In recent years, the Supreme Court has frequently observed that most statutes involve compromise. In particular, when Congress enacts a clear and precise statutory text--one that articulates not only a set of relevant aims but also the specific means of their pursuit--the Court has assumed that the operative details of such a statute may reflect a (frequently unrecorded) compromise to go so far and no farther in pursuit of its background goals. Accordingly, even when a precise statute seems over- or underinclusive in relation to its ultimate aims (as is often the case), the Court now hews closely to the rules embedded in the enacted text, rather than adjusting that text to make it more consistent with its apparent purposes.One might think that similar principles would apply with equal, if not greater, force to constitutional interpretation. The constitutional lawmaking processes prescribed by Articles V and VII reflect a conscious design to give political (or at least geographical) minorities extraordinary power to block constitutional change. Such political minorities, therefore, also have extraordinary power to insist upon compromise as the price of assent. Although constitutional scholarship tends to emphasize those constitutional texts that are framed in open-ended terms, many of the document's clauses--including some rather important ones--articulate their policies at a level of detail that suggests compromise over the acceptable means of pursuing such clauses' apparent background aims. In this Article, I argue that, just as in the case of statutes, when the Court confronts a precise and detailed constitutional text, it should adhere closely to the prescribed solution rather than stretch or contract the text in light of the apparent ratio legis. Indeed, the heightened protection assigned to minority interests in the amendment process may make it especially crucial for a court to adhere to the compromises embedded in a precise constitutional text.


[1] An idealized general circulation model is constructed of the ocean's deep circulation and CO2 system that explains some of the more puzzling features of glacial-interglacial CO2 cycles, including the tight correlation between atmospheric CO2 and Antarctic temperatures, the lead of Antarctic temperatures over CO2 at terminations, and the shift of the ocean's δ13C minimum from the North Pacific to the Atlantic sector of the Southern Ocean. These changes occur in the model during transitions between on and off states of the southern overturning circulation. We hypothesize that these transitions occur in nature through a positive feedback that involves the midlatitude westerly winds, the mean temperature of the atmosphere, and the overturning of southern deep water. Cold glacial climates seem to have equatorward shifted westerlies, which allow more respired CO2 to accumulate in the deep ocean. Warm climates like the present have poleward shifted westerlies that flush respired CO2 out of the deep ocean.


Abstract. In the case of severe accident with loss of containment in a nuclear plant, radionuclides are released into the atmosphere in the form of both gases and aerosol particles (Baklanov and Sorensen, 2001). The analysis of radioactive aerosol scavenged by rain after the Chernobyl accident highlights certain differences between the modelling studies and the environmental measurements. Part of these discrepancies can probably be attributed to uncertainties in the efficiencies used to calculate aerosol particle collection by raindrops, particularly drops with a diameter larger than one millimetre. In order to address the issue of these uncertainties, an experimental study was performed to close the gaps still existing for this key microphysical parameter. In this paper, attention is first focused on the efficiency with which aerosol particles in the accumulation mode are collected by raindrops with a diameter of 2 mm. The collection efficiencies measured for aerosol particle in the sub-micron range are quantitatively consistent with previous theoretical model developed by Beard (1974) and thus highlight the major role of rear capture in the submicron range.


This study shared unique design experiences by examining the process of transferring residential courses to the Web, and proposed a design model for individuals who want to transfer their courses into this environment. The formative research method was used in the study, and two project teams' processes of putting courses, which were being taught in classrooms at the time, on the Web were examined in depth to reveal and confirm the components of the design model. The participants were 13 instructional designers. In addition to the logbooks kept by the designers, individual and focus group interview techniques were employed in the data-gathering process. Two researchers analyzed the data concurrently using content analysis. The logbooks and the focus-group interviews were used for model formation, and the individual interviews to confirm the components of the model. Based on the findings from the two design cases, the experience-based e-course design model consisting of seven basic stages including forming design team, preliminary search, analysis, instructional and technical design, integration, tests, and improvements was proposed. It is considered that sustaining Web-based course design efforts within this model will enable both implementing the design process more effectively, and the Web-based course obtained at the end of the process to have higher quality.


Over-The-Horizon(OTH) Radars provide a survey of wide areas, using ionospheric reflections of the electromagnetic waves. Most of the time they have to face multipath problems: state estimation has to be done with measurements involving different observation models. To tackle this measurement-toobservation-model association problem, the Monte Carlo Data Association (MCDA) algorithm, and a derivative one, the Iterated Conditional Mode Data Association (ICMDA) have been developed. They only applied in linear context. We propose new versions of these algorithms, well adapted to non-linear problems.Our two algorithms are applied, through numerical simulations, to a concrete case: target tracking with the French OTH radar Nostradamus, in clutter environment.


Purpose: To explore and compare the curative effect and side effects of the patients with epithelial cell ovarian carcinoma after surgery administered by hyperthermic intraperitoneal chemotherapy (HIPEC) with lobaplatin combined with intravenous chemotherapy. Method: Forty patients with epithelial cell ovarian carcinoma treated by HIPEC and systemic chemotherapy after CRS were selected from January 2012 to September2014, and were divided into two group, Group Lobaplatin and Group Cisplatin, according to the kind of platinum used in HIPEC. The general information, 1,3-year survival rate, serum CA125 level and adverse events were recorded. Result: As for the 1,3-year survival rate, serum CA125 level, there is no statistical difference comparing data of two groups. As for adverse events between two groups, the occurring of nausea, vomiting and abdominal pain of the lobaplatin group is significantly lower than that of the cisplatin group. Conclusion: Hyperthermic intraperitoneal chemotherapy with Lobaplatin in combination with intravenous chemotherapy is effective and feasible treatment for patients with advanced ovarian carcinoma. Lobaplatin and cisplatin both have acceptable complication rate and survival rate. According to our study, patients in lobaplatin group have better compliance than cisplatin.


The study presents the importance of image compression in medical images. There are different types of medical images that are used for diagnosed. So we need to store all the diagnostic images regarding the patient. This paper is focused on selecting the most appropriate wavelet function for biomedical images. In this paper we perform compression by using different type of wavelet function with different type of biomedical images and suggested the most appropriate wavelet function that can perform optimum compression for a given type of biomedical image. To analyze the performance of the wavelet function with the biomedical images we fixed the loss amount of the data in the compressed image (Quality of the compressed image will be same for each wavelet function) and calculated their respective compression ratio. The wavelet function that gives the maximum compression for a specific type of biomedical image will be the most appropriate wavelet for that type of biomedical image compression.


The International Classification of Diseases (ICD) E codes are the most widely used coding frame for categorising the circumstances of injury and poisoning. In 1992 major revisions to the E codes were released. The aim of this paper was to consider whether the changes made are a step forward or backwards in terms of facilitating injury prevention. The approach taken was to reflect on some former injury prevention research needs and the challenges they presented using data coded according to ICD-9, and then to consider how, if at all, ICD-10 has addressed these difficulties. As with ICD-9, there are essentially two axes associated with each cause: intent and mechanism of injury, and these are captured by one code. This approach can have the unintended effect of hiding the significance of some mechanisms of injury. While there have been significant improvements in some areas, such as falls, in others, such as injuries due to firearms, ICD-10 has taken a step backward. In addition the failure to produce mutually exclusive codes presents problems for determining the incidence of downing events. A welcome addition are "optional" activity codes which enable the identification of work related and sport related injury for the first time. Nevertheless, the limited range of codes and absence of coding guides limits their utility. The revised place of occurrence codes do not represent a significant improvement on ICD-9 in that they are limited to 10, they are not mutually exclusive, and they do not adequately cover a range of specific places of occurrence. In summary, relative to its predecessor, ICD-10 represents a significant improvement in many areas. Unfortunately, it still falls far short of the mark for many injury prevention needs.


Real-time detection of traffic signs, the task of pinpointing a traffic sign's location in natural images, is a challenging computer vision task of high industrial relevance. Various algorithms have been proposed, and advanced driver assistance systems supporting detection and recognition of traffic signs have reached the market. Despite the many competing approaches, there is no clear consensus on what the state-of-the-art in this field is. This can be accounted to the lack of comprehensive, unbiased comparisons of those methods. We aim at closing this gap by the "German Traffic Sign Detection Benchmark" presented as a competition at IJCNN 2013 (International Joint Conference on Neural Networks). We introduce a real-world benchmark data set for traffic sign detection together with carefully chosen evaluation metrics, baseline results, and a web-interface for comparing approaches. In our evaluation, we separate sign detection from classification, but still measure the performance on relevant categories of signs to allow for benchmarking specialized solutions. The considered baseline algorithms represent some of the most popular detection approaches such as the Viola-Jones detector based on Haar features and a linear classifier relying on HOG descriptors. Further, a recently proposed problem-specific algorithm exploiting shape and color in a model-based Houghlike voting scheme is evaluated. Finally, we present the best-performing algorithms of the IJCNN competition.


Chondrichthyans (sharks, skates, rays and chimaeras) are captured in many marine fisheries. Management and research efforts directed at chondrichthyan fishing are often neglected because of low product value, taxonomic uncertainty, low capture rates, and harvesting by multiple fisheries. In South Africa's diverse fishery sectors, which include artisanal as well as highly industrialised fisheries, 99 (49%) of 204 chondrichthyan species that occur in southern Africa are targeted regularly or taken as bycatch. Total reported dressed catch for 2010, 2011 and 2012 was estimated to be 3 375 t, 3 241 t and 2 527 t, respectively. Two‑thirds of the reported catch was bycatch. Regulations aimed at limiting chondrichthyan catches, coupled with species‑specific permit conditions, currently exist in the following fisheries: demersal shark longline, pelagic longline, recreational line, and beach‑seine and gillnet. Limited management measures are currently in place for chondrichthyans captured in other South African fisheries. Catch and effort dataseries suitable for stock assessments exist for fewer than 10 species. Stock assessments have been attempted for five shark species: soupfin Galeorhinus galeus, smoothhound Mustelus mustelus, white Carcharodon carcharias, spotted ragged‑tooth Carcharias taurus, and spotted gully Triakis megalopterus. Fishery‑independent surveys and fishery observer data, which can be used as a measure of relative abundance, exist for 67 species. Compared with most developing countries, South African shark fishing is relatively well controlled and managed. As elsewhere, incidental capture and bycatch remain challenges to the appropriate management of shark species. In 2013, South Africa's National Plan of Action for the Conservation and Management of Sharks (NPOA‑Sharks) was published. Implementation of the NPOA‑Sharks should help to improve chondrichthyan management in the near future.


Smoking cue-exposure research has provided a powerful tool for examining cravings in the laboratory. A key attraction of this method is that tightly controlled experimental procedures can model craving experiences that are presumed to relate to addiction. Despite its appeal, key assumptions underlying the clinical relevance of smoking cue-reactivity studies have been questioned recently. For both conceptual and methodological reasons it may be difficult to tease apart cue-based and abstinence-based cravings. Moreover, conventional cue-reactivity procedures typically generate levels of craving with only minimal clinical relevance. We argue here that sometimes it is unfeasible-and in some instances conceptually misguided-to disentangle abstinence-based and cued components of cigarette cravings. In light of the challenges associated with cue-reactivity research, we offer an alternative approach to smoking cue-exposure experimental research focusing on peak provoked craving (PPC) states. The PPC approach uses nicotine-deprived smokers and focuses on urges during smoking cue-exposure without subtracting out urge ratings during control cue or baseline assessments. This design relies on two factors found in many cue-exposure studies-nicotine deprivation and exposure to explicit smoking cues-which, when combined, can create powerful craving states. The PPC approach retains key aspects of the cue-exposure method, and in many circumstances may be a viable design for studies examining robust laboratory-induced cravings.


A mirror light pipe (MLP) is an optical device consisting of a metallic
reflective closed wall structure with highly transparent open ends. Light falling
on the entrance is transmitted through the pipe to the exit by multiple
reflections off the inner walls and used at the end. The spectral transmission
through silver, aluminium and gold-coated inner walls of cylindrical mirror
light pipes has been calculated theoretically based on the Swift and Smith
model. The experimental data is also collected for MLP which is made by
silverlux. The transmission is dependent upon the angle of incident light and
the wavelength of incoming radiation. All pipes show a decrease in the spectral
transmission of solar spectrum with an increase in the angle of incidence and
the length of the pipes.


In this work, a new approach to detect sensor and actuator intrusion for Cyber-Physical Systems using a bank of Kalman filters is presented. The case where the unknown type of the intrusion signal is considered first, using two Kalman filters in a bank to provide the conditional state estimates, then the unknown type of intrusion signal can be detected properly via the adaptive estimation algorithm. The case where the target (either sensor or actuator) of the intrusion signal is unknown is also considered, using four Kalman filters in a bank designed to detect if the intrusion signal is about to affect healthy sensor or actuator signal. To test these methods, a DC motor speed control system subject to attack by different types of sensor and actuator signals is simulated. Simulations show that different types of sensor and actuator intrusion signals can be detected properly without the knowledge of the nature and the type of these signals.


Recently, strong results have been demonstrated by Deep Recurrent Neural Networks on natural language transduction problems. In this paper we explore the representational power of these models using synthetic grammars designed to exhibit phenomena similar to those found in real transduction problems such as machine translation. These experiments lead us to propose new memory-based recurrent networks that implement continuously differentiable analogues of traditional data structures such as Stacks, Queues, and DeQues. We show that these architectures exhibit superior generalisation performance to Deep RNNs and are often able to learn the underlying generating algorithms in our transduction experiments.


At approximately the same time that the Sarbanes‐Oxley Act increased the costs associated with being a public company, important Delaware case law created a difference in the standard of judicial review for the two basic methods of freezing out minority shareholders. While a freeze‐out executed as a statutory merger is subject to stringent "entire‐fairness" review, the Delaware Chancery Court held in In re Siliconix Shareholders Litigation that a freeze‐out executed as a tender offer is not. This paper presents the first systematic empirical evidence on post‐Siliconix freeze‐outs. Using a new database of all Delaware freeze‐outs executed in the 4 years after Siliconix was decided, I find that minority shareholders achieve significantly lower abnormal returns, on average, in tender‐offer freeze‐outs relative to merger freeze‐outs. I discuss the doctrinal and policy implications of these findings in a companion paper.


OBJECTIVE
To investigate population hospitalization rates to community hospitals for systemic sclerosis (SSc, scleroderma) and examine whether age, sex, race, and insurance status independently predict length of stay (LOS), hospital charges, and in-hospital death.

METHODS
The 1995 Healthcare Cost and Utilization Project national inpatient sample was used to identify 3,621 SSc hospitalizations. Weighted age, sex, and race-specific frequencies were divided by population estimates to calculate hospitalizations per million people. Regression models were used to model LOS, charges, and in-hospital death with age, sex, race, and insurance serving as the primary independent variables. Covariates included numbers of diagnoses and procedures, whether or not the admission was a transfer from another hospital, and the presence of comorbid conditions.

RESULTS
Population hospitalization rates were higher for non-whites compared to whites among those < 65, while rates were higher for whites compared to non-whites for those > or =65 years old. On average, non-whites were at least 10 years younger than whites. The mean LOS was 7.5 days, with whites' average LOS being 10% shorter than non-whites', and patients with public health insurance having approximately 9% longer LOS than those with private insurance. Charges averaged almost US$15,000 per hospitalization (median = $8,441), amounting to $280 million in community hospital charges in the U.S. in 1995. The overall in-hospital death rate was 7.1%.

CONCLUSION
These patterns are consistent with a greater burden and increased severity of disease among non-whites under age 65 with Ssc.


Mobile IPv6 has become the key enabling technology for mobile data and multimedia services and devices worldwide (i.e., cellular systems, VoIP handovers over LAN, multi-access network handovers, location privacy, enterprise mobile networking, etc.). This book covers the IPv6 host mobility protocol known as "mobile IPv6" and begins with a basic description of mobile IPv6 and then details protocol specifications and data structures as well as actual implementation. A sample configuration for a real Mobile IPv6 operation is provided at the end of the book. Source code will be downloadable form a companion website. Provides a detailed introduction to the IETF Mobile IPv6 standardIncludes extensive line-by-line code sets with meticulous explanations of their implementationNumerous diagrams and illustrations to help in visualizing the implementation


The present study included experimental effect of Metronidazole drug and Alcoholic extract of Nigella sativa seeds on T. vaginalis that cultivated on i   T i Results showed that the numbers of parasite began increasing during a period after 24-48 hrs then began decreasing after 72-96 hrs, so that 72 hrs from growth considered logarithmic phase of T. vaginalis growth. Present results showed poisonous effect of N. sativa alcoholic extract that was prepared in laboratory and imported at concentrations (450, 550, 650 and 750) mg/ml on T. vaginalis by observing gradual decrease of trophozoite numbers with concentrate increase of extracts during growth periods (24, 48, 72 and 96) hrs. Different concentrations of Metronidazole were used as chemical therapy and control model, the results of the drug effects were followed-up daily, where current results showed (after 24 hours of concentration added) a high reduction in number and activity of the parasites at all concentrations of the drug were , p ci lly 150 200 μg/ l, th parasites disappeared completely after 96 hours, also the inhibitory concentration50 (IC50) of the parasit w 100 μg/ l ( ft r 48 h r incubation). The inhibitory effect of N. sativa alcoholic extract on the number and activity of T. vaginalis parasite was noted that the concentrations (450 and 550 mg/ml) were approximated in their effect on parasite growth, while the concentrations 650 and 750 mg/ml were the best in their inhibitory activity for parasite growth after 96 hours of addition. The concentration that causes 50% of death inculture (IC50) was 550 mg/ml (after 72 hours of concentration addition).


Technological heredity of operational properties in the processes of manufacturing, operation, and restoration of machine parts is proposed to describe the graph reflecting the coefficients of transmission and mutual influence of physical, mechanical, and geometric parameters. The technological control methods of the heredity of operational properties of parts are considered, including the following: measuring parameters of the most critical parts; determining technological heredity mechanisms on the basis of transfer coefficients and mutual influence of operational properties; analyzing technological barriers during intensive effects of energy flows; and developing measures for controlling technological processes. The technological heredity of the operational quality parameters in the process of recovery and processing of the bearing journals and cams, as well as wearing of the camshaft working surfaces over admissible limits are considered. According to the findings, it is recommended: to control the deformation of the part after machining operations; to eliminate the editing operation after heat treatment; to use a combination of methods and a combination of technological effects in recovering the part surfaces with wear exceeding the maximum permissible values. The need for surfacing and subsequent tempering processes to ensure consistently high physicomechanical properties of coating materials and strictly regulate the modes of surface finishing is noted. of the camshafts the the С


Proton exchange membrane (PEM) fuel cells' main components are the anode, cathode and the membrane. A conventional membrane used in today's PEM fuel cells is the Nafion 117 membrane. In this project, the Nafion 177 membrane is discussed in detail to demonstrate its ability to absorb water and the capability to operate in a specific range of temperatures. In addition, an extensive simulation using CATIA V5 is used to determine the highest stress distribution on the membrane for various boundary conditions. Other membranes materials were also considered in this report. They include the Dias membrane, the bacterial cellulose membrane to expand the selection of candidate membranes that can be used im PEM fuel cells for future research. Optimization methods were utilized to maximize the performance of the PEM fuel cells. The Genetic Algorithm is used to solve optimization problems by implementing powerful search techniques to find an optimal solution within a large set of solutions. In this project, the Genetic Algorithm is used to show the impact of the stack positions in order to optimize voltage output. In addition, the Nafion content and platinum loading are adjusted to optimize the performance of the current density within PEM fuel cells.


Governments and other stakeholders actively promote and facilitate the development and deployment of hydrogen and fuel cell technologies. Various strategy documents and energy forecasts outline the environmental and societal benefits of the prospective hydrogen economy. At the same time, the safety-related properties of hydrogen imply that it is not straightforward to achieve and document the same level of safety for hydrogen systems, compared to conventional fuels. Severe accidents can have major impact on the development of energy technologies. The stakes will increase significantly as the use of hydrogen shifts from controlled environments in industrial facilities to the public domain, and as the transport-related consumption extends from passenger cars and buses, to trains, ships and airplanes. Widespread deployment of hydrogen as an energy carrier in society will require massive investments. This implies commercial and political commitment, involvement and influence on research priorities and decision-making. The legacy from accidents and the messages communicated by influential stakeholders impact not only how the public perceives hydrogen technologies, but also governmental policies, the development of regulations, codes and standards (RCS), and ultimately the measures adopted for preventing and mitigating accidents. This paper explores whether and how selected aspects of safety are considered when distinct groups of stakeholders frame the hydrogen economy. We assess to what extent the communication is consistent with the current state-of-the-art in hydrogen safety and the contemporary strength of knowledge in risk assessments for hydrogen systems. The approach adopted entails semi-quantitative text analysis and close reading to highlight variations between diverse groups of stakeholders. The results indicate a bias in the framing of the safety-related aspects of the hydrogen economy towards procedural, organisational and societal measures of risk reduction, at the expense of well-known challenges and knowledge gaps associated with the implications of fundamental safety-related properties of hydrogen.


Abstract
Objective – This research project sought to elucidate some of the information searching behaviours of directors/conductors of performing music ensembles when selecting repertoire for performance. Of particular focus was the kind of information needed to select repertoire and where that information was sought and acquired.
Methods – Semi-structured, guided interviews were undertaken with three conductors from varying musical ensemble forms (choral, orchestral, and wind). This included a graphical elicitation exercise following Sonnenwald's concept of information horizon maps. A narrative analysis was done, and recurring themes were sought in the various responses to questions and created drawings.
Results – The results indicated that directors make significant use of historical and print resources in creating personal lists of repertoire for current or future use. Professional connections for discussion of new or less well-known repertoire were also very important. One particularly interesting outcome was the non-temporally bound nature of conductors' information searching behaviour, as the current models of information behaviour primarily relate to temporally bound searches. The Internet was noted by the three conductors not as an information source in and of itself but rather as an extension of other information sources.
Conclusions – This research highlighted the atemporal nature of information searching behaviour in music directors and suggested a similar aspect in the broader information search process. It indicated a need for libraries that cater to performers to maintain historical lists of varying types (e.g., concert programs, similar lists created by other prominent members of the community, and other types of repertoire lists). Additionally, maintaining community connections and knowledge of new or newly available repertoire is important.


India is an agricultural country consisting 67% of rural area geographically. Agriculture and its confederated conditioning act as the main source of livelihood for further than 80% population of pastoral India. It provides employment to roughly 52% of labour. Its donation to Gross Domestic Product (GDP) is between 14 to 15. The Government has introduced several schemes and programs that support the lesser robotization of Indian Agriculture, in the light of its commitment to transfigure the husbandry sector and double growers' income by 2022-23. The Sub Mission on Agricultural Mechanization of (SMAM) is an important action of the Government, in this direction. The country is developing day by day and inventions also take place with a growing country, we also developed it by using innovative products which are discovered for our ease. We've to remain in sync with inventions to remain up with current times and make full use of them. At present, demands are different compared to the demands nearly a decade ago. For producing high-quality products growers have to keep pace with changing times. For perfecting your productivity in fields you have to use tractor tools for scattering, tending, digging etc. This application can increase your effectiveness, save lots of plutocrats, saves time etc. so, Tools are introduced for the comfort of the growers. We're noticing the top 10 tools which are perfect for you to be used with your tractor, they can help you to increase your productivity and effectiveness in the fields. They're Rotavator, Cultivator, Plough, Trailer, Harrow, Roto seed Drillmaster, Planter, Baler, Sprayer, Straw Reaper etc. All these tools are used by a tractor. Again tractor has their own subtypes similar to Utility tractors which we see generally in large, Compact Tractors, Row Crop Tractors, Industrial Tractors, Garden Tractors, and Carrier Tractors, Earthmoving tractors, Autonomous, two-wheeler type etc. On par with these machinery, growers its confederated sectors like Major Irrigation, Medium Irrigation and Minor Irrigation, PanchayatRaj, Rural Development, Agriculture, Other civil works in pastoral areas use majorly Bulldozers, Excavators, Backhoe, Graders, Trenchers, Payload, Cranes, Compactors, Dump Exchanges, Boring Machines, Wheel Tractor Scrapers etc. in large. All these types of Machines (or) (and) Vehicles are specially designed and manufactured for respective purposes. Still, the operation of said Machines (or) (and) Vehicles is fleetly increased in the last two decades and it's going to be important large in near future.


In March 2020, an intensive cultural resources survey of the proposed Moore Park athletic complex in Plano, Collin County, Texas was completed in order to inventory all cultural resources. The project parcel currently lies within an open field at the southwest corner of the intersection of Chaparral Road and Cottonwood Creek. It is bounded by Chaparral Road on the north, Cottonwood Creek to the east, Bright Star Way on the south, and Cloverhaven Way on the west in a densely residential developed area. A North Texas Municipal Water District building is located in the far northwestern corner near Cottonwood Creek. The archeological area of potential effects (APE) covers an area of approximately 103 acres (42 hectares). Because the project is owned and funded by the City of Plano, a political subdivision of the State of Texas, the project is subject to the Antiquities Code of Texas (9 Texas Natural Resources Code [TNRC] 191), which requires consideration of effects on properties designated as—or eligible to be designated as—State Antiquity Landmarks (SALs), which includes archeological resources. The survey was carried out for the City of Plano, Parks and Recreation under Texas Antiquities Permit 9334 by Brett Lang (Project Archeologist) of Cox|McLain Environmental Consulting, Inc. (CMEC). Melissa M. Green was the Principal Investigator. The parcel is situated on an upper terrace above Cottonwood Creek. From the western boundary, an unnamed tributary of Cottonwood Creek flows from the northwest corner to the southwest corner of the project parcel (as the terrace slopes southeastward) into Cottonwood Creek approximately 860 meters or 2821.5 feet away. Cottonwood Creek parallels the eastern boundary of the APE. Ground surfaces within the project area parcel were mostly covered in short, ankle-high prairie grasses used for active cattle grazing allowing for some limited visibility ranging from 20 to 50 percent. A densely wooded section was observed along the eastern boundary and along part of the tributary, allowing for 30 to 80 percent ground visibility. In all, 19 shovel test units were excavated judgmentally across the project area, of which none contained cultural materials. All materials (notes, photographs, administrative documents, and other project data) generated from this work will be housed at the Center for Archeological Studies at Texas State University at San Marcos, where they will be made permanently available to future researchers per 13 Texas Administrative Code 26.16-17. If any unanticipated cultural materials or deposits are found at any stage of clearing, preparation, or construction, the work should cease and Texas Historical Commission personnel should be notified immediately. The Texas Historical Commission concurred with the findings and recommendations of this report on 8 May 2020.


Two cases of bidirectional leader, starting almost immediately below a decaying dart or dart‐stepped leader which terminated before reaching the ground, were identified, for the first time, in rocket‐triggered lightning flashes based on high‐speed video, electric field changes, and channel base current, indicating that a bidirectional leader can be excited by a decayed dart leader and propagate in a preexisting discharge channel. The positive end of the bidirectional leader moved upward along the terminated downward dart leader path, and the negative end extended downward along the decayed initial continuous current or preceding stroke path to the ground and culminated in a return stroke. The positive leader propagated with an average speed of 1.3 × 106 m/s and 2.2 × 106 m/s in the two cases, roughly twice as fast as its negative counterpart with speed of 7.8 × 105 m/s and 1.0 × 106 m/s, respectively. The positive end started earlier than the negative end with a preceding time less than 40.3 µs. The bidirectional leader can be regarded as a recoil leader with the positive end retrogressing along a negative leader channel, whose polarity is contrary to the traditional recoil leader with negative leader end retrogressing along an existing positive leader channel. Weak luminosity was continuously observed during the terminated dart leader and bidirectional leader stage, but the channel current was less than the minimum detection capability of 9.3 A.


Objective: To determine the safety and efficiency of metered dose inhaler salbutamol delivered to the intubated rabbit. Design: Prospective, comparative, five‐group laboratory investigation. Setting: Animal laboratory, Department of Nuclear Medicine. Subjects: A total of 30 adult, anesthetized New Zealand White rabbits. Interventions: Three groups of rabbits underwent tracheal intubation through a tracheostomy and received 5 puffs of 99mTcO4 salbutamol delivered at the elbow connector (group 1) or via a catheter with its distal tip positioned at the midpoint (group 2) or bevel of the endotracheal tube (group 3). No intervention was provided for the rabbits in the fourth group. A fifth group underwent tracheal intubation through the mouth and received salbutamol (5 puffs) delivered at the bevel of the endotracheal tube. Measurements: Delivery efficiency was expressed as the ratio of radioactivity emitted from lungs and trachea to the total radioactivity of the administered dose. Histopathologic injury scores were assigned to each trachea or lung specimen. Main Results: Delivery efficiency was 30 times greater in groups 3 and 5 (full catheter) than in group 1 (elbow). The injury scores were similar in all groups. Conclusion: We conclude that the increased efficiency obtained by administration of metered dose inhaler salbutamol at the distal tip of endotracheal tube is not necessarily associated with increased epithelial injury.


In this paper we study the H∞ tracking problems with preview for a class of linear discrete-time Markovian jump systems. The systems are described by a class of switching systems with Markovian mode transition. The necessary and sufficient conditions for the solvability of the H∞ tracking problem are given by coupled Riccati difference equations with terminal conditions. Correspondingly feedforward compensators introducing future information are given by coupled difference equations with terminal conditions. In this paper we focus on the derivation method of noncausal compensator dynamics from the point of view of dynamics constraint. We derive the pair of coupled noncausal compensator dynamics and coupled Riccati difference equations by calculating the first variation of the performance index under the dynamics constraint.


RNA interference is a technique that has become popular in the past few years. This is a biological method to detect the activity of a specific gene within a cell. RNAi is the introduction of homologous double stranded RNA to specifically target a gene's product resulting in null or hypomorphic phenotypes. This technique involves the degradation of specific mRNA by using small interfering RNA. Both microRNA (miRNA) and small interfering RNA (siRNA) are directly related to RNA interference. RNAi mechanism is being explored as a new technique for suppressing gene expression. It is an important issue in the treatment of various diseases. This review considers different aspects of RNAi technique including its history of discovery, molecular mechanism, gene expression study, advantages of this technique against previously used techniques, barrier associated with this technique, and its therapeutic application.


The area of the Dead Sea valley and the adjacent regions are often affected by mineral dust. This study focuses on an extreme dust episode occurring on 22 March 2013, where near-surface dust concentrations of up to 7000 µg m−3 were encountered in the Dead Sea region. This episode is of great interest as it was accompanied by high wind speeds and a gust front that rapidly passed the Judean Mountains. Wind was even accelerated on the lee side of the Judean Mountains leading to a severe downslope wind. We simulated this situation with the comprehensive online-coupled weather forecast model COSMO-ART. Fair agreement was found between the simulated meteorological variables and the observations. The model was capable of producing a reasonable spatiotemporal distribution of near-surface dust concentration, consistent with available measurements in this area. With respect to the time of the maximum near-surface dust concentration in the Dead Sea valley, the model captured it almost perfectly compared to the observed total suspended particle (TSP) concentrations. COSMO-ART showed that the high near-surface dust concentration in the Dead Sea valley was mainly determined by local emissions. These emissions were caused by strong winds on the lee side of the Judean Mts. The model showed that an ascending airflow in the Dead Sea valley lifted dust particles, originating mainly from the upwind side of the Judean Mts., up to approximately 7 km. These dust particles contributed to the pronounced maximum in modelled dust aerosol optical depth (AOD) over the valley. Here we highlight the important point that the simulated maximum dust AOD was reached in the eastern part of the Dead Sea valley, while the maximum near-surface dust concentration was reached in the western part of the valley.


Quantitative analysis of monosaccharides or glycoprotein glycans by high-performance liquid chromatography (HPLC) often involves labeling of the saccharide aldehyde groups with fluorescent tags to enhance sensitivity and selectivity. However, the methods required to remove the large excess of labeling reagents from the reaction mixture are time-consuming. Furthermore, these methods often hinder the quantitative analysis of the labeled samples. Here, we developed an online sample cleanup procedure for HPLC analysis of 2-aminobenzoic acid (2-AA)-labeled monosaccharides or oligosaccharides using a ten-port valve and mini columns. An online purification system using a combination of short HLB columns with the valve was proposed for the analysis of 2-AA-labeled monosaccharides utilizing reversed-phase modes. In the analysis of 2-AA-labeled glycans derived from glycoproteins, a short CN column with the valve was proposed utilizing hydrophilic interaction liquid chromatography (HILIC) modes. Optimized conditions enabled the direct injection of the diluted labeling reaction mixture into the chromatographic system without any prior removal of the excess labeling reagents. These methods were successfully applied to the analysis of various monosaccharides and N -linked glycans released from specific glycoproteins.


The main objective of this study is to consider the diplomatic relations between France and Australia in the three decades following World War II with a view to documenting the events that contributed to the development of French migration to Australia. This period is significant in the context of the history of the French in Australia because in the thirty years that followed the war, more French migrants arrived in Australia than at any other time in the history of the French presence in this country. The few studies that have been concerned with French migration to Australia have not examined in great detail the events that took place during this time. In order to shed light on the diplomatic relations between France and Australia relative to the question of French migration, I have analysed archival materials, including formerly classified Commonwealth and diplomatic correspondence recently released by the National Archives of Australia. Before presenting an account of the events that shaped post World War II migration from France, this article will outline the state of the research on the French in Australia and provide an overview of the development of the French community in Australia from the days of settlement to the early 1970s.


Internet-of-Things (IoT) research has primarily focused on identifying IoT devices' organizational risks with little attention to consumer perceptions about IoT device risks. The purpose of this study is to understand consumer risk perceptions for personal IoT devices and translate these perceptions into guidance for future research directions. We conduct a sequential, mixed-methods study using multi-panel Delphi and thematic analysis techniques to understand consumer risk perceptions. The results identify four themes focused on data exposure and user experiences within IoT devices. Our thematic analysis also identified several emerging risks associated with the evolution of IoT device functionality and its potential positioning as a resource for malicious actors to conduct security attacks.


An Unobservable MDP (UMDP) is a POMDP in which there are no observations. An Only-Costly-Observable MDP (OCOMDP) is a POMDP which extends an UMDP by allowing a particular costly action which completely observes the state. We introduce UR-MAX, a reinforcement learning algorithm with polynomial interaction complexity for unknown OCOMDPs.


Methods: The hepatic and umbilical venous systems were examined in 390 fetuses in a prospective study using two dimensional (2D) ultrasonography, color, and spectral Doppler. Fetuses suspected to have ductus venosus anomalies were additionally examined with 3D power Doppler ultrasonography. Results: Eight fetuses with venous abnormalities (absent ductus venosus n = 4, direct connection between the umbilical vein and the right atrium n = 2, and direct connection between the umbilical vein and the inferior vena cava n = 2) were detected among the 310 (Incidence 2.6%) in which the venous system could be visualized. Three-dimensional power Doppler accurately showed the course of the umbilical vein, its relationship to the porto-systemic circulation, and whether a ductus venosus was present or absent. Conclusions: 3D power Doppler ultrasonography has the potential to improve the diagnostic accuracy and differentiation between distinct types of malformations of the fetal porto-systemic and umbilical venous system.


Over the past decade, the number of Earth orbiters and deep-space probes has grown dramatically and is expected to continue to do so in the future as miniaturization technologies drive spacecraft to become more numerous and more complex. This rate of growth has brought a new focus on autonomous and self-preserving systems that depend on fault diagnosis. Although diagnosis is needed for any autonomous system, current approaches are almost uniformly ad hoc, inefficient, and incomplete. Systematic methods of general diagnosis exist in literature, but they all suffer from two major drawbacks that severely limit their practical applications. First, they tend to be large and complex and hence difficult to apply. Second and more importantly, in order to find the minimal diagnosis set, i.e., the minimal set of faulty components, they rely on algorithms with exponential computational cost and hence are highly impractical for application to many systems of interest. In this article, we propose a two-fold approach to overcoming these two limitations and to developing a new and powerful diagnosis engine. First, we propose an ovel and compact reconstruction of the general diagnosis engine (GDE) as one of the most fundamental approaches to model-based diagnosis. We then present a novel algorithmic approach for calculation of the minimal diagnosis set. Using a powerful yet simple representation of the calculation of the minimal diagnosis set, we map the problem onto two well-known problems—that is, the Boolean satisfiability and 0/1 integer programming problems. The mapping onto the Boolean satisfiability problem enables the use of very efficient algorithms with a superpolynomial rather than an exponential complexity for the problem. The mapping onto the 0/1 integer programming problem enables the use of a variety of algorithms that can efficiently solve the problem for up to several thousand components. These new algorithms are a significant improvement over the existing ones, enabling efficient diagnosis of large, complex systems. In addition, the latter mapping allows one, for the first time, to determine the bound on the solution, i.e., the minimum number of faulty components, before solving the problem. This is a powerful insight that can be exploited to develop yet more efficient algorithms for the problem.


Noise can enhance perception of tactile and proprioceptive stimuli by stochastic resonance processes. However, the mechanisms underlying this general phenomenon remain to be characterized. Here we studied how externally applied noise influences action potential firing in mouse primary sensory neurons of dorsal root ganglia, modelling a basic process in sensory perception. Since noisy mechanical stimuli may cause stochastic fluctuations in receptor potential, we examined the effects of sub-threshold depolarizing current steps with superimposed random fluctuations. We performed whole cell patch clamp recordings in cultured neurons of mouse dorsal root ganglia. Noise was added either before and during the step, or during the depolarizing step only, to focus onto the specific effects of external noise on action potential generation. In both cases, step + noise stimuli triggered significantly more action potentials than steps alone. The normalized power norm had a clear peak at intermediate noise levels, demonstrating that the phenomenon is driven by stochastic resonance. Spikes evoked in step + noise trials occur earlier and show faster rise time as compared to the occasional ones elicited by steps alone. These data suggest that external noise enhances, via stochastic resonance, the recruitment of transient voltage-gated Na channels, responsible for action potential firing in response to rapid step-wise depolarizing currents.


Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer. It can be divided in different subtypes. The most common type is superficial and is most frequently occurring on the trunk and on the face. In severe cases it can be difficult to differentiate basal cell carcinoma from other skin tumors, therefore a skin biopsy is conclusive diagnostic method. In terms of treatment, curettage is a common non-surgical treatment of basal cell carcinoma. However, being superficial, curettage increases the risk of recurrence. Between 30-40 % of most recurrences occur within five years.Tissue Viability Imaging or TiVi is a diagnostic method used by the Department of Dermatology at the University Hospital in Linkoping. The technology allows the investigator to see through the top layer of the skin (epidermis) and map the skin skin blood circulation in the dermal area.The aim of this study was to investigate whether histological features of present basal cell carcinoma, inflammation, stroma and microvessels, correlates with the presence of the tumour visualized by Tissue Viability Imaging technique.The hypothesis is, that by visualizing BCC recurrence at the first visit at the clinic by using TiVi technique, we can diagnose BCC and treat patients in one step, thus reducing the amount of discomfort for the patient and also reduce the cost of care.In this pilot-study, patient material involving two basal cell carcinomas from one patient were used. The results show that microscopic examination of the tumor and blood vessels correlate with visualizing basal cell carcinoma with TiVi, although furthermore studies of existing basal cell carcinoma and several tumours are required to ensure correlation before TiVi can be used to replace skin biopsy.


Atrial fibrillation (AF) is the commonest sustained heart arrhythmia and is associated with significant morbidity and mortality, with, for example, one in five of all strokes being attributable to the condition.1 ▼Dronedarone (pronounced dro-ne-da-roan) (Multaq – sanofi-aventis) is a new anti-arrhythmic drug related to the established anti-arrhythmic amiodarone. It is licensed for use in clinically stable adult patients with a history of, or current, non-permanent AF to prevent recurrence of AF or to lower ventricular rate. Here we review its role in the management of patients with non-permanent AF.


Although the industry has raised the standards of tree risk assessment considerably in recent years, the quality of judgements is still very variable and influenced by a wide range of factors. Due to the complexity and diversity of trees and sites, collecting and verifying relevant personal experiences takes tree assessors many years. In many countries, new tree assessors learn from a small number of experienced peers. Artificial intelligence (AI) can be used to collect and condense scattered knowledge and deploy it in a support tool for basic tree assessment. In this project, the application of a commercial AI decision-making system software (Dylogos) to tree assessment is tested. The software is based on a new dynamic nonclassical logic, which combines diverse knowledge sources to an emergent system to support visual tree assessments. A set of rules describes existing knowledge about the mostly unsharp parameters affecting the likelihood of failure and damage. The software evaluates the data collected during a basic tree assessment and provides an estimate of the level of risk posed by the tree. The result and the reasons for it are presented in plain language. Users can then examine this estimate and feed their own assessment back into the system to train it further, so that this "white" AI system is self-learning based on experience acquired in practical use. The use of AI in tree risk assessment not only supports the user but can also be used to disseminate knowledge and promote the standardization of decision-making in tree assessment. Important directions for further research and knowledge gaps related to the training of AI systems in the absence of industry-wide, agreed-upon criteria for risk identified in this project are: how to collect sufficient quality-assured data sets to define the initial set of rules; and how to assess the level of expertise of users training the system further.


The paper explores the syllabic and segmental dimensions of phonological vowel disorder. The independence of the two dimensions is illustrated by the case study of an English-speaking child presenting with an impairment which can be shown to have a specifically syllabic basis. His production of adult long vowels displays three main patterns of deviance – shortening, bisyllabification and the hardening of a target off-glide to a stop. Viewed phonemically, these patterns appear as unconnected substitutions and distortions. Viewed syllabically, however, they can be traced to a single underlying deficit, namely a failure to secure the complex nuclear structure necessary for the coding of vowel length contrasts.


This is the first part of a two-part article on semantic compositionality, that is, the principle that the meaning of a complex expression is determined by the meanings of its parts and the way they are put together. Here we provide a brief historical background, a formal framework for syntax and semantics, precise definitions, and a survey of variants of compositionality. Stronger and weaker forms are distinguished, as well as generalized forms that cover extra-linguistic context dependence as well as linguistic context dependence. In the second article, we survey arguments for and arguments against the claim that natural languages are compositional, and consider some problem cases. It will be referred to as Part II.


The high resolution non-dispersive spectroscopy and unprecedented sensitivity of Athena+ will revolutionize solar system observing: the origin of the ions producing Jupiter's X-ray aurorae via charge exchange will be conclusively established, as well as their dynamics, giving clues to their acceleration mechanisms. X-ray aurorae on Saturn will be searched for to a depth unattainable by current Earth-bound observatories. The X-ray Integral Field Unit of Athena+ will map Mars' expanding exosphere, which has a line-rich solar wind charge exchange spectrum, under differing solar wind conditions and through the seasons; relating Mars' X-ray emission to its atmospheric loss will have significant impact also on the study of exoplanet atmospheres. Spectral mapping of cometary comae, which are spectacular X-ray sources with extremely line-rich spectra, will probe solar wind composition and speed at varying distances from the Sun. Athena+ will provide unique contributions also to exoplanetary astrophysics. Athena+ will pioneer the study of ingress/eclipse/egress effects during planetary orbits of hot-Jupiters, and will confirm/improve the evidence of Star-Planet Interactions (SPI) in a wider sample of planetary systems. Finally Athena+ will drastically improve the knowledge of the X-ray incident radiation on exoplanets, a key element for understanding the effects of atmospheric mass loss and of the chemical and physical evolution of planet atmospheres, particularly relevant in the case of young systems.


Per capita income in Singapore has gone from $500 to more than $20,000 in a little over twenty-five years. Edgar Schein, a social psychologist with a long and celebrated research interest in organizational studies, examines the cultural history of the key intstitution that spawned this economic miracle. Through interviews and full access to Singapore's Economic Development Board (EDB), Schein shows how economic development was successfully promoted. He delves into the individual relationships and the overall structure that contributed to the EDB's effectiveness in propelling Singapore, one of Asia's "little dragons" into the modern era. In his foreword, Lester Thurrow locates Schein's organizational and case-specific account within a larger economic and comparative framework. Over a period of two years, Schein studied how the EDB was created, the kind of leadership it provided, the management structure it used, the human resource policies it pursued, and how it influenced other organizations within the Singapore government. Schein sat in on EDB meetings and extensively interviewed current and former members of the board, Singapore's leaders who created the board, and businesspeople who have dealt with the board. His book intertwines the perspective of the board's members and its investor clients in an analysis that uses both organization and cross-cultural theory. Although there are currently studies of comparable Japanese and Korean organizations, this is the first detailed analysis of the internal structure and functioning of the economic development body of Singapore, a key player in the Asian and world markets.


Abstract. The reconstruction of the 3D geometry of a scene based on image sequences has been a very active field of research for decades. Nevertheless, there are still existing challenges in particular for homogeneous parts of objects. This paper proposes a solution to enhance the 3D reconstruction of weakly-textured surfaces by using standard cameras as well as a standard multi-view stereo pipeline. The underlying idea of the proposed method is based on improving the signal-to-noise ratio in weakly-textured regions while adaptively amplifying the local contrast to make better use of the limited numerical range in 8-bit images. Based on this premise, multiple shots per viewpoint are used to suppress statistically uncorrelated noise and enhance low-contrast texture. By only changing the image acquisition and adding a preprocessing step, a tremendous increase of up to 300% in completeness of the 3D reconstruction is achieved.


Inspired by the Archon X Prize for Genomics, our research project involves implementing a novel strategy for sequencing the human genome. This prize worth $10 million will be awarded to the first company to sequence 100 human genomes with 99.999% accuracy in less than 10 days for under $10,000 each. However, the possibility of winning the X Prize is secondary to the prospect of revolutionizing medical diagnostics. Currently, the genomic state of‐the‐art involves identifying SNPs (single nucleotide polymorphisms) that are correlated to certain diseases. Compared to such existing diagnostics, the genome‐wide, sequence‐based biomarkers that will be made possible by fast and affordable human genome sequencing are staggering. After six months of thorough investigation and development, we are pleased to present SynthSeq, a cutting‐edge, whole‐genome sequencing venture based on the novel sequencing‐bysynthesis technology. In contrast to high‐priced competitors, our inexpensive and comparatively error‐free whole genome sequencing solution will prove to be an invaluable diagnostic resource, and it will only become more valuable as advances are made in the field of molecular diagnostics. At our intended retail price of $5,000, series A investors can expect a worst‐case MIRR of 22%, and the ultimate NPV should be no less than $700 thousand. We are confident that our innovative SynthSeq technology will deliver high‐fidelity, low‐cost whole genome sequencing to as many as 3,000 customers per year as currently envisioned, with the potential for scale‐up to millions. This working paper is available at ScholarlyCommons: http://repository.upenn.edu/cbe_sdr/20


A novel theory of stages in cognitive development is presented, loosely corresponding to Piagetan theory but specifically oriented toward AI systems centered on uncertain inference components. Four stages are articulated (infantile, concrete, formal and reflexive), and are characterized both in terms of external cognitive achievements (a la Piaget) and in terms of internal inference control dynamics. The theory is illustrated via the analysis of specific problem solving tasks corresponding to the different stages. The Novamente AI Engine, with its Probabilistic Logic Networks uncertain inference component and its embodiment n the AGI-SIM simulation world, is used as an example throughout.


A continuous-time feedback controller design methodology is developed for distributed processes, whose dynamic behavior can be described by microscopic evolution rules. Employing the micro-Galerkin method to bridge the gap between the microscopic-level evolution rules and the "coarse" process behavior, "coarse" process steady states are estimated and nonlinear process models are identified off-line through the solution of a series of nonlinear programs. Subsequently, optimal feedback controllers are designed, on the basis of the nonlinear process model that enforces stability in the closed-loop system. The method is used to control a system of coupled nonlinear one-dimensional PDEs (the FitzHugh-Nagumo equations), widely used to describe the formation of patterns in reacting and biological systems. Employing kinetic theory based microscopic realizations of the process, the method is used to design output feedback controllers that stabilize the FHN at an unstable, nonuniform in space, steady state.


The human brain is able to consider that two sensory stimuli are synchronous while they activate the cortex with some delay because they follow different neurological pathways. This process is only possible if the time interval between the two stimuli does not exceed a certain limit, called "Temporal Binding Window" (TBW). Studies of this parameter, involving the vestibular perception, are difficult because subjects must be moved, which generates parasitic proprioceptive information. By cons, in patients equipped with a vestibular implant, it is possible to generate a vestibular perception selectively by electrical stimulation of the vestibular nerve. These patients are therefore an unique model to study the TBW between visual and vestibular perception.


Experimental observation of anomalous intermolecular cross‐peaks in two‐dimensional solution NMR spectra have attracted significant recent attention. Extremely simple pulse sequences on extremely simple samples with large equilibrium magnetization give resonances in the indirectly detected dimension which are simply impossible in the conventional density matrix framework of NMR. Here we extend a recently proposed density matrix treatment [Science 262, 2005 (1993)] to calculate the exact time evolution for a variety of pulse sequences. This density matrix treatment explicitly removes two fundamental assumptions of the standard theory—it includes the dipolar interaction between spins in solution (which is only partially averaged away by diffusion) and completely removes the high temperature approximation to the equilibrium density matrix [exp(−βH)≊1−βH]. We compare this quantum mechanical treatment to a corrected classical model, which modifies the dipolar demagnetizing field formulation to account for the ...


For amphibians that oviposit in temporary aquatic systems, there is a high risk of desiccation-induced offspring mortality when water evaporates prior to the completion of embryo or tadpole development. Such a strong selective pressure has led to the evolution of a variety of traits in reproducing females and their offspring to improve the odds of reproductive success when free-standing water is temporarily available. Herein, we describe an adaptive function of froth nesting in the Sandpaper Frog, Lechriodus fletcheri, as a possible maternal strategy for protecting embryos from the immediate risk of desiccating in highly ephemeral pools that frequently dry prior to hatching. Field observations revealed that embryos located near the core of nests remained alive and continued to develop for several days after becoming stranded out of water due to declining water levels, with embryo viability maintained long enough for additional rainfall to recharge pools and support hatching of tadpoles into water in some cases. In laboratory trials, the proportion of embryos surviving in nests exposed to desiccating conditions was positively correlated with nest volume, while the rate of water loss relative to nest mass declined, both of which are likely a function of reduced surface area relative to volume in larger nests. We suggest that the encapsulation of embryos within an aerated mucus shields them from desiccation by trapping moisture around their external surfaces. As embryos of L. fletcheri complete development rapidly, the ability for the froth nest to protect against desiccation for several days may allow embryogenesis to be completed largely out of water despite the larval phase not being terrestrial. These results suggest froth nesting has played an important role in facilitating this species' use of ephemeral habitats that most other amphibians with aquatic reproductive modes are incapable of exploiting.


While type 2 diabetes mellitus (T2DM) is commonly considered a putative causal risk factor for stroke, the effect of stroke on T2DM remains unclear. The intrinsic link underlying T2DM and stroke has neither been thoroughly examined. We aimed to evaluate the phenotypic and genetic relationships underlying T2DM and stroke. We evaluated phenotypic associations using data from the UK Biobank (N=472,050). We then investigated genetic relationships leveraging genomic data in European ancestry for T2DM, with and without adjusting for body mass index (BMI) (T2DM: Ncase/Ncontrol=74,124/824,006; T2DMadjBMI: Ncase/Ncontrol=50,409/523,897), and for stroke (Ncase/Ncontrol=73,652/1,234,808). We performed additional analyses using genomic data in East Asian ancestry for T2DM (Ncase/Ncontrol=77,418/356,122) and for stroke (Ncase/Ncontrol=27,413/237,242). Observational analyses suggested a significantly increased hazard of stroke among individuals with T2DM (hazard ratio 2.28 [95%CI 1.97, 2.64]), but a slightly increased hazard of T2DM among individuals with stroke (1.22 [1.03, 1.45]) which attenuated to 1.14 [0.96, 1.36] in sensitivity analysis. A positive global T2DM-stroke genetic correlation was observed (rg=0.35; P=1.46×10-27), largely independent of BMI (T2DMadjBMI-stroke: rg=0.27; P=3.59×10-13). This was further corroborated by 38 shared independent loci and 161 shared expression-trait associations. Mendelian randomization analyses suggested a putative causal effect of T2DM on stroke in Europeans (odds ratio 1.07 [95%CI 1.06, 1.09]), which remained significant in East Asians (1.03 [1.01, 1.06]). Conversely, despite a putative causal effect of stroke on T2DM also observed in Europeans (1.21 [1.07, 1.37]), it attenuated to 1.04 [0.91, 1.19] in East Asians. Our study provides additional evidence to underscore the significant relationship between T2DM and stroke.


We present ARTrack, an autoregressive framework for visual object tracking. ARTrack tackles tracking as a coordinate sequence interpretation task that estimates object trajectories progressively, where the current estimate is induced by previous states and in turn affects subsequences. This time-autoregressive approach models the sequential evolution of trajectories to keep tracing the object across frames, making it superior to existing template matching based trackers that only consider the per-frame localization accuracy. ARTrack is simple and direct, eliminating customized localization heads and post-processings. Despite its simplicity, ARTrack achieves state-of-the-art performance on prevailing benchmark datasets. Source code is available at https://github.com/MIV-XJTU/ARTrack.


This work is ostensibly a study of the archaeology and history of a single Roman landscape - the Fenlands of East Anglia. However, it was also the author's intention to consider the issues raised by the application of post-colonial theory to landscape archaeology. The aims of this study are thus two fold: to explore the nature of imperialism as practiced in the Roman Empire from a post-colonial perspective, and, secondly, to test a series of models generated in relation to the Roman Fenlands. The study as a whole is much concerned with an examination of Roman imperialism as it is with the detail of a particular case study.


In this paper we present a scalable method based on the use of microfluidics and shear force spectroscopy which can be used for determining the affinity between molecules. Our method involves the use of functionalization of the surface of microfluidic channels with ligand molecules, and the surface of microspheres with receptor molecules. Bound beads are detached from the surface of the microchannels using pressure driven flow. The drag force required to detach the beads is used to determine the affinity of the bond holding the two molecules together. The minimum force we are able to detect is 5 pN. We have used this method to determine the binding force between protein-protein interactions and DNA base-pair interactions. We also have shown the ability of this technique to distinguish between strong and weak protein-protein interactions. Using this approach, it may be possible to multiplex an array of these functionalized channels onto a chip and probe the interactions between large varieties of biomolecules.


This article investigates the impact of exports and foreign direct investments on economic growth in Tanzania. This study utilizes secondary data from the Ivan Kushnir's Research Centre database and the National Bureau of Statistics in Tanzania for the period spanning from 1970 to 2012. Furthermore, the study examined the unit root test using the Augmented Dickey Fuller test and co-integration test using Engle-Granger residuals co-integration test and Johansen co-integration test. Thereafter it employed error correction model to examine the impact of exports and foreign direct investments (FDIs) on economic growth in Tanzania. The empirical results reveal that variables are non-stationary at level and stationary at first difference. Again, all variables are found to be co-integrated, implying that all have long-run relationship and variables adjusting to the long-run equilibrium at the speed of 23 percent per annum. Further results shows that exports have significant impact on economic growth in Tanzania, whereas foreign direct investments have negative impacts on economic growth in Tanzania. Therefore, from the obtained empirical results, particularly on foreign direct investments, the government ought to check the proper type of foreign direct investments between brown and green FDIs in boosting the economy. Furthermore, FDI sectoral examination is important rather than general impacts on the economic growth. Keywords: exports, economic growth in Tanzania, foreign direct investments, error correction model


Interference between Present and Absent Performers: Time-Specific Performance as Phenomenal Experience The performance of the play Lise & Otto employed digital technology in an innovative and surprising way. Two performers presented their characters in two locations that were connected by fibre optic cables. The audiences, situated in two suburbs in Stockholm, saw either the actress or the actor live in front of them, while the other performer's image and voice were transmitted digitally. The simultaneous actions emphasized a cleavage of space - symbolic in a play about atomic fission - and created a yearning for the absent performer. This phenomenon can be described as time-specific performance, analogous to site-specific performance, while at the same time questioning the paradigm of presence as as a condition of theatrical events. The article argues for an extension of the theoretical concepts of theatre studies in order to cope with contemporary technological innovations, time-specificity, and unexpected theatrical experiences.


The design and performance of the ATLAS Inner Detector (ID) trigger algorithms running online on the High Level Trigger (HLT) processor farm for 13 TeV LHC collision data with high pileup are discussed. The HLT ID tracking is a vital component in all physics signatures in the ATLAS trigger for the precise selection of the rare or interesting events necessary for physics analysis without overwhelming the offline data storage in terms of both size and rate. To cope with the high interaction rates expected in the 13 TeV LHC collisions, the ID trigger was redesigned during the 2013-15 long shutdown. The performance of the ID trigger in Run 2 data from 13 TeV LHC collisions has been excellent and exceeded expectations, even at the very high interaction multiplicities observed at the end of data-taking in 2017. The detailed efficiencies and resolutions of the ID trigger in a wide range of physics signatures are presented for the Run 2 data. The superb performance of the ID trigger algorithms in these extreme pileup conditions demonstrates how the ID tracking continues to lie at the heart of the trigger performance to enable the ATLAS physics program, and will continue to do so in the future.


In-service embrittlement of the welds at the Doel I and II pressure vessels displays an apparent "outlier" behaviour as compared to the predictions of US NRC Regulatory Guide 1.99 Rev.2. This issue is being addressed by asystematic R&D effort, supplementary to the mandatory surveillance programmes. The status of this effort is reviewed in this paper. The anomalous trends can be outlined as follows. Extensive characterization of the chemical composition of representative test specimens reveals that these low nickel welds, although being nominally identical (same fabrication practice, heat treatment, microstructure,...), do feature an appreciable variability of their bulk copper content - covering a range of 0.13% to 0.35%. High copper Charpy-V weld specimens are however not available in the surveillance capsules. The variability could be identified only because the weld part of some HAZ (heat affected zone) Charpy-V specimens, as well as some tensile specimens, consist of the high copper melt. For the low copper contents, (0.13-0.18%), the 41 J Cv transition temperature shift, as obtained from seven capsules exposed in the neutron fluence range of 1 to 3.9 1019 n/cm 2 (>1 MeV), is rather constant, but significantly larger than predicted (by US NRC Regulatory Guide 1.99 rev.2).This has caused some concern on the upper bound shift to be adopted, given the possibility of higher copper content in the actual pressure vessel welds. High copper samples were manufactured by applying the stud welding reconstitution technique to remnants of the HAZ specimens, and the results cannot be distinguished from the low copper data. Such insensitivity to copper, confirmed by tensile and hardness measurements, is at odds with current literature knowledge and with Regulatory guidelines. A further anomaly observed for this type of weld metal is an appreciable sensitivity to thermal ageing. The surveillance results will be evaluated in accordance with the USNRC Regulatory guide-lines, and the embrittlement trends described above will be thoroughly evaluated from a micromechanical perspective, in the light of a high resolution microstructural investigation.


Objective: To test whether a frequently used cohort-nested case-control study design exaggerated exposure-response relationships because of unrecognized study design bias. Our aim was to evaluate empirically the performance of this complex study design. Methods: We applied the design from one such study to a closely related cohort using randomly selected probands as cases. Values for average exposures were assigned to probands equal to, greater than, and less than those assigned to controls (matches). Results: Under certain lag scenarios, the nested study design produced higher average exposure in probands compared with their matches, even when this was clearly not the case. Conclusions: Empirical evaluation demonstrated that the study design produced a biased case-control lagged exposure difference under the null hypothesis and could not distinguish qualitatively between null and alternate hypotheses. Empirical evaluation provided a useful check on results generated from a complex study design. It gave useful insight into the behavior of the index study design that was not otherwise readily deducible.


Abstract Since the end of the Cold War, the international arena has witnessed two concurrent worldwide trends. One is the gradual prevalence of universalism under the banner of human civilization; the other is the gradual revival of nationalism globally under exactly the same heading. Both trends are evident in China, a country which in the twenty-first century is perceived universally as a rising nation. However, does Chinese nationalism necessarily pose a threat to the world? By examining two debates on the Chinese intellectual response towards Sino-American and Sino-Japanese relations in the early twenty-first century, this paper investigates the status of Chinese nationalism. It questions whether it is a fixed set of ideas embraced by a solid entity, or whether it possesses multiple layers with dual elements contributing to both security and insecurity internationally. The paper argues that three separate nationalist processes are occurring concurrently but independently of each other: the construction of civic nationalist values; the development of an international relations strategy assigning responsible power to China; and the detection of alleged anti-Chinese conspiracies. The effect of the first two would be to encourage regional peace, and they could offset fervent nationalist expression. A somewhat counter-intuitive result of Chinese nationalism might be that it also becomes a stabilizing force within and outside China's borders.


This paper demonstrates that long-term forward interest rates in the U.S. often react considerably to surprises in macroeconomic data releases and monetary policy announcements. This behavior is inconsistent with the assumption of many macroeconomic models that the long-run properties of the economy are time-invariant and perfectly known by all economic agents. Under those conditions, the shocks we consider would have only transitory effects on short-term interest rates, and hence would not generate large responses in forward rates. Our empirical findings suggest that private agents adjust their expectations of the long-run inflation rate in response to macroeconomic and monetary policy surprises. Consistent with our hypothesis, forward rates derived from inflation-indexed Treasury debt show little sensitivity to these shocks, indicating that the response of nominal forward rates is mostly driven by inflation compensation. In addition, we find that in the U.K., where the long-run inflation target is known by the private sector, long-term forward rates have not demonstrated excess sensitivity since the Bank of England achieved independence in mid-1997. We present an alternative model in which agents' perceptions of long-run inflation are not completely anchored, which fits all of our empirical results.


The nuclear magnetic resonance properties of the nuclei of atoms is a convenient means for elucidating the morphology and pathophysiology of the human body. The fundamental principles of Larmor precession are discussed from the classical as well as from the quantum mechanical point of view. In this paper, principles of NMR medical imaging and its clinical applications are discussed.


In the current study, we applied the Monte Carlo method to study the self-assembly of linear ABC amphiphiles composed of two solvophobic A and B blocks and a solvophilic C block. A great number of multicompartment micelles are discovered from the simulations and the detailed phase diagrams for the ABC amphiphiles with different block lengths are obtained. The simulation results reveal that the micellar structure is largely controlled by block length, solvent quality, and incompatibility between the different block types. When the B block is longer than or as same as the terminal A block, a rich variety of micellar structures can be formed from ABC amphiphiles. By adjusting the solvent quality or incompatibility between the different block types, multiple morphological transitions are observed. These morphological sequences are well explained and consistent with all the previous experimental and theoretical studies. Despite the complexity of the micellar structures and morphological transitions observed for the self-assembly of ABC amphiphiles, two important common features of the phase behavior are obtained. In general, the micellar structures obtained in the current study can be divided into zero-dimensional (sphere-like structures, including bumpy-surfaced spheres and sphere-on-sphere structures), one-dimensional (cylinder-like structures, including rod and ring structures), two-dimensional (layer-like structures, including disk, lamella and worm-like and hamburger structures) and three-dimensional (vesicle) structures. It is found that the micellar structures transform from low- to high- dimensional structures when the solvent quality for the solvophobic blocks is decreased. In contrast, the micellar structures transform from high- to low-dimensional structures as the incompatibility between different block types increases. Furthermore, several novel micellar structures, such as the CBABC five-layer vesicle, hamburger, CBA three-layer ring, wormlike shape with bumps on the sides, and disk shape with bumps on the edge, are predicted in this study. The formation pathways of ring, hamburger, and worm-like micelles are also examined and their formation mechanisms are well elucidated.


The sciatic nerves of 12 male rats were examined in the electron microscope 14 days after pneumatic tourniquet compression. Tourniquet pressure was maintained at 300 mmHg for varied lengths of time (30 minutes to 3 hours). Nerves compressed for 30 minutes showed very mild fissuring of the myelin without axonal degeneration. Examination of nerves compressed for 1 to 3 hours showed progressively more varied and extensive damage. Changes included splaying of myelin lamellae, axonal shrinkage with periaxonal edema. Schwann cell hypertrophy, and an increase in the number of microtubules and mitochondria per unit area. The myelin sheaths of some fibers, compressed for more than 2 hours, were completely ruptured. These changes resemble nerve lesions which could be induced by a variety of experimental procedures. Ultrastructural changes produced by tourniquet compression are apparently time-related and affect large-diameter nerves more profoundly than smaller-diameter nerves. The data reported provide an explanation for delayed muscle rehabilitation experienced by patients who have undergone extremity surgery with pneumatic tourniquet application. The evidence presented suggests that the incidence of tourniquet palsy may be far greater than previously recognized.


The plant circadian clock is an endogenous 24h timer driving numerous metabolic, physiological, biochemical and developmental processes in the plant. As such, it is of great interest to understand the design principles of this important mechanism. In this talk I will show how mathematical modeling and novel methods have helped us gain a greater understanding of the plant clock. I will also show how this specific biological application has driven the development of new mathematical theory and a software tool.


The object of this essay is to discuss the relationship between the definition of the concept of gender equality and attitudes towards gender equality and their consequences for gender equality measures. The point of departure is feminist political theory and interviews about attitudes towards gender equality at a department at the University of Linkoping. The conclusions of this study is that there are a wide range of definitions and attitudes, and these conceptions are not necessarily the same as those being pointed out in the official gender equality policy at the University of Linkoping. In this study the opinions of measures for gender equality among the interviewed are widely spread. Some finding Swedish men and women already being equal and therefore there is no need for measures, since this would result in discrimination of men since women would gain advantages from being women. Others find measures for gender equality important since the society and the University is male-defined and therefore not equal. Following, there is a need for further discussions on the definition of, and measures for gender equality. The feminist perspective on the concept of gender equality highlights the need for consideration on how the measures are reproducing, reinforcing or reconceptualizing the signification of gender.


Wireless Local Area Network (WLAN) based on IEEE 802.11e provides Quality of Service (QoS) support at the Medium Access Control (MAC) sublayer. IEEE 802.11e MAC sublayer uses a function called Hybrid Coordination Function (HCF) with Enhanced Distributed Channel Access (EDCA). EDCA is a QoS mechanism that provides a priority scheme by differentiating interframe space and contention window size, it also uses Contention Free Bursting (CFB) scheme that can improve the efficiency of the system. In this study we analyzed performance of wireless network based on IEEE 802.11e in supporting QoS for multimedia transmission. We use three different types of traffic, those are voice, video, and data to analyze the performance of the network in supporting multimedia transmission.


The accumulation of 99mTc-glucarate, an agent recently reported to localize in acutely infarcted myocardium, zones of acute cerebral injury and tumors, has been compared with 99mTc-gluconate in an in vitro system of cultured Chinese hamster ovary fibroblasts. The effects on accumulation of hypoxia and competition with fructose have been studied. Both labeled glucose analogs showed a two- to threefold enhanced accumulation in hypoxic cells relative to aerobic cells. No such enhanced accumulation under hypoxia was observed for the nonsugar tracers pertechnetate and 99mTc-DTPA. The presence of 20 mM fructose reduced the accumulation of 99mTc-glucarate by 30% (p = 0.067) and 99mTc-gluconate by 40% (p < 0.05) in hypoxic cells, but had no significant effect in aerobic cells. These results suggest that both compounds at least partially share a common mechanism of uptake and/or accumulation with fructose.


: The relationship of the morphology of the normal pancreas, as seen on CT, and age was studied in 200 normal people aged between 19 and 87 years. The A.P. diameter, vertebral body/pancreas ratio, cranio-caudal diameter, contour and structure of the pancreas were analysed. The most marked age-related changed occurred in the vertebral body/pancreas ratio, but all other measurements showed a reduction dependent on age. With increasing age, the contour of the pancreas becomes more lobulated and, at the same time, the structure changes from an homogeneous to an inhomogeneous appearance. These findings correspond with pathological-anatomical observations.


Glycerol kinetics and total fatty acid (FA) oxidation of trained African pygmy goats were measured by continuous infusion of [2-3H]glycerol and indirect calorimetry during treadmill exercise at 40, 60, and 85% maximal O2 consumption (VO2max). Our main goals were 1) to determine whether rates of FA mobilization and utilization are eventually matched as exercise intensity increases, thereby minimizing reesterification to supply more FA to working muscles, and 2) to test the hypothesis that lipolytic rate is proportional to aerobic capacity by comparing low-aerobic goats with published values from highly aerobic dogs and humans. Mean rate of glycerol release in the circulation (Ra glycerol) was 3.83 +/- 0.11 at rest, 7.69 +/- 0.88 at 40% VO2max, reached a maximum of 15.32 +/- 0.95 at 60% VO2max, and returned to 10.53 +/- 0.76 mumol.kg-1 x min-1 at 85% VO2max. Lipolytic rate did not match total FA oxidation, implying that Ra glycerol cannot be used as an index of FA utilization, even during intense exercise. A large fraction of total FA released by lipolysis was reesterified at 60 and 85% VO2max, showing that FA mobilization does not limit whole animal FA oxidation at these intensities. Comparing goat, dog, and human responses reveals that mammalian lipolytic rate is scaled with aerobic capacity. High- and low-aerobic species exercising at the same %VO2max mobilize FA in exact proportion with their metabolic rate, suggesting that the relative contribution of FA to total energy provision is independent of VO2max.


In this work, we introduce a MoS2-based field effect transistor that can alternately operate either as a p-type or an n-type semiconductor in the same device. The proposed device is built with an adjustable threshold voltage (Vth), which can be varied by adding a layer of plasma-oxidized dielectric at the top gate structure. This facilitates a surplus of oxygen due to the relatively thin grown dielectric layer and the creation of negative charges in that layer instead of the usual ones of positive polarization in the bottom dielectric layer. Consequently, the Vth shifts and the top gate structure switches from the typical n-type to p-type while the n-type behaviour remains in the application of the bottom-gate voltages. The Vth can be tuned further by applying a gate pulse input at the top gate. Accordingly, we have demonstrated complementary logic inverters with adjustable device characteristics that are controllable by the polarity of charges induced in the device's oxide layer. This is a big step towards the concurrent implementation of both n-type and p-type characteristics in a single device.


INTRODUCTION
The aim of this study was to assess the clinical outcomes of high-risk patients with severe aortic stenosis (AS) allocated to medical treatment (MT), transcatheter aortic valve replacement (TAVR), and surgical aortic valve replacement (SAVR) through extended follow-up.

METHODS AND RESULTS
Consecutive patients with severe symptomatic AS included in a prospective single centre registry underwent sweep follow-up between March and August 2016. Clinical outcomes were assessed using a competing risk model. A total of 442 patients (median age 83 years; 52% female) were allocated to MT (n = 78), SAVR (n = 107), or TAVR (n = 257) with a gradient of surgical risk as assessed by logistic EuroSCORE (MT: 27.9 ± 14.5%, TAVR: 24.7 ± 24.9%, SAVR: 12.5 ± 8.2%; p <0.001). Survival after a median duration of follow-up of seven years was 6.4% (MT), 30.4% (TAVR), and 46.7% (SAVR), respectively (p <0.001). One TAVR and one SAVR patient underwent repeat intervention for valvular degeneration between 4.5 and 8.4 years after intervention. Compromised left ventricular function (LVEF <40%) was associated with increased mortality (HR 1.62, 95% CI 1.22–2.15; p <0.0001), whereas female sex was protective (HR 0.68, 95% CI 0.53–0.88; p = 0.0006).

CONCLUSION
Both TAVR and SAVR reduced mortality compared to MT throughout a median duration of follow-up of seven years. Repeat interventions for valvular degeneration were rare.


This article reports an investigation of embedded null subjects in both L1 and L2 Chinese. Chinese null embedded subjects can refer either to a matrix subject or to a discourse entity. In the Government-Binding (GB) framework, these two possibilities resulted from the null subject being either pro or a variable. Neither pro nor a variable is compatible with the assumptions of the more recent Minimalist Program, however. This article proposes an alternative account for null embedded subjects in Chinese that is consistent with the Minimalist Program: deletion of the anaphor ziji and deletion of a topic under identity with appropriate antecedents. It then reports a study of knowledge of such deletion in the Chinese of L2 speakers. Although the existing literature has found that embedded null subjects are allowed by L2 learners of Chinese at early stages of development, no research has investigated whether they are interpreted in a target-like way by L2 speakers. A picture judgment task and a written interpretation task showed that English-speaking learners of high-intermediate proficiency in Chinese allow an embedded null subject to refer to the matrix subject, but not to a discourse entity. It is only at advanced proficiency that L2 speakers allow co-reference with both a matrix subject and a discourse entity. The implications of these results are discussed.


In this paper, we present a study aimed at understanding whether the embodiment and humanlikeness of an artificial agent can affect people's spontaneous and instructed mimicry of its facial expressions. The study followed a mixed experimental design and revolved around an emotion recognition task. Participants were randomly assigned to one level of humanlikeness (between-subject variable: humanlike, characterlike, or morph facial texture of the artificial agents) and observed the facial expressions displayed by three artificial agents differing in embodiment (within-subject variable: video-recorded robot, physical robot, and virtual agent) and a human (control). To study both spontaneous and instructed facial mimicry, we divided the experimental sessions into two phases. In the first phase, we asked participants to observe and recognize the emotions displayed by the agents. In the second phase, we asked them to look at the agents' facial expressions, replicate their dynamics as closely as possible, and then identify the observed emotions. In both cases, we assessed participants' facial expressions with an automated Action Unit (AU) intensity detector. Contrary to our hypotheses, our results disclose that the agent that was perceived as the least uncanny, and most anthropomorphic, likable, and co-present, was the one spontaneously mimicked the least. Moreover, they show that instructed facial mimicry negatively predicts spontaneous facial mimicry. Further exploratory analyses revealed that spontaneous facial mimicry appeared when participants were less certain of the emotion they recognized. Hence, we postulate that an emotion recognition goal can flip the social value of facial mimicry as it transforms a likable artificial agent into a distractor. Further work is needed to corroborate this hypothesis. Nevertheless, our findings shed light on the functioning of human-agent and human-robot mimicry in emotion recognition tasks and help us to unravel the relationship between facial mimicry, liking, and rapport.


IntroductionThe problem list of a patient's primary care electronic medical record (EMR) generally reflects their important medical conditions. We will use association rule mining to assess between-provider and between-clinic variation in the coding of select conditions in the EMR problem list, in order to identify possible under-coding outliers.
Objectives and ApproachEMR data from participating clinics in the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) will be used, with a focus on three commonly-occurring conditions (hypertension, diabetes, and depression). Association rule mining will be used to develop association rules between these conditions and other clinical information available in the EMR, such as other diagnoses in the problem list, billing codes, medications, and laboratory results (e.g., a rule of "diabetic medication→diabetes" indicates that patients prescribed a diabetic medication are likely to have diabetes in the problem list). Under-coding outliers at the provider and clinic levels will be identified by comparing rule enforcement.
ResultsResults from this work in progress will be presented at the conference. An estimated 270 clinics, 1340 providers, and 1.8 million patients will be included from the CPCSSN database. Rule 'confidence' will be used to identify outliers; the confidence of a rule X→Y is the proportion of individuals with X who also have Y (Pr(Y|X)). For example, we may find that on average 80% of patients prescribed a diabetic medication will also have a diagnosis of diabetes in the problem list (average confidence of 80%), but an outlier clinic may have a confidence of 40%; this low rule confidence may indicate under-coding of diabetes in the problem list. Confounding by patient demographics (e.g., age, sex, urban/rural) will be assessed and adjusted for, if necessary.
Conclusion/ImplicationsThis work examines a novel method to identify potential under-coding in the EMR problem list. Providers/clinics could use this information to update patients' problem list or inform quality improvement interventions. Researchers using primary care EMR data need to be aware of potential under-coding and take steps to mitigate the effects.