A method of synthesising a biocompatible HAP coating is presented. In the current study, Nd:YAG laser was used to directly melt pre-place HAP powder beds on Ti-6Al-4V. The processing parameters used were 750 W laser power, 5 mm/s scanning speed and 27° inclined beam plane. The coating was studied under white light and scanning electron microscope where it was possible to characterise the microstructures. The produced coating was characterised of mixed morphologies of HAP, short and elongated titanium needles at the surface while in the middle of the coating dendrite trunks without arms were observed. This observation is related to the heat inputs, dilution and melting of the substrate and powder during processing. The absence of the arms growing from the trunks indicated low heat inputs. In addition, the microstructure of the HAP after soaking in Hanks' solution indicated octagonal and hexagonal crystals of HAP. The hardness values indicated good metallurgical bonding at the interface. In conclusion, this study was successful in fabricating a desirable coating of HAP on Ti-6Al-4V for biomedical applications. This work highlights that even though laser power and scanning speed are predominantly influential parameter settings, it is also necessary to consider the angle at which the laser beam is scanned across the material.


Abstract The Mars Curiosity rover carries a diverse instrument payload to characterize habitable environments in the sedimentary layers of Aeolis Mons. One of these instruments is Sample Analysis at Mars (SAM), which contains a mass spectrometer that is capable of detecting organic compounds via pyrolysis gas chromatography mass spectrometry (py-GC-MS). To identify polar organic molecules, the SAM instrument carries the thermochemolysis reagent tetramethylammonium hydroxide (TMAH) in methanol (hereafter referred to as TMAH). TMAH can liberate fatty acids bound in macromolecules or chemically bound monomers associated with mineral phases and make these organics detectable via gas chromatography mass spectrometry (GC-MS) by methylation. Fatty acids, a type of carboxylic acid that contains a carboxyl functional group, are of particular interest given their presence in both biotic and abiotic materials. This work represents the first analyses of a suite of Mars-analog samples using the TMAH experiment under select SAM-like conditions. Samples analyzed include iron oxyhydroxides and iron oxyhydroxysulfates, a mixture of iron oxides/oxyhydroxides and clays, iron sulfide, siliceous sinter, carbonates, and shale. The TMAH experiments produced detectable signals under SAM-like pyrolysis conditions when organics were present either at high concentrations or in geologically modern systems. Although only a few analog samples exhibited a high abundance and variety of fatty acid methyl esters (FAMEs), FAMEs were detected in the majority of analog samples tested. When utilized, the TMAH thermochemolysis experiment on SAM could be an opportunity to detect organic molecules bound in macromolecules on Mars. The detection of a FAME profile is of great astrobiological interest, as it could provide information regarding the source of martian organic material detected by SAM.


This study investigated the internal organisational barriers to individuals from a demographically diverse background being appointed as an independent non-executive director (INED) of a Northern Territory (Australia) organisation. Since the end of World War II in 1945, Australia has evolved into an egalitarian heterogeneous multicultural society. Nevertheless, boards of directors (BoDs) have remained homogeneous and dominated by privileged, white, middle-aged men from the 'old boy's network'. As a result of this incongruence, the demographic composition of Australia's boardrooms has been a much discussed, debated and researched topic. The focus of previous research has, however, been on the gender diversity of large profit-making listed organisations located in the densely populated metropolitan regions of Australia. This study aimed to broaden the discussion by embracing a more inclusive holistic definition of demographic diversity at the board level. The study investigated the internal organisational barriers to diversity in the boardroom among three types of organisations: profit, not-for-profit and government organisations. Collectively, the inclusive definition of demographic diversity in the boardroom among these three organisational types in regional and remote parts of Australia more often than not is ignored when discussing the diversity of the country's INEDs. For that reason, the question of what are the internal organisational barriers to people from demographically diverse backgrounds being appointed as INEDs of Northern Territory organisations has remained unanswered. Thus, based on the foundation of a research paradigm of pragmatism, this study employed a sequential exploratory mixed methods research design to answer this question. In Phase One of the study, qualitative data were collected from two data sources to uncover the salient internal organisational barriers to diversity in the boardroom. The first data source was INEDs from demographically diverse backgrounds and the second was spokespeople from peak industry bodies representing organisations with BoDs. Phase Two of the study collected quantitative data to further explore the observations from the qualitative phase. In Phase Two, an online survey was sent to independent and non-independent directors of Northern Territory organisations. The qualitative data analysis revealed six organisational barriers that either prevented or inhibited people from demographically diverse backgrounds being appointed as INEDs of Northern Territory organisations. However, the results of the quantitative analysis did not support this position, determining that the internal organisational barriers identified in Phase One were not sufficiently significant to preclude people from demographically diverse backgrounds being appointed as INEDs. However, the study also found that the participants from both phases considered that having a formal board diversity policy would promote and encourage demographic diversity in the boardroom. As a result, for Northern Territory boards to be more inclusive of people from a variety of demographic backgrounds, BoDs may need to consider creating formal diversity in the boardroom policies. Another important finding from the study was that contrary to the literature's assertions about boardrooms being dominated by men, Northern Territory boardrooms had an equal representation of female and male directors. The study determined that geographical factors may also inhibit individuals from demographically diverse backgrounds being appointed as INEDs of Northern Territory organisations.


Background. The aim of this review was to study risk factors involved in osteonecrosis of the jaw after oral surgery in patients treated with bisphosphonates due to primary osteoporosis. Methods. In order to find relevant related publications, we conducted a systematic search in specialized (Cochrane Database of Systematic Reviews, Trip Database) and general (Medline, Embase, Isi Web of Knowledge) bibliographical databases. The search strategy included the terms osteonecrosis, adults and oral surgery. It was limited to papers focused on human adults undergoing dentoalveolar surgery while being treated with bisphosphonates due to primary osteoporosis, which had been published in the English or Spanish languages between January 2006 and January 2012. Systematic reviews, meta-analyses, practice guidelines, randomized clinical trials and case report series were included. Results. Fourteen papers (case report series) including 43 cases of osteonecrosis of the jaw were selected. Jaw and extraction were the most frequent localization and dental procedure related to the lesions. Mean age of patients was 71.94 years, with lesions being more frequent among women. Alendronate was the bisphosphonate used in the majority of cases, with a mean duration of treatment before osteonecrosis of the jaw appeared of 48.25 months. Conclusions. Well-designed, prospective and retrospective studies are needed to evaluate the real weight of each of those factors considered to entail a potential risk of osteonecrosis of the jaw.


BACKGROUND
Vitamin K antagonist tablets are often split to fractionate the dose by elderly patients. We performed a study in order to assess the divisibility of one dosage strength of score-lined warfarin and of score-lined fluindione.

METHODS
Due to a recent change in the pharmaceutical form of fluindione in order to improve the divisibility, the study was performed over 2 different periods (with the « old » and with the « new » pharmaceutical form). In each period, 10 patients mean aged 82 years, 10 relatives, 10 nurses, 10 medical doctors) were asked to split in half warfarin tablets (W2 1(st) period et W2 2(d) period) and fluindione tablets (F2 et F'2), and to split fluindione tablets into 4 fragments (F4 et F'4). The first end-point was the accuracy of splitting estimated by the difference between the real and the expected weight of fragmented tablets. The statistical analysis was performed using an ANOVA test with 2 variables, subject and drug. The difference between the 2 periods were analyzed using an ANOVA test with 2 variables, subject and period.

RESULTS
Over the 2 periods, the differences between real and expected weight were of 4.65% for W2 1(st) phase, 9.48% for F2, 15.35% for F4, 5.56% for W2 2(d )period, 4.30% for F'2, and 6.98% for F'4. The quality of splitting was statistically poorer in the elderly patient group compared to other subjects.

CONCLUSION
This study was not design to assess the clinical relevance (bleeding or thromboembolism) or the anticoagulation control of the variations in drug mass due to inappropriate splitting of tablets. However, split form of drugs should be prescribe with caution to elderly patients.


The Fault Tree Analysis (FTA) is a systematic, deductive (top-down type) and probabilistic risk assessment tool which shows the causal relations leading to a given undesired event, referred to as the "Top Event" (TE). The events, which cannot be subdivided, are called the Basic Events. Fault Tree diagram displays the undesired state of the investigated system (top event) in terms of the states of its components (basic events). The Fault Tree Analysis is a graphical design technique main result of which is a tree, a dendritic graph. Probabilistic Fault Tree Analysis (PFTA) is a quantitative analysis method used to calculate the probability of Top Event from given failure probabilities of system components. The objective of the sensitivity analysis is to show how the change in any system parameter influences the resultant reliability value of the whole system.  The main aim of this study is to elaborate an easy-used algorithm for setting-up of Linear Fault Tree Sensitivity Model (LFTSM). This modular approach process uses matrix-algebraic method based upon the mathematical diagnostic modeling of aircraft systems and gas turbine engines. The paper shows the adaptation of linear mathematical diagnostic modeling methodology for setting-up of LFTSM and its possibility of use to investigate Fault Tree sensitivity by a demonstrative example. Keywords: Reliability, Availability, Maintenance, Sensitivity Analysis. 2000 MSC: 68M15, 49Q12, 93B35.


The class of games with one apex player is generalized to the class of games with a collection of apex sets. These simple games, together with a power index, canonically induce a hedonic coalition formation game. A monotonicity property of solutions is introduced and its meaning for the induced hedonic game is analyzed. Necessary and sufficient conditions for the existence of core stable partitions are stated and core stable partitions are characterized.


This paper addresses real-world challenges in the motion segmentation problem, including perspective effects, missing data, and unknown number of motions. It first formulates the 3-D motion segmentation from two perspective views as a subspace clustering problem, utilizing the epipolar constraint of an image pair. It then combines the point correspondence information across multiple image frames via a collaborative clustering step, in which tight integration is achieved via a mixed norm optimization scheme. For model selection, we propose an over-segment and merge approach, where the merging step is based on the property of the ell_1-norm of the mutual sparse representation of two over-segmented groups. The resulting algorithm can deal with incomplete trajectories and perspective effects substantially better than state-of-the-art two-frame and multi-frame methods. Experiments on a 62-clip dataset show the significant superiority of the proposed idea in both segmentation accuracy and model selection.


CONTEXT
Proliferative verrucous leukoplakia (PVL) is a highly persistent and aggressive oral pre-malignant lesion with an obscure etiopathogenesis and a malignant transformation rate of 85-100%.

AIMS
The aim of the present study is to assess the role of Ki-67, p16, CD34, Bcl-2, cyclooxygenase-2 (COX-2) in the spectrum of PVL to ascertain their role in its etiopathogenesis.

SETTINGS AND DESIGN
A retrospective chart analysis was carried out on a series of seven confirmed cases of PVL, which were followed-up for 2 years.

SUBJECTS AND METHODS
Immunohistochemical appraisal of these cases was carried out by a panel of markers, related to cell proliferation, cell cycle regulation, angiogenesis, apoptosis and inflammation. The expression of these markers was correlated with patients' clinicopathological profile.

STATISTICAL ANALYSIS USED
The frequency distribution of the group data was analyzed.

RESULTS
The latest labeling index of Ki-67 in our cases ranged from 8.18 to 12.6. p16 was positive in 3/7 cases. Bcl-2 expression was moderately positive in 2/7 cases. All cases were intensely positive for COX-2 staining. Microvascular density assessed by CD34 staining ranged from 11 to 20/high power fields. One case which transformed into squamous cell carcinoma demonstrated increased Ki-67, Bcl-2, COX-2, CD34 expression, but negative p16 and Bcl-2 expression.

CONCLUSIONS
Application of these markers in understanding the behavior of PVL suggests that an imbalance between the proliferation apoptosis dynamics of the lesion accompanied by an increase in inflammation and angiogenesis underlie the molecular pathogenesis of the PVL spectrum.


If deterministic processes consistently structure ecological communities, similar patterns in species interactions should be observed in different geographic areas that experience similar environmental conditions. I tested for convergent patterns in dietary diversity of fruit-eating birds inhabiting similar latitude forests in the Northern and Southern hemispheres. I observed birds foraging for fruits over two fruiting seasons in both Nelson Lakes National Park, South Island, New Zealand, and the Pacific Rim National Park, Vancouver Island, Canada. I then conducted rarefaction analyses to compare community-level and species-level dietary diversity between geographic locales. Relationships between the size of each bird species and the average size of fruits consumed were also assessed. Results showed that the New Zealand bird community had greater overall dietary diversity than the Canadian community. However, similar levels of dietary diversity were observed among species within communities in both hemispheres. Positive relationships between bird size and fruit size were observed in New Zealand, but not in Canada. Therefore, while results showed some support for dietary convergence between hemispheres, several substantial differences were also observed, leading to mixed support for convergent patterns in the diets of fruit-eating birds between hemispheres.


We are in the midst of the latest iteration of the "crypto wars." These conflicts, nominally waged between proponents of strong encryption technologies on the one hand and law enforcement and national security interests on the other, are the natural result of increased availability and use of strong encryption throughout the communications ecosystem. Strong encryption makes it difficult, in some cases effectively impossible, for the government to obtain information from individuals – even in cases where it has lawful basis for demanding and legitimate need to obtain access to that information. The availability of a technology that effectively moots the government's ability to compel the disclosure of information shifts the balance of power between individuals and the government. The task of rebalancing these powers ultimately falls to the political process, and, in specific, to Congress. This article uses CALEA, a law adopted in 1994 during the previous iteration of the crypto wars, as a lens to understand how Congress can, and is likely to, respond to this changing balance of power.


Neuroblastoma is the 3rd most common malignant tumor in infancy, following leukemia and CNS tumors. It is the second most common tumor encountered during childhood. Neuroblastoma is a malignant tumor originating from the neural crest . Patients are usually younger than 4 years of age. 46% of the cases are derived from the surrenal glands. But the tumor can be detected anywhere from the neck to the sacrum, wherever the sympathetic chain exists. 14% of the neuroblastomas originate within the thoracal region. Here we report a case of posterior mediastinal neuroblastoma which has some rarely encountered yet typical radiological findings.


The scale down of transistor technology allows microelectronics manufacturers such as Intel and IBM to build always more sophisticated systems on a single microchip.
The classical interconnection solutions based on shared buses or direct connections between the modules of the chip are becoming obsolete as they struggle to sustain
the increasing tight bandwidth and latency constraints that these systems demand.
The most promising solution for the future chip interconnects are the Networks on Chip (NoC). NoCs are network composed by routers and channels used to inter-
connect the different components installed on the single microchip. Examples of advanced processors based on NoC interconnects are the IBM Cell processor, composed by eight CPUs that is installed on the Sony Playstation III and
the Intel Teraflops pro ject composed by 80 independent (simple) microprocessors.
On chip integration is becoming popular not only in the Chip Multi Processor (CMP) research area but also in the wider and more heterogeneous world of Systems
on Chip (SoC). SoC comprehend all the electronic devices that surround us such as cell-phones, smart-phones, house embedded systems, automotive systems, set-top
boxes etc...
SoC manufacturers such as ST Microelectronics , Samsung, Philips and also Universities such as Bologna University, M.I.T., Berkeley and more are all proposing proprietary frameworks based on NoC interconnects. These frameworks
help engineers in the switch of design methodology and speed up the development of new NoC-based systems on chip.
In this Thesis we propose an introduction of CMP and SoC interconnection networks. Then focusing on SoC systems we propose:
• a detailed analysis based on simulation of the Spidergon NoC, a ST Microelectronics solution for SoC interconnects. The Spidergon NoC differs from
many classical solutions inherited from the parallel computing world. Here we propose a detailed analysis of this NoC topology and routing algorithms. Furthermore we propose aEqualized a new routing algorithm designed to optimize the use of the resources of the network while also increasing its performance;
• a methodology flow based on modified publicly available tools that combined can be used to design, model and analyze any kind of System on Chip;
• a detailed analysis of a ST Microelectronics-proprietary transport-level protocol that the author of this Thesis helped developing;
• a simulation-based comprehensive comparison of different network interface designs proposed by the author and the researchers at AST lab, in order to
integrate shared-memory and message-passing based components on a single System on Chip;
• a powerful and flexible solution to address the time closure exception issue in the design of synchronous Networks on Chip. Our solution is based on relay
stations repeaters and allows to reduce the power and area demands of NoC interconnects while also reducing its buffer needs;
• a solution to simplify the design of the NoC by also increasing their performance and reducing their power and area consumption. We propose to replace complex and slow virtual channel-based routers with multiple and flexible
small Multi Plane ones. This solution allows us to reduce the area and power dissipation of any NoC while also increasing its performance especially when the resources are reduced.
This Thesis has been written in collaboration with the Advanced System Technology laboratory in Grenoble France, and the Computer Science Department at Columbia University in the city of New York.


This paper presents a new and efficient heuristic procedure for determining whether or not a given Boolean function is a threshold function, when the Boolean function is given in the form of a decision diagram. The decision diagram based method is significantly different from earlier methods that are based on solving linear inequalities in Boolean variables that derived from truth tables. This method's success depends on the ordering of the variables in the binary decision diagram (BDD). An alternative data structure, and one that is more compact than a BDD, called a max literal factor tree (MLFT) is introduced. An MLFT is a particular type of factoring tree and was found to be more efficient than a BDD for identifying threshold functions. The threshold identification procedure is applied to the MCNC benchmark circuits to synthesize threshold gate networks.


As the pharmacology section continues to represent a major portion of the medical oncology exam and a key component on oncology MOC exams, this portable study guide will help prepare anyone looking to fine-tune their knowledge on cancer drugs before the test. Not to mention, with recent advancements in the field of cancer treatment, it has become more cumbersome to recall and maintain essential knowledge of every cancer therapeutic, making this book not only an exam resource but also a handy quick reference for oncologists and pharmacists alike. Key Features:Conveniently organized and arranged by drug class and subtypes for easier recall and classification Includes proper dosage adjustments to account for liver and kidney dysfunctionFeatures tables throughout that provide quick reference regarding FDA-approved medicationsSimplified diagrams and illustrations facilitate the pharmacokinetic processes


Background and Aim: It is inconclusive that periodontitis is an independent risk factor for adverse pregnancy outcomes. This study aims to investigate the association between maternal periodontitis and preterm and/or low birth weight babies. Settings and Design: This was a prospective cross-sectional study. After prior informed consent, 3500 postpartum mothers were selected from various hospitals in Tamil Nadu and categorized into the following groups: group-1 – Normal term normal birth weight (n = 1100); Group-2 – Preterm normal birth weight (n = 400); Group-3 – preterm low birth weight (PTLBW) (n = 1000); and Group-4 – Normal term low birth weight (n = 1000). Periodontal examination was done, and risk factors were ascertained by means of questionnaire and medical records. Statistical Analysis: Comparison between case groups and control groups were done, odds ratio (OR) was calculated, and statistical significance were assessed by Chi-square tests. To control for the possible confounders, all variables with P < 0.05 were selected and entered into multivariate regression model, and OR and 95% confidence limits were again estimated. SPSS-15 software was used. Results: Periodontitis was diagnosed in 54.8%, 52.3%, 53.8%, 59.4%, respectively. On comparison between the groups, none of periodontal parameters showed significant association except for the crude association observed in Group-4 for mild periodontitis (OR - 1.561; P = 0.000) and PTLBW. Conclusion: Periodontitis is not a significant independent risk factor, and obstetric factors contribute a major risk for preterm and/or low birth weight babies


This guide was created to help students navigate the beginning of their educational career at GHC! Here you will find how to's such as connecting to GHC's internet, the basics of how to use Microsoft, and much more.


Background: Breast cancer (BC) is the most frequent cancer in European women with nearly 30% of the patients eventually developing metastases. Neuroendocrine differentiation is a rare event, but overexpression of somatostatin receptors in BC has been reported in many studies. Case Report: A patient with liver metastases from BC was treated with peptide receptor radionuclide therapy (PRRT). Computed tomography scan and biochemical examinations showed a clear response to radionuclide therapy. Conclusion: PRRT may be useful in metastatic BC patients.


ABONG THE SATIRICAL VERSES THAT WILLIAM BLAKE WROTE IN HIS NOTEBOOK in the early 1800s are four lines that read: P--loved me, not as he lovd his Friends For he lovd them for gain to serve his Ends He loved me and for no Gain at all But to rejoice & triumph in my fall (1) P--has been identified as the publisher Richard Phillips, (2) who played a brief but important role in Blake's life, as a partner in the publishing of a book with Blake's illustrations and as publisher of the Monthly Magazine. Exploring Blake's relations with Phillips in these two capacities will give us a better idea of Blake's life and interests in the years immediately following his move back to London in 1803 after three years' absence. Upon returning from what he called "my three years Slumber on the banks of the Ocean," (3) Blake began to reestablish himself in the professional world of engraving in London. His first project involved the ballads that had initially been issued as quartos in Sussex, featuring William Hayley's poems about animals and Blake's engravings after his own designs. This enterprise had been Hayley's idea from the beginning, his purpose being to get some money for Blake. In 1802 four ballads were issued in quarto, the texts printed by William Seagrave in Chichester and the plates by William and Catherine Blake in their Felpham cottage, and marketed by Hayley among his friends. However, the hoped-for benefit to Blake did not materialize. Hayley reported on 30 April 1803 that Blake had paid 30 [pounds sterling] for paper and had not received even half that sum from sales. (4) In a later letter to Hayley (28 December 1804), Blake mentions "the Twelve Guineas which you Lent Me when I made up 30 Pounds to pay our Worthy Seagrave in part of his Account" (E 760), and says that he would deduct that amount from his price for engraving The Shipwreck by George Romney for Hayley's Life. So at the end of 1804 Blake was still paying the costs of the 1802 Ballads. A year later he had still not been able to repay Seagrave, for on 11 December 1805 he asked Hayley to give his thanks to "the Generous Seagrave. In whose Debt I have been too long," adding optimistically "but percieve that I shall be able to settle with him soon what is between us" (E 761). Despite the fact that the 1802 Ballads had been a financial failure, (5) Blake hoped that an octavo edition with re-engraved plates would succeed. With Blake's benefit once more in mind, in 1805 Hayley proposed (at Blake's suggestion) an octavo volume of the Ballads to Phillips. Phillips's ready acceptance of this proposal was no doubt influenced by his wish to succeed James Dodsley (d. 1797) as Hayley's principal publisher. Besides, the terms left him with little to lose. On 22 January 1805 Blake informed Hayley "[t]hat one thousand copies should be the first edition, and, if we choose, we might add to the number of plates in a second edition. And he will go equal shares with me in the expense and the profits, and that Seagrave is to be the printer" (E 763). Typically optimistic at the beginning of a project, Blake wrote in the same letter: "Truly proud I am to be in possession of this beautiful little estate; for that it will be highly productive I have no doubt." Blake gave Hayley further details of the arrangement on March 22. There were to be five "highly finished" plates by Blake by May 28, "the Price 20 Guineas Each half to be paid by P-" (E 763). So Blake would earn 50 guineas toward his share of the publishing costs. Trouble with Phillips had begun by 4 June 1805, when Blake wrote to Hayley: "I have fortunately, I ought to say providentially, discovered that I have engraved one of the plates for that ballad of The Horse which is omitted in the new edition; time enough to save the extreme loss and disappointment which I should have suffered had the work been completed without that ballad's insertion" (E 765). Providence entered into it because Phillips had sent Blake a proof of the last sheet of the Ballads for forwarding to the printer Joseph Seagrave in Chichester, and so Blake learned that the volume was to end with Hayley's fifteenth ballad, "The Baya: Or the Indian Bird," and not with the sixteenth, "The Horse," for which Blake had engraved a plate. …


Due to the large difference in thermal properties of the resin and the abrasive grits, the laser-assisted dressing technology is of great interest for grinding wheel preparation. From a viewpoint of thermal induced material removal mechanism, a numerical method was presented to simulate the laser dressing process. The numerical simulation results could reveal the relations between the laser parameters and the groove formation. The overlap coefficient was introduced for practical application. Simulation for the variation of the number of active grinding points was also made for non-uniform wheel topography. Based on the numerical modeling, the suitable grinding^wheel surface topography can be achieved through the laser-assisted dressing technology. The comprehensive researches on the laser-assisted dressing process control, grinding wheel topography reconfiguration by 3D laser scanning technology and analyses of grinding temperature were made. A series of grinding tests with the laser-assisted dressed grinding wheel and mechanically dressed grinding wheel were conducted for comparison. The results proved the feasibility of laser-assisted dressing for resin bonded superabrasive grinding wheels and revealed the importance of choosing appropriate laser dressing parameters.


We propose a parametric regression model for incidence indicators based on the use of the Richards' curve (a generalized logistic function) to analyse the current Monkeypox epidemic data for the most 10 affected countries worldwide. At present, results show that the outbreak is under control in most countries.


Recent results and future challenges in the systematic analytical description of plasma turbulence are described. First, the importance of statistical realizability is stressed and the development and successes of the realizable Markovian closure are briefly reviewed. Next, submarginal turbulence (linearly stable but nonlinearly self-sustained fluctuations) is considered and the relevance of nonlinear instability in neutral-fluid shear flows to submarginal turbulence in magnetized plasmas is discussed. For the Hasegawa-Wakatani equations, a self-consistency loop that leads to steady-state vortex regeneration in the presence of dissipation is demonstrated and a partial unification of recent work of Drake (for plasmas) and of Waleffe (for neutral fluids) is given. Brief remarks are made on the difficulties facing a quantitatively accurate statistical description of submarginal turbulence. Finally, possible connections between intermittency, submarginal turbulence and self-organized criticality (SOC) are considered and outstanding questions are identified.


Migration from the new European Union (EU) Member States to the United Kingdom (UK) has been identified as one of the most significant social phenomena of recent times and Accession 8 (A8) migration to the UK has been studied extensively particularly since 2004. Even though gendered studies of migration are now attaining recognition, there is limited literature in relation to Polish migrant women. What is more, there is now much evidence to support the view that migrant women constitute a large proportion of international migrants. In fact, when considering migration within the European context, migrant women now outnumber their male counterparts.

Drawing on a review of secondary literature and preliminary findings from new fieldwork research undertaken in Poland and the UK in 2012, this paper explores how Polish migrant women exercise their rights as EU citizens to better their own and their families' well-being. As the consequence of their newly acquired rights as EU citizens, Polish migrant women appear to be active agents who make use of the resources and opportunities that migration offers. It is concluded that migration within the EU presents positive opportunities for Polish migrant women to actively engage with and exercise national and EU citizenship rights.


Circadian rhythm is the adaptation response of animals against light alteration that affects various behavioral and physiological responses. Bright light is a danger signal for nocturnal animals because it exposes them more to predators. This research aimed to study the changes in the behavior of rats during the partial solar eclipse (PSE) period. The PSE period occurred across Bogor, Indonesia, on 9 March 2016. The PSE started at 06.19 AM, peaked at 07.21 AM, and ended at 08.30 AM. The light level decreased since the early solar eclipse, then dropped significantly at the peak period. The activities of six mature male Sprague Dawley rats were measured using Opto-Varimex-5 Auto Track System during the PSE period. The measurements were repeated one day after the PSE period as the non-PSE period. There were significant differences (P<0.05) in stereotypic time, burst of stereotypic movement, and horizontal count in the early, peak, and end periods of the PSE period compared with the values at the same time of the non-PSE period. The activities of rats changed during the PSE period. Rats did not rest as in their normal nocturnal behavior during darkness but were more active and stressed because of the rapid change in light level during the PSE period.


Globalization has led to greater demand for more uniform accounting standards throughout the world. A single global standard is vital for the investors who look for the best capital markets in which to invest, based on the financial reports available across the boundaries. International Accounting Standard Board (IASB) has taken an aggressive initiative to bring further convergence between local Generally Accepted Accounting Principles (GAAP) and international standards with the amendments of some existing standards and adopted certain new standards in the name of the International Financial Reporting Standards (IFRS).Nevertheless, the complexity on the issue of convergence with a single standard has been raised by many parties (Hoogendoorn, 2006; Bernhut, 2008).Similarly, the Malaysian's accounting bodies have also raised their anxiety as to whether the public listed companies are ready to encounter the major accounting transition.Therefore, this study tries to investigate the extent of FRS adoption among the Malaysian's top 100 listed companies. Using sample of 57 companies to represent the first annual reports to adopt 18 new or revised FRSs, this study reveals that all largest companies have promptly adhered to the FRS transition. Nevertheless, the level of adoption differs between the sample companies.


Background: Iodine deficiency is common in the Qinba mountainous area and fetal iodine deficiency disorder (FIDD) is endemic. Our previous study demonstrated that apolipoprotein E (ApoE) was a genetic risk factor for FIDD in the local area. Aim: In order to achieve a better understanding of the aetiology of iodine deficiency-based mental retardation in the Qinba mountainous area, we conducted further studies of ApoE allele frequencies obtained from the local population. Subjects and methods: A total of 818 samples from four counties in the iodine-deficient area were recruited for the study of the ApoE genotype and allele frequencies using the PCR-RFLP method, and were subsequently confirmed by sequencing. Results: The frequencies of ϵ2, ϵ3 and ϵ4 alleles of Han Chinese in Qinba were 9.67%, 81.30% and 9.03%, respectively. Furthermore, no significant differences in the distribution of ApoE (either genotype or allele frequencies) between any two subgroups divided according to location, sex and age (p > 0.05) were found. Surprisingly, however, we found a significant difference in the genotype and allele frequencies between Qinba and Shanghai (genotype: χ2 = 14.91, p = 0.0096; allele: χ2 = 15.07, p = 0.0009). Conclusion: The currently documented allele frequencies of ApoE in the Han Chinese population living in the open areas of China do not represent the distribution in the isolated Qinba mountainous area. The higher level of ϵ2 and ϵ4 allele frequencies in the Han Chinese living in the isolated Qinba area arise by chance or may result from genetic adaptation to an environment characterized by malnutrition and iodine deficiency, which may also contribute to the high incidence of mental retardation in these regions.


The coronavirus-19 (COVID-19) pandemic led to government interventions to limit the spread of the disease which are unprecedented in recent history; for example, stay at home orders led to sudden decreases in atmospheric emissions from the transportation sector. In this review article, the current understanding of the influence of emission reductions on atmospheric pollutant concentrations and air quality is summarized for nitrogen dioxide (NO2), particulate matter (PM2.5), ozone (O3), ammonia, sulfur dioxide, black carbon, volatile organic compounds, and carbon monoxide (CO). In the first 7 months following the onset of the pandemic, more than 200 papers were accepted by peer-reviewed journals utilizing observations from ground-based and satellite instruments. Only about one-third of this literature incorporates a specific method for meteorological correction or normalization for comparing data from the lockdown period with prior reference observations despite the importance of doing so on the interpretation of results. We use the government stringency index (SI) as an indicator for the severity of lockdown measures and show how key air pollutants change as the SI increases. The observed decrease of NO2 with increasing SI is in general agreement with emission inventories that account for the lockdown. Other compounds such as O3, PM2.5, and CO are also broadly covered. Due to the importance of atmospheric chemistry on O3 and PM2.5 concentrations, their responses may not be linear with respect to primary pollutants. At most sites, we found O3 increased, whereas PM2.5 decreased slightly, with increasing SI. Changes of other compounds are found to be understudied. We highlight future research needs for utilizing the emerging data sets as a preview of a future state of the atmosphere in a world with targeted permanent reductions of emissions. Finally, we emphasize the need to account for the effects of meteorology, emission trends, and atmospheric chemistry when determining the lockdown effects on pollutant concentrations.


Perhaps you've heard the stories, read the news reports, or seen it for yourself. Perhaps you let yourself lapse into daydreams—what if my library had robots?—but then quickly returned to reality. Perhaps the time has come to change that. This article's goal is to get youth and teen librarians excited about robots and their interactions with young patrons, provide them with resources for further investigation, ideas from other libraries, and tell what's going on in the world of kids and bots.


Networked systems have adapted Radio Frequency identification technology (RFID) to automate their business process. The Networked RFID Systems (NRS) has some unique characteristics which raise new privacy and security concerns for organizations and their NRS systems. The businesses are always having new realization of business needs using NRS. One of the most recent business realization of NRS implementation on large scale distributed systems (such as Internet of Things (IoT), supply chain) is to ensure visibility and traceability of the object throughout the chain. However, this requires assurance of security and privacy to ensure lawful business operation. In this paper, we are proposing a secure tracker protocol that will ensure not only visibility and traceability of the object but also genuineness of the object and its travel path on-site. The proposed protocol is using Physically Unclonable Function (PUF), Diffie-Hellman algorithm and simple cryptographic primitives to protect privacy of the partners, injection of fake objects, non-repudiation, and unclonability. The tag only performs a simple mathematical computation (such as combination, PUF and division) that makes the proposed protocol suitable to passive tags. To verify our security claims, we performed experiment on Security Protocol Description Language (SPDL) model of the proposed protocol using automated claim verification tool Scyther. Our experiment not only verified our claims but also helped us to eliminate possible attacks identified by Scyther.


Post-dispersal seed removal by ground-foraging frugivores promotes secondary dispersal of large seeds, reducing seed predation and increasing recruitment and regeneration. We studied how habitat disturbance influences seed removal patterns in the large-seeded palm Phytelephas aequatorialis within three habitats forming a continuum of disturbance (agroforestry system, disturbed forest, and less-disturbed forest) using seed removal experiments and camera trapping. We tested whether seed removal rates, and both richness and composition of seed remover communities varied between the habitats. On average, 15 seeds were removed under each tree in the agroforestry system over seven days, which was significantly lower compared to the disturbed forest (18) and the less-disturbed forest (19). Eight mammal species were identified removing seeds in the three habitats. On average, one mammal species removed seeds at each station in the agroforestry system, which was significantly lower than the two species observed in the two forests. The composition of seed remover communities was significantly different between the three habitats. Our results suggest that the loss of forest cover in the agroforestry system has reduced the richness of seed removers, which subsequently caused decreased removal rates. Nevertheless, this habitat could still maintain effective seed dispersal events because spiny rats were important seed removers. Our camera trap data should be taken as preliminary because we could only identify less than half of the animals responsible for seed removal. This study highlights the importance of medium- and large-sized rodents for the removal and effective dispersal of large seeds in disturbed tropical habitats.


Abstract. Identification and mapping of urban features such as buildings and roads are an important task for cartographers and urban planners. High resolution satellite imagery supports the efficient extraction of manmade objects. For the planning and designing of Smart cities, building footprint information is an essential component, and geospatial technologies helps in creating this large mass of data inputs for designing and planning of smart cities. In this study segmentation approach is followed for building extraction. For extraction of buildings especially from the high resolution imagery, number of various semiautomatic and automatic methods have been developed till date to reduce the time and efforts required in manual building mapping. In this study, two semiautomatic image segmentation techniques are used for building extraction from high resolution imagery using algorithms- Multi-resolution segmentation and Rule based feature extraction, which are applied on Worldview 2 (2010) imagery of Dehradun area. The segmented image were further classified to extract buildings from the segmented image features. The study identify the usefulness of both the methods in building extraction and finds the optimum set of rules for extracting buildings from high resolution data sets. The True Positive Rate using Rule based feature extraction is 88.11 % compared to 85.46 % from Multi-resolution segmentation algorithm. The False Negative Rate (FNR) of Multi-resolution segmentation algorithm (16.5 %.) is very less compared to Rule based feature extraction (67.5 %). In the study the buildings were extracted with the accuracy of 88.9 %.


Abstract We documented roosting and foraging habitat use by Wood Storks during the post-breeding season in the coastal zone of Georgia from 1994-1998. Larger, more persistent aggregations of roosting storks typically occurred in enclosed wetlands on large estuarine islands. Smaller, more ephemeral aggregations tended to occur on salt marsh/upland ecotones, where storks appeared to be waiting for local conditions (tide levels) to become suitable for foraging. Examination of habitat types within a 2-km radius of the larger (mean >10 storks/survey) vs. smaller (mean <10 storks/survey) roosts showed that surrounding habitat structure, including those used for foraging, were similar. Foraging storks typically fed in close proximity (median = 0.5 km) to large roosts, much closer than storks using coastal wetlands during the breeding season. Tidal creeks were used almost exclusively as foraging habitat (92%). Storks and other wading birds were almost always present when the study bird arrived. The foraging patterns of study birds and four storks carrying radios suggested that storks often used the same foraging sites and/or marsh systems in the non-breeding season. Coastal Wood Storks apparently selected roosting sites based on the presence of conspecifics, abundant local prey, or possibly as shelter from adverse weather conditions.


Electromigration tests on different Cu dual-damascene interconnect tree structures consisting of various numbers of straight via-to-via lines connected at the common middle terminal have been carried out. Like Al-based interconnects, the reliability of a segment in a Cu-based interconnect tree strongly depends on the stress conditions of connected segments. The analytic model based on a nodal analysis developed for Al trees gives a conservative estimate of the lifetime of Cu-based interconnect trees. However, there are important differences in the results obtained under similar test conditions for Al-based and Cu-based interconnect trees. These differences are attributed to the variations in the architectural schemes of the two metallization systems. The absence of a conducting electromigration-resistant overlayer in Cu technology and the low critical stress for void nucleation at the Cu/inter-level diffusion barrier (i.e. Si3N4) interface leads to different failure modes between Cu and Al interconnects. As a result, the most highly stressed segment in a Cu-based interconnect tree is not always the least reliable. Moreover, the possibility of liner rupture at stressed dual-damascene vias leads to significant differences in tree reliabilities in Cu compared to Al. While an interconnect tree can be treated as a fundamental unit whose reliability is independent of that of other units in Al-based interconnect architectures, interconnect trees can not be treated as fundamental units for circuit-level reliability analyses for Cu-based interconnects.


Introduction Developments have been made at building construction regarding buildings being future-proof. The purpose of these developments is to be able to adjust a building sustainably, to respond to changing needs of its users, which will happen after a certain amount of time.
Providing insight into the build process in the development of future-proof building may be valuable for various stakeholders and users. Research has been undertaken to clarify the functions and views of various parties for the Friesland area, where the client AchterboschZantman architecten is located.
A model has been developed in order to clarify the communication between stakeholders. This has been applied to the contacts which are present during a process focused on future-proof buildings.
Development of future-proof construction The current building process for the development of new construction is divided into several phases. Several methods have been developed to change this process. These try to better involve stakeholders in the design of buildings and improveme the supply of sustainable products. In addition, with the use of industrially produced parts many different (temporary) solutions should be created for the future. Current construction concepts have shown different characteristics in terms of transparency of sustainability and mobility.
Research on stakeholders and Friesland area Several parties such as an architect, housing cooperative, provider of healthcare, leisure company, contractor, entrepreneur of renewable energy and a knowledge-bases institutions are represented in the form of personas. Their functions and visions are included.
Users of future-proof buildings will be able to join collective private commissions to contribute to the development of a design. A strong sense of community has been present in Friesland originally, which makes it plausible that a private collective of Frisian user will emerge.
Design of model The main purpose of the model is to clarify the communication between different stakeholders during the development of future-proof construction. In order to create a clear model, all functions parties may execute are divided into the following categories:
Use: Function of use.
Knowledge: Function Development of knowledge.
Construction: Functions of management, design, investment and technical development.
The construction process has been shown in components initiative, design (design and development) and execution. The execution contains building, transfer and use the building. As result of an assessment a decision could be made to adjust parts or the redesign the concept. The processes of communications that will take place during these phases are illustrated in input and output. A pie chart shows which contact occurs between functions.
Based on the communication model, the processes of contact that take place will be clarified to the parties involved in a future-proof construction process. It is likely that evaluating a non-produced building concept based on the communication model could clarify why a construction concept has not been effectively executed. Future use of model
In order to better develop the initiatives in the future, a central meeting point, presented as a platform, should be developed. If a building with an ability to adjust will be developed, it is advisable to accessibly present the knowledge available on this subject. In the future, the building process described in the model can be applied as a pilot. With this application, information about the usability of the designed building could be researched.


Vehicular Ad Hoc Networks (VANETs) is a challenging field of wireless technology that offers a wide variety of useful applications. These applications span from safety related applications to infotainment services. IEEE 802.11p standard that operates in 5.9 GHz frequency band is widely adopted in VANETs for physical and MAC layers. The radio signals in 5.9 GHz band are less penetrating as compared to Wi-Fi that operates in 2.4 GHz band. Obstacles that impede radio signals have high impact on vehicular communication. Thus, maintaining line-of-sight among communicating vehicles improves vehicular communication. Modern day vehicular environment contains road infrastructure units such as curve roads, flyovers, underpasses, tunnels and irregular roads. The modern road infrastructure units introduce non line-of-sight conditions which result in either costly or no communication. This paper introduces a mechanism to maintain line-of-sight among communicating vehicles while considering modern road infrastructure units. The geometrical concepts are used here to model and formulate the line-of-sight (LOS) conditions in various real world scenarios. We have calculated the relative optimal position of signal repeaters / reflectors for maintaining line-of-sight condition in different road infrastructure units.


In the present work a piezoelectric based structural health monitoring (SHM) system is analyzed with the aim of assessing the ability of the piezoelectric patch to detect both edge and embedded delaminations proper of flange-skin composite laminated structures. The boundary element model is developed for piezoelectric solids and is implemented by taking advantage of the multidomain technique to model laminated and cracked configurations. A non-linear spring model interface is then implemented in conjunction with an iterative procedure allowing for the simulation of the finite stiffness of the bonding layers as well as of the non-penetration condition of the delamination surfaces. The dynamic behavior of the damaged structures and of the bonded piezoelectric patch is modeled by means of the dual reciprocity approach. To fully characterize the structure response the fracture mechanics behavior is studied in terms of energy release rate G and mode-mix phase angle Y. Finally, a damage index based on the electrical current output of the SHM system is introduced as an effective identification parameter of the flange-skin delamination occurrence.


Purpose

The possibility of recovery for persons with co-occurring addiction and mental health problems has been contested. Though, recent studies show that recovery might happen, but without connection to specific treatment interventions. The purpose of this paper is to analyse professionals' perceptions of their contribution to improvement.

Design/methodology/approach

In all, 15 experienced professionals were interviewed. The interviews were analysed using thematic analysis.

Findings

Recovery processes were dependent of the persons' access to different forms of recovery capital (RC). Lack of RC was often associated with lack of trust in one's self and others (identity and personal capital). Professionals had to be accepted as trustful agents through co-creating changes in the person's life. Trusting a professional might be a basis for trusting one's self as an agent in one's recovery process and develop a social network (identity and relationship capital). Other aspects stressed by the professionals were to manage their own fragmentized organisations and societal shortcomings (economic capital).

Practical implications

Recovery has been described as a profoundly individual journey. However, it is also deeply social, involving other persons and contextual factors. Focusing on just one level might counteract the complex work behind double recovery.

Originality/value

Improvement was described as dependent on the presence of personal, inter-personal, organisational and societal factors. The findings give a deep and concrete understanding of the process constituting the development of a working alliance and its dependence on factors outside the direct relation between the staff member and the person.


Graduate seminars are commonly discussion based, yet large class sizes often create a challenge for effectively facilitating class discussions. In my presentation, I will cover strategies for optimizing class discussions in larger than optimal in-person and online graduate seminars. I will discuss: (1) establishing class participation guidelines, (2) randomly assigning participants to discussion groups, and (3) facilitating large group discussions following smaller group discussions of thought-provoking questions. As a result of this session, participants will be able to implement new strategies for facilitating effective large class discussions that are applicable to any discipline. While my presentation will focus primarily on graduate seminars, the strategies are also applicable to undergraduate discussion-based classes. To help establish the desired classroom dynamic, I distribute participation guidelines on the first day of class. We discuss these guidelines as a group, which often leads to refining the guidelines. These guidelines include: (1) a request for students—particularly those who speak up frequently—to make a specific goal about their classroom participation behaviors to help ensure that everyone has an opportunity to speak, (2) specific suggestions for how to encourage quieter peers share their insights, (3) guidelines about open-mindedness and respect for others, and (4) a unique hand-raising policy that helps facilitate an organized discussion. Every class period, I randomly assign students to small groups of three or four students. This approach allows students to interact in a small group setting with each of their classmates over the course of the semester. As the Mason study body is very diverse, the rotating assigned group approach—along with discussion guidelines that promote being respectful and open-minded—allows students to derive the educational benefits of deep engagement with diverse viewpoints. During class, I provide thought-provoking questions for students to discuss in these randomly assigned small groups prior to facilitating a full class discussion. By providing small group discussion time, students—even those who tend to be quieter—are able to actively discuss the material with their peers. When discussion questions are particularly challenging, I use a think-pair-share approach, giving students a few minutes to think about the question before discussing with their small group. As I facilitate full class discussions, I encourage students to mention important insights that their quieter peers had in the small group discussion. Quieter students are often willing to share when a peer has pointed out a particularly insightful point they had in the small group discussion. As students see the value in sharing others' insights, it has become more common for more vocal students to opt out of sharing their own thought and instead to highlight and draw attention to important insights of quieter peers—a dynamic that I consider to be an important success with respect to drawing out all perspectives. I will share my initial experiences using Blackboard Collaborate Ultra to replicate these strategies online, noting the aspects that are most challenging to facilitate—and surprisingly, those that are easier to facilitate—in an online environment.


During the past ten years, my assistants and I have experimented with many various substances in the hope of throwing some light on a better understanding of the cancer problem. The work 1 first reported contained a brief case report on the use of vaccines prepared from cancer protein, and later publications 2 gave reports of various scientific findings as they were encountered during the progress of this study. Other workers, notably Blumenthal 3 and Lunchenbein, 4 have reported clinical observations which corresponded to those that I had previously reported. From a scientific standpoint, the work of Gruner 5 agrees with changes I have observed chiefly in advanced malignancy, while of decided corroborative value is the research of Murphy, 6 showing the effect of spleen destruction on the transplantability of tumors. Indeed, the literature on the subject of malignancy abounds with isolated observations made by many independent investigators which, when


This is the book which clinical bacteriologists have been waiting for since, in 1960, the authors published a short paper giving diagnostic tables for identification of the common medical bacteria. It is clearly written, well produced, and more than fulfils our expectations. It will almost certainly become the laboratory handbook for all laboratories concerned with routine diagnostic bacteriology. It is fortunate that the book was completed before the untimely death of K. J. Steel. The book opens with chapters on classification and nomenclature, the importance of pure cultures, and media. The authors then get down to the characterization and identification of bacteria. Primary grouping of Gram-negative bacteria is based on only seven characters, and the same seven, plus two others, are used in primary grouping of Gram-positive bacteria. Secondand, occasionally, third-stage tables then give the tests necessary for full identification of species. There is of course the inevitable chapter for the awkward "miscellaneous bacteria " which refuse to obey the rules, but the number of these is commendably small. Finally, after a short chapter on taxonomic implications (for those interested) a series of appendices (comprising more than half the book) give a clear and simple description of the reagents needed and methods of testing, together with 28 pages of references. Some species remain exceedingly difficult to identify. For example, the separation of Klebsiella aerogenes and Enterobacter aerogenes is based primarily on motility. This may be an important difference to the systematist, but, since a negative test for motility is always of doubtful significance, for the routine bacteriologist the test is unreliable. In other cases bacteria are more easily distinguished by an experienced bacteriologist than by consulting this book. For example, as the authors point out, Pasteurella pestis and Shigella flexneri have almost identical characteristics as indicated in the tables, whereas " at the bench no difficulty arises," as the shigella grows so much more luxuriantly. These are not criticisms of the book, however, but simply indicate that we are not yet fully in a position to diagnose bacteria by carrying out a number of biochemical tests and feeding them into a computer. MARY BARBER.


Venture capital is an important factor in the development of entrepreneurship and in the establishment of new, knowledge-and-technology-based companies. In transition economies, the intensity of equity investing is far behind the developed market economies, making the EU and individual governments face the challenge of increasing this type of financing. Increasing the supply by publicly-financed funds is an intervention based on the assumption of an existing equity gap, which means that quantity demanded exceeds quantity supplied. However, the dilemma here is whether the demand was evaluated realistically and whether a gap actually exists. If this is not the case, the increased supply will be inefficient and market equilibrium will be destroyed. This article aims to answer the question whether an equity gap really exists in Slovenia.


LLF (Least Laxity First) scheduling, which assigns a higher priority to a task with smaller laxity, has been known as an optimal preemptive scheduling algorithm on a single processor platform. However, its characteristics upon multiprocessor platforms have been little studied until now. Orthogonally, it has remained open how to efficiently schedule general task systems, including constrained deadline task systems, upon multiprocessors. Recent studies have introduced zero laxity (ZL) policy, which assigns a higher priority to a task with zero laxity, as a promising scheduling approach for such systems (e.g., EDZL). Towards understanding the importance of laxity in multiprocessor scheduling, this paper investigates the characteristics of ZL policy and presents the first ZL schedulability test for any work-conserving scheduling algorithm that employs this policy. It then investigates the characteristics of LLF scheduling, which also employs the ZL policy, and derives the first LLF-specific schedulability test on multiprocessors. It is shown that the proposed LLF test dominates the ZL test as well as the state-of-art EDZL test.


Tree-based algorithms such as random forests and gradient boosted trees continue to be among the most popular and powerful machine learning models used across multiple disciplines. The conventional wisdom of estimating the impact of a feature in tree based models is to measure the \textit{node-wise reduction of a loss function}, which (i) yields only global importance measures and (ii) is known to suffer from severe biases. Conditional feature contributions (CFCs) provide \textit{local}, case-by-case explanations of a prediction by following the decision path and attributing changes in the expected output of the model to each feature along the path. However, Lundberg et al. pointed out a potential bias of CFCs which depends on the distance from the root of a tree. The by now immensely popular alternative, SHapley Additive exPlanation (SHAP) values appear to mitigate this bias but are computationally much more expensive. Here we contribute a thorough comparison of the explanations computed by both methods on a set of 164 publicly available classification problems in order to provide data-driven algorithm recommendations to current researchers. For random forests, we find extremely high similarities and correlations of both local and global SHAP values and CFC scores, leading to very similar rankings and interpretations. Analogous conclusions hold for the fidelity of using global feature importance scores as a proxy for the predictive power associated with each feature.


This study sought to ascertain factors that affect facilitation of agricultural programmes as perceived by different gender groups among facilitators of FADAMA 111 development programme in Enugu State. It ascertained the perception of the gender groups on the organizational, job related and employee related factors. The data were analyzed with mean, standard deviation and t-test. Results indicate that out of the various identified organizational factors that affect facilitators in Enugu National Fadama Development Project III only one, monitoring and Evaluation System (t= -3.08*) was perceived differently by both men and women facilitators. From the various identified job related factors that affect facilitators in Enugu NFDP III only insufficient authority (t= 1.17) was perceived differently by both men and women facilitators. The results also show that from the various identified employee/personnel factors that affect facilitators in Enugu NFDP III, involvement in social meetings, involvement in house chores, size of family, relationship with spouse, proximity to client and extended family burden were perceived differently by both men and women facilitators. Based on the findings of the study, some factors were identified to affect the facilitators differently because of their genders differences. Hence, there is need to consider these factors and ensure balanced working conditions for both men and women facilitators in the NFDP III. This will help to ultimately improve their job performance. Key words : Gender analysis; factor; facilitation


The objective of this thesis is to analyse theconnection between test results and field claims of ECUs (electronic controlunits) at Scania in order to improve the acceptance criteria and evaluatesoftware testing strategies. The connection is examined through computation ofdifferent measures of dependencies such as the Pearson's correlation, Spearman'srank correlation and Kendall's tau. The correlations are computed from testresults in different ECU projects and considered in a predictive model based onlogistic regression. Numerical results indicate a weak connection between testresults and field claims. This is partly due to insufficient number of ECUprojects and the lack of traceability of field claims and test results. Themain conclusion confirms the present software testing strategy. Continuoussoftware release and testing results in a lower field claim and thus a betterproduct.


Introduction
Though the WHO Framework Convention for Tobacco Control (FCTC) calls for the implementation of large graphic warning labels (GWLs) on cigarette boxes, the courts have blocked the implementation of 50% labels in the United States. We conducted an experiment to explore whether changing the size of GWLs is associated with changes in visual attention, negative affect, risk beliefs, and behavioral intentions.

Method
We recruited adult smokers (N = 238) and middle-school youth (N = 237) throughout the state of New York in May 2016. We randomly assigned participants to one of three between-subject conditions (no GWL [control], 30% GWL, 50% GWL).

Results
Adult and youth participants looked at the GWLs longer when the GWL covered 50% versus 30% of the pack's front. Increasing GWL size from 30% to 50% did not influence negative affect or risk beliefs, though both GWL sizes increased negative affect relative to the no-GWL control group. Exposure to 50% GWLs increased adult smokers' intentions to quit compared to no-GWL, but smokers exposed to 30% GWLs did not differ from control. There were no differences between 50% GWLs, 30% GWLs, and control on youth smoking susceptibility.

Conclusions
Findings provide some evidence of the benefits of a 50% versus 30% GWL covering the front of the pack for adult smokers and at-risk youth from socioeconomically disadvantaged backgrounds-though not on all outcomes.

Implications
This research shows that 30% GWLs on cigarette packages increase negative affect relative to packages without front-of-package GWLs. Larger GWLs on cigarette packages (50% vs. 30%) increase visual attention to the warning and its pictorial content among low-SES smokers and at-risk youth but do not further increase negative affect. A 50% GWL increased adults' quit intention compared to no GWL at all, but we were underpowered to detect modest differences in quit intentions between a 50% and 30% GWL. Future work should thus continue to explore the boundary conditions under which relatively larger GWLs influence cognitive, affective, and behavioral outcomes.


How do income shocks affect armed conflict? Theory suggests two opposite effects. If labour is used to appropriate resources violently, higher wages may lower conflict by reducing labour supplied to appropriation. This is the opportunity cost effect. Alternatively, a rise in contestable income may increase violence by raising gains from appropriation. This is the rapacity effect. Our article exploits exogenous price shocks in international commodity markets and a rich dataset on civil war in Colombia to assess how different income shocks affect conflict. We examine changes in the price of agricultural goods (which are labour intensive) as well as natural resources (which are not). We focus on Colombia's two largest exports, coffee and oil. We find that a sharp fall in coffee prices during the 1990s lowered wages and increased violence differentially in municipalities cultivating more coffee. This is consistent with the coffee shock inducing an opportunity cost effect. In contrast, a rise in oil prices increased both municipal revenue and violence differentially in the oil region. This is consistent with the oil shock inducing a rapacity effect. We also show that this pattern holds in six other agricultural and natural resource sectors, providing evidence that price shocks affect conflict in different directions depending on the type of the commodity. Copyright 2013, Oxford University Press.


Touchscreens are a widely used medium for interacting with digital applications in public and they are found in various contexts including entertainment, culture, travel, marketing, etc. However, in the current times of COVID-19 pandemic there are safety concerns about the use of these devices, as touching a common surface may increase the risk of transmission. Thus, there is a need for alternative means for interacting with public interactive kiosks in a usable and effective way. In this paper we propose and evaluate a universal solution to safer interactions with public touchscreens using the smartphone as a touchpad controller. Users have to scan a QR code, and then use their device as a controller to interact with the public system though touch and multi-touch interactions (tap, drag and two-finger gestures). We have setup a user study, where we compare the usability and user experience of smartphone control to the traditional touchscreen input and we examine the users' intention and opinion about the proposed approach. Our study indicates that the use of the mobile device as a controller has the potential to be a safe and practical alternative to direct touch input for public interactive kiosks, and reveals some usability issues that need further consideration.


The control mechanism of glycogenolysis by phosphorylase a in contracting muscle has been investigated. The quadriceps femoris muscles of six subjects were intermittently stimulated at 15 and 50 Hz. The stimulation lasted 9.6 s and was performed twice at 15 Hz and once at 50 Hz. Epinephrine was infused continuously during the experiment. The force generation and ATP turnover rate were nearly twofold higher at 50 Hz than at 15 Hz. Calculated mean Pi was 5.7 and 10.0 mM during the two 15-Hz stimulations and 8.1 mM during the 50-Hz stimulation. Phosphorylase a varied between 85.5 and 91.5% without significant differences between periods. However, the rate of glycogenolysis was twofold higher during the stimulation at 50 Hz than it was at 15 Hz (P less than 0.05) and was related to the ATP turnover rate (r = 0.992). These results demonstrate that rapid glycogen breakdown during muscle contraction cannot be solely explained by transformation of phosphorylase b to a and increased Pi concentration. The contraction intensity may determine the glycogenolytic rate through a transient increase in free AMP level related to the ATP turnover rate.


Two-stage sampling usually leads to higher variances for estimators of means and regression coefficients, because of intra-class homogeneity. This thesis will develop and evaluate adaptive strategies for designing and analyzing twostage surveys, where sample data will be used to determine the appropriate way of allowing for intraclass correlation. The approach to analysis will be based on fitting a linear regression model to estimate means and regression coefficients. One method for allowing for clustering in fitting a linear regression model is to use a linear mixed model with two levels. If the estimated intra-class correlation is close to zero, it may be acceptable to ignore clustering and use a single level model. This thesis will evaluate an adaptive approach for estimating the variances of estimated regression coefficients. The strategy is based on testing the null hypothesis that the random effect variance component is zero. If this hypothesis is not rejected the estimated variances of estimated regression coefficients are extracted from the one-level linear model. Otherwise, the estimated variance iii is based on the linear mixed model, or, alternatively the Huber-White robust variance estimator is used. Another adaptive strategy based on assessing the estimated design effect due to clustering is also evaluated. This is based on testing the null hypothesis that the random effect variance component is zero and at the same time comparing the estimated design effect to a predetermined cutoff value. If the null hypothesis is rejected and the estimated design effect is more than the predetermined cutoff value the estimated variances of estimated regression coefficients are extracted from the linear mixed model, or, alternatively the Huber-White robust variance estimator is used. Otherwise, the estimated variance is based on the one-level linear model. This approach is found to be nearly identical in practice to the adaptive approach based on just testing the null hypothesis that the random effect variance component is zero. This adaptive strategy for estimation will be developed based on a twolevel linear model assuming normality. It will be evaluated by simulation using normal data, with equal and unequal numbers of observations per cluster, and also using log-normal data, to assess the robustness of the approach to non-normality. The simulations indicate that extreme designs with 5 or less PSUs and many observations per cluster should be avoided. For these extreme designs, most methods perform poorly, including the adaptive methods and the linear mixed model, due to the difficulty of appropriately defining iv the degrees of freedom for this model. Apart from these extreme designs, the adaptive strategy is found to perform acceptably well, resulting in simpler analysis and slightly shorter confidence intervals. The use of a pilot survey to estimate the intraclass correlation will also be considered. The pilot estimate of this parameter can be used to estimate the optimal within-PSU sample size for the main survey. The best design based on a "cost-adjusted design effect" and the estimated variance of the estimated regression coefficients will be considered. An upper cutoff should be placed on the sample size to be selected from each PSU, to allow for the possibility of an under-estimate of the intraclass correlation from the pilot data. The optimal value of this cutoff is found to be between 10 and 50 depending on the pilot sample sizes. Some results are also obtained on appropriate sample sizes of PSUs and units in the pilot study.


Aims and Background A law banning smoking in enclosed public places was implemented in Italy on January 10, 2005. The aim of this paper is to present a cross-sectional survey on two representative samples of non-smokers of two Italian towns (Florence and Belluno), conducted one year after the introduction of the ban, in order to assess prevalence of second-hand smoke exposure, to record the attitudes towards the ban, and the perception about its compliance in a representative sample of non-smokers. Methods Computer-assisted telephone interviews were carried out in March 2006, from a random sample of households from telephone registries. Respondents were 402 non-smokers from Belluno and 1,073 from Florence. Results About 12% of Florentines and 7% of Belluno respondents were exposed at home; 39% and 19%, respectively, at work; 10% and 5% in hospitality venues; 20% and 10% in cars. The smoke-free law was almost universally supported (about 98%) even if a smaller proportion of people (about 90%) had the perception that the ban was observed. Conclusions Second-hand smoke exposure at home and in hospitality premises has dropped to ≤10%, whereas exposure at work remained higher. These results suggest the need for more controls in workplaces other than hospitality venues.


The menace of counterfeiting is growing constantly, especially the German mechanical engineering is more and more attractive to copyists. To protect components and spare parts, there is a technical concept for anti-counterfeiting developed. In this system, the parts are tagged with fraud proof marks which are read out at several checking points along the supply chain and particularly within the machine. The checking results are stored in a central database in order to create new services and to simplify the communication between manufacturer and customer.


Effective Energy Management with an active Demand Response (DR) is crucial for future smart energy system. Increasing number of Distributed Energy Resources (DER), local microgrids and prosumers have an essential and real influence on present power distribution system and generate new challenges in power, energy and demand management. A relatively new paradigm in this field is transactive energy (TE), with its value and market-based economic and technical mechanisms to control energy flows. Due to a distributed structure of present and future power system, the Internet of Things (IoT) environment is needed to fully explore flexibility potential from the end-users and prosumers, to offer a bid to involved actors of the smart energy system. In this paper, new approach to connect the market-driven (bottom-up) DR program with current demand-driven (top-down) energy management system (EMS) is presented. Authors consider multi-agent system (MAS) to realize the approach and introduce a concept and standardize the design of new Energy Flexometer. It is proposed as a fundamental agent in the method. Three different functional blocks have been designed and presented as an IoT platform logical interface according to the LonWorks technology. An evaluation study has been performed as well. Results presented in the paper prove the proposed concept and design.


Introduction: Foreign body aspiration (FBA) is a life threating emergency at all ages but especially in childhood. Although wheezing, sudden cough and decreased breath sounds on one side consist the clinical triad, symptoms can be several due to the type, size and location of the foreign body. We are presenting FBAs admitted to our clinic in last 8 years. Material-Method: 271 FBA suspected patients (ages between 2 months - 74 years-old, with 134 male and 182 under 2 years-old), admitted to Kocaeli University pediatric emergency and thoracic surgery clinics between 2005 - 2012. Rigid bronchoscopy performed to all under general anesthesia in theatre room. 47 patients were admitted in first 24 hours, and remaining after 24 hours. Physical examination, chest x-ray were performed to all and thorax CT to 32. FBA diagnosed in 226 patients. Foreign bodies removed were divided into two groups. Foods most commonly hazelnut, peanut, corn, sunflower seed were grouped as organic foreign bodies and needle, buckle, pen cap, pen spring, bead, cigarette filter etc. were inorganic. Organics were removed from 165 patients. Pneumothorax and subcutaneous emphysema which required drainage occured in two cases. Discussion: FBA can be prevented, and the associated morbidity and mortality can be significantly reduced by educating the public regarding its potential dangers. All patients should be evaluated radiologically and bronchoscophy should be performed when it is not possible to rule out foreign body aspiration.


Background There is a well-documented need for more responsive promotion and prevention programming for young immigrants and refugees in the context of mental health and healthy development. Incorporating the voice of newcomers in the development of promotion and prevention efforts could assist in producing culturally-relevant materials and improve program outcomes. Objective Our goal was to utilize youth voice to identify considerations for developing programming to support newcomer youths' healthy development. Methods We employed mixed methods and analyzed data using concept mapping. A total of 37 newcomers between the ages of 14 and 22 participated in focus groups to share their ideas for creating programming that would focus on relationships and well-being. Relevant responses were collated, cleaned, and generated into unique statements, and then sorted individually by 26 youth into thematically similar categories. We used multidimensional scaling and hierarchal cluster analysis to produce a concept map. Results Six concepts, in rank order of importance, emerged as follows: create a space for sharing; discuss relational issues; teach strategies for adjusting to a new country; teach wellness skills; have feel-good activities; and plan for diversity. Conclusions Participants' lived experience and their own attendance in programming at newcomer organizations assisted them in brainstorming what types of activities, topics, and skills would be helpful for other newcomer youth, as well as considerations for facilitators implementing such programming. Promotion and prevention efforts intended for newcomer youth may benefit by incorporating ideas from the concept map.


Power issues have become a major problem of CMOS logic circuits as technology node shrinks below 90 nm. In order to overcome this limitation, emerging logic-in-memory architecture based on nonvolatile memories (NVMs) are being investigated. Spin transfer torque (STT) magnetic random access memory (MRAM) is considered one of the most promising NVMs thanks to its high speed, low power, good endurance, and 3-D back-end integration. This paper presents a novel magnetic full-adder (MFA) design based on perpendicular magnetic anisotropy (PMA) STT-MRAM. It provides advantageous power efficiency and die area compared with conventional CMOS-only full adder (FA). Transient simulations have been performed to validate this design by using an industrial CMOS 40 nm design kit and an accurate STT-MRAM compact model including physical models and experimental measurements.


The accuracy of a dementia diagnosis by specialist physicians, as verified at an autopsy, is greater than 90% in many series. Donations of brains to the Maritime Brain Tissue Bank (MBTB) by individuals who did not have expert dementia diagnoses before death led us to investigate whether clinical features could also be detected retrospectively. Informants for 36 individuals whose brains were in the MBTB (18 women, mean age = 79 years; pathologic diagnoses: 75% Alzheimer's disease [AD]; 8.4% vascular or mixed dementia) were interviewed by specialist physicians using a semistructured retrospective interview based on the Brief Cognitive Rating Scale (BCRS) (range = 1 [no impairment] to 7 [terminal dementia]). The mean duration of dementia was 8.5 ± 12.8 years based on proxy reports, and most cases suggested severe dementia—(stage 6 [severe] or 7 [terminal])—on the retrospective BCRS (RetroBCRS) before death. A score of 4 or more on the RetroBCRS had 100% sensitivity and specificity in detecting dementia. The RetroBCRS score correlated moderately with duration (.51). In linear and logistic regression models adjusted for age and sex, RetroBCRS staging helped explain 93% of the variation in duration. The accuracy of the retrospective diagnosis of the cause of dementia, compared with autopsy, was 92%. The RetroBCRS used by an expert physician with a reliable informant is a valid method of detecting dementia and determining whether AD was present.


ABSTRACT To calculate sample sizes in cluster randomized trials (CRTs), the cluster sizes are usually assumed to be identical across all clusters for simplicity. However, equal cluster sizes are not guaranteed in practice, especially when the number of clusters is limited. Therefore, it is important to understand the relative efficiency (RE) of equal versus unequal cluster sizes when designing CRTs with a limited number of clusters. In this paper, we are interested in the RE of two bias-corrected sandwich estimators of the treatment effect in the Generalized Estimating Equation (GEE) models for CRTs with a small number of clusters. Specifically, we derive the RE of two bias-corrected sandwich estimators for binary, continuous, or count data in CRTs under the assumption of an exchangeable working correlation structure. We consider different scenarios of cluster size distributions and investigate RE performance through simulation studies. We conclude that the number of clusters could be increased by as much as 42% to compensate for efficiency loss due to unequal cluster sizes. Finally, we propose an algorithm of increasing the number of clusters when the coefficient of variation of cluster sizes is known and unknown.


Natural gamma ray well logging, an effective tool in geophysical prospecting, is used to investigate the radioactive and phosphatic layers in the Khneifiss mine in Syria. The interpretation of the gamma ray measurements, using numerical methods of analysis developed previously and applied successfully in some phosphatic areas in Syria, make it possible to define precisely the phosphate thickness from place to place in the study area. This technique has been successfully applied while studying seven boreholes in the area. Sixty-three core samples from phosphatic layers in the boreholes have been analyzed, using gamma ray spectrometry for the determination of P2O5 , U, Th, and K. Good correlation between P2O5 content and U concentration has been found. The total count gamma logs correlate reasonably well with the U core analysis, suggesting that radioactive equilibrium exists in the U decay series. These gamma logs can be therefore used effectively to quantitatively map the distribution of P2O5 and U. The characteristics of both subsurface phosphatic sand and phosphatic rocks have been investigated and outlined using a statistical approach. The affinity of uranium to some trace elements such as V, Sr, Cu, and Ni has been verified using correlation matrices of these elements.


In the method of photoselection for measuring molecular polarization, it is not necessary that the molecule be embedded in a crystal of known structure, but merely rigidly fixed in a random arrangement. In this paper the possibility of using a plastic as the host solvent is examined. This would replace the previously used mixtures of organic solvents that form glasses at 77°K, and which, because of experimental conditions, might give rise to great depolarization effects. In methyl methacrylate polymer (Lucite), the phosphorescence of phenanthrene, coronene, and pyrazine is found to be polarized at room and liquid-nitrogen temperatures. The measured degree of polarization in the plastic is found to be in good agreement with the expected value. The effect on the degree of polarization of temperature, concentration, thickness, and shape of the plastic sample is discussed. The importance of using this method for further polarization investigations to increase our understanding of the structure and spectroscopic properties of complex luminescent guest molecules, as well as the internal structure and motions of different host polymers, is pointed out.


Bush encroachment is a vegetation dynamic of global interest. This study describes the pattern of succession of bush clumps in the Eastern Cape, South Africa, using a space-for-time substitution. Clumps formed following establishment of mainly Acacia karroo in grassland through nucleation via animal dispersal. A total of 49 tree or shrub species were recorded in 40 clumps. With increasing clump size, there was a corresponding increase in woody basal area, species richness and diversity, but not evenness. Correspondence analysis showed that the pattern of compositional variation was closely related to clump size; differences resulting from clump establishment disappeared as clumps developed. Population size structure of 20 (of 21) species was dominated by small individuals, indicating that regeneration has increased over time. Coddia rudis was prolific on a clump periphery; Scutia myrtina and A. karroo were dominant within clumps. Seven shrub and nine tree species were encountered more frequently within a clump than on its periphery. All species other than A. karroo had fruits suited to dispersal by birds or mammals. The overall pattern of bush clump succession shows close parallels with that initiated by invasion of Prosopis glandulosa into grassland in Texas, USA.


Learning user preferences for products based on their past purchases or reviews is at the cornerstone of modern recommendation engines. One complication in this learning task is that some users are more likely to purchase products or review them, and some products are more likely to be purchased or reviewed by the users. This non-uniform pattern degrades the power of many existing recommendation algorithms, as they assume that the observed data are sampled uniformly at random among user-product pairs. In addition, existing literature on modeling non-uniformity either assume user interests are independent of the products, or lack theoretical understanding. In this paper, we first model the user-product preferences as a partially observed matrix with non-uniform observation pattern. Next, building on the literature about low-rank matrix estimation, we introduce a new weighted trace-norm penalized regression to predict unobserved values of the matrix. We then prove an upper bound for the prediction error of our proposed approach. Our upper bound is a function of a number of parameters that are based on a certain weight matrix that depends on the joint distribution of users and products. Utilizing this observation, we introduce a new optimization problem to select a weight matrix that minimizes the upper bound on the prediction error. The final product is a new estimator, NU-Recommend, that outperforms existing methods in both synthetic and real datasets. Our approach aims at accurate predictions for all users while prioritizing fairness. To achieve this, we employ a bias-variance tradeoff mechanism that ensures good overall prediction performance without compromising the predictive accuracy for less active users.


Thoracic CT may be used in the workup of patients with pleural effusion. In humans, certain pleural features on CT aid in diagnosing an underlying cause for pleural effusion, whereas this is not well studied in veterinary medicine. This retrospective cross-sectional analytical study assessed pleural and other intrathoracic abnormalities on CT in dogs and cats with pleural effusion and explored potential discriminatory features between effusion types. Eighty-nine dogs and 32 cats with pleural cytology and/or histopathology were categorized into malignant pleural disease (15 dogs and 11 cats), pyothorax (34 dogs and 7 cats), chylothorax (20 dogs and 11 cats), transudative (11 dogs and 2 cats), and hemorrhagic effusion (9 dogs and 1 cat). Multivariable logistic regression analysis comparing malignancy to other effusions found that older patient age (dogs: odds ratio 1.28, P = 0.015; cats: odds ratio 1.53, P = 0.005), nodular diaphragmatic pleural thickening (dogs: odds ratio 7.64, P = 0.021; cats: odds ratio 13.67, P = 0.031), costal pleural masses (dogs: odds ratio 21.50, P = 0.018; cats: odds ratio 32.74, P = 0.019), and pulmonary masses (dogs: odds ratio 44.67, P = 0.002; cats: odds ratio 18.26, P = 0.077) were associated with malignancy. In dogs, any costal pleural abnormality (odds ratio 47.55, P = 0.002) and pulmonary masses (odds ratio 10.05, P = 0.004) were associated with malignancy/pyothorax, whereas any costal pleural abnormality (odds ratio 0.14, P = 0.006) and sternal lymphadenopathy (odds ratio 0.22, P = 0.040) were inversely associated with transudates. There were, however, many overlapping abnormalities between effusion types, so further diagnostic testing remains important for diagnosis.


A dangerously mutagenic protein is targeted to a single genomic site by ssDNA, report Ronai et al. (page 181). High frequency mutation at the immunoglobulin V region improves antibody affinity and specificity as part of the adaptive immune response. AID (activation-induced cytidine deaminase), which converts deoxycytidines to deoxyuridines, initiates this mutation process. These conversions then induce various error-prone repair mechanisms, increasing the mutation rate further. AID must be targeted carefully, however, as it is a potent mutagen. Indeed mistargeting of AID-induced mutations is thought to cause B cell lymphomas. AID's only in vitro substrate is ssDNA. The team isolated chromatin from B cells undergoing somatic hypermutation (SHM) and found that chromatinand transcription-dependent ssDNA was present at V regions. Many genes in B cells are highly transcribed, but the team found that such loci had much less ssDNA than those undergoing SHM. The ssDNA may be short lived during normal transcription but persist at V regions, perhaps due to RNA pol II pausing. Whatever the reason, it seems that the specific abundance of ssDNA at the V region might be one of the chromatin signals for targeting AID. Activating autoimmunity


In this issue of Heart , Parry et al 1 report results of a double-blind trial of pacing in elderly recurrent fallers with carotid sinus hypersensitivity (CSH) (see page 405) . The so-called PERF-CSH trial utilised a crossover design to determine whether dual-chamber cardiac pacing diminishes susceptibility to recurrent "falls" in older CSH patients.

The basis for undertaking PERF-CSH lay in the previously published SAFE-PACE study2 from the same investigators. In brief, SAFE-PACE provided two major findings. First, it offered an apparently close association between CSH and otherwise unexplained falls in older individuals. Second, SAFE-PACE provided observational evidence that cardiac pacing diminished the frequency of unexplained "falls" in this same population.2 This second observation tended to support, albeit inferentially, the concept that symptomatic CSH (ie, carotid sinus syndrome, CSS) not only was more prevalent than previously thought in older persons but also was a frequent cause of potentially harmful falls in this age group. Support for this inference was based on the fact that the apparent effectiveness of cardiac pacing in SAFE-PACE patients was consistent with the well-accepted value of pacing for ameliorating CSS symptoms, particularly transient loss of consciousness (TLOC) leading to falls and injury.3

Given the above described apparent connections among "falls" in older people, the seeming presence of CSH in older subjects, and the possibility of preventing falls by cardiac pacing, it was both logical and necessary to undertake a study that tested pacing effect directly in such patients; hence, the PERF-CSH study.1 However, despite the encouraging findings with regard to pacing prevention of falls in the original SAFE-PACE findings, the PERF-CSH report indicates that pacing offers, at best, only marginal benefit.

The clinical and economic impact of "falls" in older people is widely accepted as an important healthcare issue. For instance, …