OBJECTIVE
The main treatment strategies for clinical stage T1 renal mass are radical nephrectomy (RN) and partial nephrectomy (PN). Treatment decision depends largely on tumor complexity as assessed by the R.E.N.A.L. nephrometry scoring system. The authors evaluated our experience with R.E.N.A.L. nephrometry score in all patients who underwent surgery.

MATERIAL AND METHOD
The authors evaluated 61 patients who presented with clinical stage T1 renal mass and underwent radical or partial nephrectomy between 2007 and 2013 at Ramathibodi Hospital. Tumor complexity was quantified by R.E.N.A.L. nephromety score in all patients using preoperative imaging. Statistical analysis was done to study associations.

RESULTS
Sixty-one patients were included in this study, which 34 (55.70%) were male and 27 (44.30%) were female. The most common pathologic report was clear cell renal cell carcinoma followed by angiomyolipoma and papillary renal cell carcinoma. Forty-one patients underwent radical nephrectomy, of whom three, 25, and 10 patients had low, moderate, and high tumor complexity respectively. Twenty patients underwent partial nephrectomy, of whom 10 patients had low tumor complexity and 10 patients had moderate tumor complexity. No patient had high tumor complexity. In the present study, the function coefficient showed that radius had the most influence on surgical decision-making,followed by nearness to collecting system, exophytic/endophytic, and location. We also developed the Ramathibodi equation to help selecting the proper operation.

CONCLUSION
The R.E.N.A.L. nephrometry score is a feasible and standardized classification system for evaluating renal masses. It could be used to stratify tumor complexity and may help for surgical decision-making.


A seismic investigation of crustal structure of the southern Rocky Mountains in 1964 and 1965 resulted in traveltime curves that have been interpreted to indicate an average crustal thickness of 48 km in the San Juan Mountains, the Sawatch Range, and the Park Range; 52 km in the Front Range; and 37 km in the Laramie Range. The upper crust west of the Front Range includes a low-velocity zone, and the velocity in the lower crust there increases gradually to 7.1–7.3 km/sec just above the Moho. The crust in the Front Range is distinctly separated into upper and lower units. The upper-mantle velocity in the Southern Rocky Mountains is about 7.9 km/sec. The average density and velocity of the crust are lower in the San Juan Mountains, the Sawatch Range, and the Park Range than those in the Front Range. The crust in the Colorado Plateau is thinner than that in the Southern Rocky Mountains, but the crust in the Great Plains is as thick or nearly as thick as that in the Front Range.


BACKGROUND
Renal vasculitis presents as rapidly progressive glomerulonephritis (RPGN) which comprises of a group of conditions characterised by acute kidney failure (AKF), haematuria and proteinuria. Treatment of these conditions comprises steroid and non-steroid agents in combination with plasma exchange in several situations. Although immunosuppression overall has been very successful in treatment of these conditions, many questions remain unanswered in terms of dose and duration of therapy and the use of plasma exchange.

OBJECTIVES
To determine the benefits and harms of any intervention for the treatment of renal vasculitis in adults.

SEARCH STRATEGY
We searched the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Renal Group Specialised Register, MEDLINE and EMBASE without language restriction, reference lists of articles and abstracts from conference proceedings.

SELECTION CRITERIA
Randomised controlled trials investigating any intervention for the treatment of in adults.

DATA COLLECTION AND ANALYSIS
Two authors independently assessed study quality and extracted data. Statistical analyses were performed using a random effects model and results expressed as risk ratio (RR) with 95% confidence intervals for dichotomous outcomes or mean difference (MD) for continuous outcomes.

MAIN RESULTS
Thirteen studies (702 patients) were included. Plasma exchange as adjunctive therapy significantly reduces the risk of end-stage kidney disease (ESKD) at three months (one study: RR 0.45, 95% CI 0.24 to 0.84) and 12 months (five studies: RR 0.47, CI 0.24 to 0.86). Three studies compared the use of pulse and continuous administration of cyclophosphamide (CPA). Overall analysis showed a significant increase in remission with pulse CPA (2 studies: RR 1.17; 95%CI 1.02-1.35) and fewer relapses with continuous CPA. A single study addressed the use of azathioprine (AZA) after three months of CPA therapy, showing no difference in outcome except for significantly less leukopenia in patients on AZA. One study into the use of antibiotics to prevent relapse in Wegener's granulomatosis failed to show a significant effect.

AUTHORS' CONCLUSIONS
Plasma exchange is effective in patients with severe ARF secondary to vasculitis. On current data, the use of pulse CPA results in an increased risk of relapse when compared to continuous use but a reduced total dose. The use of cotrimoxazole is likely to be beneficial to prevent relapse of vasculitis. AZA is effective as maintenance therapy once remission has been achieved.


NY-ESO-1 is a "cancer-testis" (CT) antigen that is expressed in a wide variety of common cancers. We vaccinated patients with full length NY-ESO-1 protein with and without the ISCOMATRIX™ adjuvant. Immune responses were evaluated by DTH skin testing, antibody assays and cellular assays for epitope-specific CD4+ and CD8+ cells. Antibody titers and DTH reactions were significantly greater in patients who received adjuvant compared to those who received protein alone. Biopsy of DTH lesions showed CD4+ and CD8+ T-cell infiltrates. Antigen-specific T cells capable of recognizing Class I and class II NY-ESO-1 epitopes were isolated from these lesions. Circulating T-cell responses in blood were assessed with tetramers and an intracellular cytokine staining (ICS) assay for IFN-gamma to assess responses to an HLA-A2-restricted epitope NY-ESO-1157-165 (SLLMWITQC). ICS was also employed in a novel assay, which used autologous PBMCs and panels of overlapping peptides. Three of 8 patients who received 100 mg of protein with adjuvant responded to NY-ESO-1157-165. Importantly, responses to a variety of other previously described and undescribed CD4 and CD8 epitopes were seen, demonstrating a broad-based CD4+ and CD8+ cellular immune response against NY-ESO-1. In ongoing work we are defining minimal peptides, mapping these epitopes, and identifying the HLA class I and II restriction for each. Although the study was not designed to evaluate clinical outcomes, data show that those patients who received vaccine with ISCOMATRIX™ adjuvant appeared to have a longer disease-free survival than those who received protein alone or placebo. A prospective evaluation is required to determine whether immune responses to NY-ESO-1 can modify the survival of patients with tumors that express this antigen.

This abstract was published in Cancer Immunity , a [Cancer Research Institute][1] journal that ceased publication in 2013 and is now provided online in association with Cancer Immunology Research .

 [1]: http://cancerresearch.org/


In its development, the supervisor of the education unit is more directed to owning and understanding even demanded to be able to practice what is contained in the ministerial regulation on oversight. One of the demands is about competence in understanding the methods and techniques in supervision. A supervisor is a professional person when carrying out their duties, he acts on the basis of scientific principles to improve the quality of education.A supervisor fosters improved academic quality related to efforts to create better learning conditions in the form of academic aspects, not merely physical material problems. When supervision is faced with the performance and quality control of education by the supervisor of the education unit, it certainly has a different mission from supervision by the school principal. In this article the author will explain the difficulty of educational supervision so that readers can understand about educational supervision.


In Japan, the idea of citizen involvement in the judicial process has gained greater acceptance over the past decade. On May 21, 2009, Japan implemented its saiban'in seido or "lay judge system" as part of monumental legal reforms designed to encourage civic engagement, enhance transparency, and provide greater access to the justice system. About eight years before this historic day, a special governmental committee known as the Justice System Reform Council ("JSRC") set forth wide-sweeping recommendations for revamping Japan's judicial system. The underlying goals targeted three pillars of fundamental reform, namely: (i) a justice system that is "easier to use, easier to understand, and more reliable;" (ii) a legal profession "rich both in quality and quantity;" and (iii) a popular base in which citizens' trust in the legal system is enhanced through their participation in legal proceedings. The JSRC viewed the judicial system as an engine capable of propelling both economic and societal change. It believed that lay judge participation could function as a piston in this engine by helping shift Japan away from centralized control and heavy bureaucratic regulation. Lay participation was consistent with the perceived need for Japanese citizens to not only break away from excessive dependency on the government, but also to develop greater civic consciousness, become more actively involved in public affairs, and better integrate community values into the justice system. From the outset, the creation and implementation of the lay judge system have been strongly controlled by the status quo such that direct impact on the outcome of individual criminal trials has been minimized. However, the value of this monumental court reform in Japan has been educational, indirect, and real. This Article examines the direct impact of the lay judge system, describes several of the indirect benefits of the new system, and then explores the potential of the system going forward. This analysis is done through the lens of Malcolm Feeley's 1983 work entitled Court Reform on Trial. Cite as: Matthew J. Wilson, East Asian Court Reform on Trial: Assessing the Direct and Indirect Impact of Citizen Participation in Serious Japanese Trials, 27 WASH. INT'L L.J. 75 (2017).


In the 1990s, sociologists engaged in a heated controversy about class voting. Although empirical evidence accumulated, positions remained surprisingly divided. This paper argues that this disagreement is due to two factors. Firstly, it reflects diverging understandings as to the concept of class voting. Secondly, it is explained by the use of class models that do not satisfactorily represent today's social stratification in Western Europe. In consequence, this paper uses a detailed multi-class schema and examines two cleavages running through the social structure: (i) the economic divide separating holders of organizational power from the workingclass, (ii) the cultural divide opposing high-skilled classes engaged in interpersonal work settings (who hold a liberation view of community) from low-skilled classes occupied in object-related tasks (who hold an authoritarian view of community). Based on individual level data, our analyses show that classes continue to systematically differ in their party support. There is strong electoral evidence for the traditional economic cleavage in Britain's and Germany's class structure, while in Switzerland the cultural cleavage seems more salient. Hence, class voting continues but appears to involve more (and different) class-party alliances than just leftvoting by the woking class. Among others, we find salaried professionals in the social and cultural services to rally the libertarian left, while managers support parties on the right. Moreover, where a right-wing populist party alternative exists, it attracts disproportionate support from production workers and small business owners.


Recent advances in the field of data mining have led to major concerns about privacy. Sharing data with external parties for analysis puts private information at risk. The original data are often perturbed before external release to protect private information. However, data perturbation can decrease the utility of the output. A good perturbation technique requires balance between privacy and utility. This study proposes a new method for data perturbation in the context of distance-based data mining. We propose the use of non-metric multi-dimensional scaling (MDS) as a suitable technique to perturb data that are intended for distance-based data mining. The basic premise of this approach is to transform the original data into a lower
dimensional space and generate new data that protect private details while maintaining good utility for distance-based data mining analysis. We investigate the extent the perturbed data are able to preserve useful statistics for distance-based analysis and to provide protection against malicious attacks. We demonstrate that our method provides an adequate alternative to data randomisation approaches and other dimensionality reduction approaches. Testing is conducted on a wide range of benchmarked datasets and against some existing perturbation methods. The results confirm that our method has very good overall performance, is competitive
with other techniques, and produces clustering and classification results at least as good, and in some cases better, than the results obtained from the original data.


"The United Arab Emirates (UAE) has become bound - after its accession to the New York Convention of 1958 - to recognize foreign arbitral awards as binding awards and to enforce such awards according to the rules of procedure adopted in the State and in accordance with the conditions set forth in Article V of the Convention, and not to impose more stringent conditions on the enforcement of foreign arbitral awards than those imposed on the enforcement of arbitral awards rendered within the State." "The provisions of treaties or ratified international conventions concluded between the UAE and foreign countries shall be applicable regarding the enforcement of foreign judgments and arbitral awards, even if the conditions mentioned in Article 235 of the Code of Civil Procedure are not met."


The broadband spectral energy distribution (SED) of blazars is generally interpreted as radiation arising from synchrotron and inverse Compton mechanisms. Traditionally, the underlying source parameters responsible for these emission processes, like particle energy density, magnetic field, etc., are obtained through simple visual reproduction of the observed fluxes. However, this procedure is incapable of providing confidence ranges for the estimated parameters. In this work, we propose an efficient algorithm to perform a statistical fit of the observed broadband spectrum of blazars using different emission models. Moreover, we use the observable quantities as the fit parameters, rather than the direct source parameters which govern the resultant SED. This significantly improves the convergence time and eliminates the uncertainty regarding initial guess parameters. This approach also has an added advantage of identifying the degenerate parameters, which can be removed by including more observable information and/or additional constraints. A computer code developed based on this algorithm is implemented as a user-defined routine in the standard X-ray spectral fitting package, XSPEC. Further, we demonstrate the efficacy of the algorithm by fitting the well sampled SED of blazar 3C 279 during its gamma ray flare in 2014.


IRIDIUM-NEXT is the second generation of a global satellite constellation, composed by 66 cross-linked LEO satellites covering the whole globe. The attitude determination for each satellite is assigned to one MHSTR (MultiHead Star Tracker) consisting of 3 Star Trackers (STR). The prime contractor is Thales Alenia Space and, in this context, Selex ES has the full responsibility of the Star Tracker procurement. The launch of the first satellite is expected in 2015. Given the thermal insulation requirements between the STRs and the S/C (with a conductance lower than 0.1 W/K), the STR design is strongly affected in both the thermal and the structural aspects. The thermal detailed design of the sensor has been focused on: - Characterization and development of the thermal paths in order to keep the sensor temperature lower than 15°C - Optimization of the coatings The thermal design has been numerically analyzed and verified through experimental tests to validate the model. The paper describes the development of both the thermal and geometrical detailed mathematical models, the execution of the thermal balance test (TBT) and the following correlation activity for the TMM. The prediction of the expected in-orbit performances are also reported. Reference is made to the optimization of the recurring testing activities, in light of the small series (250 units) production launched.


Following the liberalization and privatization of the electricity market, Russia is now reforming the heating sector. Similarly to the electricity market restructuring, the trigger for the heat reform is the necessity to attract investments in the modernization of this sector. The existing infrastructure in Russia is obsolete and thus highly energy and carbon (CO2) intensive. The modernization program presents important opportunities to generate energy savings, reduce greenhouse gas emissions, improve local air quality and promote the use of renewable energy sources (e.g. biomass and geothermal energy). Improving the energy efficiency of the Russian heating sector is indispensable to avoid offsetting international climate change mitigation efforts with unreasonably large energy waste in Russia. Realizing energy savings in the Russian heating sector – one of the largest consumers of natural gas in Russia – would also free natural gas for export and thus improve international energy security. The present paper analyzes the extent to which the Federal Heat Law of July 27, 2010 – the legislative pillar of the reform – creates a viable environment for energy efficiency and renewable energy investments in the Russian heating sector. From an investor's perspective, this paper questions whether the new tariff structure of this law can ensure adequate return on energy efficient investment and thus stimulate the necessary modernization of heat supply. Based on Russia's long experience with district heating, the paper draws lessons that are relevant for other states (e.g. in the European Union and the United States) that advocate district heating as a solution to decarbonizing heat and electricity supply.


We present the results of alternating-current susceptibility measurements highlighting the presence of thermal hysteresis and phase coexistence across the ferromagnetic-to-antiferromagnetic transition in various CeFe 2 -based pseudobinary systems. These results indicate that the ferromagnetic-to-antiferromagnetic transition in these systems is first order in nature.


Apparent syntactic phoenixes This article investigates 'syntactic phoenixes': obsolete or obsolescent constructions that unexpectedly regain currency in language use. Four case studies are investigated to gain insight in the reasons for the revival of these old constructions: (i) transparent free relatives, (ii) the complex prepositionlike combination wat betreft, (iii) accusativus and nominativus cum infinitivo (ACI/NCI) and (iv) bare infinitive with the youngmodal hoeven. In all cases, the (temporary) reversal of the diachronic trends in the internal syntax of these constructions is argued to be driven by an analogical pull by cognate constructions. As such, the phoenixes are in fact illusions: the revival only affects a particular corner of the whole construction, namely where it borders on the neighbouring construction. The diachronic developments underscore the need to take into account the impact of the broad grammatical environment in which syntactic changes take place in grammaticalisation.


A planetary body's ability to generate a dynamo is dependent on its thermal history and possible energy sources, particularly the convective states of the core and overriding mantle. This dissertation addresses questions regarding the characteristics of magnetic fields for both the Earth and the Moon. The temporal and spatial variations of the Earth's geomagnetic field are investigated using rock magnetic properties (direction and intensity) for the past 5 Ma. This thesis analyzes both published data at \±20\⁰ and provides new paleomagnetic measurements of direction and intensity for a high latitude site ( -78\⁰) to investigate both the longitudinal and latitudinal variations of Earth's field. Investigations of zonal statistical paleosecular variation (PSV) models reveal that recent models are incompatible with the empirical \±20\⁰ directional distributions. The \±20\⁰ latitude data suggest less PSV and smaller persistent deviations from a geocentric axial dipole field during the Brunhes. High dispersion and low intensity observed at - 78\⁰ agrees with the global observation of anti-correlation between dispersion and intensity. Comparisons with temporally-varying dipole magnitude models show that the lack of increased paleointensity at high latitude likely results from temporal sampling bias. Previous paleointensity studies of Apollo era samples suggest strong paleointensities for ancient (>3.6 Ga) lunar rocks and little-to-no strength for younger (<3.6 Ga) rocks. By extrapolation, these results were interpreted as the Moon having an early, short-lived dynamo. However, previous paleointensity measurements do not meet current lab protocols and substantial scatter exists in paleointensities from the putative dynamo period. I analyze published and measure new absolute (thermal and microwave) and relative paleointensities from five Apollo samples spanning from 3.3 to 4.3 Ga to re-examine the hypothesis of an early lunar dynamo. In light of the new experiments and a thorough re-evaluation of existing paleointensities, I show that although some samples with ages of 3.6 Ga to 3.9 Ga are strongly magnetized with occasional stable directions, no observations verifiably demonstrate a primary thermal remanence. In agreement with satellite measurements of crustal magnetism, current paleointensity measurements do not support the existence of a 3.9-3.6 Ga lunar dynamo


Valuation of common stock is very important yet a very complex process. The stock requires a deeper analysis compared to preferred stock or debts. The major techniques of valuation of common stock are: (i) Relative valuation models which is based on the earnings power of the firm, the book value and sales. (ii) The discounted cash flow techniques, where the value of stock is estimated based upon the present value of some measure of cash flow including dividends, operating cash flow among others. The study was conducted to establish the reliability of the dividend discount model (which is based on the discounted cash flow techniques) on the valuation of common stock at the Nairobi Stock Exchange. Data was collected in form of share prices, market indices and dividend per share from the Nairobi Stock Exchange secretariat, and were used to predict share prices for each of the eighteen companies studied. Market model was used as a model of equilibrium to provide a link between the expected values which are non observable and real values that were used in testing the model. Predicted share prices were compared with the actual prices by computing the differences between them. The differences were then subjected to t-test. The test of significance showed that out of the eighteen companies studied; only three showed that the differences were significant. I therefore concluded that the dividend discount model is not reliable in the valuation of common stock at the Nairobi Stock Exchange.


The article explores a series of questions and hypotheses related to polygynous family structures and both household and individual-level food security outcomes, using the World Bank Living Standards Measurement Survey data from Nigeria, collected in 2011 and 2013. A Correlated Random Effects (CRE) model is used to examine the relationship between polygyny and household-level food security, and the degree to which it is mediated by household wealth, size, and livelihood. A Household Fixed Effect model is employed to explore whether a mother's status as monogamous versus polygynous relates systematically to her child's health, and also whether child outcomes of senior wives are better than outcomes of junior wives within polygynous households. We find that polygynous households have better food security outcomes than monogamous households with differences in household composition and agricultural livelihood as potential explanatory mechanisms. We also find that within polygynous households, children of junior wives have better health outcomes than children of senior wives.


This final rule incorporates into the Child and Adult Care Food Program (CACFP) regulations the provisions of the William F. Goodling Child Nutrition Reauthorization Act of 1998, which authorized afterschool care centers meeting certain criteria to be reimbursed for snacks served to at-risk children 18 years of age and younger. This rule establishes the eligibility of at-risk afterschool care centers to serve free snacks to children who participate in afterschool programs. The centers, which must be located in low-income areas, are reimbursed at the free rate for snacks. The intended effect of this rule is to support afterschool care programs through the provision of snacks that meet CACFP meal pattern requirements. The additional benefits provided by the 1998 reauthorization act and codified by this final rule were extended to institutions and children immediately after enactment. These changes were originally proposed by the Department in a rulemaking published on October 11, 2000.


The aim of the study was to determine the frequency and associated factors of Ehrlichia canis infection in dogs. Blood samples from 150 dogs infested with ticks in 10 veterinary clinics in the city of Huanuco in Peru were collected. The dogs were randomly selected without regard to breed, age or sex. Ehrlichia canis antibodies were detected by chromatographic immunoassay.51.3% of dogs were infected with Ehrlichia canis. In the multivariate analysis, factors associated with the presence of Ehrlichia canis were: poor health of the dog (p = 0.049), a higher average of tick infestation (p = 0.018), and adult dogs (p = 0.038). The frequency of Ehrlichia canis in dogs of this city is high. Control of the brown dog tick (Rhipicephalus sanguineus) vector of Ehrlichia canis is recommended.


We evaluated the veracity of a famous aphorism that is often cited in the scientific study of religion: "There are no atheists in foxholes." To provide a critical evaluation, the sample was drawn from one of the world's most secular spots, Sweden. We explored the prevalence of various religious beliefs/non-beliefs and prayer in a sample of parents (n = 57) living with a major threat: having a child with a life-threatening heart condition. For comparison purposes, the prevalence of such beliefs and prayer were explored also in a sample (n = 72) of parents with healthy children. Results showed that a majority of parents endorsed atheist or agnostic beliefs, whereas only a minority endorsed religious beliefs. Roughly half of the sample engaged in prayer. The group of parents with sick children was statistically indistinguishable from the comparison group parents on all variables. Also, between-group differences were generally negligible in terms of effect size; thus, the null results were not due to statistical power problems. We conclude that there may be plenty of atheists in some foxholes.


ABSTRACT Introduction Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting up to 5.3% of children and 2.5% of adults depending on the country considered. Current pharmacological treatments for ADHD are based on stimulant or non-stimulant medications, targeting dopaminergic and noradrenergic systems in the frontal cortex and dopaminergic system in the basal ganglia. These drugs are effective and safe for the majority of patients, whereas about 20% of treated patients do not tolerate current therapies or experience insufficient efficacy. The adequate treatment of ADHD is necessary to allow a proper social placement and prevent the acquisition of additional, more severe, comorbidities. Areas covered We conducted a review of the scientific literature and of unpublished/ongoing clinical trials to summarize the advances made in the last 10 years (2010–2020) for the pharmacological treatment of ADHD. We found many pharmacological mechanisms beyond dopaminergic and noradrenergic ones have been investigated in patients. Expert opinion Some emerging drugs for ADHD may be promising as add-on treatment especially in children, amantadine to enhance cognitive functions and tipepidine for hyperactivity/impulsivity. Stand-alone emerging treatments for ADHD include viloxazine and dasotraline, which will soon have more clinical data available to support market access requests.


The synthesis of 1,3-dioxolan-2-ylnucleosides and related chemistry is described. We have shown that 2-methoxy-1,3-dioxolane (6) reacts with silylated thymine and trimethylsilyl triflate to give the acyclic formate ester 1-[2-(formyloxy)ethyl]thymine (8) rather than 1-(1,3-dioxolan-2-yl)thymine (7). A tentative mechanism which could explain this result is discussed. On the other hand, 2-methoxy-1,3-dioxolane 13c reacts with silylated bases to give [4,5-bis(hydroxymethyl)-1,3-dioxolan-2-yl]nucleosides, thus representing the first examples of this novel class of compounds. The nature of the nucleobase and the hydroxyl protecting groups was found to have great influence on the reaction and on the stability of the nucleosides. Compounds 16 and 18 were found to be inactive when tested for anti HIV-1 activity in vitro.


How mental health services are delivered has changed significantly over the last two decades. World-wide, large custodial institutions are being dismantled in favour of the more humanistic communitybased care approach. Theoretically the transition has been smooth. Unfortunately in many instances this has not been the case in practice. Many reasons for the difficulty in implementing the community care model have put forward. The lack of resources and poor networking of the services that do exist, are the two most popular of these reasons. Very little attention has been paid to one of the most fundamental elements of these services, the mental health professional. With the advent of community-based care, the multidisciplinary team approach grew out of necessity. Clients had numerous problems that required the expertise of not just one or two professionals, but many. The meanings that the members of these professions attribute to their work with clients have not been studied. Nor have the commonality and differences in client construction between mental health professionals been addressed. I have used qualitative and quantitative techniques, specifically the Repertory Grid, an interview schedule and questionnaires, to describe how psychiatrists, psychologists and nurses make sense of what they do when they work with clients. The client constructions of these three mental health professions proved more similar than different. Some of the implications of this research for the delivery of mental health services and the training of professionals are discussed.


INTRODUCTION
Tako-tsubo cardiomyopathy (TCM) is being recognized more frequently; and a familial form of this diagnosis has been suspected but is less well-established.

CASE
A 75-year-old patient with a family history of TCM was admitted with suspected ST-segment elevation myocardial infarction. Transthoracic echocardiography showed apical dyskinesis with hyperdynamic basal walls and a left ventricular ejection fraction (LVEF) of 25%. Repeat echocardiography showed normal LVEF of 60% ejection fraction. Cardiac catheterization showed no significant stenosis.

DISCUSSION
TCM is characterized by transient systolic left ventricular dysfunction. A few cases of familial TCM have been reported in the literature and a genetic component is suspected.

CONCLUSIONS
Although there has been a paucity of data, familial cases of TCM have been reported. This case study addresses TCM and the familial occurrence of the syndrome, which may have a genetic basis.


Forests play an important role in providing ecosystem services that support the ecological integrity of an area and also supply social benefits for humans. Many of the essential ecological and social benefits derived from forest are underpinned by its biodiversity. This thesis explores how biodiversity values of forest in urban and rural settings are expressed and how these values could be implemented in biodiversity-orientated forest management and planning.

Theoretical development work focusing on the application of biotope mapping methods resulted in a modified biotope mapping model integrating vegetation structure as a tool for collecting biodiversity values. The model was validated in a process beginning with a literature study on forest biodiversity indicators in order to test the rationality of vegetation structural parameters included in the model. Two case studies, carried out in an urban and a rural setting, respectively, were then used to validate the function of the modified mapping model in covering different aspects of biodiversity values (birds, mammals and vascular plants in the urban setting; bryophytes, lichens and vascular plants in the rural setting).

The results showed that the modified biotope mapping model, where temporal and spatial vegetation structural parameters are integrated, can be applied to collect biodiversity-orientated information, which can support decision making on forest landscape planning and policy.


Video Steganography is a technique that is used to transmit information by modifying video frames in an imperceptible manner and depending on the weakness of the Human Visual System (HVS) in distinguishing the simple differences between colored images. This paper is about embedding encrypted information (texts and gray images) which have been encrypted using RSA technique at sender side in video frames, which are used as a cover. This embedding has been applied using two methods. The first is considered a parity Least Significant Bit (LSB) in the R - image (Red-image) of video frames and the second method was XORing of LSB for each pixel in the R - image (Red-image) of video frames and the bit next to it. The embedding has been applied in the frequency domain after applying Combined (Discrete Wavelet Transform - Discrete Cosine Transform) DWT-DCT Algorithm. First DWT2 for three times on each R-frame has been applied, and then these transformations followed by DCT2 for HH3 band and the quantization has been applied. The hidden data has been embedded in some coefficients in the middle sub-band. After embedding the dequantization has been applied and the inverse for all the transformations has been applied in reverse order to get a frame again in the spatial domain. Stego video has been reconstructed then has been sent over data network to the receiver who can extract the secret encrypted message after implementing the same procedure then decrypt it using the private key to get the secret message. The proposed system was tested using Mean Square Error (MSE) and Peak Signal to Noise Ratio (PSNR) for different noise (salt and pepper) densities, which have been added as a sort of effective attack that may change the secret message.


Why mathematics is not merely formulaic: an argument that to write a mathematical proof is tantamount to inventing a story. In The Meaning of Proofs, mathematician Gabriele Lolli argues that to write a mathematical proof is tantamount to inventing a story. Lolli offers not instructions for how to write mathematical proofs, but a philosophical and poetic reflection on mathematical proofs as narrative. Mathematics, imprisoned within its symbols and images, Lolli writes, says nothing if its meaning is not narrated in a story. The minute mathematicians open their mouths to explain something—the meaning of x, how to find y—they are framing a narrative.
 Every proof is the story of an adventure, writes Lolli, a journey into an unknown land to open a new, connected route; once the road is open, we correct it, expand it. Just as fairy tales offer a narrative structure in which new characters can be inserted into recurring forms of the genre in original ways, in mathematics, each new abstract concept is the protagonist of a different theory supported by the general techniques of mathematical reasoning. In ancient Greece, there was more than an analogy between literature and mathematics, there was direct influence. Euclid's proofs have roots in poetry and rhetoric. Mathematics, Lolli asserts, is not the mere manipulation of formulas.


Breast cancer is the most frequently diagnosed cancer among women worldwide. It represents the significant health problem imposing an enormous socioeconomic burden on healthcare system. Among cancer related deaths, breast cancer is the second leading cause of death. Its global incidence and clinicopathological presentation varies markedly depending on the region and ethnicity, being highest in western developed countries. But because of modernization, dramatically changed lifestyle and altered pattern of reproductive behavior, prevalence of breast cancer is rising in the developing countries also. Nearly 25% of all cancers cases are comprised of breast cancer with an estimated 1.67 million new cases diagnosed in 2012 [1]. More than 500000 deaths are recorded every year due to breast cancer [2]. The reported incidence of breast cancer among women at high risk is 43.4 per 1,000 per years.


Purpose

– This study aims to examine how to measure and evaluate the level at which the management control system of the organisation supports reflective practices. Though the literature on management control has recently recognised the value of reflection as a tool for organisational learning, there are few practical means of analysing the management control system alongside reflective activity. To improve and develop reflective practices for more comprehensive and systematic utilisation, the management control system has to support these practices.

Design/methodology/approach

– The study is based on the current literature on reflection, reflective practices and management control and the pulling together of these three areas to determine how the evaluation and measurement of reflective practices should be organised. Based on that, the maturity model for measuring how the management control system supports reflective practices is elaborated. The empirical data testing the maturity model was collected from three case organisations.

Findings

– As its main contribution, the study composes a maturity model for evaluating the stage of reflective practices within organisations/an organisation. The existing literature does not present models or frameworks for evaluating the maturity of this kind of competence development activity. The presented model has many advantages that make it useful for pragmatic assessment and facilitation of competence development processes.

Practical implications

– As a practical tool, the maturity model helps to prioritise development actions when there is a need to enforce creative thinking (transformative learning) and sense-making within the organisation. Because an organisation cannot implement all the best practices in one phase, the maturity model can be used to introduce them in stages.

Originality/value

– The study advances one way of defining measures for reflective practices such that they are led from the literature on such practices. In addition, the study composes a maturity model for evaluating an organisation's stage of reflective practice. Before an organisation can develop and manage its reflective practices or identify necessary changes, the current state of its reflective practices should be analysed.


By using a combination of new technologies together with an unconventional use of different types of materials, specific mechanical properties and structures of the material can be achieved. Some possibilities are enabled by a combination of powder metallurgy in the preparation of a metal matrix with dispersed stable particles achieved by mechanical alloying and hot consolidation. This paper explains the thermomechanical properties of new generation of Oxide Dispersion Strengthened alloys (ODS) within three ranges of temperature with specified deformation profiles. The results show that the mechanical properties of new ODS alloys are significantly affected by the thermomechanical treatment. Keywords—Hot forming, ODS, alloys, thermomechanical, FeAl, Al2O3.


Haemophilia and von Willebrands disease are inherited bleeding disorders. There are 838 people with haemophilia in Ireland and 1,273 with von Willebrands disease. Treatment for these conditions is with intravenous infusions of coagulation factor concentrates ( CFCs). The selection and purchase of these medications in Ireland is overseen by the Haemophilia Product Selection and Monitoring Advisory Board ( HPSMAB). This board includes the lead haematologists from the three comprehensive treatment centres, the Irish Haemophilia Society, the Department of Health, the HSE, a virologist, a specialist nurse, a blood transfusion expert and a regulator. In the past many people with Haemophilia in Ireland were infected with HIV and Hepatitis C through the use of contaminated CFC's. This was responsible for 97% of all the mortality in haemophilia in Ireland since 1985.The involvement of the key doctors and the patient organisation in the procurement process has greatly increased the confidence of the patient community in the safety and efficacy of the treatment they now receive. The board examine all aspects of safety, efficacy, quality, supply and cost and carry out open competitive tenders. These tenders result in the purchase of a limited number of CFCs and does limit the clinical freedom of individual clinicians. This is acceptable to patients and haematologists nationally. The board have always purchased the safest and most efficacious products on the market in the fourteen years for which they have operated. Crucially, this has also been extremely cost effective. In 2002, prior to the establishment of this board, Ireland paid 26% above the EU average price for CFCs and also paid significant handling fees. By 2015, prices paid by Ireland were 55% below the EU average for the main product and all handling fees had been abolished. As a consequence, availability of treatment for haemophilia A has increased from 3.7 IU per capita in 2002 to 8.7 IU per capita in 2015 with no increase in the budget. The Irish Haemophilia Society carried out a detailed analysis of the results of the work of the HPSMAB in 2015. We extrapolated the 2002 pre HPSMAB prices in Ireland and compared these to the average EU CFC prices from 2002 to 2015 and also assumed the handling fees had remained. We compared these prices we would have incurred with the actual prices we achieved. This demonstrated a saving in excess of € 132 million from 2003 to 2015. If we compare this with Belgium, who do not have a tender system involving both clinicians and patient leaders; in 2002, both countries used similar amounts of CFCs but Ireland paid a 33% higher price. By 2014, Ireland were using 22% more CFCs than Belgium but we were paying 56% less than Belgium. The Irish model is now being used internationally as an example of best practice.


Against the background of a growing share of renewable energies and the ensuing fluctuations in electricity supply, domestic energy storage poses a promising option to foster flexible electricity demand and grid-stabilising self-supply. Understanding the determinants of adoption decisions regarding energy storage is therefore essential to enable targeted measures to promote their diffusion. This paper presents an in-depth analysis of motivational and psychological factors as well as product characteristics that affect the willingness to adopt domestic energy storage based on a selective sample focused on solar panel owners as the main energy storage target group. We find that potential adopters differ systematically in their evaluation of economic and non-economic utility aspects of domestic energy storage. Using correlation-based average linkage clustering, we identify four distinct types of storage adopters, namely finance-oriented, security-oriented, idealistic and multilaterally oriented households. The results of random forest analysis further reveal that adoption motives and the willingness to adopt vary substantially among the different types. We show that the most promising future adopters can be predicted based solely on observable characteristics. Our findings emphasise that segment-specific policy strategies and support mechanisms are needed to stimulate energy storage adoption to pave the way for a sustainable energy system.


In this research, a numerical algorithm is employed to investigate the classical Blasius equation which is the governing equation of boundary layer problem. The base of this algorithm is on the development of RCW (Rahmanzadeh-Cai-White) method. In fact, in the current work, an attempt is made to solve the Blasius equation by using the sum of Taylor and Fourier series. While, in the most common numerical methods, the answer is considered only as a Taylor series. It should be noted that in these algorithms which use Taylor expansion, the values of the truncation error are considerable. However, adding the Fourier series to the Taylor series leads to reduce the amount of the truncation error. Nevertheless, the results of this research show the RCW method has the ability to achieve the accuracy of analytical solution. Moreover, it is well illustrated that the accuracy of RCW method is higher than the Runge-Kutta one.


The analysis of genetic variation to estimate demographic and historical parameters and to quantitatively compare alternative scenarios recently gained a powerful and flexible approach: the Approximate Bayesian Computation (ABC). The likelihood functions does not need to be theoretically specified, but posterior distributions can be approximated by simulation even assuming very complex population models including both natural and human‐induced processes. Prior information can be easily incorporated and the quality of the results can be analysed with rather limited additional effort. ABC is not a statistical analysis per se, but rather a statistical framework and any specific application is a sort of hybrid between a simulation and a data‐analysis study. Complete software packages performing the necessary steps under a set of models and for specific genetic markers are already available, but the flexibility of the method is better exploited combining different programs. Many questions relevant in ecology can be addressed using ABC, but adequate amount of time should be dedicated to decide among alternative options and to evaluate the results. In this paper we will describe and critically comment on the different steps of an ABC analysis, analyse some of the published applications of ABC and provide user guidelines.


Strontium hexaferrite is one of the very important categories of magnetic materials with a wide range applications. One of the very critical parameters in the high temperature method of production of this material is molar ratio of iron oxide to strontium oxide. Although there could be found some reports on the effect of this parameter on the physical properties of the material in the literature but there are very few investigations about the role of this factor on the reactions occurred in the process. In this work the effect of different molar ratios of precursors on the reactions carried out for processing of strontium hexaferrite have been investigated by using thermal analysis techniques such as DTA/TG. Furthermore, the microstructure and the powder and bulk magnetic properties of the products have been studied by SEM, VSM and permeameter.


Over the last decade, the lead-free, environmentally-friendly multiferroic material, BiFeO3 (BFO), has once again received tremendous attention from researchers, not only for its fundamental properties, but also for its potential applications such as novel devices that can be written by an electric field and read by a magnetic field. However, one of the most important limitations for applications is the high leakage current in pure materials. Doping has proved to be an effective way to reduce the leakage current caused by the electron hopping between Fe2+ and Fe3+. In this work, a series of Nd3+ and Ti4+ co-doped BFO compositions have been studied using a combination of atomic resolution imaging and electron energy loss spectroscopy in STEM, especially concentrating on nanostructures within the Bi0.85Nd0.15Fe0.9Ti0.1O3 composition, as nanostructures can play an important role in the properties of a crystal. Two types of novel defects – Nd-rich nanorod precipitates and Ti-cored anti-phase boundaries (APBs) are revealed for the first time. The 3D structures of these defects were fully reconstructed and verified by multislice frozen phonon image simulations. The very formation of these defects was shown to be caused by the excess doping of Ti into the material and their impact upon the matrix is discussed. The nanorods consist of 8 atom columns with two Nd columns in the very center forming the Nd oxide. Density functional theory calculation reveals that the structures of the nanorod and its surrounding perovskites are rather unusual. The Nd in the core is seven coordinated by oxygen while the coordination of B site Fe3+ at its surroundings are just five-coordinated by oxygen due to the strain between the nanorod and the surrounding perovskite. The APB is nonstoichiometric and can be treated as being constructed from two main structural units - terraces and steps. Within the terraces, Ti4+ occupy the centre of the terrace with Ti/Fe alternately occupying either side of the terrace. As for the step, this is constructed from iron oxide alone with a structure similar to -Fe2O3, and Ti is completely absent. Quantitative analysis of the structure shows the APB is negatively charged and this results in electric fields around the APBs that induce a local phase transformation from an antiferroelectric phase to a locally polarised phase in the perovskite matrix. Based on this thorough investigation of these defects, a new ionic compensation mechanism was proposed for reducing the conductivity of BiFeO3 without the complications of introducing non-stoichiometric nanoscale defects.


Current telemedicine and remote healthcare applications foresee different interactions between the doctor and the patient relying on the use of commercial and medical wearable sensors and internet-based video conferencing platforms. Nevertheless, the existing applications necessarily require a contact between the patient and sensors for an objective evaluation of the patient's state. The proposed study explored an innovative video-based solution for monitoring neurophysiological parameters of potential patients and assessing their mental state. In particular, we investigated the possibility to estimate the heart rate (HR) and eye blinks rate (EBR) of participants while performing laboratory tasks by mean of facial—video analysis. The objectives of the study were focused on: (i) assessing the effectiveness of the proposed technique in estimating the HR and EBR by comparing them with laboratory sensor-based measures and (ii) assessing the capability of the video—based technique in discriminating between the participant's resting state (Nominal condition) and their active state (Non-nominal condition). The results demonstrated that the HR and EBR estimated through the facial—video technique or the laboratory equipment did not statistically differ (p > 0.1), and that these neurophysiological parameters allowed to discriminate between the Nominal and Non-nominal states (p < 0.02).


In June 2015 Gawker Media became the first for-profit digital news organization to unionize its editorial workforce. True to their bombastic style, they did so publicly, publishing a post where staff commented on how they were going to vote regarding the union and why. This article examines the ensuing discussion to understand how this group of culture workers perceived their labor, and the value they sought not just from collective bargaining, but from doing so publicly. Gawker's unionization was aimed not exclusively at Gawker, but spoke to a vision for the entire sector. Gawker staff were motivated to collective action by the precarity that besets digital media, while the publicness of the effort was aimed at their peer organizations. The public performance of unionism at Gawker may signal a shift in the discourse around collective bargaining among young creative workers as more digital outlets come to organize their workforce.


Study Design. Retrospective, case series. Objective. To determine the prevalence of major complications and to identify factors that increase the risk of complications in patients undergoing surgery for neuromuscular scoliosis. Summary of Background Data. Complications after surgery for neuromuscular scoliosis are more prevalent than in idiopathic scoliosis. However, the associated risk factors have not been statistically significant. Methods. Our computerized Pediatric Orthopedic Spine Database identified 131 consecutive patients with neuromuscular scoliosis, excluding those with myelodysplasia, who underwent surgery and had a minimum of 2 years of follow-up. Preoperative, intraoperative, and postoperative factors were analyzed for any association with major complications and length of stay using stepwise logistic and multiple regression analyses. Odds ratios were calculated for significant dichotomous variables, and receiver operator characteristic curves were created for significant continuous variables. Results. There were 81 male and 50 female patients with a mean age at surgery of 13.4 years (range, 6–21 years). The majority of patients (n = 75) had cerebral palsy. Eighty-eight patients (67%) underwent posterior spinal fusion and segmental spinal instrumentation (only), whereas 43 patients (33%) underwent an anterior spinal fusion followed by a posterior spinal fusion with segmental spinal instrumentation. Seventy-seven patients (59%) were fused to the pelvis using the Galveston technique. The mean follow-up was 3.9 years (range, 2–16.9 years). There were 46 major complications in 37 patients (28% prevalence), including 2 deaths. Nonambulatory status (P < 0.05) and preoperative curve magnitude (P < 0.01) were associated with an increased prevalence of major complications. Nonambulatory patients (n = 94) were almost 4 times more likely to have a major complication (odds ratio of 3.8, P < 0.05) in comparison with ambulatory patients. A preoperative major curve magnitude of ≥60° (P < 0.01) was the most accurate indicator for an increased risk for a major complication. Conclusion. Nonambulatory status and a preoperative curve magnitude (≥60°) are directly associated with an increased risk for major complications and indirectly associated with increased length of stay. As such, we recommend operative intervention in neuromuscular scoliosis before curve progression to ≥60°. Level of Evidence. Level III.


Males of Dytiscinae beetles use specialized adhesive setae to adhere to female elytra during underwater courtship. This coevolution of male setae and female elytra has attracted much attention since Darwin. However, there has been little examination of their biomechanical functioning despite increasing knowledge on biofibrillar adhesion. Here, we report and compare, for the first time, the mechanisms of underwater attachment using two hair types, the primitive spatula and derived 'passive' sucker, found in male diving beetles. Results from interspecific scaling of protarsal palettes and adhesion by single seta suggest better performance in the later-evolved circular (sucker) setae. Spatula setae with a modified shallow sucker and channels use the combined mechanisms of suction and viscous resistance for adhesion. Velocity-dependent adhesion provides sufficient control for resisting the female's erratic movements while also detaching easily through slow peeling. Direction-dependent shear resistance helps reorient setae surfaces into a preferred direction for effective adhesion. Seta deformation using different mechanisms for circular and spatula setae reduces the force that is transmitted to the contact interface. A softer spring in spatula setae explains their adhesion at lower preloads and assists in complete substrate contact. Attachment mechanisms revealed in adhesive setae with modified spatula and passive suckers provide insights for bioinspired designs of underwater attachment devices.


Three hundred pikes in the Kostroma section of the Gorky Reservoir, in the Kostroma Overflow, and in the Galich and Chukloma Lakes were examined for infection with Diphyllobothrium latum larvae. In the Kostroma section of the Gorky Reservoir and in the Kostroma Overflow, diphyllobothriasis was recorded in 66.7% (12/18) and 14.7% (11/75) of the pikes, respectively. The high intensity of the epidemic process in diphyllobothriasis was confirmed in the Kostroma Region. The number of notified cases was noted to tend to increase: 35 and 173 cases in 1994 and 1999, respectively.


The decrease in locomotor activity and the number of crossed sectors in open field, has been shown in the group of animals, which for four days in the neonatal period received dexamethasone treatment. Based on these data we decided in the same experimental conditions to study the animals' state of anxiety and the behavior in passive avoidance chamber. The newborn male pups were divided on four groups. The first group was left intact, the pups of the second group were injected by saline, the third group - by dexamethasone and the fourth group - with combination of dexamethasone and L-arginine. The received results show, that deficiency of nitric oxide in the early neonatal period caused by administration of dexamethasone led to statistically significant increase of anxiety level, but statisticaly significant changes in their behavior in a passive avoidance chamber was not observed.


Collaborative filtering (CF) is a widely used approach in recommender systems to solve many real-world problems. Traditional CF-based methods employ the user-item matrix which encodes the individual preferences of users for items for learning to make recommendation. In real applications, the rating matrix is usually very sparse, causing CF-based methods to degrade significantly in recommendation performance. In this case, some improved CF methods utilize the increasing amount of side information to address the data sparsity problem as well as the cold start problem. However, the learned latent factors may not be effective due to the sparse nature of the user-item matrix and the side information. To address this problem, we utilize advances of learning effective representations in deep learning, and propose a hybrid model which jointly performs deep users and items' latent factors learning from side information and collaborative filtering from the rating matrix. Extensive experimental results on three real-world datasets show that our hybrid model outperforms other methods in effectively utilizing side information and achieves performance improvement.


Abstract. Droughts form a large part of climate/weather-related disasters reported globally. In Africa, pastoralists living in the Arid and Semi-Arid Lands (ASALs) are the worse affected. Prolonged dry spells that cause vegetation stress in these regions have resulted in the loss of income and livelihoods. To curb this, global initiatives like the Paris Agreement and the United Nations recognised the need to establish Early Warning Systems (EWS) to save lives and livelihoods. Existing EWS use a combination of Satellite Earth Observation (EO) based biophysical indicators like the Vegetation Condition Index (VCI) and socio-economic factors to measure and monitor droughts. Most of these EWS rely on expert knowledge in estimating upcoming drought conditions without using forecast models. Recent research has shown that the use of robust algorithms like Auto-Regression, Gaussian Processes and Artificial Neural Networks can provide very skilled models for forecasting vegetation condition at short to medium range lead times. However, to enable preparedness for early action, forecasts with a longer lead time are needed. The objective of this research work is to develop models that forecast vegetation conditions at longer lead times on the premise that vegetation condition is controlled by factors like precipitation and soil moisture. To achieve this, we used a Bayesian Auto-Regressive Distributed Lag (BARDL) modelling approach which enabled us to factor in lagged information from Precipitation and Soil moisture levels into our VCI forecast model. The results showed a ∼2-week gain in the forecast range compared to the univariate AR model used as a baseline. The R2 scores for the Bayesian ARDL model were 0.94, 0.85 and 0.74, compared to the AR model's R2 of 0.88, 0.77 and 0.65 for 6, 8 and 10 weeks lead time respectively.


Purpose: This paper examines the potential of 'biomarkers' to provide immutable identification for food products (chocolate), providing traceability and visibility in the supply chain from retail product back to farm. Design/methodology/approach: Research employs qualitative data collection, including fieldwork at cocoa farms and chocolate manufacturers in Ecuador and the Netherlands and semi-structured interviews with industry professionals to identify challenges and create a supply chain map from cocoa plant to retailer, validated by area experts. A library of biomarkers is created using DNA collected from fieldwork and the International Cocoa Quarantine Centre, holders of cocoa varieties from known locations around the world. Matching sample biomarkers with those in the library enables identification of origins of cocoa used in a product, even when it comes from multiple different sources and has been processed. Findings: Supply chain mapping and interviews identify areas of the cocoa supply chain that lack visibility required for management to guarantee sustainability and quality. A decoupling point, where smaller farms/traders' goods are combined to create larger economic units, obscures product origins and limits visibility. These factors underpin a potential boundary condition to institutional theory in the industry's fatalism to environmental and human abuses in the face of rising institutional pressures. Biomarkers reliably identify product origin, including specific farms and (fermentation) processing locations, providing visibility and facilitating control and trust when purchasing cocoa. Research limitations/implications: The biomarker 'meta-barcoding' of cocoa beans used in chocolate manufacturing accurately identifies the farm, production facility or cooperative, where a cocoa product came from. A controlled dataset of biomarkers of registered locations is required for audit to link chocolate products to origin. Practical implications: Where biomarkers can be produced from organic products, they offer a method for closing visibility gaps, enabling responsible sourcing. Labels (QR codes, barcodes, etc.) can be swapped and products tampered with, but biological markers reduce reliance on physical tags, reducing the potential for fraud. Biomarkers identify product composition, pinpointing specific farm(s) of origin for cocoa in chocolate, allowing targeted audits of suppliers, and identifying if cocoa of unknown origin is present. Labour and environmental abuses exist in many supply chains and enabling upstream visibility may help firms address these challenges. Social implications: By describing a method for firms in cocoa supply chains to scientifically track their cocoa back to the farm level, the paper shows that organizations can conduct social audits for child labour and environmental abuses at specific farms proven to be in their supply chains. The paper therefore provides a method for delivering supply chain visibility for firms serious about tackling such problems. Lafargue, P., Rogerson, M., Parry, G. and Allainguillaume, J. (2021) "Broken chocolate: visibility in cocoa supply chains", Supply Chain Management; An International Journal 2 Originality/value: This paper provides one of the very first examples of biomarkers for agricultural supply chain visibility. An in-depth study of stakeholders from the cocoa and chocolate industry elucidates problematic areas in cocoa supply chains. Biomarkers provide a unique biological product identifier. Biomarkers can support efforts to address environmental and social sustainability issues such as child labour, modern slavery, and deforestation by providing visibility into previously hidden areas of the supply chain.


Multibeam scanning electron microscopy (multiSEM) provides a technical platform for seamless nano-to-mesoscale mapping of cells in human tissues and organs, which is a major new initiative of the U.S. National Institutes of Health. Such cross-length-scale imaging is expected to provide unprecedented understanding of relationships between cellular health and tissue-organ as well as organismal-scale health outcomes. For example, understanding relationships between loss in cell viability and cell network connectivity enables identification of emergent behaviors and prediction of degenerative disease onset, in organs as diverse as bone and brain, at early timepoints, providing a basis for future treatments and prevention. Developed for rapid throughput imaging of minute defects on semiconductor wafers, multiSEM has recently been adapted for imaging of human organs, their constituent tissues, and their respective cellular inhabitants. Through integration of geospatial approaches, statistical and network modelling, advances in computing and the management of immense datasets, as well as recent developments in machine learning that enable the automation of big data analyses, multiSEM and other cross- cutting imaging technologies have the potential to exert a profound impact on elucidation of disease mechanisms, translating to improvements in human health. Here we provide a protocol for acquisition and preparation of sample specimen sizes of diagnostic relevance for human anatomy and physiology. We discuss challenges and opportunities to integrate this approach with multibeam scanning electron microscopy workflows as well as multiple imaging modalities for mapping of organ and tissue structure and function.


ABSTRACT Contour maps with 0.5-m depth interval were prepared for a small area seaward of Reindeer Island, a barrier island in the Beaufort Sea, Alaska, by repeated surveys with very accurate navigation and very close trackline spacing. The maps reveal numerous closed depressions and mounds about 50 to 100 m in diameter and 2 to 3 m in relief, presumably related to grounded ice floes common in the area year round. Some of the features were obliterated over the course of three seasons while new ones formed. Although the depressions resemble kettles, they are formed by very different mechanisms. We believe that these bedforms represent erosion and deposition caused by: a) intensified flow around stationary ice floes serving as obstacles and b) pulsating currents generated by vertical oscillation or rocking motions of grounded floes in a seaway. Because sediment transport occurs around the ice, not where it directly touches the sea floor, the depressions are much larger than the base of the acting floes. Ice-wallow bedforms, although not found everywhere, are characteristic of arctic nearshore regions with non-cohesive sediments, and most likely occur in other ice-stressed coastal environments in differing degrees. The bedforms studied here are highly active and must be considered in planning nearshore construction activities.


A novel nanohybrid was assembled by a layer-by-layer strategy that permitted the immobilization of nickel(II) hydroxide on multi-walled carbon nanotubes. The heterogeneous catalyst was used for the reduction of a wide variety nitroaromatics to hydroxylamines in a binary solvent mixture (tetrahydrofuran/ water), in the presence of sodium borohydride and under mild conditions. The reaction is highly selective as it afforded cleanly the expected aromatic hydroxylamines in the presence of other sensitive groups such as halogens, esters, double bonds or nitriles. The catalyst could also be readily recycled by a simple centrifugation and reused in subsequent reduction reactions with no decrease in catalytic activities, over five cycles. Analysis of the spent catalyst indicated neither alteration in the morphology, metal-content, nor oxidation state of the carbon nanotube-supported nickel(II). The catalytic nanohybrid assembly reported in this work thus compares favorably with known systems, as it is very stable, operates at room temperature with limited nickel loading (0.8 mol%), and selectively leads to N-aryl hydroxylamines without the formation of the corresponding anilines.


We consider the problem of dealing with irrelevant votes when a multi-case classifier is built from an ensemble of binary classifiers. We show how run-off elections can be used to limit the effects of irrelevant votes and the occasional errors of binary classifiers, improving classification accuracy. We consider as a concrete classification problem the recognition of handwritten mathematical characters. A succinct representation of handwritten symbol curves can be obtained by computing truncated Legendre-Sobolev expansions of the coordinate functions. With this representation, symbol classes are well linearly separable in low dimension which yields fast classification algorithms based on linear support vector machines. A set of 280 different symbols was considered, which gave 1635 classes when different variants are labelled separately. With this number of classes, however, the effect of irrelevant classifiers becomes significant, often causing the correct class to be ranked lower. We introduce a general technique to correct this effect by replacing the conventional majority voting scheme with a runoff election scheme. We have found that such runoff elections further cut the top-1 mis-classification rate by about half.


This essay surveys the evidence on the linkages between globalization and poverty. I focus on two measures of globalization: trade and international capital flows. Past researchers have argued that global economic integration should help the poor since poor countries have a comparative advantage in producing goods that use unskilled labor. The first conclusion of this essay is that such a simple interpretation of general equilibrium trade models is likely to be misleading. Second, the evidence suggests that the poor are more likely to share in the gains from globalization when there are complementary policies in place. Such complementary policies include investments in human capital and infrastructure, as well as policies to promote credit and technical assistance to farmers, and policies to promote macroeconomic stability. Third, trade and foreign investment reforms have produced benefits for the poor in exporting sectors and sectors that receive foreign investment. Fourth, financial crises are very costly to the poor. Finally, the collected evidence suggests that globalization produces both winners and losers among the poor. The fact that some poor individuals are made worse off by trade or financial integration underscores the need for carefully targeted safety nets. I would like to thank Pranab Bardhan, Ethan Ligon, Margaret McMillan, Branko Milanovic, Guido Porto, Emma Aisbett, Don Davis, Alix Zwane, and two anonymous reviewers for helpful comments and suggestions.


Mandatory vaccination programs in the United States are generally successful, but their continued success is under threat. The ever-increasing number of parents who opt their children out of vaccination recommendations has caused severe outbreaks of vaccine-preventable diseases. Public health advocates have pushed for changes to state laws, but their efforts have generally been unsuccessful. We suggest that their lack of success is due to public health advocates' failures to contend with the features of the political system that impede change and to propose reforms that are ethically defensible, efficacious, and politically feasible. Based on our earlier public health studies, ethical concerns, and our analysis of the political environment, we suggest that states consider "nudging" hesitant parents to vaccinate their children by marginally raising the costs of non-vaccination. We also offer a comprehensive model law that would implement these changes.


There are repeating patterns in the histories of communication technologies, including ordinary mail, the telegraph, the telephone, and the Internet. In particular, the typical story for each service is that quality rises, prices decrease, and usage increases to produce increased total revenues. At the same time, prices become simpler.The historical analogies of this paper suggest that the Internet will evolve in a similar way, towards simplicity. The schemes that aim to provide differentiated service levels and sophisticated pricing schemes are unlikely to be widely adopted.Price and quality differentiation are valuable tools that can provide higher revenues and increase utilization efficiency of a network, and thus in general increase social welfare. Such measures, most noticeable in airline pricing, are spreading to many services and products, especially high-tech ones. However, it appears that as communication services become less expensive and are used more frequently, those arguments lose out to customers' desire for simplicity.Flat rates are the simplest form of pricing. Although they have generally been regarded as irrational, and economically and socially undesirable, they have serious advantages. Consumers like them, and are willing to pay extra for them. Further, flat rates are extremely effective in stimulating usage, which is of advantage in a rapidly growing service like the Internet.


Background: Very low birth weight (VLBW) neonates constitute approximately 4–7 percent of all live births and their mortality is very high.
Objective: to find out if there is a relationship between Very Low Birth Weight Neonates and increased neonatal mortality for age 0 to 7 days.
Methods: A retrospective study of VLBW neonates admitted to NICU at Ibn Al- Baladi Pediatrics and Maternity hospital over one year (2012)were studied, The study period was from April till August 2013. Exclusion criteria were: (1) neonates weighing less than 700 g and with gestational age less than 24 weeks (abortion) (2) death in the delivery room (3) neonates weighing more than 1500 g. (4) Postnatal age more than 7 days. The outcome measure was in-hospital death. Medical records were reviewed and data were analyzed. Results being considered as statistically significant when the P value was≤0.05.
Result: A total of 150 cases of very low birth weight (VLBW) neonates were enrolled, of which a total of 69 (46 %) babies died. The survival rate was found to increase with the increase in birth weight and gestational age (P value was highly significant). There is no relation between gender, postnatal age, mode of delivery and social class
with number of death. Respiratory distress, gestational age, neonatal septicemia are the factors directly responsible for neonatal mortality. Premature rupture of membranes (PROM), multiple pregnancy and Young mothers were the most common maternal risk factors associated with death in VLBW.
Conclusions: Mortality rate in VLBW neonates was found to increase with the decrease in birth weight and gestational age. Prematurity, RDS and infection are major causes of perinatal deaths. Advanced medical care must be available in each neonatal care unit, including, Artificial ventilation, pulse oximetry and Surfactant. Obstetricians must be advised for Intense and regular follow up of at risk mothers (multiple pregnancies, PROM, IUGR, APH)


The area of natural product research is rapidly progressing from traditional medicine to modern medicine having proper scientific basis of its usage. However, identifying the active constituent or the basis of its mechanism holds the key to synthesis of these drugs in the laboratory. Traditional Indian literature such as Ayurveda has listed several plant and animal based resources for treatment of almost every ailment. Erectile dysfunction and male sexual debilities are among the most explored areas in traditional medicine. A number of natural products, mostly plant based, have been claimed to cure erectile dysfunction and related male sexual debilities. These products often are aphrodisiac and have multi-fold effects on male reproductive system. This review aims at compiling the animal and plant based resources which bear promise of treating loss of libido and erectile dysfunction. A special emphasis is paid to find out scientific basis of their usage. The identification of potential resources could help undertake further studies to establish their possible mechanism of action; opening the doors to proper clinical trials for human use.


This dissertation explores the contemporary U.S. women's land movement, known also as the lesbian land movement, and most recently, the landdyke movement. Data for the study is provided by a set of qualitative interviews with 32 movement participants. Of special interest are the politics of the movement and the set of practices participants utilize to embody their politics. The format of the dissertation is four articles for submission to peerreviewed journals, and introductory and concluding chapters. The first chapter introduces the three chapters that follow, and situates the landdyke movement sociologically and historically. The chapter compares the contemporary landdyke movement with a peculiar 19th century separatist women's community, the Sanctificationists. The second chapter is an ethnography of the movement, and utilizes the concept of ecological niches as its analytical framework to argue that the movement provides niches for lesbians that are unavailable to them elsewhere. The third chapter examines the strategies participants utilize to embody movement politics, using the metaphor of tools. This chapter contends that members of the movement literally embody movement strategies. The fourth chapter analyzes the early origins of the lesbian land movement and the processes by which participants, ideas, and practices flow into and out of the movement. Using images of fluidity, especially confluence, this chapter describes how the movement both benefits and faces challenges due to confluence, and how its practitioners manage confluence. The fifth chapter is a general conclusion for the dissertation. It draws the four articles embedded in the dissertation together, and proposes some of the contributions of the study and its limitations. Using these limitations, suggestions are made for future research.


Because genetic counseling is a relatively young field, there is little research on how genetic counseling services are delivered. The majority of the literature on genetic counseling models comes from Great Britain and Wales, so does not accurately represent the limitations and barriers experienced within the United States. Thus, this study sought to provide information regarding service delivery models used in the practice of genetic counseling, identifying limitations and barriers to these models, as well as potential advantages. A qualitative research design was employed, in which 20 practicing genetic counselors that utilize unique service delivery models were interviewed using an email interview format. Interview transcripts were analyzed using a thematic analysis, and themes relating to the research question were identified and presented. Two major themes were identified: 1.) Alternative service delivery models offer convenience for both the patients and the genetic counselors; and 2.) Logistical issues are a major barrier to implementing alternative service delivery models into clinical practice. Results of this research will give genetic counselors and other health care professionals a way to better assess and evaluate the genetic counseling service models that are currently being used. This work also has public health relevance. By researching and understanding alternative service delivery models, the hope is to make genetic counseling services more accessible by creating increasing access to genetic counseling by addressing the increasing demand for genetic testing and counseling among the population.


Software testing plays a major role in software development because it accounts for a large part of the development cost. Moreover, manual testing technique always makes a problem. Consequently, this paper proposes the automatic testing technique to solve partially the testing process. This technique can automatically generate and select test cases from UML statechart diagrams. Firstly, we transform this diagram into intermediate diagram, called Testing Flow Graph (TFG), explicitly identify flows of UML statechart diagrams and enhance for testing. Secondly, from TFG we generate test case using the testing criteria that is the coverage of the state and transition of diagrams. Finally, the evaluation is performed using mutation analysis to assess the fault revealing power of our test cases.


Several idiotypic (Id) specificities have been identified by immunofluorescence on the membranes of B cells in the spleens of nonimmune mice. These determinants are displayed at frequencies varying from 0.22 to 1.83% of B cells and are entirely immunoglobulin (Ig) in nature. No Id determinants were observed on the membranes of four Slg- Abelson virus-transformed pre-B cell lines that are sensitive to LPS. Under our experimental conditions, we did not observe a significant increase in 3H-thymidine incorporation subsequent to the in vitro incubation of splenic lymphocytes from normal mice with various amounts of anti-Id antibodies specific for several cross-reactive (IdX) or individual Id. Similarly, in utero exposure to anti-Id antibodies against myeloma proteins specific for T-independent antigens displaying B cell mitogenic properties did not alter the proliferation of lymphocytes induced by these mitogens. In contrast, exposure to anti-Id antibodies in vitro as well as in utero had a profound and specific effect on the corresponding antibody responses and maturation of small lymphocytes into plasma cells. When normal B cells were cultured with the B cell mitogen LPS in the presence of anti-Id antibodies directed against the J558IdX, specific suppression of the maturation of IdX+ plasma cells was observed. In mice exposed to maternal anti-Id in utero, we observed a severe inability to mount an immune response to any compound that elicited antibody molecules bearing the Id that was complementary to the maternal anti-Id. These same maternally Id-suppressed mice, however, gave a normal response when the same compound was presented as a mitogen. Our results reinforce the concept that Id on membranes of B lymphocytes are associated only with Ig receptors and do not support the possibility of mitogen-like poly-clonal stimulatory properties of anti-Id antibodies.


In this study, food web connectivity within the Kowie Estuary on the south-east coast of South Africa was evidenced by the trophic behaviour of the predominantly piscivorous Argyrosomus japonicus. We examined stable isotopes of carbon (δ13C) and nitrogen (δ15N) in the dominant consumers (zooplankton, invertebrates and fishes) and food sources (particulate organic matter, epibionts and benthic microalgae) in the system. An SIAR (Stable Isotope Analysis in R) mixing model was used to interpret the possible food sources for this dominant top predatory fish. Small fishes and large epibenthic invertebrates dominated the diet of A. japonicus. Based on the contrasting diet of these prey fish and invertebrates, we propose that organic matter enters the predatory fish community via two major pathways: (1) a littoral pathway dominated by benthic microalgae production and epibionts, and (2) a channel pathway dominated by suspended particulate organic matter (including phytoplankton). We conclude that the highly mobile A. japonicus consumes both pelagic and benthic fauna from the littoral and channel zones of the estuary, thereby playing a key functional role in linking food webs. This dietary diversity may help explain the success of A. japonicus as a dominant top predator in the system, primarily by increasing the energy available to this species.


This article reviews approaches to voluntary nutrition labeling (VNL), such as front-ofpackage (FOP) labels, that emerged in the 2001-2014 period to provide simplified nutrition information, thus lowering the search cost for nutritional information. We present a market model to assess consumer and producer responses to changes in information search cost brought about by VNL. We specifically focus on the introduction of VNL in the ready-toeat cereal (RTEC) market and illustrate trends in labeling and the overall healthfulness of RTEC products. Both the conceptual and empirical evidence suggest that VNL has been instrumental in attaining a healthier RTEC market. Finally, we suggest a research agenda to further theory development and empirical (experimental and big data) research to better comprehend the role of VNL in relation to market healthfulness.


This paper aims to analyse evidence, based on one of the largest and most representative samples of households previously flooded or living with flood risk to date, of social patterns in a range of flood resilience traits relating to preparedness prior to a flood (e.g., property adaptations, contents insurance, etc.) and mitigations enacted during and immediately following a flood (e.g., receiving a warning, evacuation into temporary accommodation, etc.). The data were collected from a 2006 survey of 1223 households from a variety of locations across Scotland between one and twelve years after major local floods. Our analysis identifies remarkably few social differences in flood preparedness and mitigation measures, although some aspects of demography, housing and length of residence in an area, as well as personal flood history, are important. In light of this finding, we argue that social differences in vulnerability and resilience to flooding arise from deep-seated socio-economic and socio-spatial inequalities that affect exposure to flood risk and ability to recover from flood impacts. The engrained, but well-meaning, assumption in flood risk management that impoverished households and communities are lacking or deficient in flood preparedness or mitigation knowledge and capabilities is somewhat pejorative and misses fundamental, yet sometimes invisible, social stratifications play out in subtle but powerful ways to affect households' and communities' ability to avoid and recover from floods. We argue that general poverty and inequality alleviation measures, such as tax and welfare policy and urban and community regeneration schemes, are likely to be as, if not more, important in alleviating social inequalities in the long-term impacts of floods than social targeting of flood risk management policy.


Road traffic accidents (RTAs) are not thought of as unavoidable random occurrences or "accidents" anymore. Public health practitioners deem RTAs preventable and predictable since they are usually caused by avoidable and anticipated human behaviors. Although prevention of automobile crashes showed huge success in road traffic injury control history, RTAs are still considered a major public health concern globally. In Saudi Arabia, injury is the leading cause of mortality. The number of registered vehicles is continuously expanding all over the world and in Saudi Arabia. The rise in demand for emergency medical services (EMS) in Saudi Arabia is associated with increasing number of RTAs. This escalation of RTAs is of profound public health significance and has been considered by the Saudi government, but little improvement was made. EMS in Saudi Arabia faces a number of issues. One issue is the lack of effective trauma systems. Trauma is the number one killer in Saudi Arabia, yet the country lacks sufficient trauma centers. One significant component of trauma system is pre-hospital care, where first responders drive to the scene, assess patients, and transport them to the hospital emergency department (ED). Since EMS is a timely service that requires prompt response, the handover of patients from paramedics to ED clinicians is very critical and requires a lot of attention. In Saudi Arabia, the EMS response time is affected by a number of factors including the lack of sufficient communication at both ends (EMS, and hospital staff), clear guidance, standardized protocols, and regulations. Patient handover is considered a "high-risk" process, and is associated with serious adverse events. Therefore, good communication between ambulance staff and ED clinicians is required. In this paper, I will discuss patient handover models and compare them to the model used in Saudi Arabian EDs, in order to design and recommend a patient transition model that improves the EMS process in Saudi Arabia.


First-year clarinet professors should have a command of the major works in the standard clarinet repertoire. During their undergraduate work they will have studied and performed pieces such as the Mozart Clarinet Concerto, Poulenc Sonata, and Fantasiestucke by Schumann. As they move into graduate school and their techniques become more advanced, however, it is common for clarinetists to focus on twentieth-century works that demand extended techniques. This focus on modern music during final years of schooling leaves little time to study the vast repertoire of works that suit younger students. A gap is thus created between literature with which the new professor is most familiar and that which is most suited to undergraduate clarinet majors. Designed to bridge that gap, this research project results in a CD-ROM database that comprises all literature found in the personal libraries of two leading clarinet pedagogues, Robert Spring of Arizona State University and Howard Klug of Indiana University. The database will also assist new professors in finding unfamiliar works, which will be useful in teaching college students.
In utilizing the personal libraries of Spring and Klug, I hoped to access a large percentage of the most current and best-regarded music for the undergraduate clarinetist. I chose the libraries of these two professors due to their unique styles of teaching and their reputations in the clarinet world. Each has extensive performance and teaching credentials, as well as very different styles of performing. I have conducted a personal interview with each professor, which centered on pedagogical issues.
My clarinet repertoire database does not include all literature from other clarinet bibliographies; however, many of the current works are also included in other indexes. The repertoire is organized by specific difficulty levels that correspond to the grades: novice undergraduate, advanced undergraduate, and graduate student. The user may search the database by composer, title, genre (i.e., Sonata or Concerto), instrumentation, or grade level. The CD-ROM includes not only the repertoire database, but also transcripts from my pedagogical interviews. The user may consult the interviews to gain further insight into teaching university students. Finally, the software is written so that the user may add works according to individual needs.


The aim of this study was to describe and compare perceptions of critical thinking, attitudes to and availability of research, research utilization and barriers to this among nursing students in Scandinavia and Indonesia. Data were collected at the beginning, middle and end of education from nursing students in Norway, Sweden (bachelor's diploma) and Banda Aceh (bachelor's diploma). Critical Thinking and Research Utilization Questionnaires were used along with the Barrier Scale. Descriptive analyses, comparisons between and within groups were performed. At the end of education, all samples exhibited positive attitudes to research and the main barrier was related to the setting. Scandinavian students reported higher critical thinking. Indonesian students perceived greater barriers on two Barrier subscales. No differences were found between the samples regarding research utilization. Significant changes over time varied among the samples except for the Norwegian sample. Indonesian students (diploma) exhibited most changes over time. Teachers must support nursing students to strengthen their critical thinking ability and develop professional competence.


This Article, part of a symposium on neuroscience and the law at Fordham Law School, argues that the field of neurolaw should more readily acknowledge that there is a history to law and neuroscience. The Article does not endeavor to provide a comprehensive history of brain science and law but rather to highlight a series of four important, yet often overlooked, "moments." These moments are (1) foundational medico-legal dialogue in the nineteenth and early twentieth centuries, (2) the introduction of electroencephalography evidence into the legal system in the mid-twentieth century, (3) the use of psychosurgery for violence prevention in the 1960s and 1970s, and, most recently, (4) the development of neurolaw in personal injury litigation in the late 1980s and 1990s.Although the terminology and technology change over time, these four moments make clear that there is a rich and complicated history of neurolaw. On the one hand, the history of law and neuroscience offers encouragement that law and policy can be improved through advances in brain science. On the other hand, however, this history offers caution about the limits of using brain science to address legal problems. I argue that we should learn from our past mistakes, build on our past successes, and forge a future of increasingly productive interdisciplinary conversation.


Pregnancy is a special period in which women experience many changes. Negative psychosocial health level and poor prenatal attachment during pregnancy can result in negative maternal behaviors, postpartum anxiety, and depression. This study was conducted as a randomized controlled experimental study which aimed at identifying the effect of pregnancy yoga on the pregnant's psychosocial health and prenatal attachment. Sixty three pregnant women who were primipara, who were in the 14 to 26 weeks of their pregnancy, who did not have any chronic disease and a past yoga experience, and who had singular and spontaneous pregnancy were included in the study. Before the intervention, all the pregnant women were evaluated with Pregnant Information Form (PIF), Pregnancy Psychosocial Health Assessment Scale (PPHAS), and Prenatal Attachment Inventory (PAI). The yoga group did yoga for 40 minutes two days a week for a period of 8 weeks under the supervision of one of the researchers. At the end of 8 weeks (post intervention), both the yoga group and the control group were re-evaluated through the Pregnancy Psychosocial Health Assessment Scale and Prenatal Attachment Inventory. Chi-square, independent sample t test, paired sample t test, Mann Whitney U test and Wilcoxon Signed Ranks were used for data analyses. Post intervention analyses revealed that the mean Pregnancy Psychosocial Health Assessment Scale scores of the experimental group were significantly higher than the scores of the control group (p ˂ 0.001). At the beginning of the study, the Prenatal Attachment Inventory mean scores of both groups were similar. However, at the end of intervention, it was observed that Prenatal Attachment Inventory mean scores of the experimental group were significantly higher than those of the control group (p ˂ 0.05). The mean anxiety and stress subscale score was found to be higher in the experimental group than the score in the control group (p ˂ 0.05). When the mean anxiety and stress subscale score increased, anxiety and stress level decreased. Prenatal yoga is an effective method in increasing the pregnant's psychosocial health level and prenatal attachment.


Although increasingly complex risk assessment tools are being marketed, little is known about "real world" practitioners' capacity to score them accurately. In this study, we assess the extent to which 78 staff members' scoring of juveniles on the California-Youth Assessment and Screening Instrument (CA-YASI; Orbis Partners, Inc., 2008) agree with experts' criterion scores for those cases. There are 3 key findings. First, at the total score level, practitioners manifest limited agreement (M ICC = .63) with the criterion: Only 59.0% of staff scores the tool with "good" accuracy. Second, at the subscale level, practitioners' accuracy is particularly weak for treatment-relevant factors that require substantial judgment—like procriminal attitudes (M ICC = .52)—but good for such straightforward factors as legal history (M ICC = .72). Third, practitioners' accuracy depended on their experience—relatively new staff's scores were more consistent with the criterion than those with greater years of experience. Results suggest that attention to parsimony (for tools) and meaningful training and monitoring (for staff) are necessary to realize the promise of risk assessment for informing risk reduction.