Muscarinic cholinergic receptors modulate dopaminergic function in brain pathways thought to mediate cocaine's abuse-related effects. Here, we sought to confirm and extend in the mouse species findings that nonselective muscarinic receptor antagonists can enhance cocaine's discriminative stimulus. More importantly, we tested the hypothesis that muscarinic receptor agonists with varied receptor subtype selectivity can blunt cocaine's discriminative stimulus and reinforcing effects; we hypothesized a critical role for the M1 and/or M4 receptor subtypes in this modulation. Mice were trained to discriminate cocaine from saline, or to self-administer intravenous cocaine chronically. The nonselective muscarinic antagonists scopolamine and methylscopolamine, the nonselective muscarinic agonists oxotremorine and pilocarpine, the M1/M4-preferring agonist xanomeline, the putative M1-selective agonist (4-hydroxy-2-butynyl)-1-trimethylammonium-3-chlorocarbanilate chloride (McN-A-343), and the novel M1-selective agonist 1-(1-2-methylbenzyl)-1,4-bipiperidin-4-yl)-1H benzo[d]imidazol-2(3H)-one (TBPB) were tested as substitution and/or pretreatment to cocaine. Both muscarinic antagonists partially substituted for cocaine and enhanced its discriminative stimulus. Conversely, muscarinic agonists blunted cocaine discrimination and abolished cocaine self-administration with varying effects on food-maintained behavior. Specifically, increasing selectivity for the M1 subtype (oxotremorine < xanomeline < TBPB) conferred lesser nonspecific rate-suppressing effects, with no rate suppression for TBPB. In mutant mice lacking M1 and M4 receptors, xanomeline failed to diminish cocaine discrimination while rate-decreasing effects were intact. Our data suggest that central M1 receptor activation attenuates cocaine's abuse-related effects, whereas non-M1/M4 receptors probably contribute to undesirable effects of muscarinic stimulation. These data provide the first demonstration of anticocaine effects of systemically applied, M1 receptor agonists and suggest the possibility of a new approach to pharmacotherapy for cocaine addiction.


The level of evidence available to inform the best regimen for each patient and the strength of the recommendation vary, and are rated accordingly (see Methods Table 2). In addition, specific recommendations are given when treatment differs for a particular group (eg, those infected with different genotypes). Recommended regimens are those that are favored for most patients in a given group, based on optimal efficacy, favorable tolerability and toxicity profiles, and treatment duration. Alternative regimens are those that are effective but, relative to recommended regimens, have potential disadvantages, limitations for use in certain patient populations, or less supporting data than recommended regimens. In certain situations, an alternative regimen may be an optimal regimen for an individual patient. Not recommended regimens are clearly inferior compared to recommended or alternative regimens based on factors such as lower efficacy, unfavorable tolerability and toxicity, longer treatment duration, and/or higher pill burden. Unless otherwise indicated, such regimens should not be administered to patients with HCV infection. Specific considerations for pediatric patients and persons with HIV/HCV coinfection, decompensated cirrhosis (moderate or severe hepatic impairment; Child-TurcottePugh [CTP] class B or C), HCV infection post liver transplant, and severe renal impairment, end-stage renal disease (ESRD), or post kidney transplant are addressed in other sections of the guidance.


Lupus is an antibody-mediated autoimmune disease. The production of pathogenic, class switched and affinity maturated autoantibodies in lupus is dependent on T cell help. A potential mechanism of disease pathogenesis is a lack of control of pathogenic T helper cells by regulatory T cells in lupus. It has been repeatedly shown that the naturally occurring CD4+CD25+ regulatory T cells in lupus prone mice and patients with SLE are defective both in frequency and function. Thus, the generation of inducible regulatory T cells that can control T cell help for autoantibody production is a potential avenue for the treatment of SLE. We have found that oral administration of anti-CD3 monoclonal antibody attenuated lupus development and arrested on-going disease in lupus prone SNF1 mice. Oral anti-CD3 induces a CD4+CD25-LAP+ regulatory T cell that secrets high levels of TGF-β and suppresses in vitro in TFG-β-dependent fashion. Animals treated with oral anti-CD3 had less glomerulonephritis and diminished levels of anti-dsDNA autoantibodies. Oral anti-CD3 led to a downregulation of IL-17+CD4+ICOS-CXCR5+ follicular helper T cells, CD138+ plasma cells and CD73+ mature memory B cells. Our results show that oral anti-CD3 induces CD4+CD25-LAP+ regulatory T cells that suppress lupus in mice and is associated with downregulation of T cell help for autoantibody production.


This thesis investigates two companies whose products offerings are alike, yet their branding via the Facebook platform is different. Throughout this thesis, there will be research gathered from organic Facebook posts between the two companies' brand pages on the Facebook Platform. The research consists of total reactions as well as comments on a per post basis for various posts throughout September of 2018 and 2019. The raw data that this thesis will be using will be positive emotionality scores from LIWC1 (after comments are entered and run through the software) as well as the total number of reactions (likes, loves, WOWs, etc.) that correspond to the post the comments are drawn from. Following the collection of this data, the coding software R2 will be used to determine significances between the two companies LIWC scores and total reactions, assessing which company received higher reaction rates and more positive emotionality. There are two hypotheses that are associated with this data. The first one is that because Peloton uses a single Facebook page for both of their product offerings, then Peloton will have more overall reactions on their organic content than ClassPass and ClassPass Live have individually. The second hypothesis is that because ClassPass and ClassPass Live choose to separate their product offerings on Facebook into two identities, then ClassPass and ClassPass Live will each individually receive comments on their organic posts that reveal more positive emotions than Peloton. This thesis is informative because it presents a clear answer as to which branding strategy is the most effective for gaining the optimal 1 Linguistic Inquiry and Word Count Software 2 The coding software R is a statistical analysis software computes numerical data to determine statistical significances between means number of reactions as well as positive emotionality on comments on organic content via the Facebook platform. Additionally, the research this thesis presents can aid in further studies for branding initiatives not only on the Facebook platform, but across all social platforms whose metrics are different yet equally important for a brand's effectiveness with consumers.


In the present era of light weighting, magnesium (Mg) alloys are gaining popularity in many industrial applications, owing to a combination of low density and high specific strength. Whilst the low density of magnesium components is a significant advantage, the hexagonal crystal structure of Mg affects fundamental properties such as ductility and toughness. Adding controlled amounts of alloying additions such as Al, Zn, Mn, Y, Zr, Gd, Li, RE (rare earth blends, including one or more of Ce, Nd, La), produces Mg alloys with good specific strength, and, with further thermo-mechanical processing, it is possible to obtain even higher specific strength (comparable to that of other metal systems, such as steels). However, microstructural heterogeneities, brought about by alloying, often result in poor corrosion resistance. As such, to exploit the promise of Mg alloys, a balance of properties must be achieved. In spite of much recent research in this field, corrosion and mechanical properties are rarely studied together. Such a task is not trivial, however it is clear that to broaden the range of potential applications of Mg alloys, significant alloy engineering and design is still required – particularly to provide an optimised balance of mechanical and corrosion performance. The present work focuses on the optimisation, and related science, required to extend the property space of Mg alloy AZ31 using previously unexplored microalloying additions. In addition an in-depth investigation of the galvanic corrosion inherent to Mg alloys is carried out, using samples specially designed to provide macroscopic examples of galvanic corrosion. The findings reveal a new insight on the phenomenon of microgalvanic corrosion of Mg, that has not been previously reported – whereby the damage evolution is principally dictated by local pH.


The economic consequences of an expanded Australian superannuation sector were recently quantified by Giesecke et al. using a financial computable general equilibrium (FCGE) model of Australia. Using this model, Nassios et al. studied the short- and long-run structural implications of expansion in the size of Australia's superannuation sector. Several structural shifts were identified: (1) A rise in the use of debt relative to equity to finance the residential housing stock; (2) A rise in the ratio of gross private debt to household income; (3) A fall in Australia's net foreign financing requirement, measured via a reduction in the current account deficit relative to GDP; (4) An expansion in non-bank financial intermediaries and life insurer's; and (5) A change in the capital structure of commercial banks, particularly a greater reliance on bond financing. In this paper, we consider the implications of these structural shifts for macroeconomic stability and growth. To this end, we survey literature addressing how economic structure and policy can influence macroeconomic stability and growth. We also summarise how several counter-cyclical macroeconomic policies we identify are modelled in the VU-Nat FCGE model applied herein. As we shall discuss, the literature on financial and macroeconomic stability suggests that a rise in the level of private-debt-to-income does not generally aid macroeconomic stability. Nevertheless, stability and future growth prospects are in all likelihood improved by the noted reduction in Australia's net foreign financing requirement, via a reduction in Australia's exposure to foreign credit supply shocks such as those the Australian commercial banks experienced during the GFC. A key structural shift driving this result is the increase in demand for corporate debt liabilities by domestic financial asset agents, such as the superannuation funds, which drives a deepening of Australia's corporate bond market.


Abstract The political behaviour of national, state or dominant churches in Western Europe is being affected by European Union (EU) integration in two ways. First, supranational legislation – especially the harmonisation of fundamental citizen rights in policy areas such as education and employment – has led to the political privileges that these churches have traditionally enjoyed being challenged. While the Amsterdam Treaty protects the right of the individual citizen to freedom of religious expression, the EU is an inherently secular body with no mention of Christianity in any of its treaties or directives. Second, the transfer of power to Brussels has meant that the territorial political influence of national churches is no longer clear, in any case. These two factors combined give evidence to suggest that this changing policy environment is leading churches increasingly to adopt interest-group behaviour. Does 'ever closer union' inevitably mean a less certain – if not necessarily less influential – political role for Christian churches throughout Europe?


A detailed analysis of measures of Soviet economic growth, with many alternative calculation methods. Six indexes of national product are synthesized from economic sector indexes (using 1937 and 1955 weightings for 3 different formulations). Results are compared with those from other sources. The indexes show that the USSR growth rate declined markedly throughout all segments of the economy, except services, within 1950-1965. Except perhaps in agriculture, the decline appears to be according to plan. During those years the growth rates for national product, national product per capita, and agriculture were essentially the same as U.S. rates for 1962-1965. Otherwise, Soviet economic growth rates for the years 1928-1940 and 1950-1965 are substantially higher than U.S. rates. The postwar increase in per capita consumption greatly exceeds the U.S. rate, but the level of consumption is less than half of the U.S. level. For the United States, national product and per capita consumption increase at the same rate.


The purpose of the work was to assess the impact of construction factors on weldability of MSRB alloy. One conducted transvarestraint test, which allowed to assess welds' susceptibility to cracking under the conditions of forced strain of the casting, Fisco test which simulates welding under the conditions of strong stiffening of the weld, as well as Houldcroft test simulating variable strain of the weld. One concluded that the strain of castings is characteristic of the process of pad welding and welding. Assessment of susceptibility of MSRB alloy to cracking under the conditions of forced strain allows to determine the width of the high-temperature brittleness range (HTBR), critical strain speed of the weld CSS and critical temperature strain intensity CST. These parameters are the criteria of hot cracking of welds from MSRB alloy, therefore, they are indicators of the assessment of the alloy's weldability. Castings from MSRB alloys with constant rigidity should be classified as easily weldable. On the other hand, variable rigidity of the casting, resulting from e.g. diverse thickness of the walls, causes significant increase in the alloy's susceptibility to hot cracking.


OBJECTIVE--The aim of this study was to examine the nature and extent of bereavement problems in HIV + ve clients and the counselling input required. DESIGN--Ninety individuals referred consecutively for counselling by the medical teams after HIV diagnoses were included in the study. Specific bereavement data was gathered by each counsellor according to schedule and semi-structured interviews for all 90 subjects. These data were analysed in conjunction with medical referral letters. SETTING--HIV positive clients attending for treatment at an inner London Hospital. SUBJECTS--The subjects were 91% males and 9% females, mean age 33.82 years (SD 7.2, range 15 to 50 years, mode 28). 44.8% were diagnosed as HIV + ve (asymptomatic), 42.5% had an AIDS diagnosis and the remainder were coded as AIDS Related Complex or unclear. MAIN OUTCOME MEASURES--The subjects were monitored for the presence or absence of bereavement issues, the nature and extent of the reactions and counselling input. The occurrence of single and multiple bereavements was monitored, as were the relationship to the index patient and the health status of the bereaved. RESULTS--Bereavement was mentioned in 28.2% of referrals from medical practitioners yet 43.1% of the patients had been bereaved and used bereavement counselling. 43% spontaneously commenced the session with bereavement issues. They had lost 348 people (average of 12.9 deaths per person reporting). These were overwhelmingly due to AIDS with only 12 (5.6%) not HIV related. 65% linked the bereavement to their own death. Emotional reaction seemed to be independent of the relationship with the deceased but linked with the diagnosis status of the bereaved. CONCLUSION--The emotional consequences of a loss can be severe and long term. The advent of AIDS/HIV has revealed a wave of deaths in a population unused to facing traumatic loss to this extent. There are particular features surrounding AIDS and HIV infection which may differ dramatically from other sorts of loss and challenge previously held notions of bereavement such as the age of the clients, the fact that bereavements are often multiple the illness state of the bereaved person, the taboo surrounding AIDS which often presents barriers to wider social support and the catalogue of losses which any individual has to face. The frequency and high rate of bereavement, often not noted by referrers, suggests similarity with disaster literature in terms of counselling demand.


Gene flow between populations can help maintain genetic diversity and prevent inbreeding, which is especially important for small, fragmented habitats. Many plant species rely on pollinators to move pollen between populations. In urban areas, insufficient pollinator services may result in limited gene flow, which can have negative consequences such as genetic drift and inbreeding depression. Furthermore, restored populations that are established with few founders of low genetic diversity may have limited long-term population persistence. Here, we tested the hypotheses that populations of a self-compatible forb established on urban green roofs from nursery stock are genetically depauperate and that limited gene (pollen) flow between populations will result in increased inbreeding. We compared the neutral genetic diversity of Penstemon hirsutus, using nine microsatellite loci, between three green roof populations established from nursery stock and three natural populations. We also established ten experimental populations on green roofs and measured rates of outcrossing and inbreeding and identified the movement of pollen within and between roofs using a paternity analysis. We found that neutral genetic diversity of populations established from nursery stock was lower than that of natural populations, although the level of inbreeding was also lower on the green roofs. In our experimental populations, we found that the rates of outcrossing and inbreeding varied between the roof populations. Our results suggest that inbreeding may be correlated with cover of co-flowering species but not with any of the other measured site properties. The location of likely pollen donors suggested that on average, 75% of pollen was derived from plants within the population (including self) and 25% came from plants on different roofs. Our results document realized pollen movement within and between green roofs, demonstrating that these habitats provide important connectivity in a fragmented environment.


Cryptorchidism and antecedent contralateral testicular tumor formation are risk factors for the formation of testicular germ cell neoplasms. The question arises if familial occurrence of testicular cancer constitutes another risk factor. In a series of 184 patients, treated for testicular tumors, three pairs of non-twin brothers were recorded. The analysis of 82 cases reported in the literature to date as well as the clinical features of early age of onset, high incidence of bilateral testicular tumors in familial cases, ethnic differences in occurrence of testicular cancer, HLA studies and the detection of oncogenes give relevance to the concept of the participation of genetic factors in the etiology of testicular germ cell cancer.


Extreme Value Theory (EVT) has been historically used in domains such as finance and hydrology to model worst-case events (e.g., major stock market incidences). EVT takes as input a sample of the distribution of the variable to model and fits the tail of that sample to either the Generalised Extreme Value (GEV) or the Generalised Pareto Distribution (GPD). Recently, EVT has become popular in real-time systems to derive worst-case execution time (WCET) estimates of programs. However, the application of EVT is not straightforward and requires a detailed analysis of, and customisation for, the particular problem at hand. In this article, we tailor the application of EVT to timing analysis. To that end, (1) we analyse the response time of different hardware resources (e.g., cache memories) and identify those that may lead to radically different types of execution time distributions. (2) We show that one of these distributions, known as mixture distribution, causes problems in the use of EVT. In particular, mixture distributions challenge not only properly selecting GEV/GPD parameters (i.e., location, scale and shape) but also determining the size of the sample to ensure that enough tail values are passed to EVT and that only tail values are used by EVT to fit GEV/GPD. Failing to select these parameters has a negative impact on the quality of the derived WCET estimates. We tackle these problems, by (3) proposing Measurement-Based Probabilistic Timing Analysis using the Coefficient of Variation (MBPTA-CV), a new mixture-distribution aware, WCET-suited MBPTA method that builds on recent EVT developments in other fields (e.g., finance) to automatically select the distribution parameters that best fit the maxima of the observed execution times. Our results on a simulation environment and a real board show that MBPTA-CV produces high-quality WCET estimates.


The aim of this study was to assess the prevalence of Antimicrosomal Antibodies AMA, thyroid function and the occurrence of hypothyroidism symptoms in patients with Multiple Sclerosis (MS). Clinical examination was carried out in 21 MS patients; thyroid-stimulating hormone (TSH), thyroxine (T4), free T4 and AMA were measured. Mean age was 41.05 years. Hypothyroidism symptoms included fatigue, weakness, lethargy and paresthesia. AMA were found in four patients (19%). Three categories of disease duration were considered: <60 months (3 patients AMA+; 7 AMA-), 60-120 months (8 patients AMA-), and >120 months (1 patient AMA+; 2 AMA-). Two patients presented decreased free T4 levels, but there was no associated decrease in T4 and TSH levels. In two patients, a mild increase in TSH levels was observed: one presented normal T4 levels (subclinical hypothyroidism) and the other one had low free T4 levels (classical hypothyroidism). We conclude that AMA measurement and thyroid function tests should become part of the routine assessment of MS patients, in view of the inaccuracy currently observed in the assessment of clinical hypothyroidism as a result of the superposition of hypothyroidism and MS signs and symptoms.


This thesis is concerned with three-dimensional scan registration, in particular of underground mine tunnels. Registration of partial range scans is an essential part of building 3D maps, and autonomous creation of reliable maps is a first step towards autonomous mining vehicles. The thesis presents a survey of relevant sensor technology and discusses the advantages and disadvantages of different sensors for use in mine environments. A survey of the state of the art in scan registration algorithms is also presented, as well as a number of relevant applications. A new algorithm for registration of 3D data is presented, which is a generalisation of the normal distributions transform (NDT) for 2D data developed by Biber and Straser. A detailed quantitative and qualitative comparison of the new algorithm with existing registration algorithms is shown. Results with actual mine data, some of which were collected with a new prototype 3D laser scanner, show that the presented algorithm is faster and in many cases more accurate, compared with the current standard in 3D registration.


[NOTE.—The numbers in brackets refer to slides in the Woodwardian Museum Cabinet at Cambridge.]

[929] From the Lower Purple Clay, South of Withernsea. A conglomerate including small rounded pebbles, some of dark limestone, about one-fifth of an inch long, and grains of quartz in a compact ground.

Under the Microscope a slice shows abundant rounded grains of quartz, with rolled pebbles of (probably dolomitized) limestone, imbedded in a mass of carbonate of lime. This calcareous matrix often shows the characteristic cleavage of crystalline calcite; but in other places are little ellipsoidal concretions with both concentric and radial structures, and showing the black cross in polarized light. Though less coarse than the usual type, there can be no doubt that this rock is the "Brockram," which forms the basement of the Permians in the Eden Valley. A slide [514] from near Appleby shows precisely the same characters, including the little oolitic concretions. Brockram boulders were long ago recorded by Phillips from the Yorkshire coast, where they are not at all uncommon.

[930] From the Basement Clay at Bridlington Quay. A dark grey doleritic rock, showing little glistening felspars in a dark compact ground-mass.

Micro. The porphyritic felspars, about one-eighth of an inch long, are rather rounded, as if by corrosion, and sometimes enclose portions of the ground-mass. They are very clear, and show Carls-bad-twinning, but the finer twin-lamellation is very difficult to detect. This is owing to the nearly straight extinction of the crystals, which must belong to a variety ...


New velocity models of lithospheric thickness and velocity structure have been developed for the Arabian Shield by three tasks: 1) Computing P-Wave Receiver Functions (PRFs) and S-Wave Receiver Functions (SRFs) for all the broadband stations within the Saudi seismic networks. The number of receiver function waveforms depends on the recording time window and quality of the broadband station. 2) Computing ambient noise correlation Green's functions for all available station pairs within the Saudi seismic networks to image the shear velocity in the crust and uppermost mantle beneath the Arabian Peninsula. Together they provided hundreds of additional, unique paths exclusively sampling the region of interest. Both phase and group velocities for all the resulting empirical Green's functions have been measured and to be used in the joint inversion. 3) Jointly inverted the PRFs and SRFs obtained in task 1 with dispersion velocities measured on the Green's functions obtained in task 2 and with fundamental-mode, Rayleigh-wave, group and phase velocities borrowed from the tomographic studies to precisely determine 1D crustal velocity structure and upper mantle. The analysis of the PRFs revealed values of 25 - 45 km for crustal thickness, with the thin crust next to the Red Sea and Gulf of Aqaba and the thicker crust under the platform, and Vp/Vs ratios in the 1.70 – 1.80 range, suggesting a range of compositions (felsic to mafic) for the shield's crust. The migrated SRFs suggest lithospheric thicknesses in the 80-100 km range for portions of the shield close to the Red Sea and Gulf of Aqaba and near the Arabian Gulf. Generally, the novelty of the velocity models developed under this paper has consisted in the addition of SRF data to extend the velocity models down to lithospheric and sub-lithospheric depths.


Three-wave mixing devices, i.e. non-linear circuits converting power among three microwave signals, are key elements of analog information processing in the microwave domain. However, they are based on dissipative components such as semiconductor diodes, or SIS tunnel junctions biased near the superconducting gap. The loss of signal limits their operation and also introduces noise above the minimum required by quantum mechanics. By using Josephson junctions and superconducting resonators, we've been able to build such a quantum device. In its amplification mode, this device can be used as a preamplifier in many experiments where a few photon wide microwave signals must be measured by commercial instruments, which are sensitive to powers several orders of magnitude larger. The price to pay for this amplification is the necessary degradation of information. Indeed, an extension of the no-cloning theorem imposes that a linear phase preserving amplifier adds at least half a quantum of noise to the signal. By amplifying the finite frequency noise emitted by an NIN tunnel junction, we demonstrated that the total measurement chain adds less than 2.3 quanta to this limit thanks to our device. The operating principle of this device is based on Josephson parametric amplification. I will explain this mechanism and present results which illustrate that it can generate quantum correlated pairs of spatially separated photons with different wavelengths known as two-mode squeezed states. This experiment exploits the tunability of our device and the ease-of-use inherent to micro-wave circuits to perform a quantum optics experiment demonstrating this entanglement.


NATIONAL WILD TURKEY FEDERATION The wild turkey, native to the North American continent, was the largest ground–nesting bird found by the first European immigrants. But the abundant numbers of wild turkey written about in early historical accounts declined with colonization until its continued existence was questionable. It wasn't until the 1960s that the restoration of the wild turkey was heralded as a wildlife management comeback marvel. Early settlers found the wild turkey in a variety of habitats as they pushed westward and felled forests with the axe and saw. Wild turkey populations dipped to their lowest numbers between the end of the 19th century and the 1930s, surviving only in the most inaccessible habitats. As forest stands regenerated following the Great Depression, the stage was set for the return of the wild turkey to former ranges. After World War II, active restoration programs and research efforts by state agencies eventually led to wild turkey populations in every state except Alaska. In 1991, spring wild turkey hunting seasons were for the first time open in every one of the 49 states having turkey populations. Spring hunting seasons are also held in Ontario and other Canadian provinces as well as in Mexico.


Belonging to a social group is one of the most important factors contributing to well-being. The Belonging Regulation model proposes that humans possess a social monitoring system (SMS) that evaluates social inclusion and monitors belonging needs. Here, we used a prospective longitudinal design to examine links between peer victimization experienced across 7 years and social monitoring at the behavioral and neural level in adolescent girls (n = 38, Mage = 15.43 years, SD = .33). Participants completed a social evaluation task during a functional magnetic resonance imaging (fMRI) scan. More severe peer victimization was associated with increased activation to in-group versus out-group peers in the amygdala, ventral striatum, fusiform gyrus, and temporoparietal junction. Moreover, participants who displayed increased activation in these regions reported lower social self esteem and higher levels of internalizing and externalizing symptoms. These results suggest that exposure to peer victimization across the school years is associated with heightened social monitoring at the neural level during adolescence, which has potential adverse implications for girls' adjustment and well-being.


Background : Endotracheal intubation is required to maintain a patent and clear airway as well as ensure good surgical access during cleft lip and palate repair in children. This study is aimed at identifying factors that would predict the risk of difficult intubation in patients presenting for cleft lip and palate surgery in order to focus on preventive measures and save lives. Patients and Methods : Data on anaesthetic techniques and ease of intubation was prospectively documented in 88 consecutive patients scheduled for elective cleft lip (61.4%) or palate repair (38.6%) over a period of 24 months. Three variables: age, type of cleft and laryngoscopic assessment using Cormack and Lehane grading were analyzed using univariate analysis in order to determine risk factors for difficult laryngoscopy. Result : There were 88 paediatric patients aged two months to 12 years comprising 51 boys and 37 girls. Tracheal intubation was easy in 73 (83%) patients and difficult in 15 (17%) patients. Of the 15 patients with difficult laryngoscopy, 13 (86.7%) were children aged less than 24 months, 8 (53.3%) presented with complete cleft palate and difficulty occurred across all the four grades of laryngoscopic view. Age and Cormack and Lehane laryngoscopic view grading were found to be significantly associated with difficult laryngoscopy (p Conclusion : Difficult laryngoscopy is common in children less than two years old presenting for cleft lip and palate surgery. Cleft surgery in this age group should be performed in hospitals where facilities for adequate monitoring and anaesthetic care are available.


Patient compliance -- i.e. the accuracy and timeliness of following therapeutical instructions -- is one of the key factors of success (or failure) in all long term treatments such as those of chronic illnesses. This paper describes a novel approach based on mobile Ambient Assisted Living (AAL) platforms to improve compliance levels. Specifically, we developed and demonstrated two technical solutions attempting to "hide" technology as much as possible in order not to interfere with their daily activities. Our first approach employs an ultra mobile personal computer (UMPC), which blends neatly into the home environment, and delivers integrated functionality including physiological and mental monitoring, mood assessment, physical and relaxation exercises, and communication with the doctor and members of the family. The second approach offers a lightweight solution requiring only a modern, 3G capable mobile phone, which nonetheless delivers a significant segment of the above functions. Both solutions attempt to improve compliance by negotiating the progress of the treatment with a central medical database that not only stores measured data, but employs rules to follow and enforce protocols, by continuously informing the user about the necessary steps to take in order to remain on schedule.


Abstract Due to the tradition of 'Nordic openness', and intensified by international trends, the norm of policy-making transparency is strong in Finland. Inspired by organizational institutionalism, the present article studies what this notion of transparency means in practice. A case study of a social security reform committee is presented. The consensus-building practices typical of Finnish corporatist policy-making significantly constrained the transparency of government communication during the lifetime of the committee. The government communicated actively in public to meet the demand for transparency; but in order to secure effective bargaining, the government communicated issues concerning the committee so vaguely that it did not inspire wide public discussion. Public discussion was instead mainly fuelled by leaks. These findings suggest that a strong norm of transparency can lead to ceremonial transparency, where government public communication is loosely coupled with policy-making practices. These ceremonies might strengthen the notion of Nordic openness.


Fraud detection rules, written by domain experts, are often employed by financial companies to enhance their machine learning-based mechanisms for accurate detection of fraudulent transactions. Accurate rule writing is a challenging task where domain experts spend significant effort and time. A key observation is that much of this difficulty originates from the fact that experts typically work as "lone rangers" or in isolated groups to define the rules, or work on detecting frauds in one context in isolation from frauds that occur in another context. However, in practice there is a lot of commonality in what different experts are trying to achieve.

In this demo, we present the GOLDRUSH system, which facilitates knowledge sharing via effective adaptation of fraud detection rules from one context to another. GOLDRUSH abstracts the possible semantic interpretations of each of the conditions in the rules in one context and adapts them to the target context. Efficient algorithms are used to identify the most effective rule adaptations w.r.t a given cost-benefit metric. We showcase GOLDRUSH through a reenactment of a real-life fraud detection event. Our demonstration will engage the VLDB'18 audience, allowing them to play the role of experts collaborating in the fight against financial frauds.


Acute hypoglycemia impacts negatively on cognitive function. However, it remains unclear which specific domains of cognitive function are affected, and the extent to which level of hypoglycemia modifies this relationship. We conducted a systematic review and meta-analysis to investigate the impact of controlled hyperinsulinaemic hypoglycemia on cognitive function in adults with type 1 diabetes, following PRISMA guidelines. Experimental studies comparing cognitive function task performance during euglycemia and hypoglycemia were eligible for inclusion. Preliminary analyses were conducted on 38 studies, involving 54 cognitive task outcomes across three domains of cognitive function of varying complexity: attention/information processing speed (simplest) , working memory, and complex reasoning (most complex) . Three-level meta-analyses of the standardized mean differences (SMD) in performance during euglycemia and hypoglycemia, moderated by hypoglycemia level (Mdn=2.51; range=1.98-3.5 mmol/l) were conducted for each domain, with study and task as random effects to allow inclusion of multiple effect sizes per study. Hypoglycemia significantly impaired performance on all domains, with large effect sizes for attention/information processing speed (SMD=-1.17, 95% CI:-1.60 to -0.74) and working memory (SMD=-0.84, CI:-1.to -0.63) , and a medium effect size for complex reasoning (SMD=-0.61, CI:-0.99 to -0.23) . The degree of hypoglycemia significantly moderated this relationship for working memory only, such that for every 1mmol/l decrease in glucose level, performance was reduced by SMD=0.84 (CI:0.2 to 1.49) . These findings suggest that the impact of hypoglycemia on cognitive function is related to the cognitive domain complexity, with more impaired performance on simpler relative to more complex tasks. Further, degree of hypoglycemia may be differentially related to performance depending on the domain of cognitive function.

 M.M.Broadley: None. C.Hendrieckx: None. R.J.Mccrimmon: Advisory Panel; Novo Nordisk, Sanofi, Research Support; Diabetes UK, European Union, MedImmune. G.Nefs: None. U.Pedersen-bjergaard: Advisory Panel; Novo Nordisk A/S, Sanofi. C.E.Verhulst: None. J.Speight: Advisory Panel; Insulet Corporation, Research Support; Novo Nordisk, Sanofi. F.Pouwer: Research Support; Eli Lilly and Company, Novo Nordisk, Sanofi. The hypo-resolve consortium: n/a. H.Chatwin: None. U.Soeholm: Research Support; Novo Nordisk A/S. J.Axelsen: None. S.A.Amiel: Advisory Panel; Medtronic, Novo Nordisk, Other Relationship; Sanofi. P.Choudhary: Advisory Panel; Abbott Diabetes, Lilly Diabetes, Medtronic, Research Support; Novo Nordisk, Speaker's Bureau; Dexcom, Inc., Glooko, Inc., Insulet Corporation, Sanofi. B.E.De galan: Research Support; Novo Nordisk. T.W.Fabricius: None. S.R.Heller: Advisory Panel; Eli Lilly and Company, Medtronic, Mylan N.V., Zealand Pharma A/S, Zucara Therapeutics, Other Relationship; Eli Lilly and Company, Research Support; Dexcom, Inc., Speaker's Bureau; Novo Nordisk A/S.

 Innovative Medicines Initiative 2 Joint Undertaking (777460)


Over the past decade, a clear trend toward distributed automation in industrial systems was observable. This means that applications are executed at heterogeneous control devices and communication networks. One of the main drivers of this development was the availability of cheap computing and communication resources. Moreover, a strong market demand for operation and adaptation of automation and control services with no downtime is also often requested. As a result, appropriate approaches recovering and (re)configuring automation and control devices as well as even their services and functions during full operation are needed. The relatively new standard IEC 61499 "Function Blocks" provides a reference model for the development and implementation of distributed industrial process measurement and control systems (IPMCSs). It provides a scalable and open architecture to model distributed automation and control applications. The high-level goals of IEC 61499 can be summarized as interoperability, (re)configurability, and portability of distributed applications for IPMCS. Therefore, it provides a very good basis for dynamic (re)configuration and recovery of applications and status information in heterogeneous IPMCS and may master some of the shortcomings of present-day systems. The main purpose of this paper is to present and discuss a general concept for autonomous recovery of applications within the context of distributed automation and control systems which has been implemented using the IEC 61499 reference model.


We examine the effects of recently adopted state merit-based financial aid programs on college attendance and degree completion. Our primary analysis uses microdata from the 2000 Census and 2001-2010 American Community Survey to estimate the effects of merit programs on educational outcomes for 25 merit aid adopting states. We also utilize administrative data for the University System of Georgia to look more in depth at the effects of the HOPE Scholarship on degree completion in Georgia. We find strong consistent evidence that state merit aid programs have no meaningfully positive effect on college completion. Coefficient estimates for our preferred specifications are small and statistically insignificant. State merit aid programs do not appear to increase the percentage of young people with a college education.


The deuteron elastic structure functions, A(Q{sup 2}) and B(Q{sup 2}), have been extracted from cross section measurements of elastic electron-deuteron scattering in coincidence using the Continuous Electron Beam Accelerator and Hall A Facilities of Jefferson Laboratory. Incident electrons were scattered off a high-power cryogenic deuterium target. Scattered electrons and recoil deuterons were detected in the two High Resolution Spectrometers of Hall A. A(Q{sup 2}) was extracted from forward angle cross section measurements in the squared four-momentum transfer range 0.684 ≤ Q{sup 2} ≤ 5.90 (GeV/c){sup 2}. B(Q{sup 2}) was determined by means of a Rosenbluth separation in the range 0.684 ≤ Q{sup 2} ≤ 1.325 (GeV/c){sup 2}. The data are compared to theoretical models based on the impulse approximation with the inclusion of meson-exchange currents and to predictions of quark dimensional scaling and perturbative quantum chromodynamics. The results are expected to provide insights into the transition from meson-nucleon to quark-gluon descriptions of the nuclear two-body system.


This is a study of folktales, referred to by the people as cuentos (stories), from the town of San Agustin Oapan in the state of Guerrero, Mexico. The study takes a close look at the function of folktales in the contemporary Indian community and how it compares to the function of myths in the pre-Hispanic past, explains why there was a decline from mythology to folklore, why the folktales are syncretic entities, and why there are similarities and differences found among them; including in their themes. It also looks to understand why the same folktales are not told among different families, examines the linguistic framing and performance of the folktales, determines their cultural relevance to the contemporary Indian community, and explains what they say about the indigenous way of life in Mexico. Folktales from six different Oapanec families were collected in Oapan Nawa and Spanish, translated into English, and examined. Oapan folktales are unique because they are not shared between families, but do contain common themes. Some of the folktales illustrate, through there overlapping themes, characteristics of European fables which are a direct reflection of contact with the Spaniards and their religion (Catholicism), while maintaining certain aspects of the pre-Hispanic mythological tradition. The goal of the study was to determine what if any specific links, cultural or religious, the contemporary Oapanec folktales have to pre-Hispanic Mexica-Tenochca mythology from before and up to the early 16th century.


Poly(e-caprolactone) (PCL) macromonomers comprising acrylate end-functionality were synthesized via enzymatic ring-opening polymerization (eROP) by utilizing commercially available Candida antarctica Lipase B (CALB), Novozyme-435. 2-Hydroxyethyl methacrylate (HEMA) was purposed to be the nucleophilic initiator in eROP. The side reactions generated due to the cleavage of ester bonds in HEMA and the growing polymer chains were investigated through altering polymerization period, initiator concentration, temperature, and enzyme concentration. 1H NMR evaluations showed that minimum quantities of side reactions were in lower temperatures, initiator concentration, enzyme concentration, and lower monomer conversions. Gel permeation chromatography (GPC) results revealed that lower polydispersity along with number-average molecular weight of end-functionalized PCL macromonomers was obtained depending on higher initiator/monomer ratios, lower temperature (60°C), enzyme concentration (100 mg), and/or polymerization time (2 h). Furthermore, 0.1 HEMA/e-caprolactone (CL) ratio had higher molecular weight than 0.5 HEMA/CL ratio, while keeping a close value of methacrylate transfer, total methacrylate end-groups, and lower polyester transfer.


A smart city is a city that binds together technology, society, and government to enable the existence of a smart economy, smart mobility, smart environment, smart living, smart people, and smart governance in order to reduce the environmental impact of cities and improve life quality. The first step to achieve a fully connected smart city is to start with smaller modules such as smart homes and smart buildings with energy management systems. Buildings are responsible for a third of the total energy consumption; moreover, heating, ventilation, and air conditioning (HVAC) systems account for more than half of the residential energy consumption in the United States. Even though connected thermostats are widely available, they are not used as intended since most people do not have the expertise to control this device to reduce energy consumption. It is commonly set according to their thermal comfort needs; therefore, unnecessary energy consumption is often caused by wasteful behaviors and the estimated energy saving is not reached. Most studies in the thermal comfort domain to date have relied on simple activity diaries to estimate metabolic rate and fixed values of clothing parameters for strategies to set the connected thermostat's setpoints because of the difficulty in tracking those variables. Therefore, this paper proposes a strategy to save energy by dynamically changing the setpoint of a connected thermostat by human activity recognition based on computer vision preserving the occupant's thermal comfort. With the use of a depth sensor in conjunction with an RGB (Red–Green–Blue) camera, a methodology is proposed to eliminate the most common challenges in computer vision: background clutter, partial occlusion, changes in scale, viewpoint, lighting, and appearance on human detection. Moreover, a Recurrent Neural Network (RNN) is implemented for human activity recognition (HAR) because of its data's sequential characteristics, in combination with physiological parameters identification to estimate a dynamic metabolic rate. Finally, a strategy for dynamic setpoints based on the metabolic rate, predicted mean vote (PMV) parameter and the air temperature is simulated using EnergyPlus™ to evaluate the energy consumption in comparison with the expected energy consumption with fixed value setpoints. This work contributes with a strategy to reduce energy consumption up to 15% in buildings with connected thermostats from the successful implementation of the proposed method.


The aim of this study was to understand what principles should be used in the future when establishing Football Vocational Schools in Turkey in order to ensure that future Turkish football players are better trained, and that this occurs in economically viable ways. The study was conducted as a case study. The data were collected using the interview technique and then subject to content analysis. Converting the football academy units currently found in Turkish sports clubs into Football Vocational Schools will fill the current deficiencies in the Turkish education system and will provide the well-trained and elite football players increasingly required by professional clubs. These schools should focus on providing education and training in football, which should be complemented by the subjects in the national education curriculum. This will make it easier for talented young footballers to choose football as a profession from an early age. Such a training model will help create a new service area with high added value in a market in which there is strong international competition. Keywords: Vocational School, Syllabus, Football Training, Turkish Education, Football Economy


Hydrogen is being considered as a pathway to decarbonize large energy systems and for utility-scale energy storage. As these applications grow, transportation infrastructure that can accommodate large quantities of hydrogen will be needed. Many millions of tons of hydrogen are already consumed annually, some of which is transported in dedicated hydrogen pipelines. The materials and operation of these hydrogen pipeline systems, however, are managed with more constraints than a conventional natural gas pipeline. Transitional strategies for deep decarbonization of energy systems include blending hydrogen into existing natural gas systems, where the materials and operations may not have the same controls. This study explores the hydrogen compatibility of existing pipeline steels and the suitability of these steels in hydrogen pipeline systems. Representative fracture and fatigue properties of pipelinegrade steels in gaseous hydrogen are summarized from the literature. These properties are then considered in idealized design life calculations to inform materials performance for a typical gas pipeline.


This paper looks at the first full year of the implementation of CISTI Source at the Queen Elizabeth II Library, Memorial University of Newfoundland. The paper comments generally on journal use by title and takes a close look at the level of ordering associated with a group of Elsevier journal titles cancelled in 2002. It looks at the difficulty of putting in place a mechanism to prevent the ordering of articles for which there are local holdings in both paper and/or electronic formats. It discusses the consequences of not having an adequate blocking mechanism in the context of the overall cost of CISTI Source versus savings garnered from journal cancellations. The paper looks at user uptake and reaction to the new document delivery service. The paper reports briefly on the trial delivery of colour articles by Ariel between CISTI and the Queen Elizabeth II Library.


Coherent and incoherent manifestations of light-pressure effects are considered. A simple analytical solution of the quantum problem of atomic scattering in a standing-wave field for arbitrarily large numbers of spontaneous transitions is obtained. Attractors of the light-pressure force in a strong field, i.e., the critical velocities at which a bunching of the particles takes place, are found. The one-dimensional problem of self-localization of an atomic ensemble in the field of counterpropagating waves is treated for a gas with an arbitrary optical thickness.


BACKGROUND: Measured maximum voluntary ventilation (MVV) correlates with maximum ventilatory capacity during exercise. As a shortcut, MVV is often estimated by multiplying measured FEV1 times 35 or 40, but this index varies with altitude due to reduced air density. The objective was to describe MVV in healthy individuals residing at 2,240 m above sea level and compare it with the reference values customarily employed. METHODS: We recruited a convenience sample of respiratory-healthy, non-obese volunteers >10 y of age who had resided for >2 y in Mexico City. All participants performed forced spirometry and MVV according to current standards. Multiple regression models were fitted, including age, height, and measured FEV1, separately for males and females to obtain reference values. The impact of lower air density on MVV at this elevation was estimated from the reported increase in peak flow in relation to altitude. RESULTS: We studied 381 individuals (210 females [55.1%]) age 10–80 y with a mean MVV of 145.6 ± 48 L/min. Both FEV1 × 35 and FEV1 × 40 underestimated the MVV observed: in males by approximately 26% and in females by approximately 10%. MVV for our population approached FEV1 × 45 (98 ± 15.6% of real MVV). Multiple regression models including height, weight, and measured FEV1 explained 70% of residual variability once sex was taken into account. CONCLUSIONS: At an altitude of 2,240 m, MVV is about 45 times the measured FEV1, and it can be estimated for other altitudes. The best predicting equations for MVV were calculated separately for females and males and included the following predictors: age, age2, and measured FEV1. The study found that reference values for MVV from studies conducted at sea level are inaccurate at this altitude.


We consider the capacity region of a three receiver broadcast channel with some message cognition at two receivers. The problem generalizes the bi-directional broadcast channel to include a third receiver, a common message, and (partial) message cognition. We characterize the capacity region for several classes of less noisy, more capable, and deterministic broadcast channels.


Volatile organic compounds (VOCs) are of interest in many different fields. Among them are food and fragrance analysis, environmental and atmospheric research, industrial applications, security or medical and life science. In the past, the characterization of these compounds was mostly performed via sample collection and off-site analysis with gas chromatography coupled to mass spectrometry (GC-MS) as the gold standard. While powerful, this method also has several drawbacks such as being slow, expensive, and demanding on the user. For decades, intense research has been dedicated to find methods for fast VOC analysis on-site with time and spatial resolution. We present the working principles of the most important, utilized, and researched technologies for this purpose and highlight important publications from the last five years. In this overview, non-selective gas sensors, electronic noses, spectroscopic methods, miniaturized gas chromatography, ion mobility spectrometry and direct injection mass spectrometry are covered. The advantages and limitations of the different methods are compared. Finally, we give our outlook into the future progression of this field of research.


Modern gears are made from a wide variety of materials. Of all these, steel has the outstanding characteristics of high strength per unit volume and low cost per pound. Although both plain carbon and alloy steels with equal hardness exhibit equal tensile strengths, alloy steels are preferred because of higher hardenability and the desired microstructures of the hardened case and core needed for the high fatigue strength of gears. This chapter provides an overview of the key considerations involved in the selection and application of heat treating processes for alloy steel gears and serves as an introduction to the subsequent chapters in this book.


The extracellular domain of several membrane-anchored proteins can be released as a soluble fragment by the action of a cell surface endoproteolytic system. This cleavage results in the generation of a soluble and a cell-bound fragment. In the case of proteins with signaling capability, such as tyrosine kinase receptors, the cleavage process may have an effect on the kinase activity of the cell-bound receptor fragment. By using several cell lines that express the TrkA neurotrophin receptor, we show that this receptor tyrosine kinase is cleaved by a proteolytic system that mimics the one that acts at the cell surface. TrkA cleavage is regulated by protein kinase C and several receptor agonists (including the TrkA ligand NGF), occurs at the ectodomain in a membrane-proximal region, and is independent of lysosomal function. TrkA cleavage results in the generation of a cell- associated fragment that is phosphorylated on tyrosine residues. Tyrosine phosphorylation of this fragment is not detected in TrkA mutants devoid of kinase activity, suggesting that phosphorylation requires an intact TrkA kinase domain, and is not due to activation of an intermediate intracellular tyrosine kinase. The increased phosphotyrosine content of the cell-bound fragment may thus reflect higher catalytic activity of the truncated fragment. We postulate that cleavage of receptor tyrosine kinases by this naturally occurring cellular mechanism may represent an additional mean for the regulation of receptor activity.


Vitamin D is essential for facilitating calcium absorption and preventing increases in parathyroid hormone (PTH), which can augment bone resorption. Our objectives were to examine serum levels of 25‐hydroxyvitamin D [25(OH)D] and PTH, and factors related to longitudinal change in a population‐based cohort. This is the first longitudinal population‐based study looking at PTH and 25(OH)D levels. We analyzed 3896 blood samples from 1896 women and 829 men in the Canadian Multicentre Osteoporosis Study over a 10‐year period starting in 1995 to 1997. We fit hierarchical models with all available data and adjusted for season. Over 10 years, vitamin D supplement intake increased by 317 (95% confidence interval [CI] 277 to 359) IU/day in women and by 193 (135 to 252) IU/day in men. Serum 25(OH)D (without adjustment) increased by 9.3 (7.3 to 11.4) nmol/L in women and by 3.5 (0.6 to 6.4) nmol/L in men but increased by 4.7 (2.4 to 7.0) nmol/L in women and by 2.7 (−0.6 to 6.2) nmol/L in men after adjustment for vitamin D supplements. The percentage of participants with 25(OH)D levels <50 nmol/L was 29.7% (26.2 to 33.2) at baseline and 19.8% (18.0 to 21.6) at year 10 follow‐up. PTH decreased over 10 years by 7.9 (5.4 to 11.3) pg/mL in women and by 4.6 (0.2 to 9.0) pg/mL in men. Higher 25(OH)D levels were associated with summer, younger age, lower body mass index (BMI), regular physical activity, sun exposure, and higher total calcium intake. Lower PTH levels were associated with younger age and higher 25(OH)D levels in both women and men and with lower BMI and participation in regular physical activity in women only. We have observed concurrent increasing 25(OH)D levels and decreasing PTH levels over 10 years. Secular increases in supplemental vitamin D intake influenced both changes in serum 25(OH)D and PTH levels. © 2012 American Society for Bone and Mineral Research.


A first-line chemotherapy program based on the ABVD regimen is currently considered the golden standard by most hematologists, being able to achieve a cure without any need of subsequent therapies in >70% of patients with advanced-stage Hodgkin's lymphoma (HL). To increase this percentage, efforts in recent decades focused on the development of new therapeutic strategies. A first major effort was the introduction of the BEACOPP chemotherapy regimen, which is able to increase the response rate and to reduce the need of salvage therapies. However, this result did not demonstrate an advantage in terms of overall survival compared to ABVD, mainly due to an excess of non lymphoma-related events in the follow-up phase. Here we describe three clinical cases of young HL patients who had relapsed/refractory disease after the induction chemotherapy. These three clinical cases provide practical and real world evidence in favor of the use of BV in monotherapy as consolidation treatment after autologous stem cells transplantation in patients with relapsed/refractory HL.


Soil Moisture Active Passive (SMAP) mission L-band brightness temperature (Tb) observations are routinely assimilated into the Catchment land surface model to generate Level-4 soil moisture (L4_SM) estimates of global surface and root-zone soil moisture at 9-km, 3-hourly resolution with ~2.5-day latency. The Catchment model in the L4_SM algorithm is driven with 1/4°, hourly surface meteorological forcing data from the Goddard Earth Observing System (GEOS). Outside of Africa and the high latitudes, GEOS precipitation is corrected using Climate Prediction Center Unified (CPCU) gauge-based, 1/2°, daily precipitation. L4_SM soil moisture was previously shown to improve over land model-only estimates that use CPCU precipitation but no Tb assimilation (CPCU_SIM). Here, we additionally examine the skill of model-only (CTRL) and Tb assimilation-only (SMAP_DA) estimates derived without CPCU precipitation. Soil moisture is assessed versus in situ measurements in well-instrumented regions and globally through the instrumental variable (IV) method using independent soil moisture retrievals from the Advanced Scatterometer. At the in situ locations, SMAP_DA and CPCU_SIM have comparable soil moisture skill improvements relative to CTRL for the unbiased root-mean-square error (surface and root-zone) and correlation metrics (root-zone only). In the global average, SMAP Tb assimilation increases the surface soil moisture anomaly correlation by 0.10–0.11 compared to an increase of 0.02–0.03 from the CPCU-based precipitation corrections. The contrast is particularly strong in central Australia, where CPCU is known to have errors and observation-minus-forecast Tb residuals are larger when CPCU precipitation is used. Validation versus streamflow measurements in the contiguous United States reveals that CPCU precipitation provides most of the skill gained in L4_SM runoff estimates over CTRL.


The effect of some steroid hormones and their synthetic analogs--dexamethasone, estradiol, progesterone, testosterone, and cytostatics--on the fibroblast nuclei in a monolayer culture was studied. Their proliferation was studied at the same time by the radioindicator method. The method of computerized morphodensitometry with the use of the apparatus-programmer complex DiaMorf (Russia) showed that the compounds under study induce reorganization of interphase chromatin of fibroblast nuclei over the molecules, the amount of which may be recorded by means of the computer system of analysis of cell and tissue images.


The 'resource nexus' has emerged over the past decade as an important new paradigm of environmental governance, which emphasises the interconnections, tensions and synergies between sectors that have traditionally been managed separately. Nexus thinking presents itself as a radically new approach to integrated governance in response to interconnected socio-environmental challenges and constraints. This paper provides a critical review of nexus thinking. The nexus paradigm, we contend, is part of a broader trend towards integrated environmental governance where previously externalised 'bad' nature is increasingly internalised by capital. In general, the nexus discourse has become techno-managerial in style, linear in its analysis and reductionist in its recommendations. Focussing particularly on urban water and energy infrastructure as important political sites in the (re)configuration of resource connectivities, we advance two principal arguments. Firstly, that the current nexus thinking inadequately conceptualises the scalar politics of interconnections between resource sectors. Secondly, we challenge the currently pervasive focus on technological and institutional 'solutions', efficiency-oriented ecological modernist vision and the presentation of 'integration' as a panacea for unsustainable resource practices.


A modified version of the time delay compensation (TDC) technique for universal mobile telecommunication system (UMTS) power control called partial TDC or PTDC is proposed. The new technique relaxes the need for information of the exact number of loop delays. Simulation results show that an adaptive power control algorithm using the PTDC technique can achieve better performance than that of standard UMTS power control in the presence of delays.


Time Warp is known for its ability to maximize the exploitation of the parallelism inherent in a simulation. However, this potential has been undermined by the cost of processing causality violations. Minimizing this cost has been one of the most challenging issues facing Time Warp. In this paper, we present dependence list cancellation, a direct cancellation technique for Time Warp which is intended for use in a distributed memory environment such as a network of workstations. This approach provides for the swift cancellation of erroneous events, thereby preventing the propagation of their (erroneous) descendants. The dependence list also provides an event filtering function which detects erroneous future events, and also reduces the number of anti-messages used in the simulation. Our experimental work indicates that dependence list cancellation results in a dramatic reduction in the time required to process causality violations in Time Warp.


This report describes a case of bilateral acute ankle syndesmosis injuries in a 15-year-old male basketball player. The patient had a background of previous inversion injuries but no symptoms of chronic pain or instability. The case report illustrates the importance of clinical suspicion when evaluating acute syndesmosis injuries in conjunction with radiographic assessments in primary care. This is the first reported case of such injury in bilateral limbs.


The anthropologist Michael Carrithers introduced the notion of polytropy in the field of the study of religion, proposing that this notion (deriving from the Greek poly, 'many', and tropos, 'turning') may account for the eclecticism and fluidity of South Asian religious life. The exploration effectuated in the article suggests that the notion of polytropy could offer a promising tool for capturing some important features of religiosity in other Asiatic contexts, too, as well as in the Mediterranean. Polytropic trends appear in different religious contexts, from the fuzzy Chinese situation, where religious affiliations are very limited in their scope and relevance, to the South Asian contexts, in which religious orientations coalesce around the multivocal concept of dharma, to the tightly structured Abrahamic religions in the Mediterranean with their strong confessionalism. Polytropy is associated with a practical mode of religiosity and is linked to a particular conception of believing in which the believer tends to multiply the transactions with different supra-mundane partners. This orientation is distinct from religious styles that are based on a discursive and scriptural approach and/or on the cultivation of oneself, which often display a tendency towards unity, coherence and continuity. This permits identifying an opposite pole with respect to polytropy, which I define as monotropy.


Large numbers of MS/MS peptide spectra generated in proteomics experiments require efficient, sensitive and specific algorithms for peptide identification. In the Open Mass Spectrometry Search Algorithm (OMSSA), specificity is calculated by a classic probability score using an explicit model for matching experimental spectra to sequences. At default thresholds, OMSSA matches more spectra from a standard protein cocktail than a comparable algorithm. OMSSA is designed to be faster than published algorithms in searching large MS/MS datasets.


When John Ayre's biography of Northrop Frye was published in 1989, its dustjacket suggested that Frye ought to be considered the foremost figure in Canadian intellectual history. He "has authored," it proclaimed, "three of the most influential books of literary criticism of all time"--Fearful Symmetry (1947), Anatomy of Criticism (1957), and The Great Code (1982). Their influence, it implied, has also made Frye into something more than a literary critic. He has become "the fourth most cited twentieth-century thinker, behind only Freud, Lenin, and Roland Barthes." In short, the dustjacket asserted that because "no critic in any time has produced so impressive a body of work," Frye is now "familiar to generations of writers, intellectuals, and students everywhere." For students of Canada, however, the significance of Frye's achievement is both more elusive and more consequential It is not just a function of his having achieved the "international renown" so heralded on his biography's dustjacket. Because Frye paid considerable attention to Canadian literature and culture throughout his career, he involved himself in a tradition of specifically national discourse. He thus established lines of relation from himself to influential predecessors and successors. His lasting national significance will ultimately be determined by these complex lines of relation, rather than proven by citation statistics. Still, the nature of Frye's elusive Canadian significance is also suggested on Ayre's dustjacket, which metaphorically casts Frye in a central and illuminating role. The metaphor appears in a 1978 quotation from Marshall McLuhan: "Norrie is not struggling for his place in the sun. He is the sun." Though the context in which McLuhan was then centering Frye remains unclear, Frye's history of English-Canadian poetry now places him, like the sun, at the center of a Canadian critical solar system.(1) He attained this position by recreating, and thereby displacing, the history that A. J. M. Smith and John Sutherland fashioned together.(2) Contextual Background During the 1940s--and largely through the agency of such publications as the Canadian Forum and the University of Toronto Quarterly--critical attention turned in a higher degree to the definition of a Canadian tradition in writing. Smith and Sutherland edited anthologies of Canadian poetry, while E. K. Brown published his early critical overview On Canadian Poetry (1943) and, almost immediately, revised it in response to Smith's reaction to what he had written, bringing out a new version in 1944. Reviewing the anthologies that Smith and Sutherland edited during the decade, Frye initially validated many aspects of their work, in which they depict a unified poetry of the present reconciling and surpassing its divided past. But when he turned his attention to English-Canadian poetry of the 1950s, Frye saw those same past divisions being more preserved than resolved in his two predecessors' anthologies and criticism. He then adopted a position similar to that which Smith and Sutherland occupied before him, one from which English-Canadian poetry appears to be prematurely split. Like them, he too sought to exorcise the division. And three decades later, Frye also supplied terms that implicitly characterize his relation to Smith and Sutherland. In an essay entitled "Literary History" (1981), he wrote: "It seems to me that the central conception involved in the historical sequence of literary works is the conception of recreation. A reader recreates everything he reads more or less in his own image.... In all recreation there is a son/father relationship which has a double aspect: an Oedipus relation where the son kills the father and a Christian relation where the son identifies with the father" (225). These terms suggest that Frye, too, re-created in his own image the history that Smith and Sutherland constructed for English-Canadian poetry. In the son/father aspect of his recreation, the Oedipal Frye metaphorically killed his fathers by asserting that a mature literary tradition was established neither by the poets that Smith promoted, nor by those that Sutherland upheld, but rather by their successors in the 1950s. …


Clays are involved in a variety of natural and managed processes, and calculation of their stability conditions is important. Such calculations are still fraught with large uncertainties owing to the lack of experimental constraints on the thermodynamic properties of clays, and bracketing of equilibrium reactions at low temperature is barely possible. Experiments aimed at studying the thermal stabilities of, and composition-temperature relations among, smectite, illite, kaolinite, pyrophyllite, mica, and chlorite at different levels of SiO2, K2O, MgO, and Al2O3 species in solution were conducted under a strong thermal gradient in the simple K2O-Al2O3-SiO2-H2O (KASH), MgO-Al2O3-SiO2-H2O (MASH), and KMASH systems. The crystallization series observed in the different experiments match to some degree those observed in active geothermal systems where clay minerals precipitate from oversaturated solutions. Smectite and/or ordered mixed-layer materials, smectite-donbassite, or possibly pyrophyllite-donbassite were observed to crystallize in both KASH and MASH experiments. Similar crystallization sequences and clay composition variations with temperature were observed in most cases when the relative positions of the starting solids were switched. The experimental results were used to refine the thermodynamic properties of K- and Mg-smectite. Stability diagrams calculated by energy minimization and activityactivity diagrams are consistent with the experimental mineral variations, suggesting that smectite is thermodynamically stable at temperatures as high as 300°C in the presence of diluted water and quartz and K-feldspar-free systems.


Eumalacostracan fossils from the Mississippian indicate the beginnings of Recent superorders other than the Eucarida; which latter probably also differentiated around this time, from a primitive shrimp with carapace sculpture like that of Palaeopalaemon, in a marine form not yet discovered There is no valid evidence to suggest Eucarid polyphyly. The only Paleozoic record of the superorder seems to be the peculiar form Palaeopemphix from the Permian, which is certainly not a Glypheid but may represent an early, calcified offshoot of the stem-form of the order Decapoda (the family P ALEOPEMPHICIDAE, n.). In the early Triassic, not only are the known Eucarids definitive Decapods, but this order was already differentiated into the suborders Dendrobranchiata and PLEOCYEMATA ( n.), which were themselves already subdivided (e.g., the Peneidae were presumably already separated from the AEGERIDAE, n. fam.). The available Mesozoic representation undoubtedly includes a disproportionate frequency of forms specialized by calcification; and this record seems too late, fragmentary and non-consecutive to supply crucial evidence either for or against the present view of Decapod phylogeny founded on evidence from Recent forms. The habits and characteristics to be expected of Paleozoic fossils representing the hypothetical stems of Eucarid groups are outlined.


Prompted by a recent article by Jiang and Liu in Antiquity (80, 2006), Dorian Fuller and his co-authors return to the question of rice cultivation and consider some of the difficulties involved in identifying the transition from wild to domesticated rice. Using data from Eastern China, they propose that, at least for the Lower Yangtze region, the advent of rice domestication around 4000 BC was preceded by a phase of pre-domestication cultivation that began around 5000 BC. This rice, together with other subsistence foods like nuts, acorns and waterchestnuts, was gathered by sedentary hunter-gatherer-foragers. The implications for sedentism and the spread of agriculture as a long term process are discussed.


This paper describes the work with F 0 and segment duration when developing a prototype system for analysis of speaker age using data-driven formant synthesis. The system was developed to extract 23 parameters from the test words—spoken by four differently aged female speakers of the same dialect and family—and to generate synthetic copies. Audio-visual feedback enabled the user to compare the natural and synthetic versions and facilitated parameter adjustment. Next, weighted linear interpolation was used in a first crude attempt to synthesize speaker age. Evaluation of the system revealed its strengths and weaknesses, and suggested further improvements. F 0 and duration performed better than most other parameters.


Received Sep 22, 2022 Revised May 19, 2023 Accepted Jun 12, 2023 The current study was designed to screen and observe dysgraphia in primary schools in Wassit governorate in Iraq. In addition, to identify the presence of any family environment characteristics associated with dysgraphia, a cross-sectional study has been applied during the period from 1st November 2018 to the end of March 2019, which was conducted on 421 students from public and private primary schools which were randomly selected. The lifetime prevalence of students with dysgraphia was 27% in the present study. Most students (53.2%) were equal to or less than 10 years old. In the population sample, dysgraphia prevailed more in boys than girls. Illiteracy was higher for the students who have fathers with dysgraphia (39.3%) as compared to the students who have nondysgraphia fathers (29.4%). The difference was more significant for the age, gender, and level of education of parents (p<0.05). It was concluded that dysgraphia among primary school students aged 7-12 years occurs at a lifetime prevalence of nearly one-third of them. In our study, it was affirmed that dysgraphia is a problem that most commonly affects males more than females. It is important to note that the difference between the two groups was statistically significant in regard to age, gender, and level of education of parents.


Leukocytes are blood cells that contain nuclei, also called white blood cells. Leukocytes have a role in the cellular and humoral defense of organisms against foreign substances. Laboratory tests of blood samples greatly influence the diagnosis of a disease. Manual blood tests do have a low price but still have some weaknesses such as the length of time needed will be longer, because health practitioners must examine them carefully to avoid misinformation. To help overcome these weaknesses, a classification of types of infections was carried out based on the results of leukocyte examination. Classification is a grouping of data where the data used has a label or target class. So that the algorithms for solving classification problems are categorized into supervised learning. The purpose of supervised learning is that label data or targets play a role as a 'supervisor' or 'teacher' who oversees the learning process in achieving a certain level of accuracy or precision. The algorithm used in this study is K-Nearest Neighbor (KNN). The data used in this study as many as 2,098 results of complete blood tests taken from one hospital in Medan. This study is in a classification accuracy of 92%.


We address visual servoing through a fixed stereo rig using an image Jacobian. Existing methods are based on the stacking of monocular servo image Jacobians, resulting in largely over-constrained control commands. In this paper we formally show that the epipolar constraint between two images can be taken into account explicitly. We then show that use of stereo significantly increases the quality of the servo task execution, especially where precision, robustness and smoothness of movement is concerned.


The relationship between periodontal sensation and Myofascial Pain (MP) is not yet fully clarified. The aim of this study was to test the null hypothesis that there is no difference in the periodontal sensation threshold between subjects with MP and subjects with no Temporomandibular Disorders (TMD).

 Participants have clinically assessed in accordance with the Research Diagnostic Criteria for Temporomandibular Disorders version 1.0 guidelines and assigned to the MP group (mean age 54.8 ± 14.8 years; 1 male and 11 females) or the control group (mean age: 63.9 ± 13.2 years; 1 male and 15 females). The Passive Periodontal Sensation Threshold (PPST) was evaluated using impulsive mechanical stimulation on the occlusal surface parallel to the tooth axis of the maxillary first molar, if present. The difference in the mean PPST between the MP group and the control group was evaluated using the Student t-test after checking for homoscedasticity.

 The mean PPST value was 1050.1 ± 480.3 mN in the MP group and 712.3 ± 288.5 mN in the control group. A significant difference was observed between these mean PPST values (p = 0.045).

 There was a significant difference in PPST between the MP group and the control group. Although the etiology of the change of PPST is still unknown, the higher PPST value observed in MP patients suggests that future study on occlusal dysesthesia or occlusal sensation-related pathosis is warranted.


The TATA-binding protein (TBP) is required for transcription by all three nuclear RNA polymerases. TBP was subjected to regional codon randomization, a codon-based mutagenesis method that generates complex yet compact protein libraries. Analysis of 186 temperature-sensitive TBP mutants yielded 65 specifically defective in transcription by RNA polymerase III (Pol III). These mutants map to a limited TBP surface that may interact with Tds4, a component of the Pol III transcription factor TFIIIB. Strains that contain the Pol III-defective derivatives have increased amounts of messenger RNA, which suggests that competition among TBP-interacting factors for limiting quantities of TBP determines the ratio of Pol II and Pol III transcription in vivo.


Recent studies have analyzed the minimal thermodynamic work required for a given logical map to be implemented on any physical system. These studies have focused on maps whose output does not depend on the input, e.g., bit erasure in a digital computer. In addition, they have considered physical systems whose design varies depending on the distribution of inputs to the map. However very often we are interested in implementing a map whose output depends on its input. In addition, we often want our system to implement the same map even if the system's environment changes, so that the distribution over map inputs changes. Here I introduce a thermodynamic engine that satisfies both of these desiderata. I then calculate how much work it requires, deriving an additive correction to the "generalized Landauer bound" of previous studies. I also calculate the Bayes-optimal engine for any given distribution over environments. I end with a short discussion on how these results relate the free energy flux incident on an organism / robot / biosphere to the maximal amount of (noisy) computation that the organism / robot / biosphere can do per unit time.


Concerns with coercion and irrational decision-making underlie many of the arguments against compensated organ donation. Nonetheless, healthy adults are allowed, and even encouraged, to donate a kidney, without compensation, to patients in dire need of a functional organ. How does the introduction of a reasonably regulated system of donor compensation influence the decision-making of kidney donors and recipients? We address this question first under the assumption that the current conditions of kidney shortage are unchanged. We then extend the discussion by examining compensation in a regime in which the shortage of kidneys for transplants is greatly reduced or eliminated.We argue that most of the issues that confront a compensated system of live kidney donation also are present in the current system, and they have prompted measures to safeguard the interests of patients. The addition of compensation does hold the potential to magnify some problems, especially for donors, such as present bias leading to imprudent decisions. Among the methods to deal with these problems are to rely primarily on in-kind compensation and to backload any monetary rewards. The pressing shortage of kidneys presents donors and recipients with perplexing dilemmas. A system of compensation that relieves the shortage would lighten these dilemmas, to the benefit of patients, their families, and medical personnel.


In 3D-IC packages, the low-k dielectrics are favored to improve many electrical characteristics in IC devices; hence the corresponding researches are being widely studied extensively. For the purpose of studying thermal-mechanical effects on Cu/low-k interconnects in the wafer, the three dimensional finite element analysis (FEA) was adopted in this paper. Several low-k dielectrics were considered in FEA, which are SiLK, BCB and SiCOH. By using FEA, the corresponding thermal-mechanical induced stresses distribution of Cu/low-k interconnects would be obtained. Furthermore, in order to study the sensitivity information of Cu/low-k interconnects, the method of design of experiments (DOE) as well as factorial design methodology and response surface methodology were also used. Five major parameters of geometric dimensions of copper interconnects/vias structure were selected as the design factors and the maximum average value of von Mises stress in copper interconnects/vias structure was selected as the response to be optimized. Through the DOE analysis, the optimum geometric parameters of copper interconnects/vias structure that resulted in smaller von Mises stresses in Cu/low-k interconnects could be obtained. The results also show that the geometric dimension of copper interconnects/vias had significant influence on von Mises stresses distribution. Moreover, the maximum value of von Mises stress for different copper interconnects/vias geometric dimensions could also be easily predicted by using the response surface curve and its corresponding regression model from DOE analysis.Copyright © 2007 by ASME


OBJECTIVE. The objective of the work was to develop an estimate of the risk of death resulting from short falls of <1.5 m in vertical height, affecting infants and young children between birth and the fifth birthday. METHODS. A review of published materials, including 5 book chapters, 2 medical society statements, 7 major literature reviews, 3 public injury databases, and 177 peer-reviewed, published articles indexed in the National Library of Medicine, was performed. RESULTS. The California Epidemiology and Prevention for Injury Control Branch injury database yielded 6 possible fall-related fatalities of young children in a population of 2.5 million young children over a 5-year period. The other databases and the literature review produced no data that would indicate a higher short-fall mortality rate. Most publications that discuss the risk of death resulting from short falls say that such deaths are rare. No deaths resulting from falls have been reliably reported from day care centers. CONCLUSIONS. The best current estimate of the mortality rate for short falls affecting infants and young children is <0.48 deaths per 1 million young children per year. Additional research is suggested.


s 15th World Congress on Disaster and Emergency Medicine sl l3 (175) Effects of Seasonal Variation on Hazardous Chemical Releases I. Zimmerman; R.L. Lima; R.P Pietrobon? DM. Marcozzi 1. University of North Carolina at Chapel Hill, Holly Springs, North


Author(s): Reinhold, Kimberly | Advisor(s): Scanziani, Massimo | Abstract: Recurrent circuits are a hallmark of mammalian sensory cortex. How they impact dynamics of sensory representation is not understood. Because recurrent circuits provide a majority of the synaptic excitation to cortical neurons in response to sensory stimulation, the intrinsic dynamics of these cortical recurrent circuits are expected to be a critical determinant of the timing of the sensory response in cortex. Previous methods could not isolate dynamics of these intra-cortical recurrent circuits from those of thalamic afferents during sensory processing. I now accomplish this by developing an approach to optogenetically silence thalamus in a model system: the mouse visual pathway. Silencing thalamus revealed the time course over which visually evoked activity in visual cortex was maintained by the intra-cortical recurrent circuits themselves, in isolation from thalamic input. I found that, at all time points during the cortical sensory-evoked response, optogenetically silencing thalamus led to a fast decay of sensory-evoked activity in cortical recurrent circuits. This activity decay time course was fit by a 10 ms network time constant, similar to a neuron's integration time window. This decay time course was invariant across all tested visual stimulation conditions and behavioral states but depended on cortical inhibition. In awake mice, the dynamics of this time course predicted the time-locking of cortical activity to thalamic input at frequencies l15 Hz and the attenuation of the cortical response to higher frequencies. Under anesthesia, however, dynamics of depression at thalamocortical synapses disrupted the fidelity of sensory transmission. Thus, I determine sensory-evoked dynamics intrinsic to the intra-cortical recurrent circuits in isolation from thalamus and show how these dynamics transform afferent input in time.


In this research, a micro-plasma system was investigated for its capability in additive manufacturing (AM). Micro-plasma AM system has the advantage of lower cost and higher deposition rate over laser based AM systems, and generates leaner and cleaner weld deposit than other arc based AM systems. However, the micro-plasma system is complex and involves a large number of process variables. In this study, the feasibility of using a micro-plasma system for additive manufacturing was assessed based on surface features, mechanical properties and microstructure. In addition, two arc and wire feed modes were examined to understand the effects of these two variables. Each was used to produce IN 718 superalloy samples for macro- and microstructure evaluation, hardness, wear, and tensile tests along both long and transverse directions. Preliminary results showed that crack free samples, measured up to 100 mm × 40 mm, can be generated without measurable distortion. Some surface discoloration was observed, ranging from light straw to a purple tint. After heat treatment, the hardness of the samples varies from 403 to 440 HV, with the transverse surface showing slightly lower hardness values. Pin-on-disk wear test yielded consistent wear volume for three sets of the samples produced using different process parameters; however, samples produced with no modifications to the current and wire feed mode showed marginally higher wear rate. Microstructural analysis with SEM and EDS revealed presence of small pinholes, measured from submicron up to 22 μm in diameter, and no indication of any cracks or boundary layers between passes. SEM analysis revealed the presence of high contrast Nb/Mo rich carbides along with γ″-Ni3Nb in the γ matrix. Finally, tensile test was carried out to understand the anisotropic behavior; the results showed that transverse direction had lower tensile strength and ductility. Samples produced with pulsed current and wire feed mode had lower yield/tensile strength but higher ductility than that without current and wire feed mode modification.


Olefin metathesis catalysts have become one of the tools for the efficient synthesis of complex molecules. Until recently, the catalysts demonstrated poor catalyst controlled selectivity. Over the past several years, complexes based on molybdenum, tungsten and ruthenium have been discovered that will produce olefins good to excellent selectivity for the generation of Z olefins both in cross and in ring closing metathesis. New ligands have been developed that result in different selectivities and open new applications of metathesis in the synthesis of an array of complex molecules. These catalysts are developed through design, computation and serendipity. Applications range from the preparation of pharmaceuticals to the control of the structure of polymeric materials.


OF DISSERTATION AN EXPLORATORY FACTOR ANALYSIS OF THE SURVIVOR OF SUICIDE LOSS SUPPORT GROUP FACILITATOR SCALE: IDENTIFYING MEANINGFUL FACTORS FOR GROUP FACILITATION AND OUTCOMES Support groups for suicide loss survivors are a relatively common resource used by those who are left to cope in the aftermath of a suicide death. Though descriptive studies have been used to provide an overview of support groups in the past, there have been no efforts to understand nuances of these groups and the impact of these groups and differing facilitation styles on the bereavement experience for attendees. This study explores primary data collected between March 2015 and December 2015 with a sample of 138 survivor of suicide loss support group facilitators in the United States and New Zealand. Meaning making and meaning reconstruction is presented as the primary theory used to examine the attitudes of support group facilitators. Basic analytic procedures were used to explore sample descriptives, and an Exploratory Factor Analysis (EFA) with an oblique rotation was used to identify the factors within the Survivor of Suicide Loss Support Group Facilitator Scale. Three factors were revealed with a simple structure, representing the latent themes of (1) Facilitator Perspective on the Role of the Story (α=.73), (2) Facilitator Perspective on the Role of the Facilitator (α=.63), and (3) Facilitator Perspective on Role of the Loss Survivor (α=.59). The final model resulted in a moderate positive correlation between factors 1 and 2 (.472), a moderate positive correlation between factors 1 and 3 (.303), and a week positive correlation between factors 2 and 3 (.037). Bivariate analyses revealed that factors 1 and 2 both had a significant relationship with length of time the facilitator had been leading the group, facilitator's level of compassion satisfaction, and facilitator's level of burnout. The findings of the EFA support the use of the scale as a tool to discern differences in facilitator attitudes about the role of meaning making and sharing of stories in the group as well as the role of the facilitator in aiding this process. The findings provide important information for understanding variation in support group facilitation styles and have implications for future exploration of outcomes for group attendees based on facilitator attitude and style. Implications for practice and future research are discussed.


Abstract Context: Residents play an integral role in educating junior residents, medical students, and patients. Objective: To determine how residents describe their training, proficiency, and comfort level in teaching before and after receiving instruction in clinical teaching. Methods: Emergency medicine residents at a 980-bed suburban hospital system filled out a 12-question survey on their training as teachers and their self-perceptions of themselves as teachers. The residents then participated in a 2-hour education session on adult learning principles, methods of clinical teaching, and how to give effective feedback. After the session, participants completed a second, 11-question survey on the effectiveness of the session. Results: Thirty-seven residents completed the presession survey and 33 completed the postsession survey. In the presession survey, 23 residents (62%) identified their proficiency as a teacher and ability to give feedback as that of a novice or beginner. Fourteen (38%) felt competent or proficient as teachers. Twenty-six (70%) reported never receiving instruction in clinical teaching during their residency, and 33 (89%) were interested in learning these skills. In the postsession survey, 28 (85%) described the teaching module as very helpful to their training, and 33 (100%) reported feeling more prepared to teach. Twenty-six (79%) stated they were very likely to teach students more often, and 33 (100%) reported a better understanding of how to give effective feedback. Conclusion: The majority of the residents surveyed expressed an interest in learning teaching skills and felt that completing the training was helpful to their education. After instruction, this cohort of residents felt more prepared and reported they were more likely to teach.


OBJECTIVE: To mathematically assess drug losses due to infusion line residuals and evaluate methods to compensate for drug loss due to residual volumes in intravenous pump tubing. DATA SOURCES: Literature was accessed through Ovid MEDLINE (1996-February 2013), using combinations of the search terms tubing residuals, residual volume, residual medication, intravenous infusions, intravenous injections, piperacillin, piperacillin-tazobactam, β-lactams, equipment design, infusion pumps, extended infusion, extended administration, and prolonged infusion. In addition, select reference citations from publications identified were reviewed. STUDY SELECTION AND DATA EXTRACTION: All articles that involved extended-infusion piperacillin-tazobactam implementation strategies were included in the review. DATA SYNTHESIS: Infusion pump characteristics and tubing residuals can affect extended-infusion piperacillin-tazobactam dosing strategies. Two studies addressing tubing residuals were identified. Both studies recommended increasing infusion volumes to compensate for tubing residuals. One study also recommended decreasing infusion-line dead space by using alternative infusion pump systems. Study calculations suggest that higher doses of piperacillin-tazobactam may be used to account for medication left in tubing residuals if alternative infusion pump systems cannot be obtained, and increased infusion volumes are not an option. CONCLUSIONS: Extended-infusion piperacillin-tazobactam has been used as a method of maximizing pharmacodynamic target attainment. Use of higher doses of piperacillin-tazobactam may be a reasonable method to compensate for drug loss due to residual volumes in large-bore intravenous pump tubing.