STUDY OBJECTIVES
This study investigated to what extent a diagnosis of COPD is erroneously made or the disease remains unrecognized in elderly asthmatic patients, and identified factors leading to misdiagnosis and underdiagnosis of asthma in such patients.

DESIGN
A multicenter study involving 24 Italian pulmonary or geriatric institutions.

PATIENTS
One hundred twenty-eight asthmatic patients (98 women, 76.6%) aged 73 +/- 6.4 years (mean +/- SD) were selected from the cohort of the Salute Respiratoria nell'Anziano (respiratory health in the elderly) study.

METHODS
All patients underwent a clinical evaluation that included clinical history and spirometry with a bronchodilator test. A diagnosis of asthma was based on criteria proposed by international guidelines adapted to the elderly population. A multidimensional geriatric assessment was performed to estimate physical and cognitive impairments and mood state. Finally, the diagnosis of respiratory disease previously made by a doctor, if any, was recorded.

RESULTS
Of asthmatic patients, COPD had been improperly diagnosed in 19.5%, whereas 27.3% of asthmatic patients did not report any previous diagnosis of asthma. The main correlates of misdiagnosis were older age and disability. Conversely, underdiagnosis was associated with better functional conditions, expressed by spirometry, even when wheezing or a significant response to the bronchodilator test occurred.

CONCLUSIONS
Asthma in the elderly is frequently confused with COPD. Misdiagnosis can be related to older age and to greater degree of disability. Asthma in patients with mild functional impairment may be underdiagnosed in spite of overt respiratory symptoms suggestive of asthma.


Abstract Aims International statistics show that relapse rates associated with opiate and crack cocaine (OCC) misuse remain high. This has led to an increased scientific interest in the topic of relapse. However, there are limited studies reflecting on the state of this field. This review provides an overview of the topic and directions for future research. Method: Guided by the overall question of how relapse into OCC misuse is understood, a scoping review was conducted using Arksey and O'Malley's framework. A total of 126 studies between 1972 and 2019 were included. The literature was thematically grouped into relapse definitions, theories, associated factors and treatment approaches. Results: This review found that the majority of relapse understandings were derived from the USA and UK, and that these studies predominantly used quantitative research designs. Relapse definitions were controversial with the majority using biomedical concepts of disease. Theories on relapse were based on psychological theories and developed through clinical and neuroscientific research. Findings show that the majority of the literature focused on relapse risk factors with very few papers focusing on protective factors. Findings on treatment approaches indicate a steer toward harm-minimization strategies over relapse management strategies. Conclusions: This review demonstrates that drug relapse research needs to grow more diverse, inter-disciplinary and user-centred in perspective so as to respond to relevant challenges ahead.


Introduction: Raising or lowering blood pressure and muscle cramps are the main barriers for dialysis. Meanwhile, lowering blood pressure is more common and its mechanism is somewhat clear. But the mechanism for increasing blood pressure is not yet clear fully. Objectives: In this study, we examined the prevalence of intradialytic hypertension (IDH) and its related factors, especially changes in plasma renin activity, hematocrit, heart rate, and electrolytes in end-stage renal disease (ESRD) patients undergoing chronic hemodialysis. Patients and Methods: In a cross-sectional study, patients with chronic end-stage renal disease under chronic hemodialysis were included to the study in the absence of a specific infection, as well as in lack of intravenous fluid providing during dialysis due to hypotension. Blood pressure and heart rate before and after hemodialysis were measured in four consecutive dialysis sessions. Elevating mean arterial blood pressure by 15 mm Hg between beginning and end of dialysis or raising blood pressure within four consecutive dialysis sessions were considered as IDH. Results: Around 17 of the 88 (19.3%) patients with hemodialysis had IDH. These subjects were compared with non-IDH patients who were similar in age and gender. The most common underlying disease in both groups was diabetes mellitus followed by hypertension. Comparison of measured parameters before and after dialysis showed that serum potassium level was significantly decreased in both groups. Serum sodium level increased in both groups, but this increase was significant only in the control group. There were no significant changes in renin plasma activity, heart rate and hematocrit levels in both groups. Conclusion: In this study, plasma renin activity in IDH group increased after dialysis compared to pre-dialysis. This finding requires to more test with larger sample size.


A direct functional contact of RNA polymerase II with Mediator activates transcription in eukaryotes. Gene transcription is highly regulated. Altered transcription can lead to cancer or developmental diseases. Mediator, a multisubunit complex conserved among eukaryotes, is generally required for RNA polymerase II (Pol II) transcription. An interaction between the two complexes is known, but its molecular nature and physiological role are unclear. We identify a direct physical interaction between the Rpb3 Pol II subunit of Saccharomyces cerevisiae and the essential Mediator subunit, Med17. Furthermore, we demonstrate a functional element in the Mediator–Pol II interface that is important for genome-wide Pol II recruitment in vivo. Our findings suggest that a direct interaction between Mediator and Pol II is generally required for transcription of class II genes in eukaryotes.


Abstract In the context of recent economic and financial crisis in Europe, questions about the power of the core executive to control fiscal outcomes are more important than ever. Why are some governments more effective in controlling spending while others fall prey to excessive overspending by individual cabinet ministers? We approach this question by lifting the veil of collective cabinet responsibility and focusing on intra-cabinet decision-making around budgetary allocation. Using the contributions of individual cabinet members during budget debates in Ireland, we estimate their positions on a latent dimension that represents their relative levels of support or opposition to the cabinet leadership. We find some evidence that ministers who are close to the finance minister receive a larger budget share, but under worsening macro-economic conditions closeness to the prime minister is a better predictor for budget allocations. Our results highlight potential fragility of the fiscal authority delegation mechanism in adverse economic environment.


ABSTRACT In this article I enquire into the sources of legitimacy of the European Union's (EU) Common Foreign and Security Policy. I suggest that as the EU has moved beyond intergovernmentalism in this policy field, it cannot derive its legitimacy solely from the national systems of the member states. It must establish an additional channel of legitimacy, which is derived directly from the EU. Challenging the conventional position on the legitimacy of global governance institutions, I further suggest that EU institutions can only make a reasonable claim to prevail over the member states in this policy field if they contribute to enhance the normative status of the foreign policy. That the co-operative endeavour is mutually beneficial is not a sufficient basis for the legitimacy of EU foreign policy. Drawing on a deliberative perspective, I suggest that we may expect to find two mutually reinforcing sources of legitimacy at the EU level. However, these would mainly contribute to enhance the external legitimacy of the CFPS. Paradoxically, they may at the same time constrain the internal legitimacy of the EU's foreign policy.


OBJECTIVE
A traumatic axonal injury (TAI) diagnosis has traditionally been based on conventional MRI, especially on those sequences with a higher sensitivity to edema and blood degradation products. A more recent technique, diffusion tensor imaging (DTI), can infer the microstructure of white matter (WM) due to the restricted diffusion of water in organized tissues. However, there is little information regarding the correlation of the findings obtained by both methods and their use for outcome prognosis. The main objectives of this study were threefold: 1) study the correlation between DTI metrics and conventional MRI findings; 2) evaluate whether the prognostic information provided by the two techniques is supplementary or complementary; and 3) determine the incremental value of the addition of these variables compared to a traditional prognostic model.

METHODS
The authors studied 185 patients with moderate to severe traumatic brain injury (TBI) who underwent MRI with DTI study during the subacute stage. The number and volume of lesions in hemispheric subcortical WM, corpus callosum (CC), basal ganglia, thalamus, and brainstem in at least four conventional MRI sequences (T1-weighted, T2-weighted, FLAIR, T2* gradient recalled echo, susceptibility-weighted imaging, and diffusion-weighted imaging) were determined. Fractional anisotropy (FA) was measured in 28 WM bundles using the region of interest method. Nonparametric tests were used to evaluate the colocalization of macroscopic lesions and FA. A multivariate logistic regression analysis was performed to assess the independent prognostic value of each neuroimaging modality after adjustment for relevant clinical covariates, and the internal validation of the model was evaluated in a contemporary cohort of 92 patients.

RESULTS
Differences in the lesion load between patients according to their severity and outcome were found. Colocalization of macroscopic nonhemorrhagic TAI lesions (not microbleeds) and lower FA was limited to the internal and external capsule, corona radiata, inferior frontooccipital fasciculus, CC, and brainstem. However, a significant association between the FA value and the identification of macroscopic lesions in distant brain regions was also detected. Specifically, lower values of FA of some hemispheric WM bundles and the splenium of the CC were related to a higher number and volume of hyperintensities in the brainstem. The regression analysis revealed that age, motor score, hypoxia, FA of the genu of the CC, characterization of TAI lesions in the CC, and the presence of thalamic/basal ganglia lesions were independent prognostic factors. The performance of the proposed model was higher than that of the IMPACT (International Mission on Prognosis and Analysis of Clinical Trials in TBI) model in the validation cohort.

CONCLUSIONS
Very limited colocalization of hyperintensities (none for microbleeds) with FA values was discovered. DTI and conventional MRI provide complementary prognostic information, and their combination can improve the performance of traditional prognostic models.


Plastic is one of the chemical materials which poses Environmental problem. Plastic is made up of various chemical elements.Therefore, it is regarded as a highly contagious mate-rial that does not easily degrade in the natural environment after its usage or utility period.Plastic causes serious damage to environment during its production and disposal process. Poly ethylene, polyvinyl chloride, polystyrene are largely used in the manufacture of Plastics.Hence, this paper analyzes the haz-ards of Plastic pollutionusing InducedFuzzy Cognitive Maps IFCMs. IFCMs area fuzzy-graph modeling approach based on expert's opinion.


EGF has been characterized as an important growth factor in mammalian development and function, but its precise roles and significance are not yet clear. EGF may have a role in embryogenesis and fetal growth, since receptors have been identified in fetal tissues. However, EGF mRNA has not been shown in the fetus, and it seems likely that the related peptide, alpha TGF, subserves a developmental role in the fetus. The mRNA for alpha TGF has been demonstrated in the fetus [22] and alpha TGF acts via EGF receptors. In the postnatal animal EGF mRNA, immunoreactive EGF and EGF receptors are present in many tissues. In the rodent the highest levels of EGF mRNA are found in the salivary glands and kidneys, and EGF is secreted in large amounts in saliva and urine. A role for salivary and urine EGF in the maintenance of stomal, gut and urinary epithelial surface integrity seems likely, although not yet proven. Many other tissues presumably produce EGF, and tissue EGF concentrations (and probably synthesis) are hormone responsive in many tissues. Thyroid and gonadal steroid hormones have been shown to influence EGF and/or EGF receptors in various tissues, and EGF, probably acting largely through autocrine or paracrine routes, can exert mitogenic or developmental actions autonomously or in response to hormonal signals. An endocrine role also is likely, but of secondary importance as is the case for the insulin-like growth factors. The precise details of these EGF actions and effects in immature and adult animals are being explored in many laboratories. Figure 3 summarizes these concepts.


The language used in health promotion warrants attention as it shapes how health promotion is understood, constraining or opening up possibilities for action. The 2016 Shanghai Declaration and the 1986 Ottawa Charter for Health Promotion call for comprehensive approaches which include policy and environmental changes. Yet many health promotion programmes in Australia continue to focus on informational and/or behavioural strategies, and there is a contemporary tendency for such programmes to be described as 'sending messages'. This paper uses frame analysis to discuss the role of language, and specifically language that frames health promotion as sending messages, in contributing to and reinforcing the predominance of informational and/or behavioural strategies. It argues such 'message' language helps to set a pattern in which informational and/or behavioural strategies are assumed to be the primary goal and extent of health promotion; rather than one component of a comprehensive, multi-strategic approach. It discusses how frames can be 'taken for granted' and ways in which such frames can be challenged and broadened. It argues that the message frame and associated behavioural framings set narrow boundaries for health promotion, contributing to the continuation of health inequities. These frames can also displace the language of the Ottawa Charter, which has capacity to reframe health issues socio-ecologically and include collective strategies. The paper concludes that a first step (of the many needed) towards applying the Charter's approach and multi-level, multi-strategic framework is to use the innovative vocabulary it offers. The words matter.


Students with intellectual disabilities are among the least likely students to spend a significant amount of time in general education classrooms. When they are included, they may spend their time on non-academic learning experiences. Universal Design for Learning is a lesson planning framework that can guide teachers in inclusive lesson planning. This article explores the Universal Design for Learning framework and how teachers can incorporate it into the lesson planning process for a book study in high school English Language Arts. This lesson planning process provides genuine learning experiences to students with intellectual disabilities in the general education classrooms. The article offers examples of how to incorporate multiple means of representation, multiple means of engagement, and multiple means of expression and action within the four steps of the lesson planning process: learning goals, instructional methods, instructional materials, and assessment.


The ground-liner interaction research has important engineering value for the underground engineering design optimization and evaluation of construction safety. The interface between ground and liner is considered. In this paper, the effect of different ground-liner stiffness ratio, lateral pressure coefficient, thickness and different interface stiffness ratio and other factors on the support structure for internal forces and interface stress is analyzed. The analysis results show that liner internal force and interface stress increase with the increase of stiffness ratio between liner and ground, and the impact is very significant. Effect of lateral pressure coefficient on liner internal force and interface stress mainly reflects on laws around the cavern, where 1 is the limitation of lateral pressure coefficient. It presents symmetrical distribution. With the increase of liner thickness, the liner internal force and interface normal stress increase, but it make no difference to the contact interface tangential stress.


DOI: 10.7764/RDLC.18.3.554 Considering the construction industry holds ten percent on average in the gross national product over the world, the importance of efficient use of resources emerges. To alleviate the possibility of the risk factors and various uncertainties' negative impact on the project, the usage of the scheduling tools should be supported for planning as well as risk management. In today's construction perspective, the quality is not a primary objective; construction projects have to be completed within the cost and duration limits. During the construction progress, the inserting of extra activities affects to construction delays. Project success; from the planning stage to the completion of the building, it is possible to plan the resources, use them efficiently, and realize the determined time and cost objectives. In this study, a model is developed by using a fuzzy logic approach and genetic algorithm in order to provide time-cost optimization in construction projects under uncertainties. Firstly, fuzzy sets are used to take into account the effects of time and cost uncertainties on construction works. Fuzzy sets are used to model uncertainties, and the genetic algorithm is used to acquire minimum Project cost and duration. Thus, by establishing a fuzzy time-cost optimization model, optimum time-cost results are obtained according to different risk levels determined by the decision-makers. At the final stage, Pareto fronts from different risk levels that contain both minimum costs and durations are obtained and plotted.


Our input is a bipartite graph $G = (A \cup B,E)$ where each vertex in $A \cup B$ has a preference list strictly ranking its neighbors. The vertices in $A$ and in $B$ are called students and courses, respectively. Each student $a$ seeks to be matched to $\mathsf{cap}(a) \ge 1$ courses while each course $b$ seeks $\mathsf{cap}(b) \ge 1$ many students to be matched to it. The Gale-Shapley algorithm computes a pairwise-stable matching (one with no blocking edge) in $G$ in linear time. We consider the problem of computing a popular matching in $G$ -- a matching $M$ is popular if $M$ cannot lose an election to any matching where vertices cast votes for one matching versus another. Our main contribution is to show that a max-size popular matching in $G$ can be computed by the 2-level Gale-Shapley algorithm in linear time. This is an extension of the classical Gale-Shapley algorithm and we prove its correctness via linear programming.


A series of V-Cr/SBA-15/Al2O3/FeCrAl metal monolithic catalysts withV content of 10wt% and Cr contents from 0 to 12.5wt% were prepared. The structure of the catalysts was characterized using XRD, XPS and TPR techniques. The catalytic activity for oxidative dehydrogenation (ODH) of propane with CO2 was evaluated. The results indicate that the mesoporous structure of SBA-15 was retained after vanadium and chromium incorporation and the vanadium species were well dispersed. The V-Cr/SBA-15/Al2O3/FeCrAl catalyst with 10wt% V and 10 wt% Cr exhibited the best activity with a propane conversion of 49.9% and a propylene selectivity of 86.5% at 650 °C.


Evaluations of drug education programmes focus on the effect on participating students. Although this is appropriate, where programmes are institutionalized the wider population impact should also be considered. This paper examines this argument and provides a practical methodology for examining programme impacts on populations. It illustrates this using the example of the Life Education (LE) programme-a mature early intervention programme operating internationally-on the Victorian (Australia) population of Year 6 schoolchildren. Data from a recent evaluation of Life Education in Victoria, Australia, were re-analysed enabling estimation of adjusted attributable risk percentage (which provide an estimate of programme effect among those who are exposed to it), population prevalence estimates and population attributable risk percentage (which provide estimates of programme impacts on the entire population). In 1992 when the data were collected LE operated in 43% of all Victorian primary schools. The findings showed that within LE-schools 43% of girls' and 35% of boys' recent smoking was attributable to participation in the LE-programme. For drinking within LE-schools, while there was no apparent effect on girls, the programme was associated with 40% of boys' recent drinking. When the data were extrapolated to the state-wide smoking and drinking estimates, these showed that of all smoking among Year 6 schoolchildren, 25% of girls' and 19% of boys' smoking could be attributed to participation in Life Education, as could 22% of all boys' recent drinking. This re-analysis showed there was no preventive effect associated with the programme, at either the school or the population level. The findings suggest that intervention programmes should be thoroughly evaluated prior to widespread implementation, and that such evaluations should include reference to the community-wide impacts of such programmes.


A "time tax" is a government policy or practice that forces one citizen to pay more in time to vote compared with her fellow citizens. While few have noticed the scope of the problem, data indicate that, due primarily to long lines, hundreds of thousands if not millions of voters are routinely unable to vote in national elections as a result of the time tax, and that the problem disproportionately affects minority voters and voters in the South. This Article documents the problem and offers a roadmap for legal and political strategies for solving it. The Article uses as a case study NAACP State Conference of Pennsylvania v. Cortes, the first-ever case in which a court has granted prospective relief to plaintiffs who sought to reduce wait times at the polls, as well as the first successful voter access case since the Supreme Court discouraged facial challenges to state voting restrictions in Crawford v. Marion County Election Board. Drawing on the litigation strategy in Cortes, the Article canvasses the available constitutional and statutory avenues for a legal challenge to the time tax and identifies conditions for relief to be granted. Those conditions include exhausting the political process, targeting a momentous election and choosing appropriate plaintiffs, using primary election experiences and expert testimony to develop an adequate evidentiary record, and seeking narrow and politically neutral relief. The Article concludes by suggesting policies that can be implemented at the state and federal levels to mitigate the time tax.


In the era of Government 2.0, the government should transform into a citizen-centric and service-oriented government. In the terms of public services delivery, more innovative IT-based methods are pursued. However, on the perspective of organizational management, leadership plays a major role in using IT to make public services delivery efficient. Therefore, this paper presents a conceptual framework for understanding how integrative leadership influence the transformation of IT-based public services delivery. From the perspective of IS strategy triangle theory, we define integrative leadership as bringing diverse leaderships—strategy leadership, organization leadership and IT leadership—in an organization together with a close-coupled association to accomplish the complex and public issue and archive the united strategic goal. The framework is illustrated with a case of a local government, Pingfang District of Harbin in China, a pilot unit of Smart City providing more convenient and effective public services under the guidance of the District Mayor, the Organization Department Minister and the Informatization Office Director that are responsible for the coordination of strategy formulation, organization restructuration and information construction respectively. The framework is, to our best knowledge, the first of their kind in the new research field of key component elements of intra-organizational integrative leadership and provides significant insights for future exploration.


Abstract I assessed the ability of dog–handler teams to recover dead bats (Chiroptera) during fatality searches typically performed at wind energy facilities to determine fatality rates for birds and bats. I conducted this study at the Mountaineer and Meyersdale Wind Energy Centers in West Virginia and Pennsylvania, USA, respectively. Dogs found 71% of bats used during searcher-efficiency trials at Mountaineer and 81% of those at Meyersdale, compared to 42% and 14% for human searchers, respectively. Dogs and humans both found a high proportion of trial bats within 10 m of the turbine, usually on open ground (88% and 75%, respectively). During a 6-day fatality search trial at 5 turbines at Meyersdale, the dog–handler teams found 45 bat carcasses, of which only 42% (n = 19) were found during the same period by humans. In both trials humans found fewer carcasses as vegetation height and density increased, while dog–handler teams search efficiency remained high. Recommendations for evaluating the biases and efficiency when using dogs for bat fatality searches are provided.


DNA quadruplex structures are attracting great scientific interest because of increasing evidence that these structures play important roles in biological processes ranging from replication, transcription, and recombination to telomere integrity. The use of small molecules to selectively target these structures in vivo is emerging as a promising way to interfere with telomere replication in tumor cells and provides potential anticancer agents. A large number of quadruplex binding ligands have already been reported. In general, they selectively interact with terminal GGGG-tetrads via π-π stacking interactions. However, in addition to GGGG-tetrads, GCGC-tetrads are known to be involved in quadruplex formation in vitro. Even though these so-called "mixed tetrads" might also have biological relevance, selective GCGC-tetrad binding probes have not yet been reported.
Hemiporphyrazines (Hps) are non-aromatic, 20 π-electron phthalocyanine (Pc) derivatives that consist of two co-facial pyridine rings and two co-facial isoindole units linked through four aza bridges. Due to their planarity, extended π-conjugation, and C2-type symmetry, they are good candidates for selectively targeting GCGC-tetrads. Unsubstituted Hps are, however, notoriously insoluble materials and therefore little is known about their chemical and photophysical properties. As a consequence, this Master thesis is focused on the synthesis, structure, photophysical and reactivity properties of Hps to assess their potential as future GCGC-tetrad binding ligands.
Free-base hemiporphyrazine (HpH2) was synthesized and its structure was analyzed by single crystal X-ray diffraction. HpH2 adopts a nearly planar structure and its macrocyclic core contains alternating double and single bonds. This is consistent with the non-aromatic character of these compounds. Furthermore, HpH2 has a very high water affinity and readily absorbs water from the atmosphere to form a yellow monohydrate (HpH2·H2O). This compound has a saddle-shaped conformation and distinct photophysical properties. The use of bulky metal triflates (M(OTf)2) as sources of metal ions during macrocyclization furnished metallo Hps (MHps) with enhanced solubility properties. Octahedral zinc and nickel trans-ditriflate hemiporphyrazine complexes "HpH2Zn(OTf)2" and "HpH2Ni(OTf)2" provide two such examples.


Sulfate-driven anaerobic oxidation of methane (SD-AOM) supports chemosynthesis-based communities and limits the release of methane from marine sediments. Formation of authigenic carbonates at active methane seeps is promoted by SD-AOM stoichiometry. While distinctively small d 18 O/ d 34 S slopes of pore fluid sulfate have been shown to typify modern methane-rich environments, identification of such environments has been difficult for the geological past due to the lack of sedimentary pore fluids. However, if the isotopic composition of sulfate were archived in authigenic carbonate during early diagenesis, carbon-ate-associated sulfate (CAS) should display the characteristic d 18 O- d 34 S pattern. To test this hypothesis, we investigated the d 18 O CAS , d 34 S CAS , and 87 Sr/ 86 Sr signatures of authigenic carbonate minerals from three modern and two ancient methane-seep provinces. The data obtained demonstrate that all deposits regardless of age or location display con-sistently small d 18 O CAS / d 34 S CAS slopes (~0.3) and CAS does not represent ambient seawater but pore-water sulfate. This finding confirms the utility of CAS as a recorder of SD-AOM in methane-rich environments. In addition, we report that aragonites bear higher CAS contents, 87 Sr/ 86 Sr ratios closer to that of contemporary seawater, and a larger d 18 O CAS / d 34 S CAS slope than calcites, reflecting the shallower formation depth of aragonite where pore-water has a composition close to that of seawater with high concentrations of sulfate. The new proxy can be used to constrain the record of SD-AOM through most of Earth history by measuring the d 18 O and d 34 S values of CAS of methane-derived diagenetic carbonates including but not limited to seep carbonates.


This paper analyzes two important reliability issues in AlGaN/GaN devices: positive bias temperature instability (PBTI) and time-dependent dielectric breakdown (TDDB). The summarized results of our previous PBTI studies in MOS-HEMTs show that the threshold voltage degradation in devices with SiO2 as gate dielectric is characterized by a universal decreasing behavior of the trapping rate parameter and is ascribed to charge trapping in the SiO2 and at the SiO2/GaN interface. On the contrary, the degradation observed in Al2O3- and AlN/Al2O3-gate stacks is mainly attributed to charge capture in the pre-existing dielectric traps with a negligible interface state generation. Additionally, the insertion of a thin AlN layer impacts on the device reliability because larger trap density, faster charge trapping, wider trap energy distribution and slower charge release are observed compared with devices without this layer. The dielectric importance of GaN-based devices has been also investigated in Schottky Barrier Diodes (SBDs) with a gated edge termination (GET). Our recent TDDB results indicate a narrower Weibull distribution, and a longer time to failure in devices with a double GET layer structure and with a thick passivation layer (2 GET-THICK) than in single GET devices with a thin passivation (1 GET-THIN). Therefore, the former structure is more suitable for high-power and high-temperature applications.


We present a method for dynamically integrating audiovisual information for speech recognition, based on the estimated reliability of the audio and visual streams. Our method uses an information theoretic measure, the entropy derived from the state probability distribution for each stream, as an estimate of reliability. The two modalities, audio and video, are weighted at each time instant according to their reliability. In this way, the weights vary dynamically and are able to adapt to any type of noise in each modality, and more importantly, to unexpected variations in the level of noise.


Scholars of traditional Western donors have frequently asked, 'Why is aid given?' With the emergence of numerous new donors after the end of the Cold War, this question has a new significance. One group of these new donors are the countries of post-communist Central and Eastern Europe. Within the literature that has developed in recent years to analyse their foreign aid programmes, Poland is surprisingly understudied despite being the most significant international actor in the region. This thesis addresses this gap by investigating the origins and development of the Polish foreign aid programme since 1989. This focus on a single country enables a comprehensive longitudinal analysis so far also missing from the literature.
The thesis develops and applies an analytical framework that focuses on the diffusion of international norms and policies into the national policy-making process. Through this framework, the thesis identifies the sources of foreign aid policies, the mechanisms through which sources exerted influence on the policy-making process and Polish opportunities to influence the international agenda. The thesis applies the framework to foreign aid policy-decisions across the post-Cold War period and enables an assessment of the extent to which Poland's 'return to Europe' provided opportunities and constrictions for foreign policy-making. The analytical framework looks beyond the focus on the 'EU factor' prevalent in the CEE donor literature, while maintaining comparability with these studies' findings.
The focus on competing explanations is a central contribution that results in several original findings. The thesis demonstrates the substantial influence of the United States on Polish thinking about aid provision. The evidence also suggests that direct interaction between countries is crucial for the implementation of international norms and policies. Highlighting the importance of interaction between member states contributes a novel perspective not just on EU policy-making about development cooperation, but also on foreign policy. This leads to the conclusion that Poland as a donor has been a 'good pupil of bad behaviour', learning from the examples of traditional donors that non-compliance and national preferences are acceptable. The thesis also introduces the argument that CEE donors are not as different from traditional donors as so far portrayed by the literature. Non-compliance with international commitments is prevalent among Western donors and national foreign-policy considerations motivate their aid flows. However, traditional donors have the advantage that their foreign policy priorities are easier to reconcile with the priorities of development cooperation. The main difference lies in the insufficient domestic capacities of Central and Eastern European donors to use aid as an effective foreign policy tool due to the legacy of the communist era.


This study aims to analyse Tunisian farmers' ability to pay (ATP) in a citrus area and propose a penalising price strategy based on the block-pricing process to decrease over-irrigation without affecting farmers' incomes. The methodology is based on the residual imputation approach to determine farmers' ATP, a stochastic production frontier to estimate the technical efficiency to determine optimal water irrigation quantity and calculation of the price elasticity of demand for an effective penalty and the Gini index before and after penalisation to study equity improvement. A survey was carried out on a sample of 147 citrus farms in the Nabeul Governorate, Northeastern Tunisia. The technical efficiency analysis confirms that an optimal quantity of 5000 m3/ha guarantees the maximisation of yields and profits. Above this quantity, the amount of overused water could be penalised without significantly affecting farmers' incomes. Results also reveal that water overconsumption represents 28% of available resources and the ATP varies according to technical efficiency. Therefore, the proposed penalty system could reduce water overconsumption by 44.56% without deteriorating agricultural welfare. To improve water management as well as farmers' welfare, this study recommends an increase in the technical efficiency level of farms to optimise all production factors for any implemented pricing policy.


Ghrelin is an orexigenic peptide hormone that acts on its receptor the GHSR1a within hypothalamic nuclei, including the DMH and PMV, but the role of GHSR1a signaling in these regions is unknown. To investigate this, in study 1, we attached a minipump filled with saline, ghrelin, or a GHSR1a antagonist to a cannula aimed at the DMH and assessed their metabolic profile. In study 2, we employed similar drug treatments as study 1, but aimed the cannula at the PMV. Chronic intra-DMH ghrelin increases body weight in the form of adipose tissue, without affecting caloric intake. This is accompanied by attenuated energy expenditure, and not locomotor activity. Infusions of ghrelin in the PMV and the DMH slows glucose clearance. Intra-PMV ghrelin promotes carbohydrate oxidation, without affecting food intake or body weight, suggesting that GHSR signaling has distinct roles in the DMH and PMV in energy homeostasis.


The study was undertaken to examine the effects of C-peptide on glomerular volume (V(GLOM)), mesangial matrix synthesis, and degradation in streptozotocin (STZ)-diabetic rats with poor or moderate glycemic control. Series 1 (poor glycemic control) included groups of healthy rats, hyperglycemic rats, diabetic insulin-treated rats and diabetic C-peptide-treated rats. Series 2 (moderate glycemic control) included groups of healthy rats, diabetic insulin-treated rats, diabetic insulin- and C-peptide-treated rats. After 8 weeks, the left kidney was excised for evaluation of V(GLOM) and mesangial matrix area via light microscopy. Mesangial cells were cultured for 48 h and type IV collagen expression and matrix metalloproteinase (MMP)-2 expression were measured by ELISA and RT-PCR. The results indicated that in Series 1, C-peptide administration suppressed the diabetes-induced increase in the V(GLOM) and the mesangial matrix area. In Series 2, C-peptide administration resulted in a similar decrease in the V(GLOM) and a greater decrease in the mesangial matrix area when compared with insulin therapy alone. Moreover, C-peptide (300 nM) completely inhibited the glucose-induced increase of the collagen IV mRNA expression and protein concentration in mesangial cells cultured in 30 mM glucose medium. MMP-2 mRNA expression was not influenced by C-peptide. In conclusion, C-peptide administration to STZ-diabetic rats for 8 weeks results in the inhibition of diabetes-induced expansion of the mesangial matrix. This effect is independent of the level of glycemic control and results from the inhibition of diabetes-induced excessive formation of mesangial type IV collagen.


The problem of allocating defensive weapon resources to hostile targets is an optimization problem of high military relevance. The need for obtaining the solutions in real-time is often overlooked in existing literature. Moreover, there does not exist much research aimed at comparing the performance of different algorithms for weapon-target allocation. We have implemented a suite of metaheuristic algorithms for solving the static weapon-target allocation problem, and compare their real-time performance on a large set of problem instances using the open source testbed SWARD. The compared metaheuristic algorithms are ant colony optimization, genetic algorithms, and particle swarm optimization. Additionally, we have compared the quality of the generated allocations to those generated by a well-known maximum marginal return algorithm. The results show that the metaheuristic algorithms perform well on small- and medium-scale problem sizes, but that real-time requirements limit their usefulness for large search spaces.


In this thesis, the first chapter provides the general description of this interpreter. The second chapter contains a formal definition of the syntax of BASIC along with an introduction to the semantics. The third chapter contains the design of data structure. The fourth chapter contains the description of algorithms along with stages for testing the interpreter and the design of debug output.
The stages and actions-are represented internally to the computer in tabular forms. For statement parsing working syntax equations are established. They serve as standards for the conversion of source statements into object pseudocodes. As the statement is parsed for legal form, pseudocodes for this statement are created. For pseudocode execution, pseudocodes are represented internally to the computer in tabular forms.


Prevalences of 15 circulatory diagnoses were investigated for 113,242 patients undergoing intracapsular cataract extraction and 67,052 reference patients discharged from a sample of North American hospitals during 1979. After controlling for distributional differences in age (nine categories between 45 and 89 years), sex, and race (white v nonwhite), seven of the 15 diagnoses occurred with sufficient frequency to allow age-, sex-, and race-adjusted analysis. All seven of those diagnoses were found to have statistically significant differences in prevalences between the two procedure groups. Only benign hypertension was found to be more prevalent among patients undergoing cataract extraction regardless of age, sex, or race. The remaining six diagnoses all had a pattern of elevated prevalence among younger patients undergoing cataract extraction changing to elevated prevalence among other surgical patients at older ages.


Throughout the last 2 decades, experimental evidence from in vitro studies and preclinical models of disease has demonstrated that reactive oxygen and nitrogen species, including the reactive oxidant peroxynitrite, are generated in parenchymal, endothelial, and infiltrating inflammatory cells during stroke, myocardial and other forms of reperfusion injury, myocardial hypertrophy and heart failure, cardiomyopathies, circulatory shock, cardiovascular aging, atherosclerosis and vascular remodeling after injury, diabetic complications, and neurodegenerative disorders. Peroxynitrite and other reactive species induce oxidative DNA damage and consequent activation of the nuclear enzyme poly(ADP-ribose) polymerase 1 (PARP-1), the most abundant isoform of the PARP enzyme family. PARP overactivation depletes its substrate NAD(+), slowing the rate of glycolysis, electron transport, and ATP formation, eventually leading to functional impairment or death of cells, as well as up-regulation of various proinflammatory pathways. In related animal models of disease, peroxynitrite neutralization or pharmacological inhibition of PARP provides significant therapeutic benefits. Therefore, novel antioxidants and PARP inhibitors have entered clinical development for the experimental therapy of various cardiovascular and other diseases. This review focuses on the human data available on the pathophysiological relevance of the peroxynitrite-PARP pathway in a wide range of disparate diseases, ranging from myocardial ischemia/reperfusion injury, myocarditis, heart failure, circulatory shock, and diabetic complications to atherosclerosis, arthritis, colitis, and neurodegenerative disorders.


We consider the problem of planning in environments where the state is fully observable, actions have non-deterministic effects, and plans must generate infinite state trajectories for achieving a large class of LTL goals. More formally, we focus on the control synthesis problem under the assumption that the LTL formula to be realized can be mapped into a deterministic Buchi automaton. We show that by assuming that action nondeterminism is fair, namely that infinite executions of a nondeterministic action in the same state yield each possible successor state an infinite number of times, the (fair) synthesis problem can be reduced to a standard strong cyclic planning task over reachability goals. Since strong cyclic planners are built on top of efficient classical planners, the transformation reduces the non-deterministic, fully observable, temporally extended planning task into the solution of classical planning problems. A number of experiments are reported showing the potential benefits of this approach to synthesis in comparison with state-of-the-art symbolic methods.


Many scenarios have been proposed for the origin of the supermassive black holes (SMBHs) that are found in the centres of most galaxies. Many of these formation scenarios predict a high-redshift population of intermediate-mass black holes (IMBHs), with masses M • in the range 10 2 ≲ M • ≲ 10 5 M ⊙ A powerful way to observe these IMBHs is via gravitational waves the black holes emit as they merge. The statistics of the observed black hole population should, in principle, allow us to discriminate between competing astrophysical scenarios for the origin and formation of SMBHs. However, gravitational wave detectors such as Laser Interferometer Space Antenna (LISA) will not be able to detect all such mergers nor assign precise black hole parameters to the merger, due to weak gravitational wave signal strengths. In order to use LISA observations to infer the statistics of the underlying population, these errors must be taken into account. We describe here a method for folding the LISA gravitational wave parameter error estimates into an 'error kernel' designed for use at the population model level. The effects of this error function are demonstrated by applying it to several recent models of black hole mergers, and some tentative conclusions are made about LISA's ability to test scenarios of the origin and formation of SMBHs.


Commercial whitetail deer farming is a growing industry in the U.S. The size of operations ranges from a few head to hundreds. Management ranges from small, part-time farmers to professionally-managed operations. There is, however, a lack of published information documenting investment costs, operating costs, cash flow, and profitability of whitetail deer enterprises. This article provides that information. Based on interviews with the Board of Directors for Whitetails of Oklahoma, small and mid-sized farms are modeled, providing construction and operating costs for both. Projected cash flow budgets and net present values under various sale price assumptions are also reported. The likelihood of profitability is directly tied to the sale price of bucks. At prices less than $2,750 for a smaller-sized farms and $3,000 for mid-sized farms, profitability is highly unlikely.


Background: Clinical practice guidelines (CPGs) represent a key mechanism for optimizing health care decision making. CPGs are a product of discussion by a group of, typically, 10-20 individuals with varying expertise. Little is known how CPG panels actually make their recommendations.
 Objective: In a study of real-life decision making, we investigated the factors considered by members of panels convened by the American Society of Hematology (ASH) to develop guidelines, when using the widely accepted formal GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system.
 Methods: To account for panel level factors and individual level factors, we employed two level hierarchical, random-effect, multivariate logistic and ordered logistic regression analysis.
 Results: 101 participants taking part in 8 CPGs panels issued 1,289 recommendations. Association of GRADE (normative) factors with the strength of recommendations (SOR) dominated the findings over the non-GRADE (descriptive) factors. In the main analysis certainty in evidence (regardless of direction for or against intervention) [OR=1.83 (95CI% 1.45 to 2.31;p<0.0001)], balance of benefits and harms [OR=1.49 (95CI% 1.30 to 1.69;p<0.0001)] and variability or uncertainty in the patients' values and preferences [OR=1.47 (95CI% 1.15 to 1.88;p<0.002)] were the strongest predictors of SOR coded as "neither for nor against" , "weak for or against" or "strong for or against" health intervention. Greater judgment of certainty of evidence proved highly associated with a strong recommendation [OR=3.60 (95% CI 2.16 to 6.00;p<0.00001] when panel members were issuing recommendation "for" interventions. When, however, panels made recommendations "against" intervention, certainty in evidence was not associated with probability of issuing strong recommendation [OR=0.98 (95%CI: 0.57 to 1.8; p=0.94)]. Two panelist characteristics were associated with strong recommendations: age (per decade) [OR=1.79 (95 CI% 1.2 to 2.84; p<0.005)], and greater intolerance of uncertainties [OR=0.57 (95 CI% 0.37 to 0.86; p<0.008)]. Agreement between individual panel members and the group ranged from very poor (average kappa of -0.01 in one panel) to moderate (kappa=0.64 in another panel), with most panels in an intermediate range. We also found that the panel members who were asked by the ASH to recuse themselves from voting due to high risk of conflict of interest (COI) would have voted differently if they were allowed to do so.
 Conclusion: Factors associated with GRADE's conceptual framework proved, in general, highly associated with strong versus weak recommendations and with the direction of recommendation. However, some non-GRADE factors of importance for decision-making were also identified. Findings that panel members with high risk of COI made different judgments than those without COI provide empirical support for the importance of managing conflict of interest. The low agreement between individual panel members and group consensus, and failure of certainty of evidence to be associated with strength of recommendations against an intervention, suggest the need for improvements in the process.

 Cuker: Synergy: Consultancy; Genzyme: Consultancy; Kedrion: Membership on an entity's Board of Directors or advisory committees; Spark Therapeutics: Research Funding.


A nationally acclaimed poet, Robert Francis continued to write and receive recognition for his work right up until his death in 1987 at age 85. His honours include the Prix de Rome given by the American Academy of Arts and Letters, the Shelley Award of the Poetry Society of America, and the Brandeis Creative Arts Award. In 1984, the Academy of American Poets presented him with its $10,000 fellowship for "distinguished poetic achievement". The 56 poems in this collection were gathered from what Francis wrote in the last decade of his life and from earlier work not reproduced in "Collected poems, 1936-1976". Included are several "lost" poems recently discovered between the pages of Francis's letters. Although age is a recurring theme, "Late fire, late snow" offers an engaging mixture of subject and tone, from the pastoral to the political, the contemplative to the Chaplinesque. This edition, which contains two photographic portraits of the poet, was produced directly from the Fort Juniper limited edition.


1. Blood transfusion experiments show that normal hardening and darkening at the imaginal ecdysis of CaUiphora erythrocephala (Meigen) is brought about by the release into the blood of an active factor. Introduction of this factor into a newly emerged fly some 35 min. prior to the time at which it would normally be released is sufficient to prevent expansion. 2. The factor is normally released some 45 min. before the appearance of the first signs of darkening and between 3 and 15 min. after the fly has reached conditions suitable for expansion, that is at about the time of initiation of air-pumping. 3. Decapitation at emergence will prevent the initiation of normal hardening and darkening but not of secondary darkening. Evidently the head is concerned in the release or the control of the release of the blood-borne darkening factor. 4. The critical period for the prevention of normal hardening and darkening by decapitation lies between 3 and 15 min. after the fly has reached conditions suitable for expansion. 5. Isolated abdomina behave in a manner similar to decapitated flies but their reactions are complicated by secondary darkening associated with damage. 6. Flies deprived of their abdomina will expand at least partially but the rate of their hardening and darkening is reduced. 7. Damage reactions resembling secondary darkening in digging flies are more extensive after damage to internal organs such as the gut than to superficial organs such as the body wall. 8. Allowing for the effects of secondary darkening it is possible to demonstrate the occurrence of the blood-borne darkening factor by means of ligatures placed at emergence between the thorax and the abdomen. Under these conditions only the head and thorax exhibit normal darkening.


Importance Adults with acute myeloid leukemia (AML) commonly require support in the intensive care unit (ICU), but risk factors for admission to the ICU and adverse outcomes remain poorly defined. Objective To examine risk factors, mortality, length of stay, and cost associated with admission to the ICU for patients with AML. Design, Setting, and Participants This study extracted information from the University HealthSystem Consortium database on patients 18 years or older with AML who were hospitalized for any cause between January 1, 2004, and December 31, 2012. The University HealthSystem Consortium database contains demographic, clinical, and cost variables prospectively abstracted by certified coders from discharge summaries. Outcomes were analyzed using univariate and multivariable statistical techniques. Data analysis was performed from November 15, 2013, to August 15, 2016. Main Outcomes and Measures Primary outcomes were admission to the ICU and inpatient mortality among patients requiring ICU care. Secondary outcomes included length of stay in the ICU, total hospitalization length of stay, and cost. Results Of the 43 249 patients with AML (mean [SD] age, 59.5 [16.6] years; 23 939 men and 19 310 women), 11 277 (26.1%) were admitted to the ICU. On multivariable analysis (with results reported as odds ratios [95% CIs]), independent risk factors for admission to the ICU included age younger than 80 years (1.56 [1.42-1.70]), hospitalization in the South (1.81 [1.71-1.92]), hospitalization at a low- or medium-volume hospital (1.25 [1.19-1.31]), number of comorbidities (10.64 [8.89-12.62] for 5 vs none), sepsis (4.61 [4.34-4.89]), invasive fungal infection (1.24 [1.11-1.39]), and pneumonia (1.73 [1.63-1.82]). In-hospital mortality was higher for patients requiring ICU care (4857 of 11 277 [43.1%] vs 2959 of 31 972 [9.3%]). On multivariable analysis, independent risk factors for death in patients requiring ICU care included age 60 years or older (1.16 [1.06-1.26]), nonwhite race/ethnicity (1.18 [1.07-1.30]), hospitalization on the West coast (1.19 [1.06-1.34]), number of comorbidities (18.76 [13.7-25.67] for 5 vs none), sepsis (2.94 [2.70-3.21]), invasive fungal infection (1.20 [1.02-1.42]), and pneumonia (1.13 [1.04-1.24]). Mean costs of hospitalization were higher for patients requiring ICU care ($83 354 vs $41 973) and increased with each comorbidity, from $50 543 for patients with no comorbidities to $124 820 for those with 5 or more comorbidities. Conclusions and Relevance Admission to the ICU is associated with high mortality and cost that increase proportionally with the comorbidity burden in adults with AML. Several demographic factors and medical characteristics identify patients at risk for admission to the ICU and mortality and provide an opportunity for testing primary prevention strategies.


Background: Lethality of suicidal attempt provides useful information regarding the behavior. There is a perceived need for a clinically useful scale that can be easily adapted to various methods and circumstances of attempt. Aims: The study intended to develop and test utility of a scale for measuring lethality that can reflect overall clinical observation taking into account various indicators of lethality and which can be used across clinical scenarios involving different methods. Settings and Design: Cross-sectional study in a hospital. Materials and Methods: The scale for assessment of lethality of suicide attempt (SALSA) has two components: The first component has four items indicating seriousness of the attempt and its likely consequences and the second component is the global impression of lethality. All the items are scored from 1 to 5, higher scores suggestive of increased lethality. SALSA was used to evaluate lethality of 82 consecutive suicide attempters; and it was compared with lethality of suicide attempt rating scale (LSARS) and risk-rescue rating scale. Statistical Analysis: Chi-square, t-test, analysis of variance, Cronbach's alpha, binary logistic regression. Result: There was significant correlation of SALSA score with that of LSARS (r: 0.89) and risk score of risk-rescue rating (r: 0.93, P < 0.001); and negative correlation with rescue score (r: −0.569; P < 0.001). Internal consistency reliability of SALSA was high (Cronbach's alpha: 0.94). Lethality scores of SALSA differentiated known groups with different lethality, e.g. deceased and survived; attempters with different levels of medical intervention: In-patient only, intensive care, ventilator support. SALSA score significantly predicted the lethal outcome (odds ratio: 3.2, confidence interval: 1.12-8.98). Conclusion: SALSA is a useful instrument for assessment of lethality of suicidal behaviors during clinical evaluations considering the ease of administration, its ability to differentiate clinical groups with known variations of lethality and clinical outcomes.


The in-situ oxidation technique is an effective method of synthesizing copper matrix composites reinforced by oxide dispersion. In this study, the process of fabricating Cu/Cr2O3 composite by Cr in-situ oxidation in Cu-Cr pre-alloyed powders was investigated. The evolution of the structure formed in the processing of Cu/Cr2O3 composites was characterized by optical microscopy and transmission electron microscopy (TEM). The results show that the sub-solution Cu-Cr alloy powders can be produced by high energy milling, in which Cr powders are first crushed into fine particulates, followed by the formation of Cr sub-solution in copper under the extrusion and impact of high energy grinding balls. In the Cu/Cr2O3 composite fabricated by the Cu-Cr pre-alloyed powders, the Cr2O3 particulates produced exist almost in the original sites of the Cr, and they are dispersed uniformly within the Cu matrix. The distribution of Cr2O3 particulates is similar to that in the full solid solution Cu-Cr powders.


These experiments were performed more than 20 years ago and duly published. They have evidently escaped Mr. Fairbank's notice, although he mentions recent experimental work on somewhat similar lines by Bruce and Walmsley (1942) and Colin (1944) and published in America. There is an obvious fallacy in applying experiments on animals to human be:ngs, but the findings are certainly suggestive. Redfern, many years ago, found also that the articular cartilage underwent degenerative changes after experimental amputations through joints. Specimens formerly in the R.C.S. Museum ((pre-war Nos. 440.1 and 442.2: I have been unable to check if these survived the holocaust due to enemy action) show the lower ends of the femora from cases of amputation through the knee-joint. In both cases the articular cartilage is very thin and has in places degenerated. One sees examples of the same kind in old unreduced dislocations, both congenital and acquired, and in various deformities. All these facts show that when normal cartilaginous apposition ceases, degeneration of the articular cartilage occurs which is indistinguishable from that seen in the early stages of osteo-arthritis, and may be followed by the complete picture. After these animadversions concerning removal of the patella, I hasten to observe that the operation is, in my experience, occasionally of value. In addition to the badly comminuted fracture of the patella, where the normal smooth articular surface cannot be reconstituted, it is occasionally of value in cases of osteo-arthritis of the knee, where the disease is concentrated in the patello-trochlear area and where pain due to friction is intolerable. It is an alternative to arthrodesis or excision which may preserve a useful range of movement. I have been pleased also with the results of excision of the patella in long-standing cases of recurrent dislocation, when painful and frequent attacks of dislocation occur in spite of previous plastic operations, and which are uncontrollable by an instrument. It is worthy of observation that the aesthetic effect of excision of the patella is far from satisfactory: in fact, the knee looks like "nothing on earth," particularly on flexion. This is a point of no small importance to the young of both sexes and even to the not so young.-I am, etc.,


Twenty-eight years after the Taylor Report into the Hillsborough disaster recommended that all football grounds in the top two divisions in England and Wales should become all-seated, the UK government, in 2018, announced a review into the safety of modern standing areas and whether developments in stadium safety might justify changing the all-seating legislation to permit Safe Standing. These events are the outcome of a 30-year social movement in which a critical mass of supporters, through the relational networks they formed, have built collective action. Drawing upon both archival and fieldwork research to analyse the longer-term impact which all-seated stadia have had on football supporters' consumption of the game in England, the article uses relational sociology to tell the story of the movement, and studies the working tactics and structure of a small network mobilizing across the political and discursive fields of contention post-Hillsborough. It argues that whilst now a more effective movement with technological and political capital, Safe Standing continues to raise important questions around the historical views on football fans as somehow deviant and reinforces the long-term impact and legacy of Hillsborough on supporters' modern cultural consumption of the game by moving within the parameters of the all-seating legislation.


A goal of health risk assessment is the determination of the reference dose: an estimate of the exposure level for the human population, which is free from appreciable risk of deleterious effects. The estimation of the point of departure: a dose level at which the incease in risk is thought to be acceptable/tolerable, plays an important role in the derivation of the reference dose. The method of benchmark dose has been widely employed in the determination of the point of departure. However, due to some practical constraints, the method sometimes faces difficulty in determining an appropriate increase in risk that meets the definition of the reference dose. As an alternative, the method of the signal-to-noise crossover dose (SNCD) was introduced in 2011. One of the main objectives here is to develop an optimal design for the SNCR: an additional risk associated with the SNCD. The feasibility of the optimal design is also investigated under different dose-response relationships.


This paper presents an online personalised non‐photorealistic rendering (NPR) technique for 3D models generated from interactively sketched input. This technique has been integrated into a sketch‐based modelling system. It lets users interact with computers by drawing naturally, without specifying the number, order, or direction of strokes. After sketches are interpreted as 3D objects, they can be rendered with personalised drawing styles so that the reconstructed 3D model can be presented in a sketchy style similar in appearance to what have been drawn for the 3D model. This technique captures the user's drawing style without using template or prior knowledge of the sketching style. The personalised rendering style can be applied to both visible and initially invisible geometry. The rendering strokes are intelligently selected from the input sketches and mapped to edges of the 3D object. In addition, non‐geometric information such as surface textures can be added to the recognised object in different sketching modes. This will integrate sketch‐based incremental 3D modelling and NPR into conceptual design.


This study of naturally occurring behaviour employed a "beeper technique" to investigate the actions carried out by 152 subjects in eight different groups, viz. adult students, employed students who were also parents, unemployed, art students, doctoral students, alcoholics, retired people and a control group. Actions were sampled for seven subsequent days, five times per day between 8 a.m. and 10 p.m. at randomly selected occasions. Each action was rated on a number of variables, shortly after it was sampled (median delay approximately 10 min). Some of the findings were: Time allocation corresponded well with national estimates. Being under situational control was highly aversive. Instrumental and consummatory orientations correlated positively. The background variables were, on the whole, only rather weakly related to action ratings, but it was found that women and retired persons tended to report a higher level of well-being.


Since its renaissance, heterogeneous integration (HI) where unique merits of different silicon or III-V technologies, has been widely explored in many power electronics and achieved remarkable success. It is known that the success of power conversion electronics is mostly attributed to the low-power, fast-response, and accurate mixed-signal control circuitry and the low-loss, high efficiency, and high power-handling power switches. Traditionally, leveraging on a single technology, i.e. monolithic approach by using either CMOS or GaN, for instance, optimization of both control and power circuits could hardly be obtained. Thus, the new challenges of power conversion electronics confront HI approaches, where optimization of various circuits is naturally enabled using different semiconductor technologies. In this review article, we first present the traits and principles of power conversion electronics from both circuit and mathematical aspects. Then, we highlight the progress of HI-enabled power conversion electronics. Rather than presenting an exhaustive literature survey, we instead describe some prominent research highlights from both commercial practices and academic frontiers and provide insight on these case study applications.


OBJECTIVE
To observe the therapeutic effect of needle-pricking therapy combined with spinal massage on ankylosing spondylitis and to probe into the mechanism.

METHODS
Ninety-three cases who were definitely diagnosed as having ankylosing spondylitis at active stage were randomly divided into a medication group (n=46) and an observation group (n=47). The observation group were treated by needle-pricking the main points, Neck No. 2 nerve, Neck No. 5 nerve point, etc., combined with spinal rotation massage, and the medication group were treated with Azulfidine. Changes of cumulative score of arthralgia and arthroncus, function of joint, Keitel test, and ESR and CRP before and after treatment were observed.

RESULTS
The effective rate and the markedly effective rate were 95.8%0 and 68.1% in the observation group and 78.3% and 23.9% in the medication group, respectively, the former being significantly better than the latter (P < 0.01).

CONCLUSION
Needle-pricking therapy combined with spinal massage has a significant therapeutic effect with a steady and long-term effect for treatment of ankylosing spondylitis at active stage.


This paper presents multi-goal planning for an autonomous blasthole drill used in open pit mining operations. Given a blasthole pattern to be drilled and constraints on the vehicle's motion and orientation when drilling, we wish to compute the best order in which to drill the given pattern. Blasthole pattern drilling is an asymmetric Traveling Salesman Problem with precedence constraints specifying that some holes must be drilled before others. We wish to find the minimum cost tour according to criteria that minimize the distance travelled satisfying the precedence and vehicle motion constraints. We present an iterative method for solving the blasthole sequencing problem using the combination of a Genetic Algorithm and motion planning simulations that we use to determine the true cost of travel between any two holes.


BACKGROUND AND OBJECTIVES
General practitioners (GPs) have an important role to play in increasing direct-acting antiviral (DAA) treatment for hepatitis C virus (HCV) among people who inject drugs (PWID). A stronger understanding of how GPs can support this group in the uptake and completion of DAA treatment is required.

METHOD
A purposive sample of 27 patients (nine women and 18 men) with a history of HCV participated in semi-structured interviews capturing perspectives about the role of GPs in facilitating and supporting DAA treatment. Thematic analysis focused specifically on experiences of accessing treatment while continuing injecting drug use and how GPs can support uptake in PWID.

RESULTS
GPs need to prioritise and initiate discussions about HCV treatment with PWID. It is important that GPs provide clear and consistent information about the treatment journey; address myths of ineligibility and feelings of guilt and apathy towards treatment; and facilitate blood sampling, particularly for those with difficult venous access.

DISCUSSION
This study contributes to HCV prevention and treatment literature by providing insights into practical ways GPs can encourage uptake and completion of treatment with PWID.


Adrenal–renal fusion is an anomaly misclassified as a renal tumor due to the absence of pathognomonic radiographic features. Herein, we report a case of a 61-year-old male who underwent a right radical nephrectomy for a presumed renal malignancy. Pathologic evaluation demonstrated a pheochromocytoma in the context of adrenal–renal fusion. Neoplastic transformation of fused adrenal tissue is rare but not unheard of and is typically adrenal cortical in origin. To our knowledge, this is the first description of a pheochromocytoma originating from an adrenal–renal fusion. The clinical presentation did not raise a high index of suspicion for the ultimate diagnosis rendered.


The cefmetazole efficacy was studied in an open non-comparative clinical trial in the treatment of 40 patients with wound infections. The clinical results were excellent and good in 90 per cent of the cases. In 2.5 per cent of the cases the treatment failed. In 7.5 per cent of the cases the results could not be evaluated. The bacteriological efficacy of cefmetazole was equal to 80 per cent. The drug tolerance was good and only in 3 patients allergic reactions were observed. No hepatotoxic or nephrotoxic effects were recorded. The results were indicative of the advisability of the cefmetazole use in the treatment of wound infections.


The writings of German landscape architecture historians Joachim Wolschke-Bulmahn and Gert Gröening have brought into question the ethical underpinnings of natural landscaping. Citing the work of Willy Lange, a German "garden architect" whose work foreshadowed and became the foundation for designs by Alwin Seifert and other National Socialist landscape engineers and planners, they develop a critique which suggests that the preservation of native landscapes and the exclusive use of native plants in gardens is both "racist" and "anti-human." Wolschke-Bulmahn has also criticized Jens Jensen, the Midwest American landscape architect who is well known for his advocacy and use of native plants during the first four decades of the twentieth century. This critique is made by highlighting excerpts of Jensen's writings in German landscape journals of the 1930s, which Wolschke-Bulmahn believes show Jensen's support for the racial policies of the National Socialist Party. This paper attempts to answer this critique against Jensen and against the contemporary use of native plants. We review Jensen's life from his birth in Dybbol, Denmark to his death in Ellison Bay, Wisconsin, looking at the personal and social influences that made him an advocate of democracy and the use of native plants. We describe Jensen as a man, like many of his generation, with racist tendencies, but one who was not sympathetic to the National Socialist (or American, or British) program of euthanasia. Instead, we view him as a person struggling with the way "progress" had outstripped the ritual and spiritual aspects of life in the "modern" world. Jensen realized that natural places and the use of native plants represented, not a superiority over others, but a way to help everyone, especially immigrants, establish a relationship with their new home. Furthermore, we argue that today's use of native plants and the emphasis on "place" are part of this thought: an attempt to diversify and humanize, in a positive way, a post-modern world that has become increasingly homogenized and artificial.


We analyze the (computational) complexity distribution of sphere decoding (SD) for random infinite lattices. In particular, we show that under fairly general assumptions on the statistics of the lattice basis matrix, the tail behavior of the SD complexity distribution is fully determined by the inverse volume of the fundamental regions of the underlying lattice. Particularizing this result to N x M, N ≥ M, i.i.d. circularly symmetric complex Gaussian lattice basis matrices, we find that the corresponding complexity distribution is of Pareto-type with tail exponent given by N-M+1. A more refined analysis reveals that the corresponding average complexity of SD is infinite for N = M and finite for N >; M. Finally, for i.i.d. circularly symmetric complex Gaussian lattice basis matrices, we analyze SD preprocessing techniques based on lattice-reduction (such as the LLL algorithm or layer-sorting according to the V-BLAST algorithm) and regularization. In particular, we show that lattice-reduction does not improve the tail exponent of the complexity distribution while regularization results in a SD complexity distribution with tails that decrease faster than polynomial.


Trajectory planning is a generalisation of path planning in
which velocity is also taken into consideration. Considering
velocity, in the context of a real-world system such as a
robotic vehicle, means considering physical constraints such
as the speed limit constraints when steering the vehicle. One
of the recent algorithms for solving this type of planning
problem is Augmented Lazy Theta*.
In this work we introduce the trajectory planner Abstract
Augmented Lazy Theta*. This planner uses a combination
of abstraction and relaxation to reduce the search space of
Augmented Lazy Theta*. We demonstrate that Abstract Augmented
Lazy Theta* significantly improves the time performance
of Augmented Lazy Theta* whilst retaining the same
overall solution quality. Additionally, we show that Abstract
Augmented Lazy Theta* performs competitively with another
state-of-the-art trajectory planning algorithm, the RRT*
algorithm, by demonstrating significantly better


One of the most important crimes against public trust and tranquility is forgery. To forge official and government documents that is to say, the documents which is to be regulated by officials in order to their legal duties, because of it's proper credit and worth and also having a stronger feedback proportionate to common documents, causes to be called intensified forgery and legist labors are going to prevent penal crimes via intensification of punishments. Unfortunately, nevertheless acute punishment the toll is increasing, and re-punishment could not do any thing, and prevention must be at the level of nation wide, area and ever in offices, official office system should not assume that their maximum duty is in litigation of official deeds, forgery in justice ministry and merely to plead for punishment but they should confront and prevent it at the first priority. In the present paper, after mentioning the most usual and common methods of state deeds' forgery, it has been suggested to constitute a preventive council about office special crimes with the purpose of legislation for proper regulations and submission of identical procedures. In this essay, besides social preventions, several thematic procedures such as anti citation for office special paper application, stapler instead of stamp, signature education to employees, leaving affairs of decals to special part utilization of coding system and paperless office system have been suggested.


This is a protocol for a Cochrane Review (Prognosis). The objectives are as follows:

The primary objective of this review is to synthesise the available evidence on the proportion of individuals who have a diagnosis of autism spectrum disorder at baseline and at follow-up one or more years later.

The secondary objectives of this review are to:

investigate whether there are differences in the proportions of individuals with autism spectrum disorder who maintain a diagnosis at follow-up dependent on use of the different classification systems (i.e. DSM or ICD criteria) and their revisions; and

investigate the proportion of individuals with autism spectrum disorder who maintain diagnosis at follow-up in important subgroups of individuals, including those of different ages and those with different language levels (verbal/non-verbal; standard score ≤ 70 or > 70), IQs (≤ 70 or > 70), adaptive behaviour (standard score ≤ 70 or > 70), and different diagnostic subgroups (Asperger's syndrome/disorder, autistic disorder, childhood autism, PDD-NOS, atypical autism, PDD and autism spectrum disorder).

We will investigate potential sources of heterogeneity that may impact outcomes such as differences in study participation, study design, length of follow-up, participant attrition and participant outcome measurement factors. We will use internationally recognised standards for systematic reviews to guide the review.


Aims and Objectives To assess the prevalence of cardiovascular disease risk among urban public school students through a collaborative school district and university partnership. Methods Children and adolescents in grades K-12 from 24 urban public schools participated in measurements of height, weight, and other health metrics during the 2009–2010 school year. Body mass index (BMI) percentiles and z-scores were computed for 4673 students. President's Challenge 1-mile endurance run was completed by 1075 students ages 9–19 years. Maximal oxygen consumption (⩒O2max) was predicted using an age-, sex-, and BMI-specific formula to determine health-related fitness. Resting blood pressure (BP) was assessed in 1467 students. Regression analyses were used to compare BMI z-scores, fitness, and age- and sex-specific BP percentiles across grade levels. Chi-square tests were used to explore the effect of sex and grade-level on health-related outcomes. Results Based on BMI, 19.8% were categorized as overweight and 24.4% were obese. Included in the obese category were 454 students (9.7% of sample) classified with severe obesity. Using FITNESSGRAM criteria, 50.2% of students did not achieve the Healthy Fitness Zone (HFZ); the proportion of students in the Needs Improvement categories increased from elementary to middle school to high school. Male students demonstrated higher fitness than female students, with 61.4% of boys and only 35.4% of girls meeting HFZ standards. Elevated BP was observed among 24% of 1467 students assessed. Systolic and diastolic BP z-scores revealed low correlation with BMI z-scores. Conclusions A community-university collaboration identified obesity, severe obesity, overweight, and low aerobic fitness to be common risk factors among urban public school students.


An off-axis setup for digital holographic microscopy in incident and transmission light arrangement for simultaneous high resolution full field amplitude and quantitative phase contrast microscopy is presented. Different kinds of algorithms for numerical reconstruction of the complex object wave are compared concerning their applicability to the microscopy arrangement. By combining a non-diffractive spatial phase shifting algorithm that performs reconstruction without the disturbing terms twin image and zero order with the numerical evaluation of the FresnelKirchhoff diffraction integral by a convolution method we achieve best results. The simultaneous reconstruction of the object wave's amplitude and phase from a single hologram requires a mathematical model of the spatial phase distribution within the hologram plane. An efficient numerical algorithm has been developed for determining the model's parameters automatically and tested concerning its accuracy. Furthermore, the relation between the axial position of the object and the distance of reconstruction which is required for the quantitative evaluation of the reconstructed images and the application of a pure numerical focus is derived. Technical objects were used to quantify the lateral resolution and the phase resolution of the system and to optimize several parameters of the setup. Biological probes such as living cells are analyzed in transmission light arrangement. As a result the knowledge of the refractive index of the medium and the cell is required to derive the cell's thickness from the reconstructed phase. Thus a special experimental method for the approximation of the integral refractive index of single cells from the reconstructed phase has been developed. Finally results of cell differentiation by morphological varieties as well as results of stimulated dynamic morphological changes are presented and discussed.


Background In 2000 Uganda adopted the Integrated Disease Surveillance and Response (IDSR) strategy, which aims to create a co-ordinated approach to the collection, analysis, interpretation, use and dissemination of surveillance data for guiding decision making on public health actions. Methods We used a monitoring framework recommended by World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC)-Atlanta to evaluate performance of the IDSR core indicators at the national level from 2001 to 2007. To determine the performance of IDSR at district and health facility levels over a 5-year period, we compared the evaluation results of a 2004 surveillance survey with findings from a baseline assessment in 2000. We also examined national-level funding for IDSR implementation during 2000–07. Results Our findings show improvements in the performance of IDSR, including: (1) improved reporting at the district level (49% in 2001; 85% in 2007); (2) an increase and then decrease in timeliness of reporting from districts to central level; and (3) an increase in analysed data at the local level (from 10% to 47% analysing at least one target disease, P < 0.01). The case fatality rate (CFR) for two target priority diseases (cholera and meningococcal meningitis) decreased during IDSR implementation (cholera: from 7% to 2%; meningitis: from 16% to 4%), most likely due to improved outbreak response. A comparison before and after implementation showed increased funding for IDSR from government and development partners. However, funding support decreased ten-fold from the government budget of 2000/01 through to 2007/08. Per capita input for disease surveillance activities increased from US$0.0046 in 1996–99 to US$0.0215 in 2000–07. Conclusion Implementation of IDSR was associated with improved surveillance and response efforts. However, decreased budgetary support from the government may be eroding these gains. Renewed efforts from government and other stakeholders are necessary to sustain and expand progress achieved through implementation of IDSR.


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As the 21C globalized world becomes increasingly complex in terms of its interconnections and the need to engage in multiple contexts simultaneously, there is a welcome resurgence of interest in the notion of citizenship and in intercultural education. The basis of this research was to address the apparent disjuncture between current professional learning practice for educators and the form of practice that is necessary to produce purposeful and visible 'glocal' 21C learning in classrooms. It explored the nature and implications of the 21C global education paradigm for both teachers and schools and constructed a networked improvement community of practice across six high schools in Denmark. The research design was intended as potentially representing a model 21C professional learning theory-in-practice. It adopted a phenomenological approach to examine the perceptions of the teachers who were experiencing the phenomenon. It found that participating teachers saw the 21C education paradigm almost exclusively in the cognitive domain. They saw citizenship in terms of skills and knowledge rather than being in the affective domain and being characterized as a set of dispositions. As most teachers had adopted a script-based teaching identity rather than a learning design identity, their practice was based in knowledge transmission practices rather than dialogic ones. The result was that at the beginning of the research, the opportunities for professional learning based conversations in the schools were minimal. To address this and to seek a sustainable theory in practice, the research employed the Effective lifelong Learning Inventory (ELLI) learning dimensions as a language to bridge the divide between the teaching and citizenship paradigms. It presents qualitative data that illuminates the effect that the project had in helping teachers to understand their classrooms as living communities in which they could simultaneously teach and model citizenship and engage in professional dialogue across the network to better develop their practice. Importantly, it highlights the challenge of global citizenship education; it recommends a theory in practice for schools to adopt in order to create in classrooms and in staffrooms, communities that model - not preach - fluid forms of enquiry, collaboration, and sense making of the type that is desired and required of citizens on a global community level.


This paper aims to identify the effects of Islamic banking on economic growth and industrial development in Turkey. For this purpose, quarterly data for the periods between 2005 and 2016 were taken into the consideration. Additionally, VAR Granger causality analysis was used in this study. It was concluded that Islamic banks' loans do not have a significant effect on the improvement of economy and industry in Turkey. The main reason for this result is that Islamic banking has a very low percentage in Turkish banking sector. Thus, it can be said that Islamic banking in Turkey should be so developed that it can contribute to GDP growth and industrial development.


While it has long been clear that prosody should be part of the grammar influencing the action of the syntactic parser, how to bring prosody into computational models of syntactic parsing has remained unclear. The challenge is that prosodic information in the speech signal is the result of the interaction of a multitude of conditioning factors. From this output, how can we factor out the contribution of syntax to conditioning prosodic events? And if we are able to do that factorization and define a production model from the syntactic grammar to a prosodified utterance, how can we then define a comprehension model based on that production model? In this case study of the Samoan morphosyntax-prosody interface, we show how to factor out the influence of syntax on prosody in empirical work and confirm there is invariable morphosyntactic conditioning of high edge tones. Then, we show how this invariability can be precisely characterized and used by a parsing model that factors the various influences of morphosyntax on tonal events. We expect that models of these kinds can be extended to more comprehensive perspectives on Samoan and to languages where the syntax/prosody coupling is more complex.


Locating the program element(s) relevant to a particular feature is an important step in efficient maintenance of a software system. The existing feature location techniques analyze each feature independently and perform a one-time analysis after being provided an initial input. As a result, these techniques are sensitive to the quality of the input, and they tend to miss the nonlocal interactions among features. In this paper, we propose to address the proceeding two issues in feature location using an iterative context-aware approach. The underlying intuition is that the features are not independent of each other, and the structure of source code resembles the structure of features. The distinguishing characteristics of the proposed approach are: 1) it takes into account the structural similarity between a feature and a program element to determine their relevance; 2) it employs an iterative process to propagate the relevance of the established mappings between a feature and a program element to the neighboring features and program elements. Our initial evaluation suggests the proposed approach is more robust and can significantly increase the recall of feature location with a slight decrease in precision.


The transcription repressor of D-galactonate metabolism, DgoR, from Escherichia coli belongs to the FadR family of the GntR superfamily. In the presence of D-galactonate, DgoR binds to two inverted repeats overlapping the dgo cis-acting promoter repressing the expression of genes involved in D-galactonate metabolism. To further understand the structural and molecular details of ligand and effector interactions between D-galactonate and this FadR family member, herein we solved the crystal structure of C-terminal domain of DgoR (DgoR_C), which revealed a unique divalent metal-containing substrate binding pocket. The metal ion is required for D-galactonate binding, as evidenced by the dramatically decreased affinity between D-galactonate and DgoR in the presence of EDTA, which can be reverted by the addition of Zn2+, Mg2+, and Ca2+. The key amino acid residues involved in the interactions between D-galactonate and DgoR were revealed by molecular docking studies and further validated with biochemical studies by site-directed mutagenesis. It was found that changes to alanine in residues R102, W181, T191, and R224 resulted in significantly decreased binding affinities for D-galactonate, as determined by EMSA and MST assays. These results suggest that the molecular modifications induced by a D-galactonate and a metal binding in the DgoR are required for DNA binding activity and consequently, transcriptional inhibition.


Total knee replacement is a powerful but complex surgical procedure. Recognizing and addressing all planes of motion at the knee is mandatory for good results. Accurate alignment of the prosthetic component and the limb is crucial. Close attention to surgical detail and prosthetic interaction is necessary. Current prosthetic replacement fails to return the bone to its normal strain environment. Clinical results with current resurfacing components rival or exceed those obtained with conventional total hip replacement in properly selected patients.


Nucleosides are fundamental building blocks of DNA and RNA in all life forms and viruses. In addition, natural nucleosides and their analogs are critical in prebiotic chemistry, innate immunity, signaling, antiviral drug discovery and artificial synthesis of DNA / RNA sequences. Combined with the fact that quantitative structure activity relationships (QSAR) have been widely performed to understand their antiviral activity, nucleoside analogs could be used to benchmark generative molecular design. Here, we undertake the first generative design of nucleoside analogs using an approach that we refer to as the Conditional Randomized Transformer (CRT). We also benchmark our model against five previously published molecular generative models. We demonstrate that AI-generated molecules include nucleoside analogs that are of significance in a wide range of areas including prebiotic chemistry, antiviral drug discovery and synthesis of oligonucleotides. Our results show that CRT explores distinct molecular spaces and chemical transformations, some of which are similar to those undertaken by nature and medicinal chemists. Finally, we demonstrate the potential application of the CRT model in the generative design of molecules conditioned on Remdesivir and Molnupiravir as well as other nucleoside analogs with in vitro activity against SARS-CoV-2. One-Sentence Summary: Generative design of nucleoside analogs relevant to antiviral drug discovery, prebiotic chemistry and synthetic biology.


Cherax is a genus of 58 species of decapod crustaceans that are widespread across Australia and New Guinea. We use single-nucleotide polymorphisms (SNPs) to examine phylogeographic patterns in the most widespread species of Cherax, namely, C. destructor, and test the distinctiveness of one undescribed species, two C. destructor subspecies, previously proposed evolutionarily significant units, and management units. Both the phylogenetic analyses and the analysis of fixed allelic differences between populations support the current species-level taxonomy of C. setosus, C. depressus, C. dispar and C. destructor, the distinctiveness of C. destructor albidus and C. d. destructor and the existence of one undescribed species. The two populations of C. d. albidus from the Glenelg and Wimmera rivers were significantly distinct, with eight diagnostic differences (<1% fixed differences, null expectation is four fixed differences), but this low level of divergence is interpreted as within the range that might be expected of management units, that is, among allopatric populations of a single species or subspecies. A southern clade of C. d. destructor comprising the Murray River and its tributaries upstream from its confluence with the Darling River is genetically distinct from a northern clade comprising populations from the Lake Eyre Basin, the northern half of the Murray–Darling Basin (Darling River catchment) and the Lower Murray River below the Darling confluence.


The introduction of antiretroviral drug has considerably reformed the course of HIV/AIDS from life threatening epidemic to a chronic manageable health problem. Mortality and morbidity associated with HIV/AIDS are changing. The main aim of this study was to assess the potential determinant of death among people infected with HIV and initiated anti-retroviral therapy (ART). A general retrospective cohort method was used on 2655 people undertaking ART at Mizan Hospital from 7 January, 2005 to 8 May, 2013 in Southern Ethiopia. The three age groups: Pediatrics (age under 10 years), teens (age between 11 and 19 years), and elderly (age older than 20 years) was used to stratify the cohort. The usual clinical follow-up registry of the ART clinic was the main data for the study. Kaplan-Meier (KM) method was used to compare the survival experience of patients after initiation of ART. Cox proportional regression model was used to assess determinant of mortality. A total of 2655 patients, consisting of 6.3% pediatrics, 3.3% teenagers and 90.4% elderly were included in the study. The survival probability at the sixth month after initiation of the treatment was 96, 94, 96 and 96% for pediatrics, teenagers and adults, respectively. A low initial CD4 (P=0.001), advanced WHO clinical disease stage (P=0.01), receiving ISONIAZID preventive prophylaxis (P=0.02), tuberculosis coinfection (P < 0.001) and being bedridden (P < 0.002) was an independent determinant of death. The cumulative incidence of mortality rate for HIV patients has been low in this study hence early initiation of the treatment is highly recommended.

 Key words: Anti-retroviral therapy, mortality, South Ethiopia.


As of late, with wide utilization of PC frameworks, web, and fast development of PC systems, the issue of interruption discovery in system security has turned into a critical issue of concern. In such manner, different interruption recognition frameworks have been produced for utilizing abuse recognition and inconsistency discovery strategies. These frameworks attempt to make strides identification rates of variety in assault sorts and diminish the false positive rate. In this paper, another interruption discovery strategy has been presented utilizing Min Max K-means clustering algorithm, which defeats the lack of affectability to starting focuses in K-means algorithm, and expands the nature of clustering. The investigates the NSL-KDD information set demonstrate that the proposed strategy is more effective than that in view of K-means clustering algorithm. Additionally, the strategy has higher discovery rate and lower false positive recognition rate.


Spatial inequality of income and employment is increasing in Australian cities. This paper explores the factors underlying increasing neighbourhood inequality with a particular focus on employment inequality. Particular attention is paid to the role of public housing: the increased targeting of public housing is identified as a partial explanation of the observed changes. A conventional Blinder decomposition is used to identify the role of observable characteristics of the population, such as education, demographics, ethnicity and industry structure, and returns to those characteristics. The changes in observable personal characteristics indicate that there has been a significant amount of sorting by these characteristics since 1976. For example, Australian cities have become more socially stratified since that time with well educated people increasingly living together. However, it is important to note that the differences between lowstatus and other areas cannot be explained solely by changes in personal characteristics of the local residents. In summary, geography apparently matters!