In order to solve the international roughness index problem of asphalt concrete pavement in seasonal frozen area, this article takes four typical highways from China's seasonally frozen regions as examples to organize and analyze the geographic location, climatic conditions, structural layer materials and traffic volume of the four roads. Based on the mechanistic-empirical pavement design guide, and by the statistical product and service solutions software for regression analysis, propose IRI correction prediction model of asphalt concrete pavement in the seasonal frozen area and choose IRI measuring values of other highways and the predicted values of IRI prediction model to verify. The result shows that there is a linear relationship between international roughness index, environmental factor, fatigue crack area, transverse crack length and average rut depth. The coefficient of determination R2 is 0.999, the adjusted R2 is 0.999, the significance level is 0, and the regression model is effective. The values corresponding to modified model, environmental factor, fatigue crack area, transverse crack length and average rut depth indicators are 0.004, 0.074, 0.143 and 51.563 respectively; The IRI predicted value of the modified model is closer to the measured value than that of the traditional prediction model. The research results are of great significance for the international roughness index prediction of an asphalt concrete pavement in a seasonal frozen area.


Following on the lines of a previous paper dedicated to cracked components by Ciavarella et al., here the case of a notch of semi-angle α is considered. Contrary to the crack case (α = 180°), the free edges of the notch are easily accessible to experimental analysis; moreover they provide information about all the terms of the Williams series expansion of the stress field about the notch apex, including the most important, i.e. the symmetric and antisymmetric singular term notch stress intensity factors (N-SIFs), whereas for the crack case the mode I N-SIFs cannot be extracted from those stresses. Another important different feature is that symmetric and antisymmetric N-SIFs have different singularities, and in several cases they are so close that their contributions tend to overlap. Therefore, a simple procedure is here proposed to use radial stresses, to separate their symmetric and antisymmetric contributions a priori by computing the sum and difference of the stresses on the two edges, to post-process these quantities in the 'asymptotic region' with standard least-squares techniques and to extract the N-SIFs. The method is applied to a simple case known in the literature and solved by means of a boundary element code, and the results are almost coincident with previous results, even with quite coarse mesh discretizations.


The data on prophylaxis efficacy of the Palivizumab (synagis) against respiratory syncytial viral infection in premature children with bronchopulmonary dysplasia are shown in the article. No side-effects, good tolerance and decrease of the frequency of bronchopulmonary dysplasia relapses and other viral diseases in whole in such children were registered.


Discussion and authors' closure of paper 41–66 by T. F. Brandt and H. L. Rorden, presented at the AIEE winter convention, Philadelphia, Pa., January 27–31, 1941, and published in AIEE TRANSACTIONS, 1941 (June section) pages 255–60.


We present systematic studies of polycrystalline La 12xSrxMnO3 wherex is varied from 0.46 to 0.53 at 0.01 intervals. We have measured the magnetic resonance, ac susceptibility, dc magnetization, x-ray diffraction, four-probe resistivity, and optical reflectivity. The data seem to indicate that, at low T, the materials are intimate mixtures of ferromagnetic and antiferromagnetic microregions. For x.0.48 we observe anomalies pointing toward charge ordering on lowering T. An effective-medium theory is presented, and an appropriate phase diagram is proposed.


Most human services practitioners at one time or another must confront cultural issues which in many ways have a direct impact on their role and effectiveness as helping professionals. This article links the phenomenon of ethnic identity to problems, practices, and policies encountered in the field of human services. Although most of the theoretical concepts presented here are related to counseling psychology and education, other practitioners with culturally diverse client populations will also find the information applicable to their work. The social scientist, teacher and researcher, who is often the disseminator of theoretical and methodological paradigms, should also find these observations useful. The professor of applied and theoretical humanistic studies in many instances is the one who lays the foundation for an understanding of how sociological, cultural, and political phenomena interact with the psychological. The primary purpose of this article, therefore, is to present a psycho-social model (the ethnic matrix) for understanding ethnicity and the ethnic process in American society, and show how this model can be used by practitioners and researchers to further expand their own work.


Objective: Congenitally missing teeth is a common dental anomaly, with the second premolars having a very high incidence after the third molars. Congenitally missing premolars may be associated with presence or absence of retained deciduous second molars. The objective of this case report is to describe the management of retained second deciduous molars with missing second premolars in a young adult patient.Case Description: This article reports a case of a 20 –year old female patient, an undergraduate in a Nigerian university, who presented to the dental clinic complaints of shocking sensation in one of her teeth in the maxillary right quadrant. Clinical examination revealed presence of retained deciduous second molars, bilaterally on the mandible and the maxillary right quadrant, with congenitally missing second premolars. There was a class II carious lesion on the maxillary deciduous second molar. The patient oblivious of the condition was bothered by the shocking sensation on the maxillary deciduous second molar. Amalgam was the restorative material used to treat the carious tooth. Conclusion: It is imperative to maintain or restore the health (the anatomic and physiologic function) of the retained deciduous second molars in cases of congenitally missing second premolars.


Unlike earlier surveys based studies on public attitudes and perceptions of biotechnology, this study investigates the importance of consumers' awareness and knowledge of and interest in biotechnology. Results suggest that Americans are largely unaware of both of the presence in their lives of GM food and of its wide application in food production. In view of this, many Americans would like to see more GM media coverage. Additionally, most Americans are unfamiliar with the laws and safety testing regarding GM food.


Entity resolution (ER) aims to identify entity records that refer to the same real-world entity, which is a critical problem in data cleaning and integration. Most of the existing models are attribute-centric, that is, matching entity pairs by comparing similarities of pre-aligned attributes, which require the schemas of records to be identical and are too coarse-grained to capture subtle key information within a single attribute. In this paper, we propose a novel graph-based ER model GraphER. Our model is token-centric: the final matching results are generated by directly aggregating token-level comparison features, in which both the semantic and structural information has been softly embedded into token embeddings by training an Entity Record Graph Convolutional Network (ER-GCN). To the best of our knowledge, our work is the first effort to do token-centric entity resolution with the help of GCN in entity resolution task. Extensive experiments on two real-world datasets demonstrate that our model stably outperforms state-of-the-art models.


CONTEXT
Effectiveness of organized depression care programs is well established, but dissemination will depend on the balance of benefits and costs.

OBJECTIVES
To estimate the incremental benefit, incremental cost, and net benefit of 2 depression care programs.

DESIGN
Randomized trial comparing 2 interventions with continued usual care, conducted between November 2000 and June 2004.

SETTING
Seven primary care clinics of a prepaid health care plan in Washington.

PARTICIPANTS
Consecutive primary care patients starting antidepressant treatment were invited to a telephone assessment 2 weeks later. Of 634 patients with significant depressive symptoms, 600 consented and were randomized.

INTERVENTIONS
The telephone care management intervention included up to 5 outreach calls for monitoring and support, feedback to treating physicians, and care coordination. The care management plus telephone psychotherapy intervention added an 8-session structured cognitive behavioral therapy program with up to 4 additional calls for reinforcement.

MAIN OUTCOME MEASURES
Independent, blinded telephone assessments at 1, 3, 6, 9, 12, and 18 months included the Symptom Checklist 90 depression scale. Health services costs were measured using health care plan accounting records.

RESULTS
Over 24 months, telephone care management led to a gain of 29 depression-free days (95% confidence interval, -6 to +63) and a $676 increase in outpatient health care costs (95% confidence interval, $596 lower to $1974 higher). The incremental net benefit was negative even if a day free of depression was valued up to $20. Care management plus psychotherapy led to a gain of 46 depression-free days (95% confidence interval, +12 to +80) and a $397 increase in outpatient costs (95% confidence interval, $882 lower to $1725 higher). The incremental net benefit was positive if a day free of depression was valued at $9 or greater.

CONCLUSION
Compared with current primary care practice, a structured telephone program including care management and cognitive behavioral psychotherapy has significant clinical benefit with only a modest increase in health services cost.


Objective: The microenvironment of cancer plays a critical role in its progression. However, the molecular features of cancer-associated fibroblasts (CAFs) are less well understood than those of cancer cells. We investigated the clinicopathological significance of podoplanin expression in stromal fibroblasts in patients with colorectal cancer (CRC). Methods: We selected podoplanin as an upregulated marker in CAF from a DNA microarray experiment. Consequently, podoplanin was identified as an upregulated gene. Immunohistochemical podoplanin expression was investigated at the National Cancer Center Hospital, Tokyo, Japan, in 120 patients with advanced CRC, and its clinicopathological significance was examined. The biological function of podoplanin expression was also assessed by a coculture invasion assay with CRC cell lines such as HCT116 and HCT15. Results: Podoplanin expression was exclusively confined to stromal fibroblasts and absent in tumor cells. Podoplanin is absent in normal stroma except for lymphatic vessels. Staining was considered positive when over 30% of the cancer stroma was stained. Positive podoplanin expression was significantly correlated with a more distal tumor localization (p = 0.013) and a shallower depth of tumor invasion (p = 0.011). Univariate analysis revealed that negative podoplanin expression in stromal fibroblasts was significantly associated with reduced disease-specific survival (p = 0.0017) and disease-free survival (p < 0.0001). Multivariate analysis revealed that negative podoplanin expression (p = 0.016) and lymph node metastasis (p = 0.027) were significantly associated with disease-free survival. CRC cell invasion was augmented by co-culture with CAFs that were treated with siRNA for podoplanin. Conclusions: Our results suggest that a positive podoplanin expression in stromal fibroblasts could have a protective role against CRC cell invasion and is a significant indicator of a good prognosis in patients with advanced CRC, supported by biological analysis showing that podoplanin expression in CAFs is associated with decreased CRC cell invasion.


Preparing, recruiting, and retaining high-quality teachers into the profession has been a concern of policy makers and practitioners for some time. Teacher attrition is problematic and costly for schools and districts. However, relatively few studies have investigated the relationship between preservice teacher quality and teacher attrition. In this study, we analyze data from an apprenticeship-style teacher preparation program to understand the relationship between a measure of preservice teacher quality—student teachers' observational scores—and their decisions to (a) enter into the profession, and (b) stay in the profession within the first 2 years after graduation. We find that more qualified student teachers are more likely to enter into the profession and stay in the profession, even after controlling for student teachers' demographic characteristics and their academic achievement.


The Vaidya solution describes the gravitational collapse of a finite shell of incoherent radiation falling into flat spacetime and giving rise to a Schwarzschild black hole. There has been a question whether closed trapped surfaces can extend into the flat region (whereas closed outer trapped surfaces certainly can). For the special case of self-similar collapse we show that the answer is yes, if and only if the mass function rises fast enough.


Existing routing and broadcasting protocols for ad hoc networks assume an ideal physical layer model. We apply the log-normal shadow fading model to represent a realistic physical layer and use the probability p(x) for receiving a packet successfully as a function of distance x between two nodes. We define the transmission radius R as the distance at which p(R)=0.5. We propose a medium access control layer protocol, where receiver node acknowledges packet to sender node u times, where u*p(x)/spl ap/1. We derived an approximation for p(x) to reduce computation time. It can be used as the weight in the optimal shortest hop count routing scheme. We then study the optimal packet forwarding distance to minimize the hop count, and show that it is approximately 0.73R (for power attenuation degree 2). A hop count optimal, greedy, localized routing algorithm [referred as ideal hop count routing (IHCR)] for ad hoc wireless networks is then presented. We present another algorithm called expected progress routing with acknowledgment (referred as aEPR) for ad hoc wireless networks. Two variants of aEPR algorithm, namely, aEPR-1 and aEPR-u are also presented. Next, we propose projection progress scheme, and its two variants, 1-Projection and u-Projection. Iterative versions of aEPR and projection progress attempt to improve their performance. We then propose tR-greedy routing scheme, where packet is forwarded to neighbor closest to destination, among neighbors that are within distance tR. All described schemes are implemented, and their performances are evaluated and compared.


The economic recession has hit especially hard the residential building sector in the EU region, e.g., the number of the housing completions has decreased -49% and the total residential output has been squeezed down by -24% between 2007 and 2014 (Euroconstruct, 2015). In turn, the aim of our paper is to suggest a set of radical, novel programmes for developing the national residential building sectors within EU member countries up to 2025. We have applied the framework of strategic niche management (SNM) to the diagnoses of the current portfolios of the innovation, R&D programs in our two member country contexts. In the case of the Northern Finland, the prime example is Hiukkavaara, the largest district to be built in the City of Oulu. Homes will be constructed for 20,000 new residents. Hiukkavaara is a model for climate- conscious design in the northern hemisphere. Energy and materials are conserved, nature is valued and human beings adapt to their environment. One sub-programme involves Future Buildings and Renewable Energy Project. In the case of the Netherlands, the prime example is Energiesprong (Energy Leap), i.e., the innovation programme commissioned by the Dutch Ministry of the Interior. The aim is to make buildings energy-neutral and boost large-scale initiatives. The sub-programmes are targeting homes owned by housing associations, privately owned homes, office buildings, shops and care institutions. This programme is about ensuring new supply by encouraging companies to package a variety of technical sub-solutions, full services and financing options as well as about asking clients to put out tenders and ask for quotes in novel ways, with the government making changes to the rules and the regulations. Experiences on which the Dutch case in this paper focuses are sub-programmes for residential buildings, which include de Stroomversnelling, LALOG and Ons Huis Verdient Het. Based on the emerging Finnish and Dutch evidence, we are suggesting key elements to be incorporated into future national residential programmes within EU member countries on: (1) radical direction with balanced stakeholder groups, trustworthy advocates, contextual goal-setting and barriers management, (2) radical networking with entrepreneurial roles and causal links, novel expertise, transparent choices and digital platforms and (3) radical learning processes to arrive at better informed markets on user preferences, co-innovating, new rules and regulations, higher performance/price ratios, higher quality, new roles and responsibilities assignments.


A new mechanism, stimulating the precipitation of calcite, is postulated. The supersaturation with respect to carbonate minerals is changed, as a result of CO2 consumption by chemolithoautotrophic, hydrogen-oxidizing bacteria. This mechanism controls the growth of atypical, microcrystalline cave pisoids in Perlova Cave, in Slovakia. The pisoids grow under calm conditions in rimstone pools, where they are bathed continuously in stagnant water. The water is supersaturated, with respect to calcite and aragonite. The bacteria inhabit the outer parts of the pisoids, covered by biofilms. The biofilm influences the supply of the Ca2+ ion, slows down the precipitation rate, and favors calcite precipitation over that of aragonite. The calcite initially precipitates as bacterial replicas, which further act as seeds for the growing calcite crystals. This process leads to the obliteration of the primary, bacterial fabrics. Since hydrogen-oxidizing bacteria occur in a wide spectrum of natural habitats, the mechanism of calcification, postulated above, also may operate in other environments.


It is evident that administrative reforms are undertaken by many countries in the world today and in fact, administrative change appears to be a constant factor in regimes that desire to reform their social, political and economic systems. Normally, reform initiatives are regarded as necessary for organizations that want to adapt to the changing environment and to be able to expand and cope with increasing activities and global challenges. Nevertheless, strategies for reform initiatives will differ between sectors and also between nations as each country tries to handle reform in accordance with the country?s administrative traditions, political and cultural nuances and level of economic development. The process of reform may involve a particular sector or administration of the government or an entire level of the government such as the local government. The main characteristic of administrative reform is normally projected in attempts to decentralize powers and autonomy to lower levels of government. It connotes importance that such transition of powers is supposedly significant to the unification and development of a nation. This is especially so, as some studies have shown, where the shift of power to local government has created a series of hierarchically ordered units of administration at some of the lowest levels of government. The implication is a movement of power from the centre and may determine the scope of decentralization, nonetheless it involves a transition process that ultimately may change the characteristics of power structure of the different levels of government.


[reaction: see text] Reformatsky-type reactions have been performed efficiently using an electroassisted iron-complex catalysis. Valuable product such as beta-hydroxyesters, ketones or nitriles are thus prepared with high yields.


Several diamond coatings were performed on -TiAl substrates by a microwave-plasma assisted CVD, which were made directly to the substrate and indirectly to the TiC, Ti5Si3, Al2O3+TiO2 and Si layers on the substrate. The direct coatings suffered from severe delamination and cracks. The deposited layers on TiC and Ti5Si3 layers partially delaminated, while those on Al2O3+TiO2 and Si layers adhered well without delamination. All the diamond films deposited were characterized using scanning electron microscopy, Raman spectroscopy, and X-ray diffraction. Raman spectra showed that poly- and nano-crystalline diamond films were obtained for the coatings of -TiAl.


The performance of bit-interleaved coded modulation with iterative decoding is significantly influenced by the mapping of bits to the symbol constellation. A range of mappers have been suggested in the literature, however, no attempt has been made to systematically enumerate all unique mappers for a given signal constellation. In this paper, we classify 8PSK mappers based on bit-wise distance spectra for no prior information, and full prior information, respectively.


The structure and dynamic of social network are largely determined by the heterogeneous interaction activity and social capital allocation of individuals. These features interplay in a non-trivial way in the formation of network and challenge a rigorous dynamical system theory of network evolution. Here we study seven real networks describing temporal human
interactions in three different settings: scientific collaborations, Twitter
mentions, and mobile phone calls. We find that the node's activity and social capital allocation can be described by two general functional forms that can be used to define a simple stochastic model for social network dynamic. This model allows the explicit asymptotic solution of the Master Equation describing the system dynamic, and provides the scaling laws characterizing the time evolution of the social network degree distribution and individual node's ego network. The analytical predictions reproduce with accuracy the empirical observations validating the
theoretical approach. Our results provide a rigorous dynamical system framework that can be extended to include other features of networks' formation and to generate data driven predictions for the asymptotic behavior of large-scale social networks.


The paper reports 4 cases of early Lyme borreliosis which presented as lymphadenopathy at the site of the tick bite. Erythema migrans and dissemination of infection were absent. The diagnosis was verified via diagnostic titer of antibodies to Borrelia. Administration of antibiotics at the stage of lymphadenopathy contributed to better prognosis. One patient did not receive antibacterial treatment in acute disease and had progression with infection dissemination. Regional lymphadenopathy may serve a clinical marker of early Lime borreliosis.


Between 1971 and 1991 we treated 98 patients with giant-cell tumours, 15 of whom presented with a pathological fracture. They were most common around the knee (12). Nine fractures were intra-articular. The tumours were treated by curettage and acrylic cementing (10), excision and endoprosthesis (1), excision and allograft (1), curettage and autologous graft (2) or by resection of the fibular head (1). Four patients had local recurrence, three of whom were cured by repeat curettage and cementing. Pathological fracture through a giant-cell tumour is not a contraindication to treatment by curettage and acrylic cementing.


: A pRP19.6 plasmid is the derivative of the temperature sensitive RPlts12 plasmid and contains a duplicated IS21 (IS8) element. Using temperature sensitive pRP19.6 replication, Hfr strains have been obtained by integration of the plasmid into the chromosome of E. coli rec+ and recA- cells and their properties were studied. According to the results obtained, pRP19.6 insertion into the genome of the rec+ bacteria IS reversible, and its integration into the chromosome of the recA- bacteria produced the stable Hfr strains. To elucidate the mechanism of pRP19.6 excision from the bacterial chromosome, plasmids of R+ transconjugates generated with a low frequency in the crosses between the stable Hfr strains and the rec+ recipients were analyzed. It was shown that the stable Hfr clones might produce stable R1 plasmids as well as a family of deletion KmsTra- derivatives of the pRP19.6. The structure of the KmsTra- was investigated and the mechanism of their formation was proposed. In the light of the data obtained, prospects of pRP19.6 practical application are discussed.


Following on the arguments adumbrated in his previous works, Piotr Hoffman here argues that the notion of and concern with violence are not limited to political philosophy but in fact form the essential component of philosophy in general. The acute awareness of the ever-present possibility of violence, Hoffman claims, filters into and informs ontology and epistemology in ways that require careful analysis. In his previous book, "Doubt, Time, Violence," Hoffman explored the theme of violence in relation to Descartes' problematic of doubt and Heidegger's work on temporality. The pivotal notion deriving from that investigation is the notion of the other as the ultimate limit of one's powers. In effect, Hoffman argues, our practical mastery of the natural environment still leaves intact the limitation of human agents by each other. In a violent environment, the other emerges as an insurmountable obstacle to one's aims and purposes or as an inescapable danger which one is powerless to hold at bay. The other is thus the focus of an ultimate resistance to one's powers. The special status of the other, as Hoffman articulates it, is at the root of several key notions around which modern philosophy has built its problematic. Arguing here that when the theme of violence is taken into account many conceptual tensions and puzzles receive satisfying solutions, Hoffman traces the theme through the issue of things versus properties; through Kant's treatment of causality, necessity, and freedom in the Critique of Pure Reason; and through the early parts of Hegel's Logic. The result is a complete reorientation and reinterpretation of these important texts. "Violence in Modern Philosophy" offers patient and careful textual clarification in light of Hoffman's central thesis regarding the other as ultimate limit. With a high level of originality, he shows that the theme of violence is the hidden impulse behind much of modern philosophy. Hoffman's unique stress on the constitutive importance of violence also offers a challenge to the dominant "compatibilist" tradition in moral and political theory. Of great interest to all philosophers, this work will also provide fresh insights to anthropologists and all those in the social sciences and humanities who occupy themselves with the general theory of culture.


Establishing and maintaining millimeter-wave (mm-wave) links are challenging due to the changing environment and the high sensibility of mm-wave signals to user mobility and channel conditions. mm-Wave link configuration problems often involve a search for optimal system parameter(s) under environmental uncertainties from a finite set of alternatives that are supported by the system hardware and protocol. For example, beam sweeping aims at identifying the optimal beam(s) for data transmission from a discrete codebook. Selecting parameters such as the beam sweeping period and the beamwidth is crucial to achieving high overall system throughput. In this article, we motivate the use of the multi-armed bandit (MAB) framework to intelligently search out the optimal configuration when establishing the mm-wave links. MAB is a reinforcement learning framework that guides a decision maker to sequentially select one action from a set of actions. As an example, we show that within the MAB framework, the optimal beam sweeping period, beamwidth, and beam directions could be dynamically learned with sample-computational-efficient bandit algorithms. We conclude by highlighting some future research directions on enhancing mm-wave link configuration design with MAB.


In this digital age, we are observing an exponential proliferation of sophisticated hardware- and software-based solutions that are able to interact with the users at almost every sensitive aspect of our lives, collecting and analysing a range of data about us. These data, or the derived information out of it, are often too personal to fall into unwanted hands, and thus users are almost always wary of the privacy of such private data that are being continuously collected through these digital mediums. To further complicate the issue, the infringement cases of such databanks are on a sharp rise. Several frameworks have been devised in various parts of the globe to safeguard the issue of data privacy; in parallel, constant research is also being conducted on closing the loopholes within these frameworks. This study aimed to analyse the contemporary privacy by design frameworks to identify the key limitations. Seven contemporary privacy by design frameworks were examined in-depth in this research that was based on a systematic literature review. The result, targeted at the healthcare sector, is expected to produce a high degree of fortification against data breaches in the personal information domain.


The Committee on Foreign Investment in the United States (CFIUS), which reviews transactions based on national security concerns, has recently become critical to the operation of the U.S. economy. In March of 2018, CFIUS review led to the prohibition of Broadcom Limited's acquisition of Qualcomm Corp., which would have been the largest technology merger in history. In August of 2018, CFIUS was dramatically expanded with the enactment of the Foreign Investment Risk Review Modernization Act of 2018 (FIRRMA). Major transactions must now reckon with the uncertainties of CFIUS review.

Created over thirty years ago as a reporting and monitoring committee, CFIUS has evolved into a formidable force with the power to review and investigate foreign investments in U.S. businesses, and to recommend that the President prohibit or order divestment of those investments. This Article traces the origins of CFIUS from its establishment in 1975 through the changes made by the 1988 Exon-Florio Amendment, the Foreign Investment and National Security Act of 2007, and now FIRRMA. The Article examines the key transactions CFIUS has considered, and CFIUS's expansive understandings of what constitute U.S. businesses and its authority over foreign investors.

In the Broadcom-Qualcomm transaction, CFIUS review was requested by target company (Qualcomm) board, and the review and resulting Presidential order operated as a powerful antitakeover defense. Turning from history to process, this Article looks closely at the ramifications of corporate boards seeking CFIUS review as a defensive measure to ward off hostile takeovers, a kind of "super poison pill." To that end, the Article looks at mergers and acquisitions, and the longstanding conceptions of both the market for corporate control and the agency problem in corporate governance. The Article then reviews board powers and the traditional antitakeover measures, as well as the jurisprudence developed by state courts to review those defenses.

CFIUS review may be deployed by corporate boards as an antitakeover device. Given the strong global M&A market, and the significant increase in CFIUS's jurisdiction as a result of the enactment of FIRRAM, CFIUS is expected to review more transactions, including more hostile takeovers. In assessing notifications in this context, CFIUS may benefit from the jurisprudence developed by state courts. Given the amount of global capital being invested across borders, and the intensity of global security concerns, foreign investment transactions are likely to continue, and to continue to need review, for the foreseeable future. A CFIUS review process that can assess target board motivations and measures, with an experienced perspective on blocking or allowing the transaction, will help ensure that CFIUS review achieves its national security goals without doing unnecessary societal harm.


Background and Objective: The findings of the Health Care in Danger project in Karachi suggests that there is presence of behavioral negligence among vehicle operators on roads in regards to giving way to ambulances. A mass media campaign was conducted to raise people's awareness on the importance of giving way to ambulances. The main objective of this study was to determine the effectiveness of the campaign on increasing the proportion of vehicles that give way to ambulances. Methods: This was a quasi-experimental study that was based on before and after design. Three observation surveys were carried out in different areas of the city in Karachi, Pakistan before, during and after the campaign by trained observers who recorded their findings on a checklist. Each observation was carried out at three different times of the day for at least two days on each road. The relationship of the media campaign with regards to a vehicle giving space to an ambulance was calculated by means of odds ratios and 95% confidence intervals using multivariate logistic regression. Results: Overall, 245 observations were included in the analysis. Traffic congestion and negligence/resistance, by vehicles operators who were in front of the ambulance, were the two main reasons why ambulances were not given way. Other reasons include: sudden stops by minibuses and in the process causing obstruction, ambulances not rushing through to alert vehicle operators to give way and traffic interruption by VIP movement. After adjustment for site, time of day, type of ambulance and number of cars in front of the ambulance, vehicles during (OR=2.13, 95% CI=1.22-3.71, p=0.007) and after the campaign (OR=1.73, 95% CI=1.02-2.95, p=0.042) were significantly more likely give space to ambulances. Conclusion: Mass media campaigns can play a significant role in changing the negligent behavior of people, especially when the campaign conveys a humanitarian message such as: giving way to ambulances can save lives.


Nanodiamond/Ni and Ni coatings were fabricated via brush plating. Nanocrystalline structure of the composite coating was investigated by SEM and XRD. The results showed that the composite coatings are nanocrystalline structure. The hardness of the nanodiamond/Ni composite coating is higher greatly than that of Ni coating. At same time, the reasons of formation nanocrystalline were discussed, which include the nucleation rate with the increase of a high over-potential, the reciprocating motion between brush and work piece, the heterogeneous nucleation of nanodiamond. The nanodiamonds as second phases make grain finer. The nanodiamonds of core-shell structure play the important role in wear resistance and antifriction. So the wear resistance of the composite coatings is significantly higher than nickel coating's.


In the year 1021 CE, blind author and skeptic Abū l-ʿAlāʾ al-Maʿarrī (d. 1057 CE) wrote Risālat al-ṣāhil wa-l-shāḥij (The Epistle of the Horse and the Mule), a winding prose work populated by animal characters who talk about poetry, grammar, riddles, and Syrian society on the eve of the crusades. Traditionally forgotten as a source for al-Maʿarrī's pacifism, and his vegan worldview, the Ṣāhil lets readers see his thinking on animals more than most other works. After a brief survey of animals in Islam, which shows a mainstream desire for balance between human and non-human needs, as well as exceptional cases that strongly uphold animals as subjects per se and which stand as key inter-texts for al-Maʿarrī, this paper considers how the Ṣāhil champions non-human creatures through images of animal cruelty deployed to shock readers into compassion, and through poetry and popular sayings (amthāl) recast in a zoocentric mold. It, therefore, advocates with more fervor than anthropocentric Islamic writings on animals, such as Kalīlah wa-Dimnah or the letters of the Ikhwān al-Ṣafāʾ. However, this happens in a way that makes it hard to pin down the sources of al-Maʿarrī's thought. Furthermore, al-Maʿarrī seems to contradict himself when, for example, he employs literal meaning when it comes to animal justice, even as he avoids literalism in other contexts. This calls his concern for animals into question in one sense, but in another, it affirms such concern insofar as his self-contradictions show an active mind working through animal ethics in real time.


A full-length molecular clone of equine infectious anemia virus (EIAV) was isolated from a persistently infected canine fetal thymus cell line (Cf2Th). Upon transfection of equine dermis cells, the clone, designated CL22, yielded infectious EIAV particles (CL22-V) that replicated in vitro in both Cf2Th cells and an equine dermis cell strain. Horses infected with CL22-V developed an antibody response to viral proteins and possessed viral DNA in peripheral blood mononuclear cells, as determined by polymerase chain reaction assays. In addition, horses infected with CL22-V became persistently infected and were capable of transmitting the infection by transfer of whole blood to uninfected horses. However, CL22-V, like the parental canine cell-adapted virus, did not cause clinical signs in infected horses. Reverse transcriptase assays of CL22-V- and virulent EIAV-infected equine mononuclear cell cultures indicated that the lack of virulence of CL22-V was not due to an inability to infect and replicate in equine mononuclear cells in vitro.


A US power generation company had 36 similar high heat rate gas turbines in two of their plants. These units were used for peaking power in a large metropolitan area. On two of these units in the early 1990's they tried switching from lubricated, gear-type couplings to single, machined diaphragm-type couplings for reduction of maintenance and improved flexibility. The gear couplings also caused a great deal of vibrations during startup, and many times units were shut down because of excessive vibrations. Due to the extreme thermal growth of these applications, along with the stop-start nature of the application, the couplings were required to handle enormous amounts of misalignment. While the standard diaphragm couplings seemed like a good choice for the application because of their large misalignment capability, they proved to be unable to handle the excessive offset movements caused by thermal growth. The problem with the standard diaphragm was that it was too stiff or in other words, the spring rate was too high. In one case the coupling failed catastrophically very quickly under normal running conditions. In the mid 1990's the power company tried a different, unique style of diaphragm couplings that used multiple diaphragms with holes in them. The diaphragms were made of thin, uniform thickness steel instead of the more common machined 'profile' diaphragms. Because of the holes, these new diaphragms provided much more misalignment capability, and they also had far lower spring rates than the previous diaphragm couplings. The lower spring rates caused an enormous reduction in reactionary forces from the coupling, and they also eliminated many vibration problems caused by the original gear couplings. The overall effect of this discovery was for the company to begin changing all similar units to this type of coupling. Now these 36 units which previously had severe vibration problems during startup, run very reliably. They have also eliminated the need for maintenance, which was an issue with the original gear couplings.Copyright © 2006 by ASME


The true insights for long-term competitive advantage will be generated by deep observation of both new and established business wrestling with the challenges of online marketing and general business strategy. The internet marketing is just emerging and has yet to occupy a significant place. We do anticipate that this will change in the next couple of years. In the meantime, we believe that practice is ahead of theory and that we must mine the practice of Internet marketing for new ideas. The task of the internet marketer is to asses new market opportunities. Analysis of marketing opportunities should be informed by rich data on the competitors, customers, and industry. Internet marketing program is the specification of the marketing strategy. We identify two marketing strategy formulation pathways: one for pure-play online companies and one for the integrative play. An in-depth discussion of key elements of the marketing strategy, segmentation, and target market choice and positioning sets the stage for the design of the customer experience and actual marketing program.


Abstract This is the first report of a natural Mg-rich protoanthophyllite. It is common in metamorphosed serpentinites from three Japanese ultramafic complexes, and some crystals contain anthophyllite (Pnma) lamellae. The Mg/(Mg + Fe) ratios of the Hayachine, Tari-Misaka, and Takase protoanthophyllites are 0.90, 0.92, and 0.91, respectively. The samples have identical optical properties: X = a, Y = b, Z = c, and 2Vx = 64 ± 5°. Their space group is Pnmn (or Pn2n), as revealed by systematic extinctions in selected-area electron-diffraction patterns. The protoanthophyllite and anthophyllite have similar compositions and orthorhombic symmetry. They are difficult to distinguish using optical, microanalytical, and powder X-ray diffraction measurements. This problem raises the possibility that some of the published data on geological and synthetic anthophyllite samples may be of misidentified materials, potentially leading to errors in the published stability relations of anthophyllite. We provide a method to identify protoanthophyllite and differentiate it from its polymorphs using selected-area electron diffraction and high-resolution transmission electron microscopy methods.


This thesis examines the effect long -term versus short-term mortgage rates have on housing prices in Sweden, in order to shed some light on the possible shortsightedness among house buyers. According to economic theory, house prices should reflect the long-term mortgage rate as it contains information and predictions about future costs of lending, inflation and other macro- and micro level cost determining factors. It is suggested that rational buyers estimate the real value of houses as the present value of all future transactions –including cost of capital. Should the short-term mortgage rate be a more important determinant of the price, the financial system and distribution of wealth could be set out of order, as the short-term rate fluctuates more dramatically than the long-term rates.As is shown in the thesis, the long-term rate appears to have a greater negative impact on house prices, but after controlling for variables such as average income in the regression, there is no statistical significant proof that long term rate affects prices negatively. However in the corresponding analysis, the short-term rate proves to be significant in explaining the prices even after controlling for average income, numbers of sold houses and population density. The results could be misleading and arise because of limited possibilities to control for all potentially confounding factors such as inflation and the economic cycle or time-lag disturbance. If housing prices do not depend on expected costs of living but speculations, the market could be threatened by the burst of a price bubble.


Background and epidemiology: Typhoid fever is a systemic bacterial infection caused by Salmonella typhi. Typhoid is usually acquired through ingestion of water or food contaminated by the urine or feces of infected carriers and, as such, is a common illness in areas where sanitation is poor. One of the most famous carriers was Typhoid Mary, a cook who infected at least 51 people.1 Today, outbreaks of typhoid fever occur most often in developing countries, in refugee camps and in overwhelmed areas with a high population density. In some areas the annual incidence is as high as 198 cases per 100 0002 and, contrary to a previously held view, the disease causes considerable morbidity in children.3 Worldwide, at least 17 million new cases and up to 600 000 deaths are reported annually.4 The disease is less common in North America: an estimated 400 cases are reported each year in the United States, 70% occurring in travellers returning from endemic areas.5

The case-fatality rate of typhoid fever is 10%, but it can be reduced to 1% with appropriate antibiotic treatment.4

Infections with other Salmonella bacteria also occur. Paratyphoid fever is also a systemic disease, caused by Salmonella paratyphi. Its presenting symptoms are similar to those of typhoid fever, but they are milder and the case-fatality rate is much lower.

The other pattern of Salmonella infection is primarily enteric ("food poisoning") and can occur with exposure to one of hundreds of different Salmonella species.

Clinical management: Although in most cases a transient and mild episode of diarrhea develops shortly after ingesting S. typhi bacteria, most cases are asymptomatic during an incubation period of 7–14 days. The disease manifests most often a week or so after ingestion and begins with an intermittent fever that becomes high and sustained, severe headache, poorly localized abdominal discomfort, malaise and anorexia. There may also be a nonproductive cough. Although the focus of the infection is the intestine, constipation is more common than diarrhea in adults. The reverse is true in AIDS patients and children.

Physical signs are few. Bradycardia in the presence of high fever, once considered a hallmark of typhoid fever, is not common. The abdomen may be tender to palpation, with poorly localized discomfort. Rose-coloured spots (small maculopapular blanching lesions) appear on the trunk of about 25% of patients with light skin. The spots are less frequent and more difficult to locate in people with darker skin. Laboratory screening may reveal a normal hemoglobin level, normal leukocyte and platelet counts, and elevated liver enzyme levels.6

Complications occur in 10%–15% of cases; gastrointestinal bleeding, perforation and typhoid encephalopathy are the most serious. Gastrointestinal bleeding can occur in up to 10% of cases, most likely from intestinal erosion, but it is clinically significant in only 2% of cases.6

Typhoid fever is diagnosed by means of bacterial culture. Blood culture is usually done and is most sensitive in the first week of illness. Bone marrow culture is more sensitive than blood culture, regardless of the duration of illness or treatment with antibiotics, but it is technically more difficult to perform. Fecal culture yields positive results in only one-third of cases. Serologic testing for Salmonella antibodies (Widal's test) is possible but shows cross-reactivity with some other Salmonella species and has a sensitivity of only 70%.

Treatment of typhoid fever is with antibiotics, usually fluoroquinolones. Chloramphenicol, amoxicillin and trimethoprim–sulfamethoxazole remain reasonable choices when quinolones are unavailable. Unfortunately, resistance of S. typhi strains to all of these drugs is becoming more common, particularly in Asia, the Middle East and Latin America. As such, appropriate treatment varies with geographic distribution of resistant strains. In resistant cases, consideration is given to a longer duration of quinolone therapy or to treatment with azithromycin or a third-generation cephalosporin.6

Prevention and control: Prevention measures target handwashing, sanitary disposal of human feces, provision of safe public water supplies, controlling of flies, scrupulous food preparation, and pasteurization of milk and other dairy products. In addition, because many seafood beds are contaminated with sewage, attention is given to limiting the collection and marketing of shellfish to approved sources, and to steaming or boiling shellfish for at least 10 minutes.

Immunity is conferred after infection or through vaccination. In either case, it is only temporary. Typhoid fever vaccine can be given orally or parenterally, and the efficacy of, and adverse reactions to, each type differ.7 Vaccination is often recommended for people travelling to endemic regions, although the cost-effectiveness of this strategy has been questioned.7 The effectiveness of mass vaccination in endemic regions is undergoing further study but should be considered in high-risk situations, such as disaster relief sites and refugee camps.

James Maskalyk Editorial Fellow CMAJ


Many existing imitation learning datasets are collected from multiple demonstrators, each with different expertise at different parts of the environment. Yet, standard imitation learning algorithms typically treat all demonstrators as homogeneous, regardless of their expertise, absorbing the weaknesses of any suboptimal demonstrators. In this work, we show that unsupervised learning over demonstrator expertise can lead to a consistent boost in the performance of imitation learning algorithms. We develop and optimize a joint model over a learned policy and expertise levels of the demonstrators. This enables our model to learn from the optimal behavior and filter out the suboptimal behavior of each demonstrator. Our model learns a single policy that can outperform even the best demonstrator, and can be used to estimate the expertise of any demonstrator at any state. We illustrate our findings on real-robotic continuous control tasks from Robomimic and discrete environments such as MiniGrid and chess, out-performing competing methods in $21$ out of $23$ settings, with an average of $7\%$ and up to $60\%$ improvement in terms of the final reward.


Combinatorial optimization is a common theme in computer science. While in general such problems are NP-Hard, from a practical point of view, locally optimal solutions can be useful. In some combinatorial problems however, it can be hard to define meaningful solution neighborhoods that connect large portions of the search space, thus hindering methods that search this space directly. We suggest to circumvent such cases by utilizing a policy gradient algorithm that transforms the problem to the continuous domain, and to optimize a new surrogate objective that renders the former as generic stochastic optimizer. This is achieved by producing a surrogate objective whose distribution is fixed and predetermined, thus removing the need to fine-tune various hyper-parameters in a case by case manner. Since we are interested in methods which can successfully recover locally optimal solutions, we use the problem of finding locally maximal cliques as a challenging experimental benchmark, and we report results on a large dataset of graphs that is designed to test clique finding algorithms. Notably, we show in this benchmark that fixing the distribution of the surrogate is key to consistently recovering locally optimal solutions, and that our surrogate objective leads to an algorithm that outperforms other methods we have tested in a number of measures.


Marked sex differences in the growth of enzyme-altered hepatic foci have been observed in rats treated according to the "resistant hepatocyte model." The present study was performed to investigate the effect of neonatal and adult castration of male rats, with or without testosterone substitution, on the growth rate of foci during selection of initiated cells with 2-acetylaminofluorene and partial hepatectomy. Neonatal castration of male rats decreased focal growth to the same level as in female rats. Castration of adult male rats 2 wk before initiation with diethylnitrosamine also decreased the growth rate of foci, but less markedly than in neonatally castrated rats. Testosterone substitution of male rats castrated as neonates or as adults, from 10 days after initiation with diethylnitrosamine, restored focal growth to that of sham-castrated controls. Previous investigations concerning the role of gonadal hormones in sex differentiation of various liver functions indicated a role of the hypothalamo-pituitary-liver axis in mediating the effects of androgens. It is therefore also suggested that the effects of androgens on early steps of hepatocarcinogenesis observed in the present study are mediated by similar mechanisms, possibly through an influence on the metabolism of 2-acetylaminofluorene.


In this study, 20 qualitative children's interviews were conducted and evaluated using the grounded theory method to investigate the following research question: What is relevant from the perspective of the surveyed children about equine-assisted interventions? To reconstruct the children's perspective, drawings painted by the children during each interview had been collected as another means of expression. The consideration of the children's perspective has received little attention in research so far and this methodological access gave an insight into children's experiences and thus, into the effects of the interventions. The interviews were analyzed with the qualitative grounded theory methodology and the segment analysis of the drawings offered additional material. The interviewed children took part in the equine-assisted intervention for emotional stabilization, because they had been exposed to increased psychosocial stress, like growing up in residential groups for children and youth welfare and not with their parents. The interviews revealed that, from the children's point of view, it is of particular importance to the experience that they can trust others and trust themselves as well. Trust in others is supported by the pedagogical riding instructor, who ensured the safety of the animal. The positive experiences with the animal and the resulting trust had a positive effect on the children. If the intervention took place in a group, the children experienced mutual support. The children's self-confidence was mainly strengthened by learning new things in the equine-assisted setting. At the beginning of the intervention, it was often necessary to overcome fears and in further intervention, there were always new challenges to be conquered with the support of the riding instructor, so that various experiences of success arose and the children felt able to act.


The implementation of Small Claims court mechanism according to Supreme Court Regulation (PERMA) Number 2/2015 concerning Procedures for Small-Claims Court Resolution recently granted a breakthrough in the civil justice system particularly in Indonesia. It was reached by the Supreme Court in order to reduce the court burden against cases with disputes below IDR 200 million rupiah. The disputes resolution by Small Claims court mechanism is done by a single judge assisted with registrar and must completed within 25 working days, the final decision is binding, thus unable to ask for appeal or judicial review. This article tries to comprehend dispute resolution through Small Claims mechanism in several state courts, such as Medan district Court, Palu, and the Jember. The study, also aims to comprehend the comparison of Small Claims mechanism in Indonesia and small claims in the Netherlands and UK in business disputes resolution. The study employs a normative juridical method. Based on the studies, the implementation through Small Claims court mechanism in Indonesia has been carried out in accordance with the Supreme Court Regulation Number 2/2015. Comparison on business dispute resolution using Small Claims court mechanism in Indonesia and in Netherlands and UK proof that the proof mechanisms whether in Indonesia, Netherlands and United Kingdom relatively simple. Legal remedies for Small Claims decision in Indonesia and the verdict in the Netherlands and in England are limited. The distinction is that the case number in Indonesia is higher than the number in the Netherlands and England.


The FORMOSAT‐7/COSMIC‐2 (F7/C2) satellite mission was launched on 25 June 2019 with six low‐Earth‐orbit satellites and can provide thousands of daily radio occultation (RO) soundings in the low‐latitude and midlatitude regions. This study shows the preliminary results of space weather data products based on F7/C2 RO sounding: global ionospheric specification (GIS) electron density and Ne‐aided Abel and Abel electron density profiles. GIS is the ionospheric data assimilation product based on the Gauss‐Markov Kalman filter, assimilating the ground‐based Global Positioning System and space‐based F7/C2 RO slant total electron content, providing continuous global three‐dimensional electron density distribution. The Ne‐aided Abel inversion implements four‐dimensional climatological electron density constructed from previous RO observations, which has the advantage of providing altitudinal information on the horizontal gradient to reduce the retrieval error due to the spherical symmetry assumption of the Abel inversion. The comparisons show that climatological structures are consistent with each other above 300 km altitude. Both the Abel electron density profiles and GIS detect electron density variations during a minor geomagnetic storm that occurred within the study period. Moreover, GIS is further capable of reconstructing the variation of equatorial ionization anomaly crests. Detailed validations of all the three products are carried out using manually scaled digisonde NmF2 (hmF2), yielding correlation coefficients of 0.885 (0.885) for both Abel inversions and 0.903 (0.862) for GIS. The results show that both GIS and Ne‐aided Abel are reliable products in studying ionosphere climatology, with the additional advantage of GIS for space weather research and day‐to‐day variations.


Current question answering systems are usually based on a knowledge base which is populated with domain specific knowledge and managed through Unstructured Information Management Architecture (UIMA). But drawback in this approach is that knowledgebase may be grown with knowledge which is not relevant to the users connected with the system. In order to address this drawback we propose unsupervised knowledge accumulation algorithm which can monitor user preferences and acquire knowledge without any supervision of the system management unit. Basically, this algorithm learns domain of interest of each and every user connected with the system and extract knowledge from the web or from a given corpus. We have also adopted several Natural Language Processing algorithms to design this high-level algorithm. Knowledge modelling is done through a conceptual graph based knowledge base. This novel paradigm is evaluated with the help of several connected users and with more than 280 questions. We have achieved excellent accuracy during the evaluation phase. It shows our novel approach is effective and can be used to address the drawback decently.


At the beginning of the 20th century, the department store developed from markets and urban arcades, from which the shopping mall evolved in the post-war period. The operators of department stores and shopping centers are coming under increasing pressure from the competition of the continuously growing internet trade. By the same token, however, there is also an increasing tendency for the internet trade to become involved with real shops. The challenge is to optimize the quality of the customers stay. This is accomplished by the interspersing of the offer by cultural institutions, a variety of dining opportunities and exciting leisure activities. The time spent in a department store or a shopping center must be conceived as an experience, separate from the consumption of goods, which engages all the senses. Which is where architectural quality as well as a targeted design can play an increasingly important role.


Regression analysis is a widely used statistical method for modelling relationships between variables. Multivariate adaptive regression splines (MARS) especially is very useful for high-dimensional problems and fitting nonlinear multivariate functions. A special advantage of MARS lies in its ability to estimate contributions of some basis functions so that both additive and interactive effects of the predictors are allowed to determine the response variable. The MARS method consists of two parts: forward and backward algorithms. Through these algorithms, it seeks to achieve two objectives: a good fit to the data, but a simple model. In this article, we use a penalized residual sum of squares for MARS as a Tikhonov regularization problem, and treat this with continuous optimization technique, in particular, the framework of conic quadratic programming. We call this new approach to MARS as CMARS, and consider it as becoming an important complementary and model-based alternative to the backward stepwise algorithm. The performance of CMARS is also evaluated using different data sets with different features, and the results are discussed.


Composite materials are gaining their demand due to their attractive properties. Conventional machining of composites is difficult because of the presence of hard reinforcement particles which causes high tool wear, particle pullout, tool breakage etc. and is greatly affected by the reinforcement percentage in metal matrix composites (MMC). To overcome these problems more research is going on unconventional machining methods of MMC. Electric Discharge Machining (EDM), Electro Chemical Machining (ECM) and Electro Chemical Discharge Machining (ECDM) have been reviewed in this paper to understand the process capabilities and the limitations associated with each of the process while dealing with aluminium MMC. Keywords— Metal Matrix Composites (MMC), Electro Discharge Machining (EDM), Electro Chemical Machining (ECM), Electro-Chemical Discharge Machining (ECDM), Material Removal Rate (MMR), Tool Wear Rate (TWR) and Surface Roughness (SR).


Under drought conditions, barley grain related traits are affected by water stress and reduced grain yield potential. Therefore, two experiments were carried out at  the Kalar technical institute for two seasons of 2016-17 and 2017-18 testing five hybrid of tow-rowed barley (Hordeum vulgare L.) under irrigated and unirrigated conditions. Genotypes were assessed for thousand grain weight, grain filling duration and grains number per particular of spike length. The average of both years , drought significantly reduced thousand grain weight by 7.63 g and shortened grain filling duration by 44.3 oCd, but not affected grains number may due to genetically controlling this trait. Genotypes 3//4 and 3//14 scored highest values of thousand grain weight and grain filling duration under both irrigated and drought conditions. However, genotype 3//1 was least affected by drought for both thousand grain weight and grain filling duration indicating higher resistance against water stress for this genotype. Regression analysis showed a positive relationship between thousand grain weight and grain filling duration under both irrigated (R2=0.85; P=0.03) and unirrigated (R2=0.80; P=0.04) conditions averaging over seasons showing the importance of post-anthesis period to increase the single grain weight. The correlation between thousand grain weight and grains number, however, was negative for the cross-year mean under drought conditions (R2=0.75; P=0.05) may due to the trade-off between these two traits.


A female infant weighing 2,200 g was delivered at 34 weeks of gestation by vaginal delivery. She presented with an irreducible mass in the left inguinal region at 32 days of age. An ultrasonography (US) was performed and an incarcerated hernia containing uterus, fallopian tube, and ovary was diagnosed preoperatively. Surgery was performed through an inguinal approach; the uterus, fallopian tube, and ovary were found in the hernia sac. High ligation and an additional repair of the internal inguinal ring were performed. Patent processus vaginalis was found during contralateral exploration and also closed. The postoperative course was uneventful. After one year of follow-up, there have been no signs of recurrence.


The research was aimed at understanding the perception and raising awareness on colorectal cancer among the public and in particular among individuals with anorectal and gastrointestinal disorders, usually traditionally designated as "pile" in northern Nigeria. The fact that some gastrointestinal abnormalities with symptoms of inflammation and hemorrhages in individuals could be signs of early-stage polyposis justifies the need to raise awareness on colorectal cancers among this particular risk group and the general populace. Survey information like background knowledge on colorectal cancer, familial cancer history, usage of herbal remedies, and incidence of anal inflammation, bleeding, and hemorrhages was collected using a self-administered questionnaire. Criteria used for inclusion were that the respondents have symptoms of anorectal or gastrointestinal disorders or were asymptomatic but believed they are at risk and hence were taking herbal remedies for preventive purposes against such disorders. A total of 142 men patronizing herbalists selling pile remedies in rural Zaria were sampled for the study. All were adults, 25% were above fifty years, 31% were in their forties, and 26% were in their thirties while 18% were less than thirty years. From the survey, 82% of respondents believed they have symptoms of gastrointestinal or anorectal disorders (out of whom 77% are using herbal remedies) while 18% consume this herbal preparations because they believe they have preventive effects against gastrointestinal diseases. From the results, 95% are aware of the term "cancer," but only 44% have an idea of what colorectal cancers are while only 12% have knowledge of the signs and symptoms of colorectal cancers. Majority of the respondents (79%) believed that cancers generally are better managed using traditional alternative medicine. The study further reveals that majority (86%) of the respondents do not know or believe that inflammatory bowel diseases and anal bleeding are potential risk factors in colorectal cancer; however, 47% of the respondents know or believe that early detection of cancers in general is important for treatment. In addition, only 17% of these respondents have attended clinics in respect to their gastrointestinal or anorectal disorders while none of these have undergone any clinical screening for colorectal cancer. The results from the study summarily indicate that there is generally poor knowledge of colorectal cancer and a general perception among the respondents that gastrointestinal disorders and cancers are better cured using alternative traditional medicines. The study recommends, among others, increased cancer education with particular attention to enlightenment on benefits of clinical treatments and importance of screening for early detection and possible intervention. Citation Format: Mubarak Labaran Liman, Mubarak L. Liman, Sunday E. Atawodi, Iliemene E. Dorathy, Iliemene E. Dorathy, Nafisat Aliyu. Knowledge and perceptions on colorectal cancer among male adults taking herbal remedies against anorectal or gastrointestinal disorders in rural Zaria, Nigeria [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C13.


Iliopsoas bursitis is often overlooked as the cause of symptoms involving the inguinal area and lower extremity. We report 8 patients with iliopsoas bursitis. All had either osteoarthritis or rheumatoid arthritis of the hip but only 3 had significant hip pain. Patients presented with an inguinal mass and hip pain (2); unilateral leg swelling (2); inguinal mass and unilateral leg swelling (1); hip pain (1); pelvic mass with bladder compression (1); and no symptoms (1). The diagnosis was entertained initially in only 2 patients. Computed tomography was useful in establishing the diagnosis.


Steam traps are part of a steam-in-place system. The current design allots 18 in. of vertical leg for condensate backup. A design with a sensitive bellows has been proven In laboratory tests to need only 6 In. of vertical leg during the 15 min. of 121°C sterilization. Loads of 1 to 27 Ib/h are covered by the capability of the new trap, equivalent to required steam for vessels 20 to 40,000 L.


ERK5 (also known as BMK1), a member of the mitogen-activated protein kinase (MAPK) superfamily, was known to be activated strongly by oxidant and osmotic stresses. Here we have found that ERK5 is strongly activated by epidermal growth factor and nerve growth factor, whose receptors are tyrosine kinases. The activation of ERK5 was inhibited by expression of dominant-negative Ras and induced by expression of active Ras in PC12 cells, indicating a requirement for Ras in ERK5 activation. The epidermal growth factor-induced activation of ERK5 was found to be inhibited by PD98059 and U0126 inhibitors, which were previously thought to act specifically on classical MAPK kinase (also known as MEK1) and readily reversed by CL100 and MKP-3 dual-specificity phosphatases for which classical MAPKs were previously shown to serve as preferred substrates. The reporter assays demonstrated that the serum-induced enhancement of transcription from serum response element was significantly inhibited by expression of a dominant-negative form of MEK5, which was a direct and specific activator for ERK5 and that transcription from serum response element mediated by the Ets-domain transcription factor Sap1a, but not by Elk1, was stimulated by coexpression of ERK5 and active MEK5. In addition, Sap1a was shown to be phosphorylated by ERK5 in vitro and by the activation of the ERK5 pathway in cells. Moreover, the serum-induced c-Fos expression was markedly inhibited by expression of dominant-negative MEK5. These results reveal a novel signaling pathway to the nucleus mediated by ERK5 that functions downstream of receptor tyrosine kinases to induce immediate early genes, in parallel with the classical MAPK cascade.


Numerical simulation for the three-dimensional laminar flow through a forward facing step channel was simulated by Fluent 6.3 code. Four Reynolds numbers and four step lengths were analyzed. The results showed that the length of the recirculation zone upstream the step depends on Reynolds number, as well as on the step height (h), while the height of the recirculation zone extends about 70% of the step height. In addition, it was found that the velocity profile in the stream direction at the channel exit presents a fully developed profile for the axial component. Nonetheless, the profile along the transversal direction does not have a parabolic profile, even for a length of 60h


Purpose

– The purpose of this paper is to help leaders to reflect on how to make difficult decisions by developing practical wisdom based on Indian traditions. In complex scenarios, when leaders are is crisis, they often tend to rush into decisions without proper reflection, rely too heavily on data and analytics, and demonstrate an inability to decide based on subtle, intangible and often very important elements like emotion, intuition and spiritual discernment. In this paper, the author discusses what it means to make wise decisions based on the Hindu concept of discrimination (viveka) – that is, the ability to perceive and make fine distinctions and also to notice and value quality which is very important part of spiritual discernment.

Design/methodology/approach

– This paper uses four decision-making scenarios from an Indian epic Mahabharata to cast light on dilemmas that seem to trip up so many twenty-first century leaders. The author draws lessons from the four stories and highlight key challenges in decision making – developing spiritual discernment to support logic based and emotion-laden decision making.

Findings

– Allowing crisis to drive decisions, failing to recognize and account for the biases and attachments, and not developing good role clarity keep leaders from making the decisions they need to, from a place of ethical clarity. The subtle but essential spirit of ethical decision making is discernment and quality of discernment increases when leaders develop "viveka" or discrimination capability and use it regularly.

Research limitations/implications

– It is important to remember that developing skills in using viveka in discernment suggested in this paper requires "unlearning" some of the beliefs and practices that served leaders in the past. This framework might be thought provoking and rich conceptually but only action and practice using this framework with awareness makes managers wise leaders.

Practical implications

– This paper proposes a framework for making difficult decisions and has implications for developing managers and leaders who can make decisions with discernment. Especially in these days of complexity and turbulence, we need to develop people to resolve dilemmas wisely and effectively. The framework for developing discernment by using intuition, instinct and emotions along with data effectively can help leader using this framework make wise decisions. The stories of leadership success and failure in the Mahabharata serve to remind us that reactive or unreflective decision making are not the answer to rapid change and uncertainty. Yet, leaders need to be able to make sound decisions rapidly in a complex and changeable context by paying attention to both explicit and tacit factors. Stories open up other paths to cultivating this ability of paying attention to viveka that is at the root of spiritual discernment. With clear engagement with the role of leader; the will to detach from desired outcomes; and a stance of courage, humility and ethical clarity, we have the tools we need to manage accelerating complexity, whatever its source.

Originality/value

– Decision-making process is examined holistically – by bringing in recent developments in brain research along with stories and lessons from an ancient epic from India to recognize that making decisions is complex and important element that distinguishes wise leaders from smart leaders. This paper could help smart leaders gain ethical clarity by developing discernment integrating fine qualities of discrimination.


Objective:The prevalence of overweight and obesity is increasing among HIV-infected patients. Whether standard antiretroviral drug dosage is adequate in heavy individuals remains unresolved. We assessed the virological and immunological responses to initial efavirenz (EFV)-containing regimens in heavy compared to normal-weight HIV-infected patients. Design:Observational European cohort collaboration study. Methods:Eligible patients were antiretroviral-naïve with documented weight prior to EFV start and follow-up viral loads after treatment initiation. Cox regression analyses evaluated the association between weight and time to first undetectable viral load (<50 copies/ml) after treatment initiation, and time to viral load rebound (two consecutive viral load >50 copies/ml) after initial suppression over 5 years of follow-up. Recovery of CD4+ cell count was evaluated 6 and 12 months after EFV initiation. Analyses were stratified by weight (kg) group (I – <55; II – >55, <80 (reference); III – >80, <85; IV – >85, <90; V – >90, <95; VI – >95). Results:The study included 19 968 patients, of whom 9.1, 68.3, 9.1, 5.8, 3.5, and 4.3% were in weight groups I–VI, respectively. Overall, 81.1% patients attained virological suppression, of whom 34.1% subsequently experienced viral load rebound. After multiple adjustments, no statistical difference was observed in time to undetectable viral load and virological rebound for heavier individuals compared to their normal-weight counterparts. Although heaviest individuals had significantly higher CD4+ cell count at baseline, CD4+ cell recovery at 6 and 12 months after EFV initiation was comparable to normal-weight individuals. Conclusion:Virological and immunological responses to initial EFV-containing regimens were not impaired in heavy individuals, suggesting that the standard 600 mg EFV dosage is appropriate across a wide weight range. Video Abstract:http://links.lww.com/QAD/A635


Contents: Introduction Part I Theoretical Frameworks: Globalization, criminogenic asymmetries and economic crime, Nikos Passas Global anomie, dysnomie, and economic crime: hidden consequences of neliberalism and globalization in Russia and around the world, Nikos Passas Enron et al: paradigmatic white collar crime cases for the new century, David Friedrichs Criminogenic cyber-capitalism: Paul Virilio, simulation, and the global financial crisis, Eric Wilson Counterfeiting as corporate externality: intellectual property crime and global insecurity, Simon Mackenzie. Part II Types of Transnational Financial Crime: A good century for tax? Globalisation, redistribution and tax avoidance, John Braithwaite E-gaming and money laundering risks: a European overview, Michael Levi Trade-based money laundering and terrorist financing, John S. Zdanowicz Demystifying Hawala: a look into its social organization and mechanics, Nikos Passas Financial crime, near crime, and chicanery in the Wall Street meltdown, Richard B. Freeman Mortgage origination fraud and the global economicl crisis: a criminological analysis, Tomson H. Nguyen and Henry N. Pontell Odious debt, odious credit, economic development and democratization,Tom Ginsberg and Thomas S. Ulen Defence expenditures, arms procurement and corruption in sub-Saharan Africa, Susan Willett Why do so many anti-corruption efforts fail?, Michael Johnston The genesis of the BCCI scandal, Nikos Passas Organized fraud and organizing frauds: unpacking research on networks and organization, Michael Levi Crime on the line: telemarketing and the changing nature of professional crime, Neal Shover, Glenn S. Coffey and Dick Hobbs The insurgent economy: black market operations of guerrilla organizations, R.T. Naylor Addressing identity crime in crime management information systems: definitions, classification, and empirics, Rodger Jamieson, Lesley Pek Wee Land, Donald Winchester, Greg Stephens, Alex Steele, Alana Maurushat and Rick Sarre Transnational organised cyber crime: distinguishing threat from reality, Rob McCusker Intellectual capital and economic espionage: new crimes and new protections, Herbert Snyder and Anthony Crescenzi Cross-border crime and the interface between legal and illegal actors, Nikos Passas. Part III Control Issues: Criminalizing consequences of sanctions: embargo busting and its legacy, Peter Andreas Financial controls and counter-proliferation of weapons of mass destruction, Nikos Passas Balancing financial threats and legal interests in money-laundering policy, Petrus C. van Duyne, Marc S. Groenhuijsen and A.A.P. Schudelaro Do European procurement rules generate or prevent crime?, Nicholas Dorn, Michael Levi and Simone White Criminal profits, terror dollars, and nonsense, R.T. Naylor Asset and money laundering in Bolivia, Colombia and Peru: a legal transplant in vulnerable environments?, Francisco E. Thoumi and Marcela Anzola Testing the global financial transparency egime, J.C. Sharman Name index.


Understanding factors influencing medication utilization and provider prescribing behavior has important implications for the quality improvement and cost containment in health care. This dissertation seeks to shed light on the quality and efficiency of medication prescribing. Chapter one examines the association between Medicare Part D plan features and choice of generic antidepressants, antidiabetics, and statins using Medicare claims data. Low cost-sharing for generics, large differentials in cost-sharing for generic vs. brand drugs, and tools such as prior authorization and step therapy are associated with higher generic drug use. Modifying the benefit design and utilization management of Medicare prescription drug plans might increase generic use, which could generate substantial savings for the Medicare program and for beneficiaries. Chapter two examines physician antipsychotic prescribing behavior in a large Medicaid program. By linking multiple data sources and using the multiple membership modeling approach, we examine the degree to which psychiatrists are diversified vs. concentrated in their choice of antipsychotic medication and identify factors associated with the concentration of prescribing. Antipsychotic prescribing behavior is relatively concentrated and varies substantially across psychiatrists regularly prescribing antipsychotics. Several characteristics of the treated patient population and physicians are significantly associated with antipsychotic prescribing. The few characteristics of organizations examined have little influence over psychiatrist prescribing behavior. Chapter three assesses provider-level clozapine and antipsychotic polypharmacy practices – one with strong evidence base and the other with little support. Using multiple years' claims data in a large Medicaid program, we find provider-level underuse of clozapine and use of non-evidence supported practice of non-clozapine antipsychotic polypharmacy. However, these prescribing practices vary tremendously across providers. In particular, a sizable portion of providers use more antipsychotic polypharmacy than clozapine to their patients. Quality initiatives may take actions to improve evidence-based practice and to decrease unsupported practices in the management of antipsychotic drug use. This dissertation has important implications for public health because appropriate prescribing can alleviate tremendous health and economic burdens while inappropriate prescribing can generate substantial costs and increase risk of undesirable consequences. Understanding how providers make prescribing decisions points to potential opportunities for improving the quality of care and reducing cost through altering providers' prescribing behavior.


Background Glioblastoma multiforme (GBM) is a highly aggressive type of brain cancer with short survival time, poor prognosis and high mortality. Although research based on molecular data plays a crucial role in predicting cancer, few studies have been developed to combine high-throughput molecular data with clinical variables. Our goal is to establish machine learning based models to predict GBM survival. Methods The molecular data and clinical information of GBM were downloaded from The Cancer Genome Atlas (TCGA) database. The molecular data include somatic copy-number alteration (SCNA) and microRNA. Logistic regression and support vector machine (SVM) were used to establish the predictive models using molecular data, clinical variables and their combinations. Receiver operating characteristic (ROC) was conducted to estimate the sensitivity and specificity. Results The AUC scores are 0.72, 0.69 and 0.82, respectively using clinical variables, SCNA data and their combinations. The AUC scores are 0.97 and 0.98, respectively using microRNA data and the combinations of microRNA data and clinical variables. Conclusion Our study developed machine learning based models to predict GBM survival. The combination of molecular data and clinical variables can improve prediction accuracy. Moreover, it also brings us new insights into the molecular mechanisms underlying GBM cancer. Acknowledgements Supported by the National Natural Science Foundation of China (61471078, 31270903), the Scientific Research Foundation for the Returned Overseas Chinese Scholars, State Education Ministry, the Program for Liaoning Excellent Talents in University (LJQ2015011) and the Fundamental Research Funds for the Central Universities (3132016330, 3132014306, 3132015213, and 3132017075).


Catalytic conversion of ethanol to fatty acid ethyl esters
(FAEE) was carried out by homogeneous and heterogeneous
transesterification of melon seed, shea butter and neem seed
oils using NaOH, KOH and 5wt%CaO/Al2O3 catalyst systems
respectively. Oil content of the seeds from n-hexane or hot
water extract ranged from 25.0-33.3% and increased in the
order melon seed< shea butter seed < neem seed. The heterogeneous catalyst maintained an optimal activity after 5
cycles of reusable applications and produced higher FAEE of
95.63% than 91.2% and 92.8% obtained with KOH and NaOH
respectively. After purification by distillation of excess ethanol
and neutralisation and separation of the homogeneous catalysts, the FAEE was subjected to qualitative analysis to
determine its potential application as commercial biodiesel
based on international specifications. With the exception of
neem seed oil FAEE that shows high acid value and total ash
content the esters could be used directly or as blend in diesel
engines to give good performance.

Key words: Ethyl ester, synthesis, catalytic activity, common oils, biodiesel potential.


Substrate limitation responsive biosensors have been used for the development of a mini‐bioreactor platform that can be used as a scale‐down tool. Three green fluorescent protein (GFP) transcriptional reporters have been chosen in Escherichia coli, i.e., uspA::gfp, csiE::gfp, and yciG::gfp. Our previous studies have shown that these kinds of promoters are induced in response to substrate limitation and are significantly repressed when cultures are carried out in heterogeneous bioreactors. This sensitivity to substrate limitation has been confirmed in the case of the csiE and yciG biosensors. A mini‐scale‐down platform is proposed as a high throughput tool to rapidly investigate the usefulness of a given microbial biosensor. This platform is composed of shake flasks able to operate in fed‐batch mode either using the slow release or the intermittent feeding principle. Local heterogeneities were reproduced at the level of these mini‐bioreactors (operating under the intermittent feeding principle) and caused a decrease in GFP expression as in conventional scale‐down reactors. The presence of GFP in supernatants was also noted and seems to be correlated with the substrate limitation signal for the three cultivation systems considered in this work (i.e., chemostat, conventional and mini‐bioreactors) and with membrane permeability. © 2012 American Institute of Chemical Engineers Biotechnol. Prog., 2013


We describe and analyze some Monte Carlo methods for manifolds in euclidean space defined by equality and inequality constraints. First, we give an MCMC sampler for probability distributions defined by unnormalized densities on such manifolds. The sampler uses a specific orthogonal projection to the surface that requires only information about the tangent space to the manifold, obtainable from first derivatives of the constraint functions, hence avoiding the need for curvature information or second derivatives. Second, we use the sampler to develop a multistage algorithm to compute integrals over such manifolds. We provide single‐run error estimates that avoid the need for multiple independent runs. Computational experiments on various test problems show that the algorithms and error estimates work in practice. The method is applied to compute the entropies of different sticky hard sphere systems. These predict the temperature or interaction energy at which loops of hard sticky spheres become preferable to chains. © 2018 Wiley Periodicals, Inc.


In ordinary life, people who assess other people's assessments typically take into account the other judgments of those they are assessing in order to calibrate the judgment they are now assessing. The restaurant and hotel rating website TripAdvisor is exemplary, because it facilitates calibration by providing access to a rater's previous ratings. This makes it possible to see whether a particular rating is coming from a rater who is enthusiastic about every place she patronizes, or from someone who is incessantly hard to please. And even when less systematized, as with the assessment of a letter of recommendation or a college transcript, calibration by recourse to the decisional history of those whose judgments we are assessing is a ubiquitous feature of ordinary life. Yet despite the ubiquity and utility of such calibration, the legal system seems perversely to reject it. Appellate courts do not openly adjust their standard of review based on the previous judgments of the judge whose decision they are reviewing, nor do judges who review legislative or administrative decisions, magistrates who evaluate search warrant representations, and even jurors who assess witness perception. In most legal domains, calibration by reference to the other decisions of the judgment being reviewed is invisible, either because it does not exist or because what reviewing bodies know informally is not something they are willing to admit to using. Appellate courts do not, at least openly, look more carefully at the decisions of a trial judge whose decisions are often reversed, and administrative law judges do not acknowledge examining the decisions of some administrators more closely because of what they know about the decisional history of that administrator. However common it is for ordinary people to attempt to calibrate the decisions of those on whom they rely, the law generally resists such calibration, implicitly prohibiting access to a reviewee's decisional history and discouraging publicly acknowledging that a decisional history has played a role in a reviewer's decision. Assisted by insights from cognitive psychology and philosophy, this Article examines law's seeming aversion to calibration, and to explore what this aversion says about the nature of law and legal decision-making.


In the last decades the model that associates a State with a language has spread in the Balkans, often merging the codification of a standard literary language with the ethnic identity of the nation. Macedonia is defining a new approach to the question of linguistic pluralism. Through some recent legislative changes such as the bill (2018) on the use of languages, now passed into law (2019), and the promotion of international agreements with neighbouring countries like the Agreement on Friendship, Neighbourhood and Cooperation with Bulgaria, and more recently the Prespa agreement with Greece, a new linguistic scenario both within borders and beyond them is taking shape.


Coupled problem involving several domains required to describe accurately the interfaces while preserving a certain flexibility. The object of this paper is to focus on the exhaustive usage of the Level Set method combined with anisotropic mesh adaptation to represent various surfaces and interfaces within a general monolithic approach for coupling. We introduce first the convected Level Set method using a convective time derivative with the redistancing Hamilton Jacobi equation. Then, the anisotropic mesh adaptation framework will be introduced in the context of a local mesh generation method based on mesh topology modification and a minimal volume principle. In this case one needs to account for a metric field when length and volume evaluations are required. Convincing results have been already obtained in the past years by deriving the metric field from a posteriori interpolation error analysis. We propose here a different route to get a metric field directly at the node of the mesh, by introducing the length distribution tensor and an edge based error analysis. Applications combine a stabilized Finite Element flow solver with the Level Set for multiphase flow calculation within a monolithic approach. The a posteriori error estimation is applied to a modification of the Level Set scalar field, giving automatically the anisotropic mesh refinement in the interface region. The potential of this approach will be shown on several examples including free surface calculation, fluid buckling simulation, fluid structure interaction and moving interface problems.


1 Whole‐cell patch‐clamp recordings were made from subthalamic nucleus (STN) neurones in brain slices from rats. Stimulation with bipolar electrodes evoked synaptic currents mediated by glutamate (EPSCs) and GABAA (IPSCs) receptors. 2 Dopamine reversibly reduced the amplitude of GABAA IPSCs by up to 48% with an IC50 value of 3.4 ± 0.8μm. The dopamine D2 receptor agonist quinpirole, but not the D1 receptor agonist SKF 82958, also inhibited GABAA IPSCs. This effect was completely reversed by the D2 receptor antagonist sulpiride but not by SCH 23390, a D1 antagonist. 3 Muscarine reversibly reduced the amplitude of GABAA IPSCs by up to 70 % with an IC50 value of 0.6 ± 0.1μm. Inhibition of IPSCs by muscarine was completely blocked by scopolamine (10 μm), a muscarinic receptor antagonist. The M3 muscarinic receptor antagonist 4‐DAMP effectively reversed muscarine‐induced inhibition of IPSCs with an IC50 of 0.11 ± 0.03μm. Although the M1 receptor antagonist pirenzepine also reversed the inhibition of IPSCs by muscarine, this effect was only observed at relatively high concentrations (IC50=21.7 ± 9.4μm). 4 Dopamine and muscarine both increased the paired‐pulse ratio of GABAA IPSCs. Neither agent produced sustained changes in postsynaptic holding current. 5 Glutamate EPSCs were also inhibited reversibly by dopamine (by up to 29 %; IC50= 16 ± 3 μm) and muscarine (by up to 41 %; IC50=1.0 ± 0.4μm). However, both agents were more potent and efficacious for reducing GABA IPSCs compared with glutamate EPSCs. 6 These results suggest that the most significant effect of dopamine and muscarine in the STN is to reduce inhibitory synaptic input by acting at presynaptic dopamine D2 and muscarinic M3 receptors, respectively.


Wireless Video Capsule Endoscopy (VCE), Magnetic resonance enterography (MRE) and Small Bowel ultrasound (SBUS) are well-established diagnostic tools, used in the evaluation of small bowel disease in paediatric inflammatory bowel disease (IBD) patients.The aim of this study was to compare VCE findings with those of MRE and SBUS and evaluate discrepancies between them.

 VCE examinations were conducted in histologically confirmed paediatric IBD patients in a period of 19 months (March 2018 – November 2019) in a tertiary center. The VCE findings were retrospectively compared to relevant findings on MRE and SBUS, collected from electronic data records.

 34 patients were included in the study (16 males,18 females) with an age range at the moment of diagnostic assessment between 4–17 years (median 12 years). 21 patients were diagnosed with Crohn disease (CD), 9 patients with Ulcerative Colitis (UC) and 4 patients with IBD Unclassified (IBD-U). 8/34 (23.5%) patients were found to have all three diagnostic investigations, 21/34 (61.8%) had MRE and 21/34 (61.8%) had SBUS. Concordance between the three modalities were seen in 5/8 (62.5%) patients. Of these, 3/5 (60%) had no small bowel disease identified on VCE, MRE and SBUS, while in 2/5 patients (40%) the same distribution of small bowel disease was identified using all three diagnostic modalities. When comparing VCE to MRE, differing distributions of disease were seen in 10/21 patients (47.6%). 6/10 (60%) had terminal ileitis, 2/10 (20%) had ceacal disease and 3/10 (30%) jejunal disease noted on MRE, but with no disease identified on VCE. 1/10 patient (10%) had a normal MRE but duodenal and proximal jejunal ulceration was reported on VCE. VCE and SBUS had a higher concordance (71.4%) in identifying disease distribution. In 6/21 patients (28.5%) there was a discrepancy in the findings reported on SBUS when compared to VCE.Of these, 4/6 (66.7%) had a normal SBUS but small bowel disease (jejunal and ileal disease) on VCE.1/6 patient (16.7%) had caecal inflammation and 1/6 (16.7%) had active terminal ileitis on SBUS, which was not reported on their VCE.

 The identification of small bowel disease is essential in the diagnosis and subsequent management of paediatric IBD. VCE, MRE and SBUS are established modalities to detect intestinal disease. This study demonstrates that performing all three diagnostic modalities may have important practical significance and increase diagnostic yield in detecting small bowel inflammatory bowel disease.