, use, quality, and reliability. Most studies were from Sub‐Saharan Africa or South Asia. In the domain of access, the most common coping strategies were building infrastructure, and storing, purchasing, and sharing water. For use, changing food consumption, agricultural practices, and hygiene were most frequently mentioned. For quality, water treatment was the most common strategy. To ensure water reliability, people most frequently reported changing routines or relocating their homes altogether. Our review provides a useful framework to understand coping strategies, but more research is needed to address three gaps in particular. First, we recommend more representative exploration of the range of coping strategies, particularly in middle‐ and high‐income countries. Second, the links between coping with water insecurity and a range of other nutritional, social, financial, and health outcomes need to be better understood to address overall household wellbeing. Third, we recommend the development of a metric to quantify individual and household‐level water insecurity‐related coping strategies. This line of inquiry can enable practitioners to design and implement context‐specific interventions that leverage preexisting strategies to improve experiences of water insecurity.


To the Editor.— The elegant and important data reported by Farmer and colleagues 1 raise several issues that deserve comment. A different interpretation of their data would be to exclude from analysis those twin pairs with one twin with an affective disorder and one schizophrenic twin, on the grounds that there is a reasonable possibility of a misdiagnosed affective psychosis in the schizophrenic twin. Reanalysis of the remainder of the sample lends support to the possibility of a single-gene dominant form of schizophrenia. The co-occurrence of schizophrenia and affective psychosis in the same identical twin pair is more likely (in any individual case) to be due to misdiagnosis of the "schizophrenic" twin than to a genetic relationship between schizophrenia and mood-incongruent affective disorders (as suggested by Farmer and associates). Patients with early-onset affective psychoses often receive schizophrenic diagnoses because they tend to have more bizarre and psychotic symptoms than patients


This article examines how international hotel industry expansion affects sustainable development in the context of least developed countries. The study focuses on power asymmetries in the governance processes of hotel value chains. First it develops a model to analyse these processes. Subsequently this model is used to present a case study of Inle Lake, Myanmar. The results show the relations between hotel industry growth, economic development, and sustainability in the particular governance setting of this destination. The analysis sheds light on how actors purposely produce and maintain strategic situations in which the interests of particular actors are protected at the costs of many others. In conclusion we therefore argue that practitioners and academia should direct their efforts at creating (knowledge about) governance arrangements that enable genuine community involvement in decision-making processes related to hotel industry expansion.


In this paper, we introduce a class of rings which is a generalization of reversible rings. Let R be a ring with identity. A ring R is called central reversible if for any a,b א R, ab=0 implies ba belongs to the center of R. Since every reversible ring is central reversible, we study sufficient conditions for central reversible rings to be reversible. We prove that some results of reversible rings can be extended to central reversible rings for these general settings.


The paper proposes a modification to the strict priority scheduler, to guarantee the Quality of Service (QoS) of a network with variable and undetermined bandwidth capacity. The proposed modifications make it possible to accomplish QoS along the path. The presented solution allows providing the minimum guaranteed transmission rates for all active flows with the respect to their priorities and to provide the fair share of the additional bandwidth. The scheduler also rejects flows, for which the minimum rate requirements exceed the available bandwidth. Moreover, a simple algorithm for mapping the WiMAX traffic classes to the strict n-priority scheduler bands is described. This allows providing WiFi WiMAX internetworking with the QoS support. The presented test results show that the proposed scheduler preserves the defined, minimum transmission rates and improves the performance of the delay and throughput. Keywords-packet scheduling; strict priority scheduler; Quality of Service; wireless network.


Vegetable consumption in African countries such as Kenya is low, which has a negative impact on the nutritional condition of the population, and on the production by smallholders. The goals of the project were to determine the potentials for consumption and cultivation in the Nairobi metropolitan region, to analyse the reasons for low consumption and to define strategies to stimulate consumption and production. Vegetable consumption can be increased, especially during the dry season when availability is low, and for low-income groups. Production can be increased through technical interventions and improvement of skills. Important is to improve the leverage of producers in the value chain and the efficiency of the value chain. Key elements are: stimulate urban farming; reduce the cost price throughout the value chain and make the value chain more transparent, accountable, shorter with less transaction costs; reduce post-harvest losses, develop a revenue system that better rewards farmers; improve cold storage and logistics, improve irrigation in the dry season; offer dry-season solutions through food processing; and pay attention to a number of life-style issues. The Netherlands can contribute in the fields of re-structuring the value chain, brokering between parties, food processing, consumer behaviour, production and product quality (irrigation, quality seeds, crop management), and R&D.


The purpose of this study is to investigate the predictive value of the characteristics of teaching profession for teac- hers' professional commitment to their job. The target population of the research consists of 812 teachers working in public primary and secondary schools in Fatsa district of Ordu. Of the entire target population, 327 teachers are selected by cluster sampling method. Using the correlational survey design, the set data is obtained by using Teaching Job Characteristics and Teachers' Professional Commitment scales. Results of the study suggest that teachers' perceptions of job characteristics and their professional commitment levels are very high. Multiple linear regression analysis results suggest that there is a moderate level of positive relation between teachers' perceptions of job cha- racteristics and professional commitment, commitment to job and commitment to students, and a low level of positive relation between perceptions of job characteristics and devoted work. It is also revealed that job characteristics explain 34% of professional commitment and that the sub-dimensions of job characteristics; teacher competencies, teacher performance feedback and teacher autonomy are significant predictors of professional commitment. It is determined that teachers' perceptions of job characteristics and general levels of professional commitment do not differ in terms of gender, area and educational level; although the perceptions of job characteristics do not differ in terms of marital status and year of service, the general level of Professional commitment is found to differ in favor of single teachers and teachers with 1-10 years of service. competencies, teacher autonomy, significance of teaching job, and teacher roles and responsibilities.


As bricks-and-mortar companies battle Internet upstarts, some succeed in harnessing the Web to better serve consumers, generate profits and increase market share. Meanwhile others never get their e-business initiatives off the ground. What differentiates the "leaders" from the "laggards"?

Leslie Willcocks, who is professor of information management and e-business at the Warwick Business School, University of Warwick, United Kingdom, and Robert Plant, an associate professor of computer information systems at the University of Miami, conducted a year-long research project and interviewed more than 130 executives in 58 established business-to-consumer (B2C) corporations spanning three continents and a range of industries. They have created a new framework for e-business, which explains strategies that have worked for traditional companies.

The framework shows that "laggard" organizations typically lack a clear business model to govern their use of Web technologies, becoming mired in debates about the relevance of Web technology itself or spending vast sums on brand building without delivering on the promises their brand conveys.

"Leading" organizations tie e-business to their bottom lines by following a distinctive path. Although these companies may start with the idea of achieving technology leadership, they shift attention to brand building and/or customer service and concentrate on generating profitable market share and differentiating the company from competitors.

These e-business leaders share certain characteristics: They integrate Web technologies into the core business; they use information gathered via the Internet to gain insight into their customers; they augment their service; they focus on customers and marketing; and they adapt to the constantly changing Internet marketplace. All have identified ways of using Web technologies for competitive advantage and seek ways to sustain that advantage by focusing on brand, size and customer relationships as well as differentiation.

Increasingly, companies trying to enter the field of B2C e-business will discover what leading organizations already know: E-infrastructure is a boardroom investment and ownership issue that is central to executing sustainable, anticipatory performance.


This paper addresses an I/O interference problem encountered in on-line reconstruction of erasure-coded storage clusters, where user I/Os compete with reconstruction I/Os for both disk and network bandwidth. We propose a redirection scheme called `RAM-RS' to minimize the I/O interference among user and reconstruction requests. RAM-RS redirects user read/writes targeted at failed nodes to an RS-coded RAM region, which is formed by pre-allocated main memory in surviving nodes in the RS-coding manner. The RS-coded RAM region quickly serves all user read/write misses; therefore, a rebuilding node can devote its disk and network bandwidths to the node reconstruction. The RAM region substantially reduces the amount of data rebuilt by the rebuilding node, because (1) missed writes are buffered in the RAM region and (2) missed reads are satisfied by using surviving nodes to co-rebuild failed blocks. We build two Markov models to estimate the reliability of the RAM-RS system. Modeling results demonstrate that the MTTDL of RS-coded RAM region in a storage cluster is larger than that of the same cluster comprised of surviving nodes. We implement both RAM-RS and the traditional Redirection schemes in an erasure-coded storage cluster, on which real-world I/O traces are replayed. Experimental results show that compared with the Redirection scheme running on a 9-node storage cluster, RAM-RS improves system performance in terms of both user response time and reconstruction time by a factor of 1.78 and 1.20, respectively.


Arctic ecosystems hold massive amounts of the global carbon in their soils and are of great importance for the global terrestrial exchange of greenhouse gases to the atmosphere. The arctic region has in general been acting as a C sink for the past 10000 years, however with climate change the C balance in some areas is shifting towards becoming a C source. Herbivory are an important part of many ecosystems and have been found to have an important impact on the C balance. This seemingly important aspect of the C balance in arctic ecosystems are however very rarely considered. In this project, the interactions between plants, soil and herbivores have been studied in a high arctic mire in Zackenberg, northeast Greenland. The aim of the project was to study the impact of the large herbivores muskoxen on the vegetation composition and density, CO2 and CH4 fluxes and substrate availably for CH4 production.
Over a time period of three years three in-situ field studies were conducted. In paper one and two of this thesis treatments were applied that simulate plausible responses of the muskoxen population with climate change. In paper I muskoxen was excluded from part of the Zackenberg mire, thus representing a decrease in the population. In paper II the grazing pressure was increased, by clipping of plots twice each summer. In paper IV the main in-situ drivers of the spatial variability of CH4 flux was studied. Further, a laboratory study (paper III) was conducted to make an in-depth study on the C allocation pattern in the area and the consequences of clipping.
To our surprise, the results from paper I and II showed that the ecosystem responded in similar ways to changes in grazing pressure despite the contrasting treatments. Both increased and decreased grazing resulted in a decrease in the density of vascular plants, in particular of Eriophorum scheuchzeri (Erioph), and in a substantial decrease in CO2 and CH4 fluxes. The third year into the exclusion experiment in paper I the mean Net Ecosystem Exchange (NEE) of CO2 had decrease with 47%, while the CH4 emission had decreased with 44%. In the clipping experiment in paper II NEE decreased already in year one of the experiment and had after three years decreased with on average 35%. A change in CH4 emission was apparent in year two and over the last two years CH4 emission decreased with on average 26%. In the laboratory study, several factors indicated that clipping altered the C allocation pattern and resulted in more C allocation to above ground vegetation and more root exudation. The results from paper IV showed that there is a strong dependence of the spatial variability in CH4 flux on productivity and C input to vegetation and pore water. The main driver of this carbon input is the vegetation composition, with high number of Erioph tillers leading to high input. Consequently, since both decreased and increased grazing pressure resulted in a decrease in Erioph density both these treatments ultimately resulted in lower productivity and decreased CH4 fluxes.
In conclusion, the results from this thesis clearly show that herbivores are of great importance for the C balance of this wet arctic ecosystem, the driving forces behind this effect being interactions between plants, soil and herbivores. The results from this thesis further points to the importance of considering the impact of herbivory when the past, present or future C balance in the arctic is discussed.


A hybrid method combining a three-dimensional unsteady RANS simulation of a cropped CROR at approach conditions and an acoustic analogy based on a frequency formulation of the Ffowcs-Williams and Hawkings' analogy, originally developed by Hanson and extended to non compact chord length, has shown three main sources, the impacts of the front-rotor wakes on the rear-rotor, of the front-rotor tip vortex on the rear-rotor tip, and of the front-rotor hub horse-shoe vortex on the rear-rotor foot. Consequently, this study confirms that the rear-rotor is the dominant tonal noise source and has identified another potential noise source when the CROR is installed caused by the strong tip vortex of the highly-loaded cropped rear-rotor. The rotor-rotor distance should not be reduced as the potential effect is already felt on the front rotor. The influence of the grid refinement has been evaluated on both aerodynamic and acoustic performances.


We conducted a study on the clinical and angiographic characteristics of 140 patients with unstable angina. Average age of 57, male/female ratio 4 to 1. The most frequent risk factors: tobacco smoking (73%) and arterial hypertension (42%). They had old infarct (57%), and unstable angina at rest (37%). We did early submaximal stress test to 31% of them; in 38.6% test was stopped due to angina, 25% for fatigue. 91% had ischemic changes, there weren't any severe complications. Regarding significant coronary obstruction: 20% had one vessel, 26% two, 50% three and left trunk 4%. Normal ventriculogram 43%. Eight patients died; the causes were: disease of the trunk (37.5%) and "active" angina (87.5%), 25% during catheterization . All survivors responded to medical treatment. 54 patients were not candidates for surgical treatment, among them 70.3% were released in class I (NYHA). At follow up 90% were in class I-II, 12% had unstable angina recurrence, 3% had acute infarct. In the pathogenesis of unstable angina intervene fixed atherosclerosis, obstructive lesions, repetitive spasms and non-occlusive thrombosis, this physiopathologic behavior is responsible for the stages of ischemic activity. Treatment should be directed to maintain the balance between the distribution and the demand of O2, and also treating spasm and thrombosis.