The goal of this research was to help define a microenvironment that optimizes
nerve regeneration. The research focuses on the effects of extracellular matrix
composition and structure and on neurotrophic factor combinations. This dissertation
describes the optimization of a combination of neurotrophic factors and of the
composition of extracellular matrix-based hydrogels. These optimums are goals for the
microenvironment of new nerve grafts. Collaborative work to decellularize human nerve
tissue and create bioactive scaffolds is also covered. The decellularized tissue has a well
preserved extracellular matrix structure which provides mechanical and chemical cues to
regenerating axons. The combination of neurotrophic factors was a mixture of the
neurotrophin nerve growth factor (NGF), the glial cell-line derived neurotrophic factor
(GDNF) family ligand GDNF, and the neuropoietic cytokine ciliary neurotrophic factor
v
(CNTF). In an explant model, the combination of 50 ng/ml NGF, 10 ng/ml GDNF, and
10 ng/ml CNTF induced the highest level of neurite outgrowth at a 752 ± 291% increase
over controls and increased the longest neurite length to 2031 ± 436 microns from 916 ±
203 microns for controls. The optimum concentrations of the three neurotrophic factors
applied in combination corresponded to the optimum concentration of each factor when
applied individually. Neurite extension from the explant model through extracellular
matrix-based hydrogels made from mixtures of laminin, fibronectin, collagen 1, and
hyaluronic acid was also studied. A co-gel made with 1.5 mg/ml collagen 1 and 1.5
mg/ml laminin was optimum in this study, resulting in outgrowth of 85.9 ± 9.3 % and
length of 1532 ± 91 µm, versus 0 ± 10.0 % and 976 ± 32 µm for the controls. The
hydrogel results suggest that interactions between hydrogel components are not
significant. The decellularized human nerve exceeded the minimum levels of
extracellular matrix preservation and removal of cellular proteins. The overall results
suggest the use of a composite nerve graft using segments of decellularized nerve to
provide a highly structured, laminin rich scaffold and delivering exogenous neurotrophic
factors from an external reservoir as a next generation nerve graft.


PURPOSE
To investigate in human skin and other cells the role of tyrosine kinase and protein kinase-C (PKC) in eliciting cell-signalling responses to UV radiation (UVR) that affect the survival of irradiated cells.

MATERIALS AND METHODS
The survival of HeLa S3 cells, NCTC 2544 human keratinocytes and A431 human epidermal carcinoma cells was measured following incubation with various tyrosine kinase or PKC inhibitors and exposure to UVC (254nm) radiation. In addition, Western blotting measured PKC isozyme expression in human keratinocytes following UVC exposure.

RESULTS
It was confirmed that inhibition of tyrosine kinase activation reduces the survival of UV-irradiated HeLa S3 cells. However, no effect was seen on the survival of either NCTC 2544 human keratinocytes or A431 human epidermal carcinoma cells. In contrast, specific inhibition of PKC reduced the survival of UV-irradiated keratinocytes but had no effect on HeLa cells. Comparison of the effects of different inhibitors in keratinocytes suggested that this effect was mediated mostly through PKCmu and PKClambda/iota. In addition, keratinocyte exposure to UVC induced large and temporally distinct increases in PKCmu and PKClambda/iota.

CONCLUSIONS
The survival of NCTC 2544 keratinocytes, but not HeLa S3 cells, following UVC exposure is mediated by signalling through PKC, mostly PKCmu and PKClambda/iota. Further study is required to confirm these results in normal human keratinocytes.


Over the past decades, we have witnessed the growth demands of portable lab-on-chip biosensors. These lab-on-chip devices are mostly powered by battery, and intelligent power management systems are required to provide supply voltage for different functional units on biosensors (e.g. a microfluidic control system might require higher voltage than the rest working units of biosensors). In this paper, a fully integrated multiple-stage voltage multiplier is proposed to provide high-voltage power needs. The proposed design was implemented with the IBM's 0.13um CMOS process with a maximum power efficiency of 81.02% and maximum voltage conversion efficiency of 99.8% under a supply voltage of 1.2 V.


A programme for investigation of secondary amenorrhoea is described, which is based upon a functional classification of the endocrine causes of anovulation. All diagnostic enquiries not directly yielding a therapeutic dividend are excluded from this protocol. Three main categories of amenorrhoea are recognised: primary ovarian disease, hyperprolactinaemia and disorders of gonadotrophin secretion. There are subdivisions of each category, each with its own special diagnostic and therapeutic implications. Initial investigations take 6 weeks to complete and include measurements of follicle-stimulating hormone and prolactin, pituitary radiology and assessment of oestrogen production and of the response to clomiphene. The results of analysis of 75 consecutive cases of amenorrhoea and of 18 patients treated for infertility are presented and a cost benefit analysis applied.


The little that has been written about expressions of religious experience in the field of Composition Studies focuses on the many ways religious belief places its adherents at a disadvantage in writing classrooms. We discuss in our journals and staffrooms only those religious conservatives who are most expressive of their beliefs. Many others sit in silence during discussions that may reveal anything of their beliefs, fearing to offend teachers and peers or to expose themselves to offenses from others. Unfortunately, these silent students contribute little or nothing to our understanding of the abilities of faith-centered students. Many are writing with distinction, engaging with ideas and with their peers with enthusiasm, and exercising skillfully the conventions of the classroom and academic discourse--in fine, performing in all the ways much of our discourse on faith-identified students suggests they cannot do. Additionally, many faith-identified students come to the academy with a critical consciousness postmodern compositionists are at pains to instill in their peers who identify more fully with dominant culture. Within ongoing dialectics in Composition Studies about discourse, ideology, culture, and literacies, too little has been written about the discourse, cultures, and literacies of religious conservative students, and, more importantly, almost none of what has been written is written by such a student. This study begins to rectify that situation. Making use of Cultural and Literacies Studies theories and methods, I reexamine my own experiences as a twenty-three year old, working-class, displaced Appalachian, Pentecostal, first-year student entering the academy. Finally, I look at the debate between epistemic, expressivist, and postmodern pedagogies from the perspective of faith-centered students who (often) remain marginalized by any and all of these writing pedagogies.


Present day spatial planning began with something called urban planning, or landuse
planning, or town-and-country planning. These were introduced in the second
half of the nineteenth century in response to the appalling conditions in the towns
and cities which were growing rapidly to accommodate the industrial revolution.
Governments decided that the use of property rights in land and buildings should
be regulated. Owners should neither always be allowed to build what they wanted
where they wanted, nor always to use their buildings in ways that they wanted.
So regulations were introduced, and plans were made to guide and legitimize
the contents of those regulations. Later, in the first half of the twentieth century,
such regulations were extended in response to cities growing rapidly into the
countryside. So, gradually, most industrialized countries came to have a system
of plans, control over building development, and ordinances about environmental
nuisances. Gradually, spatial planning has grown as a recognizable and recognized
discipline – academically and in practice. Now, the task of planning is much wider
than the facilitation and regulation of urban growth. The tasks and challenges
of planning have changed over the last decades – and they keep changing. As
planning challenges change, planning approaches also change.
Nevertheless, those approaches are still rooted in the activities of making,
implementing and enforcing legal rules about how people may use their property
rights over land and buildings. This we call planning by law and property rights
and that is the subject of this book. It is still commonly practised, for it includes
the making of land-use plans, the issuing of building permits, and so on. But is it
necessary to write a book about it?
The answer is yes, for it is our contention that planning by law and property
rights is so familiar and taken for granted that we do not think about the theory
behind it. As a result, we do not think abstractly about its strengths and weaknesses,
about what can be achieved with it and what not, how it can be improved, how it
could be complemented. Such reflections are essential to cope with current and
future challenges of spatial planning. In this book, we make the (often implicit)
theory behind planning by law and property rights explicit and relate it to the
challenges. Therefore, we ask questions such as: Is planning by law and property
rights desirable? What are its strengths and limitations? Because of its limitations, could it be replaced by another way of planning? Or is it indispensable, in one
form of another? In short, we 'reconsider' planning by law and property rights.
Our argument is that planning by law and property rights is unavoidable and
indispensable in a society with a rule of law. But it is not just a necessary evil,
for it can give the users and producers of the physical environment the stability
and certainty that they desire. On the other hand, it has its limitations, for the
corollary of stability and certainty is inflexibility. Once rights in land have been
determined by a combination of private law and public law, changing them can
be difficult. If the assignment of property rights thus determined turns out to be
inconvenient or out-dated, spatial planning by legal regulations carries the danger
of creating lock-in situations. Planning by law and property rights which aims to
be flexible runs the risk of doing that by treating peoples' property rights in an
ad hoc way.
It is partly because of those limitations that in the last few years planning
theorists have given much attention to another way of spatial planning, namely
planning by agreement or 'collaborative planning'. This book is not about such
planning, but we do have to pay some attention to it as a possible alternative, or
complement, to planning by law and property rights, as a way of remedying the
limitations of that latter.
This introduction analyses a central dilemma with this type of planning, namely
how can planning by law and property rights be practised to the best advantage
without creating undesirable (for example unsustainable or socially unfair) lock-in
situations? In the remainder of this book, this and other important issues for the
development of such a theory of planning by law and property rights are explored.


Recent work has established that marine teleost (bony) fish represent a prolific source of mud grade, mainly high‐Mg calcite, carbonate sediment by means of primary precipitation within the intestine. Previously documented crystalline products display a diverse array of morphologies, many unique in shallow tropical marine settings, and have a wide range of magnesium contents (from 18 to 39 mol% MgCO3). This study utilizes scanning electron microscopy, energy‐dispersive X‐ray spectroscopy, X‐ray diffraction and liquid ion chromatography to provide a more extensive and expansive morphological, mineralogical and chemical characterization of the crystalline forms produced by a wider range of piscine functional groups (covering 21 different fish species common in The Bahamas). Several crystal morphologies not previously described in fish‐derived carbonates are documented, and chemical composition is found to be more variable than previously reported: in addition to high‐Mg calcites with >18 mol% MgCO3, high‐Mg calcites with lower MgCO3 contents and low‐Mg calcites are identified. From the expanded species range, MgCO3 content in fish‐derived carbonates ranges from ca 0˙5 to > 40 mol%, and particle length is in the range 0˙1 to >50 μm (typically <2 μm for individual crystals). Amorphous Mg‐carbonates (with detectable CaCO3 of <2 mol%) are also found to varying extent in the precipitates of many species. Dominant mineralogy and MgCO3 content varies with producing species and crystal morphology (itself a species‐dependent variable). Given the very small grain size and often high MgCO3 contents of these carbonates, interesting questions arise about their preservation potential. Thus, the extent to which carbonates produced by different species may follow different post‐excretion preservation pathways is considered.


For centuries, maps have codified the extent of human geographic knowledge and shaped discovery and economic decision-making. Economists across many fields, including urban economics, public finance, political economy, and economic geography, have long employed maps, yet have largely abstracted away from exploring the economic determinants and consequences of maps as a subject of independent study. In this essay, we first review and unify recent literature in a variety of different fields that highlights the economic and social consequences of maps, along with an overview of the modern geospatial industry. We then outline our economic framework in which a given map is the result of economic choices around map data and designs, resulting in variations in private and social returns to mapmaking. We highlight five important economic and institutional factors shaping mapmakers' data and design choices. Our essay ends by proposing that economists pay more attention to the endogeneity of mapmaking and the resulting consequences for economic and social welfare.


Novel class-based entropy coding algorithms for lattice quantised hierarchical (or interband) vectors are presented. The vectors are formed from wavelet coefficients on different scales from similarly oriented sub-bands corresponding to the same spatial location. Structures have been designed specifically for interband vectors drawn from wavelet coefficients, where large groups of approximately equiprobable lattice points are grouped into relatively few classes, known as sub-classes, super-classes and super-super-classes, enabling accurate probability estimates from training data to be obtained for entropy coding of the class indices. Further, it has been found that the best quantiser is a combination of the Z/sub n/, and D/sub n/ lattices which has been termed an augmented lattice. The performance of the method, entitled entropy-coded pyramid vector quantisation (ECPVQ), is evaluated on real images and the results show that ECPVQ is competitive, particularly at low bit-rates, with current state-of-the-art wavelet-based coders. A subjective comparison with current high performance scalar quantisation based coders shows that ECPVQ is likely to better preserve fine texture detail in the decoded images because of the finer quantisation of low energy wavelet coefficients that occurs with the augmented lattice.


Aim: The aim of this study is to determine the prevalence of apical periodontitis (AP) in root canal-treated teeth in females in Qassim region, Saudi Arabia and to evaluate the correlation of quality of the root canal fillings, coronal restorations (CRs), and cast restorations with the AP. Study Design: Cross-sectional retrospective study. Place and Duration: Female Dental Clinics at College of Dentistry at Qassim University, Saudi Arabia from January 2014 to February 2017. Materials and Methods: A total of 400 orthopantomograms were evaluated out of which root canal treatment (RCT) had been performed in 1108 teeth. Frequencies and percentages of quality of RCT, CR, and periapical status were recorded. Their association was recorded by Chi-square test and Pearson correlation was computed at significance level of 5%. Results: A total of 813 (73.4%) endodontically treated teeth presented with AP radiographically. The percentages of teeth which fulfilled the criteria of an acceptable RCT, CR, and cast restoration radiographically were 8.8%, 64%, and 93.6%, respectively. The incidence of AP among teeth with acceptable RCT (35.1%) was significantly lower than those with unacceptable RCT (77.1%) (P < 0.001). Moreover, adequate CR demonstrated a significantly better periapical status (60.2%) compared to teeth with inadequate CR (95%) (P < 0.001). The incidence of AP ranged from 24.1% (in acceptable RCT and CR cases) to 96.6% (in unacceptable RCT and CR cases) (P < 0.001). Adequate cast restoration demonstrated a better periapical status (76%) compared to teeth with inadequate cast restoration (87.5%). The incidence of AP ranged from 15.6% (in acceptable RCT and cast restoration cases) to 86.7% (in unacceptable RCT and cast restorations cases) (P < 0.001). Pearson correlation coefficient was computed. Length of obturation, density of root filling, quality of CR and quality of cast restoration were found to have highly significant positive correlation with AP (r = −0.375, r = −0.162, r = −0.118, r = −0.079, respectively). Conclusion: The prevalence of AP has been found 73.4% in root treated teeth. Quality of RCT, CR, and of cast restoration is significantly associated with periapical status in root-filled teeth.


ABSTRACT Most statistical analyses use hypothesis tests or estimation about parameters to form inferential conclusions. I think this is noble, but misguided. The point of view expressed here is that observables are fundamental, and that the goal of statistical modeling should be to predict future observations, given the current data and other relevant information. Further, the prediction of future observables provides multiple advantages to practicing scientists, and to science in general. These include an interpretable numerical summary of a quantity of direct interest to current and future researchers, a calibrated prediction of what's likely to happen in future experiments, a prediction that can be either "corroborated" or "refuted" through experimentation, and avoidance of inference about parameters; quantities that exists only as convenient indices of hypothetical distributions. Finally, the predictive probability of a future observable can be used as a standard for communicating the reliability of the current work, regardless of whether confirmatory experiments are conducted. Adoption of this paradigm would improve our rigor for scientific accuracy and reproducibility by shifting our focus from "finding differences" among hypothetical parameters to predicting observable events based on our current scientific understanding.


- The problem of developing an optimal structure of N-version software system presents a kind of very complex optimization problem. This causes the use of deterministic optimization methods inappropriate for solving the stated problem. In this view, exploiting heuristic strategies looks more rational. In the field of pseudo-Boolean optimization theory, the so called method of varied probabilities (MVP) has been developed to solve problems with a large dimensionality. Some additional modifications of MVP have been made to solve the problem of N-version systems design. Those algorithms take into account the discovered specific features of the objective function. The practical experiments have shown the advantage of using these algorithm modifications because of reducing a search space.


Computer simulation of rockfalls has been widely used in rockfall analysis in recent years, and the coefficient of restitution is an important parameter input that is difficult to determine. Aimed at finding an easy solution to this problem, three stages of laboratory and field tests have been carried out. Rockfall trajectory analysis at a specific site has been done as an application to verify the method developed. In the first stage of laboratory testing, quasi-spherical rock "'balls" made from different rock samples were dropped from 1 m onto polished rock slabs that were clamped on a concrete deck, which can be set to different slope angles. A high-speed video camera was used to record the impact processes, and normal and tangential coefficients of restitution were calculated from the video records. The results show a linear relationship between the normal restitution coefficient and the Schmidt hammer numbers of both the rock slabs and the falling rock "balls", and the slope angle. An empirical equation was then established to calculate the normal coefficient of restitution from those three parameters. However, the correlations between the tangential coefficient of restitution and the above parameters are poor, indicating that the tangential coefficient of restitution is not adequately determined by such rock properties. The second stage of laboratory testing was under more practical conditions. Three different rough rock blocks were used as rock slopes. Angular rock boulders were dropped from different heights onto the rock blocks, and a rock "ball" was also used to make a comparison. The results show that the normal coefficients of restitution from impacts of angular rocks are much smaller than those of rock "'balls", and have a linear correlation with those calculated from the empirical equation obtained by the earlier test. Tests on beds of gravel, soil, rock fragments and sand have also been carried out to obtain the coefficients of restitution of those materials. Finally, field tests have been carried out at a quarry site in Lyttelton. Basalt rock boulders of about 0.3 m in diameter were dropped from about 4 m onto rock and debris slopes using an excavator. The values of restitution coefficients obtained are similar to those from laboratory tests but larger than those calculated from the empirical equations due to the effect of weathering and surface roughness of rocks in the field on the Schmidt hammer measurement. Forty basalt boulders were then rolled down a bench slope of about 16 m, three cameras were used to record the rockfall processes. Two different rockfall simulation programs (CRSP and RocFall) were used to simulate the rockfall processes. The simulated bounce heights and velocities from CRSP are close the field trial, while those from RocFall are smaller than the field results. Comprehensive rockfall analysis has been carried out for the Marine apartments, Sumner, where a steep cliff of 35-45 m represents potential rockfall hazards to a car park and proposed buildings at the base. Site investigation, rockfall simulation and risk assessment have been carried out for the site. The results show that without any protection measures, a majority of rocks from the cliff face reach the edge of the car park. The probability of an accident at the car park is moderate (1 in 195 years), while the probability of fatality at the car park is low (8.69* 10-) and acceptable under the proposed risk criteria for "Major Civil Engineering Projects".


Collision detection is a critical problem in five-axis high speed machining. Using a combination of process simulation and collision detection based on image analysis, a rapid detection approach is developed. The geometric model provides the cut geometry for the collision detection and records a dynamic geometric information for in-process workpiece. For the precise collision detection, a strategy of image analysis method is developed in order to make the approach efficient and maintian a high detection precision. An example of five-axis machining propeller is studied to demonstrate the proposed approach. It has shown that the collision detection task can be achieved with a near real-time performance.


Purpose – The purpose of this paper is to analyze the environmental management policies and practices of the top 50 hotel companies as disclosed on their corporate web sites.
Design/methodology/approach – This study employed content analysis to review the web sites of the top 50 hotel companies as defined herein.
Findings – Only 46 per cent of the selected hotel companies used web pages to post information related to environmental issues on their public web sites. The web pages of Wyndham, IHG, Accor, Whitbread, Hyatt, Rezidor, Sol Melia, TUI, and Scandic featured more revealing environmental information than that posted by other companies, which indicated their environmental commitment and engagement. The results of content analysis identified 12 major environmental focus areas in which the sample hotel companies engaged.
Research limitations/implications – The findings on environmental policies and practices are limited to the environmental information featured on the web sites of the top 50 hotel companies. Some of these companies may have established environmental policies or initiated environmental programs not disseminated on their web sites. In addition, web page information can be changed at any time, and the findings of this study are based upon a snapshot of the web sites as of March 2010.
Practical implications – This study establishes a benchmark of the dissemination of environmental information on the internet by leading hotels, and provides a preliminary picture of environmental initiatives and engagement among these top hotel companies. The information generated from this study can serve as a guide for hotels that would like to engage in an environmental management program. This study also provides a source of information for hotels that would like to develop environmental web sites to demonstrate their environmental commitment to their stakeholders.
Originality/value – Information concerning the content of environmental information disseminated on the web sites of large hotel companies is sparse. Consequently, this study aims to provide a snapshot of where the hotel industry is with regard to on-line environmental disclosure and related environmental policies and practices.


Abstract Recent investigations indicate that three distinct lithostratigraphical units can be recognized in the Red and Norwich Crag deposits of the area around Aldeburgh and Orford, Suffolk. These effectively represent a refinement of a stratigraphy originally suggested by Prestwich in 1871. A lowermost coarse-grained shelly sand, the Red Crag Formation, rests on an eroded London Clay surface and is banked against the Pliocene Coralline Crag. The Red Crag Formation passes upwards into a fine-grained generally unfossiliferous well-sorted sand, the Chillesford Sand Member, which overlaps the Red Crag Formation to rest directly on the Coralline Crag. The Chillesford Clay Member is regarded as the lateral equivalent of the upper Chillesford Sand Member, the two members together comprising the Norwich Crag Formation in this area. Sections that have been zoned palaeontologically may be integrated into this lithostratigraphical framework. These indicate that the Red Crag Formation correlates with the Pre-Ludhamian Stage, and the Chillesford Sand Member and the Chillesford Clay Member correlate with the Bramertonian Stage. Type sections are established for the three units described.


By analyzing the characteristic of each link and each stage in smart gird, smart grid maturity model has been established. This model involves 8 dimensions, 5 hierarchies and 50 assessments, is accompanied by the whole innovation process of smart grid and cover each link: generation, transmission, substation, distribution, consumption, dispatch and communication information. Based on this model, one method of multi-objective planning of smart grid has been proposed. Through assessing each dimension's maturity by gray target decision model, the distinction between each dimension and multi-objective of smart grid has been ascertained, thus the planning content of smart grid can be defined with pertinence. Practical application effects in two cities indicates this method can thoroughly describe the planning elements of smart grid, help to develop construction definitely, embody feasibility, practicability and economy, and has good application value.


An update is presented on finding faster and or more accurate implementations of differentiator filters in the sampled domain (space or time). A previous work (Bancroft and Geiger, 1997) is reviewed, a description of the recursive filter is provided, and a theoretical derivation of the ideal filter is presented.


A major restriction in the development of a working Rapid Single Flux Quantum (RSFQ) logic circuit with high-Tc superconductors is given by the influence of thermal noise. This gives reason to ask for a general determination of the digital bit error rate. As other approaches, our method of calculating the switching probability is based on the Fokker-Planck equation. In the past few years the bit error rates for a single Josephson junction, SQUIDs and the comparator were calculated by using this theory. We demonstrate numerical solution of the multidimensional Fokker-Planck equation to calculate bit error rates due to thermal noise for a Toggle Flip Flop circuit. In the present work, we combine thermal noise analysis with the effects of process variations in order to derive rules for designing high-Tc RSFQ logic circuits.


Objective. Although modern medical technology and treatment regimens in well-resourced countries have improved the survival of sick or injured children, most of the world's families do not have access to adequate health care. Many hospitals in poorly resourced countries do not have basic water and sanitation, a reliable electricity supply, or even minimal security. The staff, both clinical and nonclinical, are often underpaid and sometimes undervalued by their communities. In many countries there continues to be minimal, if any, pain control, and the indiscriminate use of powerful antibiotics leads to a proliferation of multiresistant pathogens. Even in well-resourced countries, advances in health care have not always been accompanied by commensurate attention to the child's wider well-being and sufficient concerns about their anxieties, fears, and suffering. In accordance with the United Nations Convention on the Rights of the Child,1 the proposals set out in this article aim to develop a system of care that will focus on the physical, psychological, and emotional well-being of children attending health care facilities, particularly as inpatients. Design of the Program. To develop in consultation with local health care professionals and international organizations, globally applicable standards that will help to ensure that practices in hospitals and health centers everywhere respect children's rights, not only to survival and avoidance of morbidity, but also to their protection from unnecessary suffering and their informed participation in treatment. Child Advocacy International will liase closely with the Department of Child and Adolescent Health and Development of the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) in the implementation of the pilot scheme in 6 countries. In hospitals providing maternity and newborn infant care, the program will be closely linked with the Baby Friendly Hospital Initiative of WHO/UNICEF that aims to strengthen support for breastfeeding. United Nations Children's Fund, United Nations Convention on the Rights of the Child, child protection, breastfeeding, pain control, palliative care, child abuse.


In many Western nations traditional medical associations are encountering an opportunity in threat's clothing. If they see through the disguise, and act accordingly, they can lead health care. If they do not, they may find themselves bewildered by their sense of helplessness.

The opportunity comes from the social need for better health care. Any honest review of the literature in clinical science and health services research must conclude that there is a large gap between how health care could perform and how it does perform. In medical care error rates are too high, waste is too pervasive, technically correct clinical services are too often withheld, and technically incorrect procedures are too often used.1 Service characteristics of health care–such as waiting times, consistency of response, and attention to dignity–are well below those of many other industries.2 The patients whom we serve are neither insatiable nor ungrateful when they demand that we do better, although that demand is becoming more strident, inducing new forms of surveillance, regulation, market pressure, and media attention.

Therein lies the opportunity for new leadership from medical associations: not to explain why we cannot do better but to set about the task of leading improvements. Unfortunately (because it makes the job harder), leading improvement requires most medical associations to change both their attitude and agenda. The change in attitude is necessary because the associations' traditional aim–to perfect and protect the profession–will not suffice to meet the social need for improved care. To improve health care we require not better professions but better systems of work.

A "system" in this sense is a set of elements interacting to achieve a shared aim. Here is the trick: to improve the performance of a system, …


Herein is described the case of a 79-year-old woman who underwent elective aortic valve replacement. The procedure was complicated by a particulate embolism into the left anterior descending artery leading to a myocardial infarction, complicated by ventricular septal rupture. Subsequently, the patient was reoperated on and the septal defect closed successfully, with an uneventful recovery.


Fishing is an important economic activity in Kenya which provides employment, income and food to a significant share of Kenyan population particularly the local community around Lake Victoria. Over the last decade the aggregate landings of fish from inland waters have increased tremendously within Lake Victoria contributing about 98% of production from Kenya's inland lakes, and constitute about 93% of all fish landed in 2011. In spite of these enormous contributions, population round the Lake has remained relatively poor in economic terms. Moreover, gender and cultural barriers impede participation by women in some activities within the fish value chain. This paper investigates the location of women fish traders in the fish value chain and the rewards accruing to them. One of the major findings of this paper is that women traders in Lake Victoria are located in the lower nodes of the chain whose returns are low. In addition, women fish traders tend to operate in very micro-scale enterprises.Women fish traders are also challenged by cultural and gender constraints in terms of their potential to upgrade within the value chain. The paper recommends the need for affirmative action to empower women in the fish trade to upgrade. This can be achieved through tailor made training on business practices, assisting them to register as community based organization in order to link them with formal institutions; and finally to assist them acquire modernized technology that can help them grow. Keywords: Affirmative action, upgrading, women entrepreneurs, women empowerment,value chain


Abstract The common claim that dolomitization creates 12% porosity is based on the mole-for-mole replacement equation. However, in the past 50 years, data have been collected demonstrating that dolomitization does not create porosity. Instead, dolostones inherit the porosity and fabric of the precursor limestone, and porosity is reduced by overdolomitization. The porosity of the precursor limestone depends on the diagenetic history up to the time of dolomitization. Data show that: (1) carbonates are born with high porosity and lose porosity gradually over a long period; and (2) mud-dominated fabrics compact more readily than grain-dominated fabrics. The problem of estimating the time of dolomitization is minimized by confining observations to young limestones and associated dolostones. Limited data from Holocene dolomitic sediments suggest no change in porosity with dolomitization. Study of Plio-Pleistocene carbonates in Bonaire, Netherlands Antilles, demonstrates that precursor limestones are more porous than dolostones. Limestones average 25% porosity, whereas dolostones average 11% porosity. Data from the Neogene of the Great Bahama Bank show that dolostones and adjacent limestones both have 40% porosity. Porosity studies of the Jurassic Arab D Formation show that dolostones and associated grain-dominated limestones have similar porosity ranges and that the decrease in porosity with increasing dolomitization results from compaction of the mud-dominated fabrics. These data suggest that porosity in dolostone is not created by a mole-for-mole replacement mechanism. Instead, dolostone porosity is: (1) inherited from the precursor limestone; and (2) occluded by the process of overdolomitization. Palaeozoic dolostones, however, are commonly more porous than juxtaposed limestones. The explanation for this observation is that limestones lose porosity through compaction and cementation, whereas dolostones resist compaction and retain much of their porosity. Permeability studies have demonstrated that dolomitization of grain-dominated limestones usually does not change porosity-permeability relationships. Instead, precursor limestone fabric controls pore-size distribution. The dolomite crystal size of a muddominated dolostone may, however, be larger than the carbonate mud size, improving the porosity-permeability relationship substantially. Hence, there is a predictable relationship between interparticle (grains or crystals) porosity, permeability, precursor grain size and dolomite crystal size.


Abstract The high price of some cancer drugs has recently come under attack by the medical profession. We examine the reasons behind the pricing strategies of cancer drugs. On the one hand, prices should reflect value and research demonstrates that the health benefits from novel cancer drugs have been enormous in terms of additional years of life patients can now enjoy. This provides some justification for the high price tag of these drugs. On the other hand, drug pricing is also a product of a hidebound reimbursement system that does a poor job in letting prices adjust to new information about value. Regulators set thresholds for cost-effectiveness, which establishes not only a price ceiling but also a price floor. Manufacturers often price drugs high at launch in efforts to recoup their initial investment, but a more efficient system would allow prices to both rise and fall over time. Removing distortions in the reimbursement system is crucial to ensuring continued success in saving lives.


In patients with cerebrovascular pathology, the interrelation between the cerebral hemodynamic parameters (determined by the method of rheoencephalography) and memory for current events (determined by special physiological tests) were examined. The data obtained showed that the deterioration of the memory for current events depended not so much on the poorer vascular elasticity, as on a diminution of their blood content, i. e. on brain blood supply deterioration. A direct relationship between the degree of this deterioration and the cerebrovascular insufficiency caused by it, on the one hand, and the degree of the memory deterioration, on the other, was observed. These findings explain to a certain degree the observed disagreement between the pathomorphological changes of the cerebral vessels and the psychopathological impairments (degree of dementia) in patients with cerebrovascular pathology. They underline the diagnostic importance of rheoencephalography and open further prospects in evaluation of brain functions on the basis of rheoencephalographic findings.


The Adolescent Discouragement Indicator (ADI) was developed to assess the Adlerian construct of discouragement. The 75-item ADI contains five subscales corresponding to the five life tasks specified in Individual Psychology and is specifically designed to pinpoint the area and degree of adolescent discouragement. Item selection was based on ratings by five prominent Adlerians and item correlation with subscale scores.
Age and sex norms for the ADI were established on 225 females and 299 males 12 to 18 years of age. Findings indicate that female adolescents are less discouraged than male adolescents on all scales except the love scale and both sexes reported the least amount of discouragment on the love scale. The only significant difference among the age groups is between the 13-year-olds and the 15, 16, and 17-year-olds on the love scale.
An internal consistency coefficient of .95, a 2-week test-retest coefficient of .89, and a 4-week test-retest coefficient of .92 indicates that the ADI is a reliable instrument. Negative and significant (p < .001) correlations between the ADI and Social Interest Index (Greever, Tseng, & Friedland, 1973) and between the ADI and the Social Interest Scale (Crandall, 1975) contribute to construct validity and support Adler's belief that discouragement and social interest are inversely related. Results of behavioral and academic comparisons on a sample of adolescent males (N=57) seem to indicate a link between behavior, academic performance, and levels of discouragement.
Results of factor analysis and interscale correlations are presented. Implications for further research include continued validation using behavioral criteria associated with discouragement, refinement of the subscales and establishment of score ranges to indicate when an adolescent is considered discouraged.


Dear Editor, The persistent pupillary membrane (PPM) is a remnant of the tunica vasculosa lentis, which provides blood supply for fetal crystalline lens development. During normal fetal development, the tunica vasculosa lentis undergoes involution and disappears between the 8th and 9th gestational months. The PPM develops due to incomplete atrophy of the fetal pupillary membrane [1]. Rarely, if a thick PPM covers the visual axis, administration of topical atropine or surgical intervention is required to prevent the progression of amblyopia and improve visual acuity [1]. Previous studies have reported on the surgical excision of a remnant membrane with cataract surgery or neodymium-doped yttrium aluminum garnet (Nd-YAG) laser lysis of the PPM before phacoemulsification [2,3]. Femtosecond laser-assisted cataract surgery (FLACS), which includes three main steps (corneal arcuate incision, anterior capsulotomy, and lens fragmentation), is an advanced technology that increases the accuracy and reduces the complications compared to conventional cataract surgery [4]. The advantages of FLACS include astigmatism correction, increased stability of the implanted intraocular lens with reproducibility and accuracy of capsulotomy, and reduced use of ultrasound [4]. Capsulotomy performed using the femtosecond laser can excise the PPM, reduce the risk of intraoperative bleeding, and help ensure visibility of the surgical field [5]. Here, we report a case in which a cataract in an eye with a PPM was treated by FLACS. Written informed consent for publication of this case and clinical images was obtained from the patient. A 61-year-old female patient presented to the ophthalmology department of Severance Hospital with bilateral decreased visual acuity and visual discomfort. She had diabetes mellitus but had no history of ocular trauma or operation and no familial ocular disease. Her preoperative corrected distant visual acuity (CDVA) was 0.3 (decimal) with autorefraction -3.00 diopters (D) -1.50 D × 138° in the right eye and 0.7 (decimal) with +2.25 D -0.75 D × 84° in the left eye. The intraocular pressure was 17 and 18mmHg in the right and left eyes, respectively, using a noncontact tonometer. On slit-lamp examination, we observed cataracts with nuclear opacity grade 3 by Lens Opacities Classification System III classification in her both eyes and PPM in her right eye. The pupillary threads were superotemporally connected to the other parts of the iris and attached to the anterior lens capsule (Fig. 1A). Although the PPM did not completely cover the pupil, it was suspected to adversely affect her visual acuity with the cataract in the right eye. The patient was scheduled to undergo FLACS in both eyes, with an interval of 1 week between the left and right eye. We used a LenSx femtosecond laser system (Alcon, Aliso Viejo, CA, USA). Most of the PPM strands were disconnected during the anterior capsulotomy step using the femtosecond laser (Fig. 1B, 1C). However, anterior capsulotomy was suspected to be incomplete on the side of the thick strands. The capsulotomy was completed by holding the edge of the anterior capsule using capsulorhexis forceps and pulling it carefully toward the center of the lens. The cut PPM and anterior capsule were successfully removed together, and the remaining surgical procedures were completed without any problems. The postoperative follow-up showed a perfectly round pupil with removed PPM and an adequately positioned intraocular lens in the bag (Fig. 1D). The patient revealed a stable course without complications like intraocular pressure elevation, infection, and macular edema. At the 1-month postoperative follow-up, her CDVA was 1.0 (decimal) in both eyes with manifest refraction -0.25 D × 90° in the right eye and -0.50 D in the left eye, respectively. This case shows that PPM can be removed concurrently with cataract surgery using a femtosecond laser, without Korean J Ophthalmol 2022;36(5):474-475 https://doi.org/10.3341/kjo.2022.0046


Formation of the platelet plug represents a primary response to the vessel wall injury, but may also result in vessel occlusion. The decrease of the local blood flow due to platelet thrombus formation may lead to serious complications, such as ischemic stroke and myocardial infarction. However, mechanisms responsible for regulation of thrombus dynamics are not clear. In order to get a deeper insight into the role of blood flow and platelet interactions in the formation of the primary platelet plug we developed a particle-based model of microvascular thrombosis using quasisteady flow approximation. In order to simulate thrombus dynamics at physiologically relevant timescales of several minutes, we took advantage of the supercomputer technologies. Our in silico analysis revealed the importance of platelet size heterogeneity for describing experimental data on microvascular thrombus formation. Thus, our model represents a useful tool for the supercomputeraided computational analysis of thrombus dynamics in the microvessels on physiologically relevant timescales.


The objective of this study is to establish a framework for analyzing infrastructure dynamics affecting the long-term steady state, and hence resilience in civil infrastructure systems. To this end, a multi-agent simulation model was created to capture important phenomena affecting the dynamics of coupled human-infrastructure systems and model the long-term performance regimes of infrastructure. The proposed framework captures the following three factors that shape the dynamics of coupled human-infrastructure systems: (i) engineered physical infrastructure; (ii) human actors; and (iii) chronic and acute stressors. A complex system approach was adopted to examine the long-term resilience of infrastructure based on the understanding of performance regimes, as well as tipping points at which shifts in the performance regime of infrastructure occur under the impact of external stressors and/or change in internal dynamics. The application of the proposed framework is demonstrated in a case of urban water distribution infrastructure using the data from a numerical case study network. The developed multi-agent simulation model was then used in examining the system resilience over a 100-year horizon under stressors such as population change and funding constraints. The results identified the effects of internal dynamics and external stressors on the resilience landscape of infrastructure systems. Furthermore, the results also showed the capability of the framework in capturing and simulating the underlying mechanisms affecting human-infrastructure dynamics, as well as long-term regime shifts and tipping point behaviors. Therefore, the integrated framework proposed in this paper enables building complex system-based theories for a more advanced understanding of civil infrastructure resilience.


This methodological article reflects on the contribution audio diaries can make to accessing important, and commonly silenced, dimensions of the lived experience of growing up with HIV and their acceptability to children. Audio diaries were used by 12 young people, aged 11 to 13 years, as part of a longitudinal qualitative study embedded within the Anti-Retroviral Research for Watoto (ARROW) clinical trial. The method provided an alternative means for young people to express detailed reflections on their day-to-day encounters, as well as ordinarily silenced topics, including hidden and suppressed emotions regarding the circumstance surrounding their perinatal infection. Although the audio diary has great potential as method, its efficacy rests on young people's understanding of how to use it. There are ethical challenges around maintaining confidentiality while participants are in possession of the diaries and provision of appropriate support. The technology used in the study was in many ways cumbersome compared with opportunities increasingly available.


Abstract Objective: To analyze endostatin serum level and VEGF-C serum level as predictors of lymph nodes metastasis and lymph nodes metastasis in early stadium of cervical cancers. Method: This research was done in Oncology Division, Department of Obstetrics and Gynecology Faculty of Medicine University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta. The design of this research was nested case control and consecutive sampling. The subjects were all of the early stadium cervical cancer patients in Oncology clinic, Dr. Cipto Mangunkusumo hospital that had qualified according to inclusion criteria and exclusion criteria. The bloods were taken, the serums were separated, VEGF-C serums were examined by ELISA method, and endostatin serums were examined by Immunoassay method. Patients went through radical hysterectomy surgeries, and then pathology anatomy examinations. Result: The samples were 47 patient, consisted of 33 patients (70.21%) without lymph nodes metastasis and 14 patients (29.79%) with lymph nodes metastasis. By using ROC cut off point method, the obtained cut off point of VEGF-C level was 10,066.9 pg/ml,with sensitivity 78.57%, and specificity 96.97%. It was obtained the increasing risk of lymph nodes metastasis in patients with VEGF-C level > 10,066.9 pg/ml compare to patients with VEGF-C level ≤ 10,066.9 pg/ml, with OR 80, 95% CI (7.99; 800.71), and p < 0.001. Based on cut off point, 184.5ng/ml, with sensitivity 64.3%, and specificity 63.4%, the endostatin level was divided into two groups, which were the < 184.5ng/ml group and the ≥ 184.5ng/ml group. Patients in ≥ 184.5 ng/ml group had the risk of lymph nodes metastasis 3.15 times more compare to patients in <184.5 ng/ml group, but not statistically significant (p=0.075, 95% CI (0.856;11.595)). Conclusion: VEGF-C serum levels can be used as prognosis factor or predictor of lymph node metastasis in early stage cervical cancer patients. Endostatin serum levels as the predictor of lymph node metastasis still need further research by adding sample quantity. [Indones J Obstet Gynecol 2011; 35-4:225-9] Keywords: endostatin, VEGF-C, lymph node metastasis, cervical cancer


Suitable cylinder charge preparation is deemed critical for the attainment of a highly homogeneous, diluted, and lean cylinder charge which is shown to lower the flame temperature. The resultant low temperature combustion (LTC) can simultaneously reduce the NOx and soot emissions from diesel engines. This requires sophisticated coordination of multiple control systems for controlling the intake boost, exhaust gas recirculation (EGR), and fueling events. Additionally, the cylinder charge modulation becomes more complicated in the novel combustion concepts that apply port injection of low reactivity alcohol fuels to replace the diesel fuel partially or entirely. In this work, experiments have been conducted on a single cylinder research engine with diesel and ethanol fuels. The test platform is capable of independently controlling the intake boost, EGR rates, and fuelling events. Effects of these control variables are evaluated with diesel direct injection and a combination of diesel direct injection and ethanol port injection. Data analyses are performed to establish the control requirements for stable operation at different engine load levels with the use of one or two fuels. The sensitivity of the combustion modes is thereby analyzed with regard to the boost, EGR, fuel types and fueling strategies. Zero-dimensional cycle simulations have been conducted in parallel with the experiments to evaluate the operating requirements and operation zones of the LTC combustion modes. Correlations are generated between air-fuel ratio (λ), EGR rate, boost level, in-cylinder oxygen concentration and load level using the experimental data and simulation results. Development of a real-time boost-EGR set-point determination to sustain the LTC mode at the varying engine load levels and fueling strategies is proposed.Copyright © 2013 by ASME


Agrichemical users face increasing pressures to adhere to, and document, safe and responsible use practices. Many requirements are set by the Resource Management (RMA) and Hazardous Substances and New Organisms (HSNO) legislation. Additional use and user requirements are dictated by market expectations for residues and adherence to different GAP programmes. Widespread adoption of industry relevant user training programmes is arguably the most effective way to achieve safe and effective agrichemical use in New Zealand. RMA requirements under all Regional Plans in the country require some level of agrichemical user training, with HSNO legislation requiring separate approved handler (AH) certification for at least one person on most properties. With over 50,000 farms and horticultural properties in NZ, the estimated agrichemical user trainee population is well over 100,000 people. GROWSAFE and AH certificate numbers from 2004-09 after the 2004 enactment of the HSNO legislation for agrichemicals averaged 9,900 per annum. These certificates are required to be renewed every 5 years, but average trainee numbers from 2008-12 dropped to only 4,950 per annum. Training requirements and outcome expectations are reviewed in light of these declining trainee numbers and a new, industry-focussed, training initiative is described.


Cellular genome is considered a dynamic blueprint of a cell since it encodes genetic information that gets temporally altered due to various endogenous and exogenous insults. Largely, the extent of genomic dynamicity is controlled by the trade-off between DNA repair processes and the genotoxic potential of the causative agent (genotoxins or potential carcinogens). A subset of genotoxins form DNA adducts by covalently binding to the cellular DNA, triggering structural or functional changes that lead to significant alterations in cellular processes via genetic (e.g., mutations) or non-genetic (e.g., epigenome) routes. Identification, quantification, and characterization of DNA adducts are indispensable for their comprehensive understanding and could expedite the ongoing efforts in predicting carcinogenicity and their mode of action. In this review, we elaborate on using Artificial Intelligence (AI)-based modeling in adducts biology and present multiple computational strategies to gain advancements in decoding DNA adducts. The proposed AI-based strategies encompass predictive modeling for adduct formation via metabolic activation, novel adducts' identification, prediction of biochemical routes for adduct formation, adducts' half-life predictions within biological ecosystems, and, establishing methods to predict the link between adducts chemistry and its location within the genomic DNA. In summary, we discuss some futuristic AI-based approaches in DNA adduct biology.


Currently, radiotherapy with electrons and photons beams is the most common approach in health care facilities; it allows widespread use of technology. Only a fast and accurate verification of the dose characteristics of the beams provides a safe and effective use of the methodology. We have designed, built and tested a new instrument based on a layer of square scintillating fibers of 0.5 mm thickness that can run a scan of the beam. The system provides the dosage profiles, related to a plane orthogonal to the beam axis at a fixed depth. The device was tested with a photon beam of 6 MV delivered by a linear accelerator Varian Clinac DHX 2100. The data collected were processed for the tomographic reconstruction of the dose by means of the FBP (filtered back projection) algorithm with different filters. An iterative reconstruction algorithm was also tested. In this paper, the results are presented and suggestions for future developments are made.


While early ideas surrounding the influence of the Internet on political participation and communication were often overtly optimistic, comparably recent years have seen the rise of online hate speech and similar issues gaining influence in a variety of online spheres. The study presented here seeks to detail the impact of positive ('thumbs-up') and negative ('thumbs-down') feedback on the popularity of politically themed YouTube videos, uploaded during the 2017 Norwegian parliamentary election. Given the apparent dearth of studies on YouTube in this regard, the insights provided here furthers our understanding regarding the drivers of online popularity during election campaigns. Specifically, results indicate that while commenting on uploaded videos appear as related to the 'thumbs-up' variety, video view count appear as more clearly related to the dismissive 'thumbs-down' feedback option. Discussing these results, the final section of the paper also provides a few suggestions for future research efforts in this vein.


Polymers are multiscale systems by construction. They are formed by several monomeric units connected by covalent bonds whose chemical nature defines the rigidity of the chain. The interconnection between the monomeric units determines the interdependence of the motion of the different chain segments and the intrinsic multiscale nature of polymeric materials. This characteristic is reflected on the different modeling techniques that can be used to simulate polymeric materials. Because of the large conformational space that needs to be sampled when simulating polymers, coarse‐grained (CG) models are commonly used and depending on which part of the system free energy (enthalpy, entropy, or both) is relevant for the properties of interest, the appropriate modeling techniques should be used. Each model is characterized by advantages and limitations that can have a great impact on the quality of the results obtained. In this overview, we address some of the more common CG techniques presented in the literature for the modeling of polymeric materials at different length scales. WIREs Comput Mol Sci 2014, 4:62–70. doi: 10.1002/wcms.1149


The hippocampal region has long been considered critical for memory of time, and recent evidence shows that network operations and single-unit activity in the hippocampus and medial entorhinal cortex (MEC) correlate with elapsed time. However, whether MEC activity is necessary for timing remains largely unknown. Here we expressed DREADDs (designer receptors exclusively activated by designer drugs) under the CaMKIIa promoter to preferentially target MEC excitatory neurons for chemogenetic silencing, while freely moving male rats reproduced a memorized time interval by waiting inside a region of interest. We found that such silencing impaired the reproduction of the memorized interval and led to an overestimation of elapsed time. Trial history analyses under this condition revealed a reduced influence of previous trials on current waiting times, suggesting an impairment in maintaining temporal memories across trials. Moreover, using GLM (logistic regression), we show that decoding behavioral performance from preceding waiting times was significantly compromised when MEC was silenced. In addition to revealing an important role of MEC excitatory neurons for timing behavior, our results raise the possibility that these neurons contribute to such behavior by holding temporal information across trials. SIGNIFICANCE STATEMENT Medial temporal lobe (MTL) structures are implicated in processing temporal information. However, little is known about the role MTL structures, such as the hippocampus and the entorhinal cortex, play in perceiving or reproducing temporal intervals. By chemogenetically silencing medial entorhinal cortex (MEC) excitatory activity during a timing task, we show that this structure is necessary for the accurate reproduction of temporal intervals. Furthermore, trial history analyses suggest that silencing MEC disrupts memory mechanisms during timing. Together, these results suggest that MEC is necessary for timing behavior, possibly by representing the target interval in memory.


Author(s): Loerinc, Amanda Gloria | Advisor(s): Craske, Michelle G | Abstract: Anxiety disorders and depression are among the most prevalent mental disorders with close to one third of the population meeting diagnostic criteria at some point during their lifetimes (Kessler et al., 2005; 2012). Cognitive and behavioral therapies (CBT) are considered to be the most efficacious and empirically supported psychosocial interventions for anxiety and depression (Hofmann a Smits, 2008; Norton a Price, 2007; Tolin, 2010). While research indicates CBT to be superior to several other treatments, placebos, and waitlist controls, there is evidence that not every individual benefits from CBT and response rates hover around 50% at post-treatment (Loerinc et al., 2015). There are also several barriers to evidence-based outpatient treatment for anxiety and depression including cost effectiveness, adherence to the CBT model, and clinical attitudes about delivering evidence-based treatments (Addis, 2002; Barlow, 2004; Barlow et al., 1999; Chorpita a Nakamura, 2004). To address the barriers, researchers have begun developing self-guided or internet-based delivery of CBT. Research indicates no differences in effectiveness between self-guided CBT and traditional face-to-face CBT (Cuijpers et al., 2010; Hedman et al., 2012). Additionally, reliance upon the DSM for clinical decision-making does not appropriately align with neuroscience or genetics (Insel et al., 2010) and recent research suggests that anxiety disorders and depression share common higher-order constructs (Brown, 2007). The Research Domain Criteria (RDoC) is an initiative designed to address these limitations (Insel et al., 2010). Thus, using the principals of RDoC, this study sought to examine the effectiveness of a self-guided approach to the treatment of deficits in reward sensitivity using a positive affect protocol. Participants who self-referred for treatment and met criteria for Depression (CSR g4) on the SCID 5 (First et al., 1994) were recruited for the study. Utilizing a multiple baseline experimental design, participants were randomized to a 2, 4, or 6-week baseline prior to treatment administration to test the effects of the positive affect intervention on symptoms of depression and anxiety. The 15-session intervention included pleasant events scheduling, attending to the positive, and cultivating positive emotions. The daily measures largely did not reflect that symptoms remained stable during the baseline phase and reduced during the intervention period. We did find, however, that symptoms of depression and anxiety decreased overall on pre/post measures of depression and anxiety symptoms. Additionally, diagnosis severity of depression decreased for all participants on the SCID 5.


Flow pattern and pressure drop in highly concentrated slurries transportation pipelines were discussed. The particles are settling, and tend to settle down to the bottom of pipes due to the action of gravity force forming different flow patterns which can be indicated by particle concentration profile. Three distinct flow patterns can be observed for different particle size distribution at different velocities: fully stratified, partially stratified and fully suspended flow patterns. As for pressure drop, it is well known that pressure drops in pipeline flows of slurries are strongly dependent on the flow pattern developed in a pipeline. Furthermore, fine particles suspended in water make the water more viscous, and increase the friction. In case of coarse particles, having larger volume, they have the tendency to contact with the pipe wall and with the other coarse particles more times, which increase the friction of flow. Meanwhile, coarse particles are lifted by the pressure difference generated as they rotate in the liquid preventing the coarse particles from settling down which results in less friction. The mixture of particles of different sizes is helpful to reduce pressure drop in pipeline flow slurries. Narrow grading particles tend to have high frictional losses, while broad grading particles have low frictional losses at high concentrations.


Background: Some types of sexually transmitted infection (STI) have higher prevalence in females than males, and among black, relative to white, females. Identifying mechanisms of STI risk is critical to effective intervention. The authors tested a model in which alcohol and marijuana use serve as mediating factors in the associations between depression and conduct problems with sexual risk behavior (SRB) and STI in adolescent females. Methods: The Pittsburgh Girls Study is a longitudinal observational study of females who have been followed annually to track the course of mental and physical health conditions. The 3 oldest cohorts (N = 1750; 56.8% black, 43.2% white) provided self-reports of substance use, depression and conduct problems, SRB, and STI at ages 16–18. A path model tested alcohol and marijuana use at age 17 as mechanisms that mediate the associations of depression and conduct problems at age 16 with SRB and STI at age 18. Results: Race was involved in 2 risk pathways. In one pathway, white females reported greater alcohol use, which was associated with greater SRB. In another pathway, black females reported earlier sexual onset, which was associated with subsequent SRB. Public assistance use was independently associated with early sexual onset and STI. SRB, but not substance use, mediated the association of depression and conduct problems with STI. Conclusions: Differences by race in pathways of risk for SRB and STI, involving, for example, alcohol use and early sexual onset, were identified for young white and black females, respectively. Depression and conduct problems may signal risk for SRB and STI in young females, and warrant attention to improve health outcomes.


This paper presents the different characteristics of Ozone Friendly Hydro fluorocarbon refrigerants (HFCs) group refrigerant i.e. R32 and R410A in vapour compression refrigeration system. The performance parameters were simulated with available experimental data of R22 and R410A (near azeotrope) mixture refrigerant with 1.565 'TR' (Ton of Refrigeration) capacity, by using REFPROP and cool pack simulation tool. For simulation the evaporator operating temperatures from -10°C to +10°C and condenser temperature from 35 °C to 60°C was considered. With compare to R22 and R410A refrigerants, the refrigerant R32 yield better Coefficient of Performance at higher ambient temperatures.R32 is emerging in the refrigeration market because of its better energy efficiency and environmental friendly refrigerant. The atmospheric life for R22 is 15 years and for R32 is 4.9 years hence R32 has been accepted as safety group refrigerant under the class A2L ASHARE standers.


The Virtual Facebow has been developed as an open-source tablet app that provides an alternative to the conventional facebow for the mounting of casts to an articulator. The Virtual Facebow implements several design features to prevent and minimize errors, provide accurate mounting and reinforce the anatomical considerations associated with articulators. The Virtual Facebow is an effective, efficient and accessible digital companion to dental implant diagnoses and treatment planning.


The origin and evolution of venom proteins in helodermatid lizards were investigated by multidisciplinary techniques. Our analyses elucidated novel toxin types resultant from three unique domain-expression processes: 1) The first full-length sequences of lethal toxin isoforms (helofensins) revealed this toxin type to be constructed by an ancestral monodomain, monoproduct gene (beta-defensin) that underwent three tandem domain duplications to encode a tetradomain, monoproduct with a possible novel protein fold; 2) an ancestral monodomain gene (encoding a natriuretic peptide) was medially extended to become a pentadomain, pentaproduct through the additional encoding of four tandemly repeated proline-rich peptides (helokinestatins), with the five discrete peptides liberated from each other by posttranslational proteolysis; and 3) an ancestral multidomain, multiproduct gene belonging to the vasoactive intestinal peptide (VIP)/glucagon family being mutated to encode for a monodomain, monoproduct (exendins) followed by duplication and diversification into two variant classes (exendins 1 and 2 and exendins 3 and 4). Bioactivity characterization of exendin and helokinestatin elucidated variable cardioactivity between isoforms within each class. These results highlight the importance of utilizing evolutionary-based search strategies for biodiscovery and the virtually unexplored potential of lizard venoms in drug design and discovery.


This chapter draws upon data collected over several research trips to Cuba undertaken between 2013 and 2017, that evidences how the concept of Corporate Social Responsibility (CSR) is understood there. Firstly, some background on Cuba is provided, describing the island nation's economic journey from the status of a free enterprise oriented US 'neo-colony' in the first half of the 20th century, through several decades of strong Soviet inspired state control after the 1959 revolution, before gradually adopting what has been termed a 'market socialist' model since Raul Castro formally took over from Fidel Castro as President in 2007. The chapter then presents a snapshot of the fledgling state of CSR in Cuba as understood and practised in newly licensed private small and medium-sized enterprises and state-business partnerships. The kinds of practices that are seen as belonging under the CSR umbrella are compared. The chapter acknowledges the unique political and economic conditions in Cuba and the problems that arise in applying concepts, measures and definitions which have been formulated in the context of Western economies. The chapter therefore provides an insight into how CSR is constructed in a country that has adopted cultural norms of solidarity and collectivist ethics. This is contrasted with the way the concept is understood and operationalized in liberal capitalist countries with paradigmatically 'neoliberal' and individualist values, where the norm of self-interest prevails in economic discourse. Finally, we argue that this case study of CSR in a highly regulated economy offers a valuable input to the on-going debate over the merits and demerits of strong state regulation in terms of achieving socially and environmentally responsible business practices.


We present a result of a search for supersymmetry in final states with missing transverse energy and b-tagged jets. This search is performed with data collected by the CMS experiment at the LHC in pp-collisions at a center-of-mass energy of 7 TeV. Data-driven techniques used to mea-sure the Standard Model background are demonstrated. The result is in-terpreted in terms of the constrained Minimal Supersymmetric Standard Model and compared to a similar search without any b-tag requirement.


Vietnam is one of countries with the highest number of smokers in the world and the high smoking prevalence among men in the region. Although the real cigarette prices increased by around 4% during the 2010–2015 period, the prevalence of daily cigarette smoking among men decreased slightly from 31.3% to 30.7% during this period. This raises the question of whether cigarette consumption is sensitive to price. In this study, we estimated the effect of cigarette prices on smoking participation and tobacco expenditure in Vietnam. We found that a one-percent increase in the real cigarette price reduced the probability of cigarette smoking among males by 0.08 percentage points (95% CI from -0.06 to -0.10), equivalent to the price elasticity of the smoking prevalence at -0.26 (95% CI from -0.16% to -0.33%). Using this estimate, we predict that if the cigarette price is increased by 10%, the daily cigarette smoking prevalence among men would decrease from 30.7% to 29.9% and the number of male smokers would decline by around 270 thousand. Higher cigarette prices also reduced per capita tobacco expenditure of households. A one-percent increase in the cigarette price decreased per capita expenditure on tobacco consumption expenditure of households by 0.43 percent (the 95% CI from -0.029 to 0.822). This finding suggests that raising tobacco taxes and prices can be an effective measure to reduce tobacco use.


The basic principles of building an educational system of students engaged in yachting are considered; reveals the increasing role of students in yachting in the system of maritime vocational education and the lack of development of their practical organizations; analysis of the need for modern society in students with highly developed professional qualities and insufficient use of educational opportunities for yachting; shows the need to develop the professional qualities of students and the insufficiently developed scientific and methodological support of the basics of practical yachting.


Sorption and fixation of Cs by the upland soils of the US Department of Energy's Savannah River Site (SRS) have been attributed to micaceous grains consisting mostly of hydroxy-interlayered vermiculite (HIV). Results of experiments to characterize SRS soil samples, to examine aspects of their radiocesium sorption, and to determine how much of their natural Cs is accessible for chemical extraction and isotope dilution are presented in support of mechanistic hypotheses to explain Cs sorption and fixation in HIV grains. The HIV is responsible for most of the soil cation exchange capacity, and concentrations of naturally occurring Cs, Rb, and K in soil samples are closely related to the concentration of HIV. Experiments with 137Cs to examine (1) sorption kinetics, (2) blocking of exchange sites with silver thiourea, and (3) susceptibility of sorbed 137Cs to chemical extraction, support the idea that added Cs is sorbed at different kinds of cation exchange sites in HIV grains. Sites highly selective for Cs but relatively few in number are inferred to exist in interlayer wedge zones within such grains. Little of the naturally occurring Cs in the soil samples was extractable by chemical agents that would remove Cs from ordinary cation-exchange sites and from within non-silicate soil components. Furthermore, most of the natural Cs was inaccessible for isotope dilution under slightly acidic conditions approximating the natural soil environment. These observations support the idea that most of the Cs in these soils has become effectively fixed in the narrower parts of interlayer wedge zones. Control of Cs uptake and fixation by highly Csselective interlayer wedge sites would account for the large distribution coefficients found for 137Cs at the low aqueous Cs concentrations typical of environmental systems and also for the relatively large concentrations of stable Cs in the SRS soils.


Communication networks have increased dramatically in size and complexity. As communication networks become larger and more complex, the need for advanced fault management system has increased. A single fault in a large communication network may result in a large number of fault indications making the isolation of the fault source a difficult task. In this paper, we propose an efficient alarm correlation and fault identification scheme based on OSI managed object classes to isolate the fault source quickly. Our algorithm uses managed object class dependency graphs. These graphs are more practical than other object instance basis graphs in the previous literatures, since the size of them are small and they remain unchanged even after the creation and deletion of real active object instances. It is shown that our algorithm is much simpler to implement.


Hydrophobic prolamins are endosperm storage proteins accounting for about 40% of the total protein in most cereal seeds. Despite the absence of a reference method, several procedures have been periodically published to quantify prolamins in cereals. The aim of this study was to compare a conventional fractionation assay (LND) vs three other methods: one based on sequential extractions (HAM) and two rapid turbidimetric procedures (L&H and DRO). Prolamins were extracted in duplicate on barley, corn and wheat samples. For the turbidimetric prolamin evaluation in barley and wheat, a universally available purified gliadin, as alternative to purified zein, was also tested as standard reference material (SRM). The extraction prolamin values were different among grain types (P<0.01) and methods (P<0.01) without interaction (P>0.05). LND agreed sufficiently well both with HAM and with L&H methods (R2=0.664 and R2=0.703, respectively, P<0.01). On all tested cereals, LND and L&H gave similar prolamin extraction values (P>0.05), whereas a higher prolamin quantification was obtained using HAM (P<0.05). Overall, DRO did not provide similar comparison and performance parameters with respect to other method comparisons. The effect of changing purified zein with purified gliadin was noteworthy only for L&H, both for wheat and barley samples (P<0.01). Considering the increasing attention of animal nutritionists on prolamins, our results could get useful information for routine laboratory analysis.


In this paper we report on 3D Monte Carlo device simulation of silicon nanowire MOSFETs including quantum mechanical and strain effects. The newly developed simulator solves self-consistently in 1D, 2D or 3D the Schrodinger Eq. for the quantum mechanical correction of the potential, while mechanical strain effects are accounted for by an appropriate change of the band structure. The simulation program has been then applied to the simulation of silicon nanowire MOSFETs achieving a good agreement with experimental data, demonstrating the feasibility of 3D semi-classical Monte Carlo simulation with quantum mechanical correction for very advanced devices


Vaccination has led to remarkable health gains over the last century. However, large coverage gaps remain, which will require significant financial resources and political will to address. In recent years, a compelling line of inquiry has established the economic benefits of health, at both the individual and aggregate levels. Most existing economic evaluations of particular health interventions fail to account for this new research, leading to potentially sizable undervaluation of those interventions. In line with this new research, we set forth a framework for conceptualizing the full benefits of vaccination, including avoided medical care costs, outcome-related productivity gains, behavior-related productivity gains, community health externalities, community economic externalities, and the value of risk reduction and pure health gains. We also review literature highlighting the magnitude of these sources of benefit for different vaccinations. Finally, we outline the steps that need to be taken to implement a broad-approach economic evaluation and discuss the implications of this work for research, policy, and resource allocation for vaccine development and delivery.


Aiming at the measurement of cement rotary kiln's axis, the paper presents the design method of a wireless dynamic measurement system for rotary kiln's axis. A wireless sensor network monitoring system that can collect multiple parameters was designed, which integrates the detection functions for kiln shell axis deviation, kiln tire axis deviation and drive gear synchronizing signal, and has the advantages of wireless transmission, low power consumption, and easy to install. ZigBee tree network was developed, which is beneficial to expand the capacity of wireless network, improve the efficiency of data transmission, reduce the cost, and shorten the development cycle. The sever measurement software was designed, which has the functions of data wireless acquisition and analysis for rotary kiln axis. The related prototypes of the monitoring device were developed, which verified the effectiveness of the system on the cement rotary kiln.


The habitat use by stream fish can provide an understanding of this important component of species niches, and the changes in the availability of certain structures of instream habitats have a strong influence on the occurrence and abundance of fish species. In this study, we identified the interaction networks between fish and microhabitats in 19 streams of three watersheds from the Brazilian savanna, known as the "Cerrado". We also investigated whether the connectance between fish species and microhabitats depends on either the species abundance or availability of microhabitats and verified whether the use of stream microhabitats vary among watersheds. The data for the fish were obtained using standardized fish collections and underwater (snorkeling) observations to record the association of fish species with 11 stream microhabitats. We used the incidence data to calculate the connectance of species with different microhabitats, a Spearman correlation analysis to test the dependence of the connectance to the species abundance and microhabitat availability, and an Analysis of Similarity to test whether the use of stream microhabitats by fish can vary among watersheds. In all of the watersheds, the tetras of the family Characidae used the largest number of microhabitats. The most-used microhabitats by the fish watersheds were the lateral surface, column surface, and unconsolidated substrate, which were differentially used by the fish in each watershed, indicating the variable importance of microhabitats. Despite this observation, the fish occurred more frequently in the lateral microhabitats. When the data for all of the streams were combined, the species connectance was correlated with the species abundance. We also discuss the consequences of the elimination of certain bottom structures in the context of siltation, which is the main issue in the studied region. The results of our study allowed the detection of key microhabitat structures and can be used for the aquatic ecosystems restoration. (© 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim)


BACKGROUND Malignant bowel obstruction (MBO) is a condition secondary to intra-abdominal metastatic spread of advanced-stage tumors. There is no consensus for the treatment approach of MBO. This study aims to present the results of medical treatment and palliative surgery in patients diagnosed with MBO. METHODS The patients who were treated for advanced-stage tumors between 2010 and 2017 and for whom consultation was requested from the surgical clinic for MBO symptoms were identified. A selective approach together with palliative care for the indication of surgery was instituted. The patients with surgical treatment and medical treatment were compared concerning survival, oral food intake and symptom relief. RESULTS Seventy-six patients (30 female, 46 male) aged 60.5±12.8 years (range: 27-88) were included in this study. Forty-eight of the patients (64.9%) underwent surgical treatment, while 28 (35.1%) had medical treatment. Although the patients with surgery had longer duration of stay in the hospital (median 16 days vs. 4 days) (p<0.001) and higher complication rates (27.1% vs. 3.5%) compared to medically treated patients; the restoring oral food intake was better (97.9% vs. 78.6%) (p=0.005) and the survival was longer (105 days vs. 43 days). CONCLUSION This study revealed that surgical treatment resulted in better outcomes for life quality parameters in highly selected patients with malignant bowel obstruction evaluated by multidisciplinary team, including palliative care.


The estimation of demographic target groups for web videos -- with applications in ad targeting -- poses a challenging problem, as the textual description and view statistics available for many clips is extremely sparse. Therefore, the goal of this paper is to link a clip's popularity across different viewer ages and genders on the one hand with the video content on the other: Employing user comments and user profiles on YouTube, we show that there is a strong correlation between demographic target groups and semantic concepts appearing in the video (like "teenage male" and "skateboarding"). Based on this observation, we suggest two approaches: First, the demographic target group of a clip is predicted automatically via a content-based concept detection. Second, should sufficient view statistics already give a good impression of a video's audience, we show that this information can serve as a valuable additional signal to disambiguate concept detection. Our experimental results on a dataset of 14,000 YouTube clips commented by 1 mio. users show that -- though content-based viewership estimation is a challenging problem -- suitable demographic groups can be suggested by concept detection. Also, a combination with demographic information as an additional signal leads to relative improvements of concept detection accuracy by 47%.


In this study, we developed an enhanced approach for large-scale flood damage and risk assessments that uses 10 characteristics of buildings and the built environment as object-based information to represent exposure and vulnerability to flooding. Most current large-scale assessments use an aggregated land-use category to represent the exposure, treating all exposed elements the same. For large areas where previously only coarse information existed such as in Africa, more detailed exposure data is are becoming available. For our approach, a direct relation between the construction type and building material of the exposed elements is used to develop vulnerability curves. We further present a method to 15 differentiate flood risk in urban and rural areas based on characteristics of the built environment. We applied the model to Ethiopia, and found that rural flood risk accounts for about 22% of simulated damages; rural damages are is generally neglected in the typical land-use-based damage models particularly at this scale. Our approach is particularly interesting for studies in areas where there is a large variation in construction types in the building stock, such as developing countries. It also enables comparison across different natural hazard types that also use material-based vulnerability, paving the way to 20 the enhancement of multi-risk assessments.


The costs for discovering and developing new drugs continue to escalate, with current estimates that the average cost is more than $800 million for each new drug brought to the market. Pharmaceutical companies are under enormous pressure to increase their efficiency for bringing new drugs to the market by third-party payers, shareholders, and their patients, and at the same time regulators are placing increased demands on the industry. To be successful in the future, pharmaceutical companies must change how they discover and develop new drugs. So far, new technologies have done little to increase overall efficiency of the industry and have added additional costs. Platform technologies such as monoclonal antibodies and antisense oligonucleotides have the potential of reducing costs for discovery of new drugs, in that many of the steps required for traditional small molecules can be skipped or streamlined. Additionally the success of identifying a drug candidate is much higher with platform technologies compared to small molecule drugs. This review will highlight some of the efficiencies of antisense oligonucleotide drug discovery compared to traditional drugs and will point out some of the current limitations of the technology.


The aim of this study was to measure cardiovascular and renal function, including the renal transport capacity for glucose, in male and female C57BL/6J mice with diet-induced Type II diabetes mellitus. Typical of Type II diabetes, mice fed a high-fat, high-simple carbohydrate diet for 3 months were obese (45–65 g), hyperglycemic (138–259 mg%), and hyperinsulinemic (1.8–15.06 ng/ml); significant gender differences were observed in all cases. Based on systolic pressure measurements in conscious mice and arterial blood pressure measurements in anesthetized mice, no diet-induced hypertension was observed in either male or female mice. Urine flow rate, sodium, potassium, osmolar, and protein excretion rates were significantly increased (P < 0.05) in male mice fed the high-fat, high-simple carbohydrate diet compared with female mice fed the same diet. However, no differences in the excretion variables existed between male and female mice fed the control diet. The glomerular filtration rate (ml min-1 g kw-1), determined by FITC-inulin, in male and female mice fed the control diet (0.87 ± 0.01 and 0.90 ± 0.1, respectively) and high-fat, high-simple carbohydrate diet (0.96 ± 0.1 and 0.93 ± 0.2, respectively) was not different between the groups. These hyperglycemic mice were also not glucosuric. Infusions of progressive amounts of glucose in male mice fed either diet for 3 or 6 months demonstrated that the renal threshold for glucose was 400 mg% for all these mice, well above the fasting plasma glucose concentrations observed in this study. Thus, C57BL/6J mice were valuable tools for studying diet-induced obesity, hyperglycemia, and hyperinsulinemia; however, no hypertension or kidney dysfunction was apparent within the time frame of the current study.


The authors describe the most relevant aspects of the occurrence, distribution and relative importance of the main diseases of the Pancreas in Portugal, comparing their incidence and mortality rates with other European countries in recent years. The main risk factors associated with pancreatic cancer are referred, stressing the appropriate preventive measures. Hospital management and cost-efficiency analysis of such patients are also estimated.


ABSTRACT The right of persons with disabilities for equal access to education and educational resources is enshrined by international and country-specific anti-discrimination laws. Taking the Ethiopian context as an example, this paper sought to identify barriers of access to educational resources and explored ways for removing them. Seventeen students with visual impairments studying at Hawassa University were selected for semi-structured interviews. Moreover, five individuals working at the disability centre and the university library were interviewed. The results of the interviews were analysed thematically using the International Classification of Functioning, Disabilities and Health (ICF) as a framework. Access and accessibility problems that emanate from the learners' diverse background, lack of educational resources in alternative formats, lack of institutional tools (policy, procedure, guidelines, etc.) to bridge the gap between law and practice, and the digital divide were among the problems identified and discussed. At the end, the paper showed how libraries, revitalised as learning and information commons, could help to ensure the accessibility of educational resources and help learners with disabilities to acquire skills that may help them in their studies and their future undertakings.


This article examines features of spoken German and English complement dass/that-clauses. It focuses on clauses with and without a complementiser, correlative constructions and unintegrated complement clauses, as well as a related English copular construction. Differences between the languages are discussed in terms of the role of the complementiser in relation to word order, assertional vs presuppositional clauses, epistemic main clauses, deixis and discourse function. While German and English have a similar set of possible complement clauses, they are shown to differ in terms of what is typical in spoken language. The article underlines the need to examine spoken language structures in use on their own terms and further confirms that complementation by a finite-clause is not a unitary phenomenon within each language. The analysis is carried out from a usage-based perspective of language which works with the concept of constructions and sees a close relationship between lexis and grammar. The article also has implications for typological work on complementation in spoken language.


The Raman spectra of NiS2-xSex (0<x<2) polycrystalline thin films have been measured for the first time in the whole x range and for NiSe2. The NiSe2 spectrum is qualitatively similar to the spectrum of NiS2, but all frequencies are shifted to lower energies. The shift has been analysed in terms of the increment of the anion mass and the lattice expansion. Peaks in the Raman spectrum of the NiS2-xSex alloy can be assigned to stretching and rotational modes of the S-S, Se-Se and S-Se pairs. The stretching vibration of the S-Se pairs shifts almost linearly from 400 cm-1 for NiS2 to 330 cm-1 for NiSe2. There is an accidental degeneracy between the S-S stretching and Se-Se libration frequencies. The relative Raman intensities fit well with a random occupation of the anion sites by S and Se atoms, and different scattering cross sections.


This paper describes an integrated learning platform intended to support Internet-based control-engineering education. Four environments have been developed, namely, remote experimentation, mathematical analysis, dynamic simulation, and self-learning. The learning platform is a virtual support for problem-based education in control engineering. The reported development allows multiple users the access to concepts and both experimental and computational resources through an intuitive and powerful user interface that only requires a Web browser, a low-bandwidth Internet connection, and low user-side technical specifications. The server side is scalable and reproducible since it is based on general public license (GPL) Linux operating system and a Matlab license. The integration of the proposed theoretical, computational, and experimental tools improves previous experiences in Internet-based control education.


In multiclass classification, the goal is to learn how to predict a random label $Y$, valued in $\mathcal{Y}=\{1,\; \ldots,\; K \}$ with $K\geq 3$, based upon observing a r.v. $X$, taking its values in $\mathbb{R}^q$ with $q\geq 1$ say, by means of a classification rule $g:\mathbb{R}^q\to \mathcal{Y}$ with minimum probability of error $\mathbb{P}\{Y\neq g(X) \}$. However, in a wide variety of situations, the task targeted may be more ambitious, consisting in sorting all the possible label values $y$ that may be assigned to $X$ by decreasing order of the posterior probability $\eta_y(X)=\mathbb{P}\{Y=y \mid X \}$. This article is devoted to the analysis of this statistical learning problem, halfway between multiclass classification and posterior probability estimation (regression) and referred to as label ranking here. We highlight the fact that it can be viewed as a specific variant of ranking median regression (RMR), where, rather than observing a random permutation $\Sigma$ assigned to the input vector $X$ and drawn from a Bradley-Terry-Luce-Plackett model with conditional preference vector $(\eta_1(X),\; \ldots,\; \eta_K(X))$, the sole information available for training a label ranking rule is the label $Y$ ranked on top, namely $\Sigma^{-1}(1)$. Inspired by recent results in RMR, we prove that under appropriate noise conditions, the One-Versus-One (OVO) approach to multiclassification yields, as a by-product, an optimal ranking of the labels with overwhelming probability. Beyond theoretical guarantees, the relevance of the approach to label ranking promoted in this article is supported by experimental results.


An 11-year-old boy presented with a 3-month history of a slow-growing asymptomatic nodule on his back. His adoptive mother reported that the lesion, which was initially thought to be an insect bite, did not respond to treatment with topical steroids or antibiotics. The patient had been adopted from the Ukraine Republic when he was 5 years old. Since the adoption, his medical history had been unremarkable and he was otherwise healthy. Physical examination showed a 3-cm reddish purple nodular lesion surrounded by a whitish halo in the right scapular region (Figure 1). There was no adenopathy or other skin lesions. A cutaneous punch biopsy specimen was obtained from the erythematous portion of the lesion (Figure 2 and Figure 3). What is your diagnosis?