We present a simple transformation of any linear program or semidefinite program into an equivalent convex optimization problem whose only constraints are linear equations. The objective function is defined on the whole space, making virtually all subgradient methods be immediately applicable. We observe, moreover, that the objective function is naturally smoothed, thereby allowing most first-order methods to be applied.
We develop complexity bounds in the unsmoothed case for a particular subgradient method, and in the smoothed case for Nesterov's original optimal first-order method for smooth functions. We achieve the desired bounds on the number of iterations, $ O(1/ \epsilon^2) $ and $ O(1/ \epsilon) $, respectively.
Perhaps most surprising is that the transformation from a linear program or a semidefinite program is simple and so is the basic theory, and yet the approach has been overlooked until now, a blind spot. Once the transformation is realized, the remaining effort in establishing complexity bounds is mainly straightforward, by making use of various works of Nesterov.


extensive review of the practical experience of several acknowledged experts using PCA for a variety of clinical pain states. There is a particularly good chapter on pharmacokinetics of opioids with a discussion relating the theory to difficulties in management of the individual patient in pain. The book also identifies problem areas, safety aspects and directions for future research. In short, it covers every aspect of patient-controlled analgesia. As emphasised by the authors in the Preface, there is a considerable repetition in the book. The casual reader will find this irritating. The book is nevertheless recommended reading for every doctor who uses or is particularly interested in patientcontrolled analgesia, or who is considering the purchase of one of these instruments. Those with a lesser interest in the subject will find it too lengthy.


Root-knot nematodes (Meloidogyne incognita) induce specific feeding sites in cucumber roots where they absorb carbon nutrients from the host, thereby turning the feeding sites into a strong sink for assimilates. Nematode infection may alter host sugar metabolism in the roots of sucrose-transporting species. However, much less is known about the species translocating raffinose family oligosaccharides (RFOs), such as cucumber. To address this knowledge gap, the dynamics of RFOs and sucrose metabolisms, two major sugar-metabolism processes, in cucumber roots during nematode infection at transcription and protein levels were analyzed. In the nematode-infected root, the expressions of RFO-synthesis genes, CsRS (Raffinose Synthase) and CsGolS1 (Galactinol Synthase 1), were upregulated at early stage, but were significantly decreased, along with CsSTS (Stachyose Synthase), at the late stage during nematode infection. By contrast, α-galactosidase hydrolyzed RFOs into sucrose and galactose, whose encoding genes was suppressed (CsaGA2) at early stage and then elevated (CsaGA2, 4, and CsAGA1) at the late stage of nematode infection. Consistently, stachyose level was significantly increased by ∼2.5 times at the early stage but reduced at the late stage of infection in comparison with the uninfected roots, with a similar trend found for raffinose and galactinol. Moreover, the genes encoding sucrose synthase and cell wall invertase, which are responsible for sucrose degrading, were differentially expressed. In addition, sugar transporter, CsSUT4, was enhanced significantly after nematode infection at early stage but was suppressed at the late stage. Based on the observation and in connection with the information from literature, the RFOs play a role in the protection of roots during the initial stage of infection but could be used by nematode as C nutrients at the late stage.


We investigate identity-based solutions associated with marginal deformations in open string field theory. We find that the identity-based marginal solutions can be represented as a difference of wedge-based solutions plus an integration of a deformed BRST exact state. Using this expression, the gauge invariant overlap can be calculated analytically for the identity-based solutions. Moreover, we show that, by gauge transformation, the overlap is transformed into a disk correlation function with the integrations of currents at the boundary.


The complex shapes of biominerals cannot be explained with simple mechanistic models of crystal growth. In their Perspective,
 De Yoreo and Dove,
 argue that the popular "stereochemical recognition" model, which postulates that some shapes are stabilized through the binding of peptides and proteins to otherwise unstable faces, is not the full answer, either. According to recent studies, specific interactions between growth modifiers such as proteins and the edges of individual steps on existing crystal faces change the elementary step change to generate a similarly modified bulk crystal shape. The emergence of new faces is a macroscopic manifestation of the kinetics caused by molecular-scale interactions at the step edges.


Endogenous redox systems not only counteract oxidative damage induced by high levels of hydroxyl radicals (OH·) under pathological conditions, but also shape redox signaling as a key player in the regulation of physiological processes. Second messengers like hydrogen peroxide and nitric oxide, as well as redox enzymes of the Thioredoxin (Trx) family, including Trxs, glutaredoxins (Grxs), and peroxiredoxins (Prxs) modulate reversible, oxidative modifications of proteins. Thereby redox regulation is part of various cellular processes such as the immune response and Trx proteins have been linked in different disorders including inflammatory diseases. Here, we have analyzed the protein distribution of representative oxidoreductases of the Trx fold protein family—Trx1, Grx1, Grx2, and Prx2—in a murine model of allergic asthma bronchiale, as well as their potential therapeutic impact on type-2 driven airway inflammation. Ovalbumin (OVA) sensitization and challenge using the type-2 prone Balb/c mouse strain resulted in increased levels of all investigated proteins in distinct cellular patterns. While concomitant treatment with Grx1 and Prx2 did not show any therapeutic impact on the outcome of the disease, Grx2 or Trx1 treatment before and during the OVA challenge phase displayed pronounced protective effects on the manifestation of allergic airway inflammation. Eosinophil numbers and the type-2 cytokine IL-5 were significantly reduced while lung function parameters profoundly improved. The number of macrophages in the bronchoalveolar lavage (BAL) did not change significantly, however, the release of nitric oxide that was linked to airway inflammation was successfully prevented by enzymatically active Grx2 ex vivo. The Grx2 Cys-X-X-Ser mutant that facilitates de-/glutathionylation, but does not catalyze dithiol/disulfide exchange lost the ability to protect from airway hyper reactivity and to decrease NO release by macrophages, however, it reduced the number of infiltrating immune cells and IL-5 release. Altogether, this study demonstrates that specific redox proteins and particular enzyme activities protect against inflammatory damage. During OVA-induced allergic airway inflammation, administration of Grx2 exerts beneficial and thus potentially therapeutic effects.


A method for generating tetrahedra for the open boundary 3-D FEM (finite element method) in magnetic field analyses is proposed that uses two algorithms: topological mapping for a multimedia region including cores and coils, and a multilayer space dividing the air region surrounding the media region. The former region usually has complicated geometric shape, and requires dense distribution of elements; the latter requires elements to become gradually coarser towards the outside. Combining these two algorithms greatly decreases the processing time and generation of a suitable mesh density for tetrahedra becomes easy. >


GPU-based raycasting has emerged as the defacto standard for interactive volume rendering on off-the-shelf graphics hardware. Even though in theory this technique can be easily extended by shadow feelers in order to support shadows, this obvious approach has a major impact on the rendering performance. In this paper we will investigate shadowing extensions for GPUbased volume raycasting and compare them with respect to their quality and their performance. In particular, we will consider shadow rays, shadow mapping and deep shadow maps. For these techniques we will address their implementations using current graphics boards, and we will compare their visual results as well as their runtime behavior.


Interview with Caltech alumnus Melvin Levet, BS '39, MS '40, in two sessions on February 20, 2015. With memories of Caltech that stretch back nearly eight decades, he describes growing up in Monterey Park, California, in the 1920s and 1930s, with "orange groves all over the place." He talks about his family background and youthful interests, his experiences during the Depression, and his decision to enroll at Caltech. After a rocky start with the core curriculum, he thrived as a geology major, working with professors I. Campbell, H. Fraser, R. Jahns, and W. P. Popenoe. He recalls the rigors of his daily commute between Monterey Park and campus; his enjoyment of his geology coursework and field work in Ensenada, Pala, and the Inyo mountains, as well as the Grand Canyon; and his participation in Caltech baseball, including winning the Institute's Rawlings Trophy and captaining the varsity team.

After receiving his MS, also in geology, Levet married his high-school sweetheart, Perle Wilkins; and after Pearl Harbor he enlisted in the Army Air Force meteorology program, based first at UCLA and later at the University of Chicago. He served as a weather officer, first stateside and then in the Pacific at every Headquarters 13th Air Force location (except Fiji)—South Pacific, South West Pacific, Asiatic Pacific and the Philippines. He vividly recounts some of his wartime experiences, including island hopping in multiple aircraft, his introduction to "persistence forecasting," visiting Tokyo following V-J Day, and "taking in stride" the experience of being aboard a B-17 lost in a typhoon over the East China Sea. In the 1980s he and Perle returned twice to Guadalcanal with fellow veterans and their spouses.

After the war, Levet spent 35 years with Standard Oil California (later Chevron) as a research geologist and manager with the company's computer services department. Beyond his career, he enjoyed hiking, backpacking, and other outdoor activities with his family; and in retirement he and Perle traveled extensively, including trips with the Caltech Alumni Association and Caltech Associates, led by, among others, geologist R. Sharp. This oral history concludes with Levet's account of his ongoing relationship with Caltech, his observations of how Caltech has changed since his undergraduate days and his reflections on the Institute's impact on his life and career.


This thesis examines Dickens"s uses of images of the river throughout his fiction, and also in the early sketches, the reprinted pieces from Household Words and The Uncommercial Traveller. The river concerned is usually but not exclusively the Thames, usually but not exclusively in London. The thesis offers some practical evidence to account for the powerful influence of the Thames upon Dickens"s imagination and shows how he conceives of it both within existing frames of reference and in some distinctively Dickensian ways. It considers how Dickens"s representations of the river play into the cult of the picturesque which emerged at the end of the eighteenth century, and into the tradition which sees it as a symbolic conduit of the empire. It goes on to consider his use of the river as a boundary, the consequent importance of river crossings in his work, and his conception of the riparian space as a liminal one. It then explores a distinctive scheme of discourse which uses the river to represent rebellious forces beyond the control of human agency and shows how this reflects the sense of spiritual threat which is to be found in some of the other, albeit rare, depictions of nature to be found in his writing. It then shows how Dickens uses the river symbolically to express ideas about death and rebirth, together with the loss of and changes in identity, and how he draws on a scheme of distinctively Christian iconography to do so. Finally it shows how he uses it to create and represent an underworld for London, using tropes of epic founded on classical models. The thesis concludes that, in its use of natural forces to signify social ones, Dickens"s writing about the river serves to amplify his conception of stratification in Victorian society and adds weight to the socially conservative political stance which is known to be present in his world view.


After the attainment of independence from colonial rule in 1963, the priority issues on which the post-colonial Kenya Government focused its attention was eradication of poverty, improvement of healthcare facilities and expansion of education. National development plans in thefirst decade therefore addressed these three main issues. At that time, sport did not feature as a facet to development. Though people participated in sports, this was to a less extent and was generally regarded as pastime activity. In addition, sports were regarded as an activity for children in schools. In the 1960 's, some athletes who excelled in major international competitions provided the impetus for increased interest and participation in sports by Kenyans from all walks of life. Consequently, many sports federations and organization to manage and administer various sports disciplines were formed and registered by the Government. At this moment in the history of Kenya, there has been tremendous development of sports. Its popularity has stemmed from the understanding of the Government and the people of Kenya of the role of sports as a vehicle for national development. Indeed, the contribution of sports towards social, economic, cultural and political development of Kenya has been immense. Unfortunately, there has been no documentation of the important role of sports in Kenya's development. The present paper therefore presents an overview of the status of sports in Kenya, the achievements attained and an elaboration on tangible contributions that sports has made towards the development of the nation. It is hoped that the information will provide some ideas and lessons that could benefit other countries of the world in their efforts to develop mass sport.


This passage discusses the comprehensive strength of the five football clubs, Barcelona, Real Madrid, Inter Milan, Bayern, Chelsea. According to the problems to be solved, with the method of mathematical modeling and evaluation research, this passage calculates with Matlab after it gets the weight. Due to many factors which influence the football team, this passage just analyzes with the times that the team won the competitions, the history of the team, the social status of the football player. There may be some random errors based on the data, so that the result is not in a long residual action. Then this passage adds a relvar about the factors that influence the comprehensive strength of the football team to the time, which makes it in a long residual action. In the end, we come to the conclusion that the Barcelona football team has the strongest comprehensive strength, and then is Real Madrid; after that is Bayern Munich, then the Inter Milan, at last the Chelsea.


Depression is a common mental disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite and poor concentration. This study therefore investigates the manifestations of depression among undergraduates of universities in Kwara State. It also examined the influence of variables of religious affiliation and level of study on undergraduates' responses. Descriptive survey design was adopted for this study and multi-stage sampling procedure which comprises purposive, proportional, stratified and simple random sampling techniques were adopted to draw a total sample of 600 undergraduates from two universities in Kwara State. "Manifestations of Depression Questionnaire (MDQ)" was used to collect relevant data. The instrument was subjected to test re-test reliability co-efficient which yielded the score of 0.78 and the hypotheses were analysed using t-test and Analysis of Variance (ANOVA) at 0.05 significance level. Frequency counts and percentages were used to present the demographic data. The findings of the study identified poor school academic performance, avoidance of responsibility and difficulty in day to day tasks, health problems and loss of self-confidence as major manifestations of depression among undergraduates of universities in Kwara State, Nigeria. The hypotheses tested revealed no significant difference in the manifestations of depression among undergraduates of Universities in Kwara State based on religious affiliation and level of study. In line with the findings of this study, it was recommended among others that members in peer groups should be encouraged to assist one another and encourage prompt reportage of depression.


Decisions under uncertainty are often biased by the history of preceding sensory input, behavioral choices, or received outcomes. Behavioral studies of perceptual decisions suggest that such history-dependent biases affect the accumulation of evidence and can be adapted to the correlation structure of the sensory environment. Here, we systematically varied this correlation structure while human participants performed a canonical perceptual choice task. We tracked the trial-by-trial variations of history biases via behavioral modeling and of a neural signature of decision formation via magnetoencephalography (MEG). The history bias was flexibly adapted to the environment and exerted a selective effect on the build-up (not baseline level) of action-selective motor cortical activity during decision formation. This effect added to the impact of the current stimulus. We conclude that the build-up of action plans in human motor cortical circuits is shaped by dynamic prior expectations that result from an adaptive interaction with the environment.


This thesis is a critical examination of English social and urban regeneration policy and programme delivery implemented
between 1997 and 2015 under New Labour and the Conservative-Liberal Democrat Coalition government. It assesses the extent
to which the community empowerment rhetoric of both governments translated into increased opportunities for community-led
regeneration and reflected genuine shifts in power from central government to the local and neighbourhood level. The thesis
argues that the opportunities have not been fully realised due to systematic failures in acknowledging and supporting the
enabling conditions necessary for meaningful community participation and empowerment. This hypothesis is tested using an
adapted version of the Institute of Development Studies 'Place, Space and Power' framework, interviews conducted with
residents and community development practitioners in England and the USA,and by a comprehensive review of policy literature
and programme evaluations spanning this period. By doing so, this thesis identifies a top-down-bottom-up dichotomy, whereby
government promotes community-led regeneration but continues to control the parameters within which the activity takes place.
The impact of which can be disempowerment and disillusionment at the local and community level - ultimately hindering
regeneration practice and the achievement of sustainable community development.
The influence of American social policy and community development practice on English policy design and rhetoric is strong,
with America's less centralised model of community development cited as an aspirational model. Presenting empirical research
conducted with community development stakeholders in England and the USA, this thesis compares and contrasts the
government-led community development approach adopted in England with the experiences of community organisations and
intermediaries in the USA. By demonstrating a number of findings which would enhance participatory programme design and
delivery in England going forwards, this thesis aims to fill a gap in the understanding of what regeneration policy can and should
be and contribute to knowledge in the tradition of law and geography, social policy, and in sustainable regeneration


Viewed on a day in late June 1997, Metropolitan Toronto stretches north and is lost in a yellow haze -- an import, in part, from Ohio mills and power plants. News reports that day told not only of smog, but of a UV alert, and of the failure of the Earth Summit, 1997 edition, that week in New York. Less than a month before, the environment had played only a bit part in the federal election campaign, appearing as menace, in the form of a swollen Red River. Such weighty matters as national unity and jobs evidently could be discussed as if they related not at all to a landscape that has shaped our national story, and that remains a foundation of both production (forests, fish, food) and consumption (especially tourism). Perhaps we really can take air, water and land for granted, at least until prodded from the south -- by floodwaters, dirty winds or news of a failed conference.But this apparent dependence on environmental imperatives from elsewhere is not entirely accurate. During the last 25 years a distinctive Canadian environmental politics has emerged, played out through diverse environmental institutions and perspectives, and reacting with our profligate use of resources, and with changes in the global environment. This emergence has been chronicled by a substantial academic literature, providing interpretations of the recent history of Canadian environmental politics, explorations of contemporary environmental issues and conflicts and projections of potential sustainable futures for Canada.Imperfect PastsMost of the institutions of contemporary Canadian environmental politics came into existence in the late 1960s or early 1970s. Environment Canada led the way: cobbled together from both existing and new federal units, it owed its existence to an expanded sense of government responsibilities, the ambitions of federal bureaucrats and politicians, and pressure from environmentalists and an alarmed public. G. Brace Doern and Thomas Conway provide in The Greening of Canada: Federal Institutions and Decisions a highly useful account of this complex entity, from its origins in the late 1960s to the implementation of the Green Plan of the early 1990s, and the Earth Summit in 1992. Drawing on an array of published and unpublished government documents, as well as interviews with many of those involved in the events described, Doern and Conway provide essentially a history of Environment Canada, that should be of interest to anyone seeking to understand how federal environmental policy is formulated and implemented. While focussing on Environment Canada, they also explore the context of federal environmental policy making: the relations of Environment Canada with other, often more powerful federal departments; with the provinces, business and environmental interests: and with international institutions and other nations. And beyond this human context of decisions and actions, as Doern and Conway acknowledge, is the natural environment, imposing its own, often unpredictable dynamic on environmental politics.Whether evaluated in terms of specific actions for protecting the environment, or in terms of defining an overall federal environmental mission, Environment Canada's record has been mixed. But as Doern and Conway explain, the obstacles faced by the department make any success seem almost remarkable. Sixteen ministers in its first 22 years hindered efforts to establish a longterm, coherent agenda for the department. These ministers also exhibited widely varying levels of competence and commitment. Some, both Liberal (such as the first minister, Jack Davis), and Conservative (for example, Lucien Bouchard and Robert de Cotret, who helped push the Green Plan through the Ottawa system) put their stamps on federal environmental policies, while others were disastrous, or simply ineffective.The challenge posed by frequent ministerial changes (itself reflecting the low status of Environment Canada within the federal government) was sharpened by centrifugal forces created when the department was brought into existence. …


The aim of this text is to relate the three triads presents on the Plotinus' Enneads - 1. the three types of man: the musician, the lover, and the philosopher; 2. the three men: the sensible man, the rational man and the Form of man; 3. the potencies, faculties or capacities of the soul: the desiring one, the perceiving one, and the reasoning faculty or discursive one - in order to clarify the conditions or presuppositions of man's ascent to the One through the ways of the musician, the lover, and the philosopher. We analyze how these men use soul's faculties to return to the One and, in consequence, we propose a delimitation of the differences between men and their capacities for such ascent. KEY-WORDS: Man, faculties of the soul, return, One. Em nossa pesquisa, obtivemos os seguintes


The term "bilateral deficit" (BLD) has been used to describe a reduction in performance during bilateral contractions when compared to the sum of identical unilateral contractions. In old age, maximal isometric force production (MIF) decreases and BLD increases indicating the need for training interventions to mitigate this impact in seniors. In a cross-sectional approach, we examined age-related differences in MIF and BLD in young (age: 20–30 years) and old adults (age: >65 years). In addition, a randomized-controlled trial was conducted to investigate training-specific effects of resistance vs. balance training on MIF and BLD of the leg extensors in old adults. Subjects were randomly assigned to resistance training (n = 19), balance training (n = 14), or a control group (n = 20). Bilateral heavy-resistance training for the lower extremities was performed for 13 weeks (3 × / week) at 80% of the one repetition maximum. Balance training was conducted using predominately unilateral exercises on wobble boards, soft mats, and uneven surfaces for the same duration. Pre- and post-tests included uni- and bilateral measurements of maximal isometric leg extension force. At baseline, young subjects outperformed older adults in uni- and bilateral MIF (all p < .001; d = 2.61–3.37) and in measures of BLD (p < .001; d = 2.04). We also found significant increases in uni- and bilateral MIF after resistance training (all p < .001, d = 1.8-5.7) and balance training (all p < .05, d = 1.3-3.2). In addition, BLD decreased following resistance (p < .001, d = 3.4) and balance training (p < .001, d = 2.6). It can be concluded that both training regimens resulted in increased MIF and decreased BLD of the leg extensors (HRT-group more than BAL-group), almost reaching the levels of young adults.


This study was carried out to know the prevalence of hepatitis B, syphilis and co-infection of both among the people of Ekiti, South-West, Nigeria. Individuals and patients who visited the Haematology and Blood Transfusion Unit of Ekiti State University Teaching Hospital, Ado-Ekiti to screen themselves for HBV and Syphilis infections between January to November, 2014 were recruited for this study having obtained their consent. 4ml of blood sample was collected from each subject into a plain bottle and was allowed to stand for 1hour for clotting and clot retraction to take place. Sera were separated into khan tubes labeled appropriately and were screened for the presence of antibodies to HVB and syphilis using One-Stage Rapid Test Kits (DiaSpot Diagnostics) and were later confirmed using enzyme linked immune sorbent assay (ELISA) (Stat Fax Awareness, England). One Thousand Six Hundred and Thirty-Nine subjects were recruited for this study, out of which Seven Hundred and Seventy-Four were males while Eight Hundred and Sixty-Five were females. 101(6.16%) were positive to HBV, 51(0.92%) positive to syphilis and 5(0.31%) were co-infected with both infections. The results of this study showed higher prevalence of hepatitis B infection than syphilis infection with the highest prevalence found within the age group 31-40 years and 21-30 years indicating that most of the infected people got the infection through sexual intercourse.


Taking the South African constitution as an eminent symbol of the South African social contract, and noting the opinion of many that the contract has failed to deliver, this article explores the concept of the social contract in South Africa by examining two contentions. The first, that the South African social contract, or constitution, was not entirely inclusive to begin with. And the second, that the radical opposition party – the Economic Freedom Fighters (EFF) – represents the rise of a new constituent power from the unemployed and disenfranchised populous: those seen to have been left out of the social contract. Within this article, I follow Negri's work on constituent power, broadly taking the term to denote "the power of the people". Through exploring these contentions, this article comes to an impasse: that South Africa's social contract was, and continues to be, conditioned in advanced by the preceding administration or constituted power, which limits, too, the possibilities of a new constituent power represented by the EFF.


Wheat (Triticum aestivum L.) varietal susceptibility to the Mediterranean flour moth, Anagasta kuehniella) Zeller, 1879) was evaluated in ten dry land and irrigated wheat that was produced at Azarbayejan, Iran. In this study some biological parameters of pest were affected by evaluated wheat varieties. Investigated parameters were included weight of larvae, emergence rate of pupae, emergence rate of adults, sex ratio and fecundity. Weight of larvae, emergence rate of pupae and sex ratio in the different cultivars at probability levels of 5% were not significant. The varieties on the emergence rate of adults and fecundity at probability levels of 5% had significant difference. As the highest and lowest rates were obtained at varieties of 'Sardari' and 'Shirudi', respectively. Also the highest and lowest fecundity were observed at varieties of 'Azar 2' and 'Rasad' respectively. Emergence rate of adults in wheat with high protein levels were decreased and fecundity in this varieties increased. According to these experiments different wheat varieties have high resistance to infestion by mediterranean flour moth, Anagasta Kuehniella (Lep.: Pyralidae) and results of this study is disreble for use in agriculture.


Petrographic studies of first-cycle desert alluvium of Cenozoic age in the southwestern United States and northwestern Mexico show that the mineralogy, texture, and chemical composition of the deposits have been changed diagenetically. The mineralogy has been changed by addition of mechanically infiltrated clay, partial removal of framework grains of feldspars and ferromagnesian silicates, and precipitation of authigenic potassium feldspar, zeolite, montmorillonite, quartz, hematite, and calcite. The texture has been changed by three processes: (1) infiltration of detrital clay and formation of authigenic montmorillonite, which form interstitial clayey matrix not present in the original sediment, (2) formation of voids where framework grains have been dissolved, and (3) in situ formation of silt and other fine-grained sizes. The chemical composition has been changed by infiltration of clay minerals that are richer in aluminum and lower in alkalis and alkaline earths than the original sediment and by removal in ground water of some of the ions released by dissolution and replacement of framework grains. These changes have significantly increased the mineralogical maturity and decreased the textural maturity of the sediments diagenetically. Four major conclusions are drawn from the studies. (1) Some or all of the diagenetic alterations observed in these deposits probably occurred in many analogous ancient first-cycle alluvial deposits at a comparable time in their history. (2) Prolonged movement of ground water through first-cycle deposits may cause unstable minerals to be removed completely, or nearly so, leaving no direct evidence that they were important original constituents of the deposits. (3) Ancient first-cycle alluvium probably rarely, if ever, has the same mineralogy, texture, or chemical composition that the sediments had when deposited. (4) The present mineralogy, texture, and chemical composition of ancient first-cycle alluvial deposits probably do not accurately reflect lithology and climate in the source area or the nature of depositional currents and other environmental factors in the depositional basin.


Data-driven predictive modeling is increasingly being used in risk assessments. While such modeling may provide improved consequence predictions and probability estimates, it also comes with challenges. One is that the modeling and its output does not measure and represent uncertainty due to lack of knowledge, that is, "epistemic uncertainty." In this article, we demonstrate this point by conceptually linking the main elements and output of data-driven predictive models with the main elements of a general risk description, thereby placing data-driven predictive modeling on a risk science foundation. This allows for an evaluation of such modeling with reference to risk science recommendations for what constitutes a complete risk description. The evaluation leads us to conclude that, as a minimum, to cover all elements of a complete risk description a risk assessment using data-driven predictive modeling needs to be supported by assessments of the uncertainty and risk related to the assumptions underlying the modeling. In response to this need, we discuss an approach for assessing assumptions in data-driven predictive modeling.


Bisphosphonates (BPs) anti-fracture efficacy may be due in part to inhibition of osteocyte apoptosis. This effect requires opening of connexin (Cx) 43 hemichannels and phosphorylation of the extracellular signal regulated kinases (ERKs). However, unlike ERK activation by other stimuli, the Cx43/ERK pathway activated by BPs does not result in nuclear ERK accumulation. Instead, the anti-apoptotic effect of BPs depends on phosphorylation of cytoplasmic ERK targets and is abolished by forced nuclear retention of ERKs. We now report that ERKs and the scaffolding protein β-arrestin co-immuno-precipitate with Cx43 in MLO-Y4 osteocytic cells and that the BP alendronate increases this association. Moreover, ERK2 fused to red fluorescent protein (ERK2-RFP) co-localizes with Cx43 fused to green fluorescent protein outside the nucleus in cells untreated or treated with alendronate. Alendronate does not induce ERK nuclear accumulation in cells transfected with wild type β-arrestin (wtARR) or vector control, whereas it does in cells expressing a dominant negative β-arrestin mutant (dnARR) consisting of the β-arrestin-clathrin binding domain that competes with endogenous β-arrestin for binding to * Correo electrónico: firstname.lastname@example.com # Current address: IMMA Facultad de Medicina, Universidad San Pablo CEU, 28868 Boadilla del Monte, Madrid, Spain clathrin. Alendronate activates ERKs in dnARRtransfected cells as effectively as in cells transfected with wtARR, demonstrating that dnARR only interferes with subcellular localization but not with activation of ERKs by BPs. Further, whereas alendronate inhibits apoptosis in cells expressing wtARR or vector control, it is ineffective in cells expressing dnARR. Thus, BPs induce the formation of a complex comprising Cx43, β-arrestin, and clathrin, which directs ERKs outside the nucleus and is indispensable for osteocyte survival induced by BPs.


The purpose of this study is to investigate what motivates buyers to purchase tourism products through mobile-commerce applications, and how these motives have an impact on consumers' impulse buying behavior. For this study, we conducted a mixedmethods approach that combines qualitative and quantitative research methods. First, we interviewed via the qualitative research methods to study motivation for mobilecommerce application use. Then, we extracted the motivation factors and examined how these factors affect impulse purchase intentions for tourism products through mobile-commerce applications. To do this, a questionnaire survey was conducted. Based on the results of the questionnaire, we conducted a hypothesis test of the research model set up through the previous research study. In addition, fuzzy-set qualitative comparative analysis (fsQCA) provided in-depth analysis of factors that may influence impulse buying. As a result of the study, it was found that the characteristics of mobile devices had a positive effect on perceived value. The perceived value, transaction characteristics, and impulsiveness of the individual had a positive influence on urge to buy impulsively.


Why is Canadian unity important to democratic pluralism worldwide? Democratic pluralism is the ability of different cultural and language communities to find representation under a single set of democratic institutions, however configured. Although traditional liberal arguments at best ignored culture, in practise, out of a long struggle to eliminate gargantuan prejudices, errors and wrongs, the liberal tradition has created in democratic pluralism a dialectic of culture and liberal politics that resolves the theoretical conundrums so dear to both. Canadian democracy is a monument to success in its capacity to provide dignity, freedom, opportunity, and prosperity to its citizens throughout the polity. Secession, if it takes place in Quebec, puts these achievements at risk, raising the spectre that cultural-linguistic norms, not a mature liberal democracy, will fashion the kind of state that future generations will inherit. Charles Doran examines why Canadian unity is important, what drives Quebec separatism in the American view, the concern that after Quebec succession the rest of Canada could unravel, and the nature of the historical era that has shaped and conditioned secessionist impulse.


Tuberculosis (TB) is an infectious disease associated with poverty. In the European Union TB tends to concentrate in urban settings. In Lisbon, previous studies revealed, the presence of migrant populations from a high endemic country, is one of the risk factors contributing to TB. To better understand TB in foreign-born individuals in the Lisbon Metropolitan Area, a mixed-method case study was undertaken on a TB treatment centre in a high-risk part of urban Portugal. Quantitatively, annual TB cases were analysed from 2008 to 2018, dividing foreign-origin cases into recent migrants and long-term migrants. Qualitatively, we explored recent migrants' reasons, experiences and perceptions associated with the disease. Our results showed that foreign-born individuals accounted for 45.7% of cases, mainly originated from Angola, Guinea-Bissau, and Cabo Verde. TB in recent migrants increased over the years for Angola and Guinea-Bissau, while for Cabo Verde TB cases were due to migrants residing in Portugal for more than 2 years. Recent migrants' reasons to travel to Portugal were to study, to live and work, tourism, and seeking better healthcare. Visiting family and friends, historical links and common language were key drivers for the choice of country. Recent migrants and long-term migrants may present distinct background profiles associated with diagnosed TB.


Cluster rightsizing facilitates cost-performance trade-off in resource-constrained clouds. Multidimensional bin-packing algorithms can address this rightsizing problem, but these assume that every task on the cluster is always active. In contrast, real-world tasks may be active only during specific time-periods, which allows reusing resources via time sharing and optimal packing. This motivates our generalized problem of rightsizing for time-limited tasks: given a timeline, time-periods and resource demands for tasks, the objective is to place the tasks on a minimum cost cluster of nodes without violating node capacities at any time instance. We design a baseline two-phase algorithm that performs penalty-based mapping of task to node-type and then, solves each node-type independently. We prove that the algorithm has an approximation ratio of O(D. min(m, T)), where D, m and $T$ are the number of resources, node-types and timeslots, respectively, We then present an improved linear programming based mapping strategy, enhanced further with a cross-node-type filling mechanism. Our experiments on synthetic and real-world cluster traces show significant cost reduction by LP-based mapping compared to the baseline, and the filling mechanism improves further to produce solutions within 20% of (a lower-bound to) the optimal solution.


Importance of p-type transparent conducting oxide (TCO) is much needed in the optoelectronics industry. Due to lack of intrinsic p-type TCO, it is necessary to design or tune the properties existing n-type TCO are very essential. This present work describes, n-type ZnO is tuned to p-type by doping of nitrogen on to the nanocluster. The structural stability of ZnxOx-1N for x=(2-5) is optimized using Gaussian 09 program package with a B3LYP/6-31G level basis set. The optimization result shows that when the cluster size increases the stability also increases. The dipole moment depends on the structure of the ZnxOx-1N cluster. These optimized structural geometries are used to calculate the binding energy, HOMO-LUMO energy gap, ionization potential and electron affinity of nanoclusters. The binding energy for ring structures is found to be more than the other two structures. Vibrational analysis is carried out for all the structures and reported. The ring structure is found to be more stable than the linear and 3D structures. The findings of the present work will provide an insight to synthesis, p-type ZnO nanoclusters. Copyright © 2015 VBRI Press.


As a concept and in practice, Indigenous food sovereignty (IFS) offers insights into the social, cultural, and environmental challenges of a deficient food system. The associated poor health outcomes of this system include infant and child health issues such as early childhood caries and childhood obesity, and are a grave concern in many First Nations communities. Extant research has failed to consider the role of infant feeding traditions as an element of Indigenous food sovereignty. Breastfeeding and country food (also called traditional food or cultural food) consumption among infants has been long practiced in First Nations communities, resulting in healthier infants. The research described in this article originated with a research project called the Baby Teeth Talk study (BTT). This is a community-based trial which is testing a pre-natal/post-natal behavioural and preventive intervention for early childhood caries (ECC) among pregnant First Nations women and their infants in urban and on-reserve communities in Ontario and Manitoba. In Norway House Cree Nation, located in northern Manitoba, research participants shared stories on the methods used by caregivers for oral health care, including breastfeeding promotion. This paper reviews the literature relating to IFS, breastfeeding, and the introduction of country food to infants. Through the voices of grandmothers in one community in northern Manitoba, Canada, we connect the introduction of country food and breastfeeding to the larger IFS movement and positive health outcomes for infants, and improve the conceptualization and practice of IFS.


The microfossil hosted in the strata of the upper part of the San Juan Formation has been widely studied in several sections to the northward of the Argentinian Central Precordillera. In contrast, the coeval strata at the Los Baños de Talacasto section, in the southern part of the Central Precordillera, have scarce biostratigraphic and sedimentological data. In this work, a conodont association together with single ostracod species are documented for the first time in this section. The record of the Lenodus crassus and L. pseudoplanus zones confirms the Darriwilian age for these beds and accurately correlates them with equivalent strata of the San Juan Formation studied in several sections of the Central and Eastern Precordillera. The microfacies analysis verifies the presence of Nuia síbirica Maslov, 1954, peloids, intraclasts, cyanobacteria, calcareous algae, and a possible microbialite indicating a shallow warm-water subtidal environment, in equatorial to subequatorial climate. This suggests a low latitudes position for Precordillera during the early-middle Darriwilian. The conodont genus Aurilobodus Xiang and Zhang is recognized for the first time from the Precordillera, and the Aurilobodus leptosomatus An specimens are described and illustrated. This genus shows affinities to the warm water in shallow marine environments of North China, Central Asia, South Tibet, western Thailand, Australia, and Newfoundland, suggesting probable ties between Precordillera and these regions. The record of the ostracod Pilla nodospinosa Salas in the study section would agree with the correlation of the top of San Juan Formation with the lower levels of the Las Aguaditas Formation in the Central Precordillera, and also suggests paleobiogeographic links with Eastern Gondwana and Australia regions during the Darriwilian times.


This research investigated the evolution of an open source development community by undertaking network analysis across time. Several open source communities have been previously studied using network analysis techniques, including Apache, Debian, Drupal, Python, and SourceForge. However, only static snapshots of the network were considered by previous research. In this research, we created a tool that can help researchers and practitioners to find out how the Eclipse development community dynamically evolved over time. The input dataset was collected from the Eclipse Foundation, and then the
evolution of the Eclipse development community was visualized and analyzed by using different network analysis techniques. Six network analysis techniques were applied: (i) visualization, (ii) weight filtering, (iii) degree centrality, (iv) eigenvector centrality, (v) betweenness centrality, and (vi) closeness centrality. Results include the benefits of performing multiple techniques in combination, and the analysis of the evolution of an open source development community.


Background: Dementia is a disease characterized by brain atrophy, leading to cognitive decline. The clinical picture includes the presence of neuropsychiatric symptoms (NPSs), which can increase the caregiver burden. The present research was aimed at studying the effect of group therapy intervention with caregivers of patients with dementia on caregiver burden and NPSs of patients. The study was prospective, interventional, and exploratory. Materials and Methods: The study included 30 primary caregivers of geriatric patients (aged 60 and above) with dementia. The caregivers were divided into two groups of 15, in which one group received routine treatment and the other group received group therapy in addition to routine treatment. The patients in both groups were assessed on Neuropsychiatric Inventory Questionnaire, Everyday Abilities Scale for India, and Hindi Mental State Examination, and the caregivers of both groups were assessed on Zarit Burden Interview before and after the intervention. Statistical Analysis Used: Independent t-test was used to compare the age between two groups and Chi-square test to compare other sociodemographic variables between groups. Paired samples t-test was used for within-group comparison, and Mann–Whitney U-test was used between-group comparison. Results: There was significant improvement in NPSs of the patients and caregiver burden after intervention in the combined group. However, there was greater improvement in NPS of patients and caregiver burden in the group that received group therapy. Conclusions: Group therapy in caregivers of the patients with dementia is effective in improving the NPSs of patients, as well as in reducing caregiver burden.


A 75-year-old woman presented with rapidly progressive fatigue, abdominal pain and jaundice. Physical examination revealed tender abdomen and splenomegaly. Magnetic resonance cholangiogram showed marked hepatomegaly, splenomegaly and scattered nodules or masses in the liver and spleen. The patient expired from multiorgan failure. Autopsy revealed infiltration of the liver, spleen and bone marrow by acute myeloid leukaemia.


The Measuring of PartsPhilosophers such as Husserl, Twardowski, Ingarden and others distinguished different types of parts of an object such as possible parts, independent/dependent parts, parts of different order and the extent of the impact of some parts, but also some of these philosophers recognize unity and identity of an object as it's parts. In this article we propose to identify the different types of parts as a different measures defined on the whole which consists of these parts. We propose to use for this purpose mathematical measure theory and the issue of measurement in quantum mechanics — as examples of good practice in the matter of measuring. Ontological problem of measurement has not been so far sufficiently developed. Our work is aimed at raising some insights which may eventually contribute to the formulation of the precise ontological theory of the measurement of parts of some whole.


Three tropical vegetable species (Talium triangulare, Amaranthus cruentus and Telfairia occidentalis) were selected based on their availability and agronomic desirability. The freshly harvested vegetable leaves were subjected to 2 processing techniques (shredding and sundrying) before milling into the vegetable leaf meals (VLMs). The crude protein ranged from 19.9+1.8 to 35.1+1.7. The crude fibre ranged from 8.8+3.1 to 12.7+4.2. Ether extract (fat) had a wide range of 5.4+3.2 to 29.2+2.1. Ash contents had a range of 10.9+6.2 to 19.4+3.0. The nitrogen free extract ranged from 19.7+0.3 to as high as 43.5+0.7. Gross energy values had a range of 251.5MJKg-1 to 383.2MJKg-1. The mineral contents of the air-dried VLMs indicated that Ca, Mg, Na, K are the most abundant minerals with values as high as 2.0, 2.5, 7.1 and 4.8gkg-1DM for Ca, Mg, Na and K respectively in some samples analysed. The amino acid profiles of the VLMs indicated favourable nutritional balance except for lysine and methinone which appear marginal. The Water Absorption Capacity (WAC), Fat Absorption Capacity (FAC), Fat Emulsion Capacity (FEC) and Emulsion Stability (ES) were similar for the 3 VLMs. The values obtained for Foaming Capacity, Least Gelation Concentration and Foaming Stability after 30 minutes for the 3 VLMs were also similar. The protein solubility curves of all VLMs were similar at both alkaline and acid media with minimum solubility (isoelectric point) at between pH 4 and 5 for the VLMs. Keywords: Vegetable leaf meals, nutritional potentials, amino acid profile


"Nihilistic act embraces doomsday
The Age – December 2012
By Rebecca Harkins-Cross
For The Book of Revelations

A WOMAN stumbles backwards through the audience, burdened by an overflowing backpack, muttering about the home she's left behind. When she reaches the mountain onstage, she looks upon its cloud-swirled peak with awe.

This stillness is ruptured by an involuntary outburst as she begins spitting out the scourges of the modern world – "nuclear explosion… war… car salesman", she yells.

This is the final show in La Mama's explorations season, which allows performers to stage works still in development. Devised and performed by theatre maker and academic Alison Richards, it questions our eschatological paranoia that the end times are upon us. It is fitting then that it is premiered on the eve of the Mayan's prophesised doomsday.

Like many pilgrims before her, Ada (Richards) ascends the mountain in search of salvation, but her journey evokes sublime terror; she speaks in tongues, collapses into fitful sleeps. Richards combines operatic singing with an ethereal score by Faye Bendrups, her eruptions into song apparently brought on by the mountain's ecstatic pull. Richards' seraphic voice is haunting, the lyrics evoking visions of birth and death.

But when Ada finally converses with the heavens, she does not receive the revelations she hopes for: the voice of the divine is nihilistic, urging her to accept the universe's chaos.

While the work is still fragmentary, unfolding like a dream, this is a powerful performance by Richards. Its striking imagery fails to cohere yet in narrative terms, but it is promising nonetheless."


Introduction: Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterised by chronic hyperglycaemia, leading to long-term complications. The prevalence of diabetes mellitus in Cameroon was estimated at 5.9 % in 2017. In a study done in 2011, only about 41 % of patients had a good glycaemic control that is, HbA1c < 6.5 %. Amongst several factors, poor glycaemic control may be due to failure of clinicians to intensify diabetes treatment when required, known as therapeutic inertia. The aim of this study was to evaluate the treatment intensification over time in T2DM patients.

Methods: This was a hospital-based cross-sectional analytical study with diabetic outpatients at the Yaounde Central Hospital. In a group of T2DM patients followed up at the National Obesity Center (NOC) with poorly controlled blood sugar (HbA1c ≥ 7 %), we evaluated the treatment intensification and outcome between the period January 2016 to April 2018. Data was collected from patients' medical booklet and by a face-to-face interviewer-administered questionnaire. Therapeutic inertia was defined as the failure to intensify therapy (addition of a new oral anti-diabetic drug (OAD) or insulin) when indicated.

Results: One hundred and eleven patients (31 males, 27.9 % and 80 females, 72.1 %) were recruited. The mean age was 59 ± 10 years and the mean duration of diabetes 8.6 ± 7.0 years. The patients' treatment consisted: 1) oral anti-diabetic (OAD) agents, monotherapy (24.3 %), bitherapy (28.8 %), tritherapy (2.7 %), 2) insulin only, (19.8 %) and 3) insulin mixture, (24.3 %). The mean baseline HbA1c was 9.3 ± 2.0 %. Within the given follow-up time of 16 [11-21] months, only 40 out of the 111 patients had their treatment intensified and 71 had no intensification (therapeutic inertia) despite poor HbA1c levels. The median time to treatment intensification was 1.4 month. The age, index treatment, duration of diabetes and number of non-diabetic treatment were variables significantly associated to treatment intensification. A second HbA1c was available in 83 patients. Forty five (45) % of the patients had HbA1c level < 7 %. Their mean HbA1c was 7.4 ± 1.7 %.

Conclusion: Therapeutic inertia affected two third of our population. Despite the high level of inertia, both patients with intensified treatment and non-intensified treatment reached treatment targets.


In this paper, we present a flexible high-throughput LDPC decoder architecture that can support different code rates and block sizes in wireless applications such as IEEE 802.11n, IEEE 802.16e, and IEEE 802.15.3c standards. Several flexible LDPC decoders have been presented in the literature but their throughput (less than 640 Mbps) is limited due to block-serial scheduling of the decoding computations. The proposed architecture is based on a block-parallel scheduling scheme using a layered decoding method. To achieve higher throughput, check node-based processes are implemented in a fully parallel architecture and the memory is partitioned into a number of banks. System flexibility is achieved by allowing the check node-based units and the memory banks to be configured according to the code rate and block size of the LDPC code of interest.


Background: Prehospital identification of acute stroke increases the possibility of early treatment and good outcome. To increase identification of stroke, the Face Arm Speech Time (FAST) test was introduced in the Emergency Medical Communication Center (EMCC). This substudy aims to evaluate the implementation of the FAST test in the EMCC and the ambulance service. Methods: The study was conducted in the region of Stockholm, Sweden during 6 months. The study population consisted of all calls to the EMCC concerning patients presenting at least one FAST symptom or a history/finding making the EMCC or ambulance personnel to suspect stroke within 6 h. Positive FAST was compared to diagnosis at discharge. Positive predictive values (PPV) for a stroke diagnosis at discharge were calculated. Results: In all, 900 patients with a median age of 71 years were enrolled, 667 (74%) by the EMCC and 233 (26%) by the ambulances. At discharge, 472 patients (52%) were diagnosed with stroke/transient ischemic attack (TIA), 337 identified by the EMCC (71%) and 135 (29%) by the ambulances. The PPV for a discharge diagnosis of stroke/TIA was 51% (CI 47-54%) in EMCC-enrolled and 58% (CI 52-64%) in ambulance-enrolled patients. With a positive FAST the PPV of a correct stroke/TIA diagnosis increased to 56% (CI 52-61%) and 73% (CI 66-80%) in EMCC- and ambulance-enrolled patients, respectively. Positive FAST from EMCC was also found in 44% of patients with a nonstroke diagnosis at discharge. A stroke/TIA diagnosis at discharge but negative FAST was found in 58 and 27 patients enrolled by the EMCC and ambulances, respectively. Conclusions: The PPV of FAST is higher when used on the scene by ambulance than by EMCC. FAST may be a useful prehospital tool to identify stroke/TIA but has limitations as the test can be negative in true strokes, can be positive in nonstrokes, and FAST symptoms may be present but not identified in the emergency call. For the prehospital care situation better identification tools are needed.


This study explores the existence of a net union premium and of the extent of rationing by quality of the resulting excess supply. The net union premium was estimated by relating changes in wages to changes in union status of the same worker in longitudinal panels (NLS and MID), and by two cross-section wage level regressions, a "prospective" and "retrospective" which permit more direct observation of selectivity in hiring. Over a half of the cross-section differential of over 20% for the "same" (standardized) worker is a net union rent and much of the rest reflects a quality adjustment in hiring, as measured by wages. This conclusion was less reliable for older workers. Subsequent analysis explores the effects of successful union wage pressure on: quit rates, fringe benefits, wage profiles, and training. The reduction in quit of union joiners depends on the size of the net wage premium. Quit rate differentials are also positively related to the gross, cross-section wage differentials within groups of workers, classified by location and occupation, less so by industry. In Section 4, it is hypothesized that the imposition of larger fixed labor costs (such as fringes) helps to deter employers from preferring reductions in hours to reductions in men, and it helps to stabilize employment in the face of fluctuating demand, by a more frequent use of overtime and of temporary layoffs in the union sector. This hypothesis links the size of fringe benefits to the union wage gain. An analysis of firms in 70 industries confirms this link. Union pressure is exerted on the whole tenure profile of wages. The explicit linking of wage levels to seniority reduces incentives for worker investment in general (transferable) training. The total volume of training is indeed reported to be smaller in union jobs, and this is consistent with the flatter profile.


The skin‐blanching assay is used for the determination and bioequivalence of dermatologic glucocorticoids (GCs). The exact mechanism of the production of blanching is not fully understood, but it is considered that local vasoconstriction of the skin microvasculature and the consequent blood‐flow reduction cause this phenomenon. Several factors influence skin blanching, including drug concentration, duration of application, nature of vehicle, occlusion, posture and location. The intensity of vasoconstriction can be measured in several ways: visual or quantitative methods, such as reflectance spectroscopy, thermography, laser Doppler velocimetry and chromametry. In literature, contradicting results in the correlation of the skin‐blanching assay with different tests to determine GC sensitivity have been reported, limiting its clinical usefulness.


Powdered detergent products are formulated with various components, such as aqueous polymers and surfactant solutions, to which powdered components such as salts and zeolites are added and these are mixed at a high shear rate for a few hours. The interactions between the surfactant and polymer directly influences the supramolecular structure (particularly the phase and colloidal structure) of the formulation. This in turn influences the final detergent powder structure, properties and performance. Therefore, a thorough understanding of the structural changes resulting from the addition of polymer to aqueous NaLAS dispersions, as well as the structural changes arising from shearing the formula is vital when considering cost effective formulation decisions, but the effect of both of these factors are poorly explored. This PhD is designed to understand the influence of the addition of polycarboxylate polymer on the phase and colloidal structure of linear akylbenzene sulphonate (NaLAS) surfactant dispersions in aqueous conditions and saturated sodium sulphate solution conditions. For the aqueous system, a phase diagram was constructed using centrifugation and optical polarised microscopy.Following this, a more in-depth understanding of the phase behaviour was realised using Small Angle X-Ray scattering (SAXS), as well as the influence of polymer on the colloidal structures using 2H nuclear magnetic resonance NMR. The combination of these studies led to the conclusion that the polymer behaves as a flocculant in the system, causing phase separation in the micellar regime. Additionally, a decrease in the bilayer spacing in the lamellar phase was observed due to the addition of the polymer compressing the bilayers. Also, the the osmotic effects resulting from the polymer addition caused multilamellar vesicle fusion, which then sub-sequently increased the average multilamellar vesicle size. This change in vesicle size was measured using 2H (NMR).

Following this, the influence of the addition of the polymer on microstructure of NaLAS in saturated sodium sulphate solution were explored. Firstly, by constructing a phase diagram and then followed by pulsed-gradient simulated train echo (PGSTE) diffusion experiments to characterise the microgeometry of the system. How this microstructure changed with polymer concentration was also explored. A phase diagram of the system which was constructed using centrifugation, showed that the addition of the polymer increased the ratio of the lamellar phase to the isotropic phase until there was just a single lamellar phase remaining.Surface area to volume ratio, pore size and tortuosity measurements using NMR,as well as SAXS experiments helped show that this change in ratio was not due to microgeometry changes. Hence, it was likely that the ratio change observed was a result of the polymer sterically stabilising the vesicles.

Finally, the structural changes over time resulting from the application of a high constant shear rate on a model formulation system were explored. Upon the application of high constant shear rates (above 1800 s−1), an irreversible increase in the viscosity was observed. In-situ cryo-SEM experiments were carried out to conclude that in this system prior to the high shear mixing, kinetically stable vesicles were present due to the low bubble rise velocity resulting from the high viscosity of the system without the bubbles. The application of high shear rates for extended periods of time increased the Reynolds number of the system, which promoted bubble coalescence, and this consequently significantly increased the bubble rise velocity. This bubble rise velocity increase in time reduced the bubble fraction in the system, and hence the measured viscosity. This is because the high shear rates significantly increases the Reynolds number within the system to a turbulent regime, promoting the creaming of the bubbles to the surface and subsequently bubble breakdown. The addition of the polycarboxylate polymer prevented all the time dependent viscosity changes as inhibited the formation of kinetically stable bubbles in the system.


This paper investigates the determinants of intra-CARICOM bilateral trade and the CARICOM member's trade with the North American and European countries using the gravity model. Seventeen annual cross-sections are estimated for the period 1980 through 1996. Overall, the empirical results indicate that the gravity model has considerable potential to explain intra-CARICOM bilateral trade as well as trade between CARICOM members and non-members. The evidence suggests that both the importer's GDP per capita and the exporter's GDP per capita exert strong positive effects on CARICOM trade levels. Since these effects are found to be statistically the same, we conclude that the gravity model is symmetric with respect to GDP per capita. Further, sharing a common language, colonial ties, or membership in the CARICOM all significantly contribute to larger volumes of bilateral trade, while geographic distance has the opposite effect. Both the exporting and the importing countries' populations have a positive effect on trade levels, indicating that larger economies have a wider production base and thus export and import more than would smaller economies.


Al-Mg-Si alloy is the suitable material for the automotive body application. However, it is found that a rope-like profile (ridging) develops when the Al-Mg-Si alloy sheet is stretched along the transverse direction. In this study, in order to clarify the formation process of ridging developed in Al-Mg-Si alloy, the relation between ridging and texture components of the sheet was investigated by 3D profile microscope and SEM/EBSD method. It was found that the ridging developed remarkably in the hot-rolled (at higher temperature) and annealed sheets. In ridging sample, there was the band of cube oriented grains (cube band). It was also found that the region of cube band corresponded to the ridges and valleys which caused a rope-like profile in the sheets. It could be thought that the difference of plastic deformability between cube-oriented grains and other oriented grains led to the development of ridging. This assumption is supported by the lower Taylor factor of cube oriented grains than other oriented grains. From these results, it was concluded that the development of ridging was strongly affected by the distribution of cube oriented grains.


One out of four people age 65 and older residing in a long term care facility (LTCF) has type 2 diabetes (T2DM). Care and management of this population is a challenge for nurses and other providers. American Diabetes Association Guidelines (2017) recommend application of individualized HbA1c targets for LTCF residents, especially for those with compromises in clinical and functional status. A needs assessment in a local LTCF identified deficiencies in the provision of evidence-based T2DM care for this LTCF population. This quality improvement (QI) project strove to 1) educate nurses about these residents' needs and 2) incorporate the use of best practice diabetes standards in the nurse practitioner's practice by providing in-service education. Specifically, emphasis was placed on HbA1c and finger stick monitoring, eye exams, and foot care. Results indicated that educational in-services were an effective approach to improving knowledge concerning care of complex TD2M patients. The Advanced Practice Registered Nurse (APRN) (60% to 100%), the 3 registered nurses (63% to 87%) and 9 licensed vocational nurses (63% to 71%) increased in knowledge from baseline to the final 10 question post-test. However, ophthalmology and podiatry referrals were not ordered routinely because of APRN, staff, and organizational resistance. Per an audit of 22 patient charts, utilization of standardized orders improved routine T2DM care. There were 13 HbA1c due and 12 were ordered (92%); the one renal panel that was due was ordered, and all 5 urine to albumin creatinine ratio were ordered. In addition, the APRN has awareness to evaluate discrepancies between HbA1c results and finger stick values. QI projects in LTCFs may be difficult to implement and sustain related to staff turnover, understaffing, high patient acuity, and organizational and provider opposition. APRNs must advocate for continual utilization of evidence-based practice guidelines for all LTCF residents. Disclosure A.L. Hubberd: None. C.M. Hernandez: None.


This thesis details the current methods for meta-selective C-H functionalisation and contains three chapters relating to the area of ruthenium catalysed meta selective functionalisation by σ-activation. The first of which contains a published manuscript entitled "Catalytic meta-selective C-H functionalization to construct quaternary carbon centres" and describes a meta selective tertiary alkylation procedure on 2-phenylpyridine substrates. Key findings from this work provide good evidence for a radical based mechanism and proposes a catalytic cycle involving two distinct roles for the ruthenium catalyst; both in the activation of the substrate molecule and in the formation of a tertiary radical coupling partner. The second chapter contains another published manuscript entitled "Mechanistic insight into ruthenium catalysed meta-sulfonation of 2-phenylpyridine" and provides mechanistic analysis for the meta selective sulfonation of 2-phenylpyridine. Key findings from this work show through stoichiometric experiments that sulfonation occurs at the position para to the C-Ru bond formed following cyclometalation with a radical addition being implied. The work also shows that the catalytic species involved do not require an arene ligand and deuterium labelling studies identified a likely rate limiting radical sulfonation step. The final chapter contains additional work relating to the use of α-halo carbonyl coupling reagents to enable meta selective primary, secondary and tertiary alkylations. The use of a triphenylphosphine ligand source was necessary for the coupling of primary α-halo carbonyl coupling partners at the meta position. Crucially, this transformation was not possible with simple, straight-chain alkyl halides, highlighting the privileged reactivity of α-halo carbonyl coupling reagents. This work also contains experimental and computational mechanistic analysis which reveals additional support for a dual activation pathway.


Of 89 children with angiographically-documented pulmonic stenosis and intact ventricular septum (PST), 76 (85.4%) had valvular, 11 (12.4%) infundibular and 2 (2%) had supravalvular lesions. Standard, p. a. view, chest X-rays of children with a mean age of 6 7/12 years were evaluated with respect to 1. cardiac enlargement; 2. prominence of the pulmonic trunk; 3. diminished pulmonary vascular markings. The patients were divided into 3 groups according to the gradient measured across the pulmonic valve: Group 1: systolic pressure gradient less than 30 mm Hg (mild PST), 28 children; group 2: systolic pressure gradient between 30 and 80 mm Hg (moderate PST), 37 children; group 3: systolic pressure gradient greater than 80 mm Hg (severe PST), 24 children. Cardiac enlargement was found in a total of 56.2% of the children with no statistical difference in the severity of the lesion. A markedly ectatic pulmonary segment was observed in 12.5% of the children in group 3 but only in 2.7% of those in groups 1 and 2 respectively. Diminished pulmonary vascular markings were observed in a total of 9% with a distribution including no patient in group 1, 10.8% in group 2 and 16.6% in group 3. On combining all three of the radiologic criteria, 9% demonstrated completely normal findings of the heart and lungs, 5.6% showed cardiac enlargement with marked prominence of the pulmonic trunk and diminished pulmonary vascular markings. In the remaining patients, no statistically significant relationship between the constellation of findings and the severity of the stenosis was found. Thus, the results show that, in the individual case, the diagnosis of pulmonic stenosis with intact ventricular septum cannot be established from the standard chest X-ray.


Metal-related occupations have been associated with prostate cancer (PCa) risk but little data exist on metal exposures per se. We examined the association between lifetime occupational exposure to chromium VI (CrIV), nickel (Ni) and cadmium (Cd) compounds, and PCa risk in a large population-based case-control study. Methods Cases were 1933 men with histologically-confirmed incident prostate cancer (PCa), aged ≤75 years and diagnosed between 2005 and 2009. Concurrently, 1994 population controls from the same residential area and age distribution were randomly selected from electoral lists. Detailed lifestyle and work histories were collected during in-person interviews. Chemists used job specific information from questionnaires to provide semi-quantitative evaluations of concentration and frequency (% of work-day exposed) of exposure to chemical agents, including toxic metals, and a measure of confidence in the evaluation. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals for PCa risk associated with exposure to Cr, CrVI, Ni and Cd. Results Ever exposure to Cr (9%), CrVI (7%), Ni (5%) or Cd (2%) was similar among cases and controls. The risk for non-aggressive PCa (Gleason score < 7 or [3+4]) did not vary according to duration of exposure to any level or to substantial level of Cr, CrVI, Ni or Cd. However, the risk for aggressive PCa (Gleason score > 7 or [4+3]) was significantly increased with ≥25 years of exposure to any level of Cr (OR = 1.68 [1.05–2.69]) or Ni (OR = 2.25 [1.28–3.94]), and to a substantial level of Cr (OR = 2.77 [1.34–5.76]), CrVI (OR = 2.69 [1.28–5.66]) or Ni (OR = 3.80 [1.36–10.57]). The positive associations observed with Cr exposure disappeared when excluding subjects ever exposed to Ni. Conclusion Our results suggest that long exposure to nickel, or to both nickel and chromium, may increase the risk for aggressive PCa.


Most knowledge of clathrin‐mediated endocytosis has been gained by biochemical fractionation and in vitro assays. Recently, the study of endocytosis has extended into the living cell. The tracking of individual clathrin‐coated pits and vesicles (CCPs and CCVs) has provided new insight into understanding the dynamic nature of CCPs. The use of total internal reflection fluorescence microscopy (TIR‐FM), also termed evanescent field microscopy, has enabled the direct observation of events occurring within a restricted area of the cell adjacent to and including the adherent plasma membrane. TIR‐FM is now actively being pursued in the study of endocytic processes. The direct observation of CCP‐associated proteins including clathrin itself, dynamin and, most recently, AP‐2 has considerably challenged old models, confirming some points but raising very interesting new questions.


A reliable method of remotely detecting concealed guns and explosives attached to the
human body is of great interest to governments and security forces throughout the world.
This thesis describes the development and trials of a new remote non-imaging concealed
threat detection method using active millimetre wave radar using the microwave and mmwave
frequencies bands 14 – 40 and 75 – 110 GHz (Ku, K, Ka and W). The method is
capable of not only screening for concealed objects, like the current generation of
concealed object detectors, but also of differentiating between mundane and threat objects.
The areas focused upon during this investigation were: identifying the impact of different
commonly worn fabrics as barriers to detection; consulting with end users about their
requirements and operational needs; a comparison of different frequency bands for the
detection of guns and explosives; exploring the effects of polarisation on object detection;
a performance comparison of different detection schemes using Artificial Neural
Networks; improving existing data acquisition systems and prototyping of a real-time
capture system.


In many applications, there is a need to model and reason with imprecise probabilistic knowledge. In this paper, we discuss how to model imprecise probabilistic knowledge obtained from experiments in biological sciences on enzymes for rapid screening of potential substrate or inhibitor structures. Each imprecise probabilistic knowledge base is modelled as a probabilistic logic program (PLP). To predict a meaningful substrate structure, we have developed a framework (and a tool) in which a user (bioscientist) can query against a PLP (or a collection of PLPs), can examine how relevant a PLP is for answering a query, and can select a query result that is more satisfactory. This framework is implemented by integrating an optimizer in MatLab to solve the optimization problems subject to linear constraints. A preliminary version of the tool was demonstrated in the ECAI08 Demo session. Experimental results on evaluating the tool with probabilistic knowledge on enzymes for rapid screening of potential substrates or inhibitor structures demonstrate that this tool has a great potential to be used in many similar areas for the initial screening of compound structures in drug discovery.


Silicon photonics research can be dated back to the 1980s. However, the previous decade has witnessed an explosive growth in the field. Silicon photonics is a disruptive technology that is poised to revolutionize a number of application areas, for example, data centers, high-performance computing and sensing. The key driving force behind silicon photonics is the ability to use CMOS-like fabrication resulting in high-volume production at low cost. This is a key enabling factor for bringing photonics to a range of technology areas where the costs of implementation using traditional photonic elements such as those used for the telecommunications industry would be prohibitive. Silicon does however have a number of shortcomings as a photonic material. In its basic form it is not an ideal material in which to produce light sources, optical modulators or photodetectors for example. A wealth of research effort from both academia and industry in recent years has fueled the demonstration of multiple solutions to these and other problems, and as time progresses new approaches are increasingly being conceived. It is clear that silicon photonics has a bright future. However, with a growing number of approaches available, what will the silicon photonic integrated circuit of the future look like? This roadmap on silicon photonics delves into the different technology and application areas of the field giving an insight into the state-of-the-art as well as current and future challenges faced by researchers worldwide. Contributions authored by experts from both industry and academia provide an overview and outlook for the silicon waveguide platform, optical sources, optical modulators, photodetectors, integration approaches, packaging, applications of silicon photonics and approaches required to satisfy applications at mid-infrared wavelengths. Advances in science and technology required to meet challenges faced by the field in each of these areas are also addressed together with predictions of where the field is destined to reach.


OBJECTIVE
To describe the level of sedation for a cohort of mechanically ventilated adult intensive care unit (ICU) patients using validated subjective and objective tools.

DESIGN
Prospective convenience sample.

SETTING
Multidisciplinary 34-bed ICU at Maine Medical Center, a 599-bed nonuniversity, academic medical center.

PATIENTS
Sixty-three adult ICU patients were monitored during 64 episodes of ventilatory support.

MEASUREMENTS AND MAIN RESULTS
Patients were prospectively evaluated by one trained investigator using the revised Sedation-Agitation Scale (SAS) and were simultaneously monitored for 1 to 5 hrs using the Bispectral Index (BIS), a numeric scale from 0 to 100 derived from the electroencephalogram. BIS values were assigned to baseline, stimulated, and average conditions for each patient by a separate investigator blinded to SAS scores. Ventilator settings, medications, and the lung injury severity (LIS) score were also recorded. Sedation levels varied from very deep sedation (SAS score = 1, BIS score = 43) to mild agitation (SAS score = 5, BIS score = 100). Heavily sedated patients (SAS score = 1-2, n = 20) had higher FIO2 (0.52 vs. 0.42, p = .008), oxygenation index (9.4 vs. 5.4, p = .03), and LIS scores (1.3 vs. 0.7, p = .004) and lower baseline (66 vs. 78, p = .01), average (66 vs. 81, p < .001), and stimulated (89 vs. 96, p = .016) BIS scores compared with more awake patients. Patients with intermittent neuromuscular blockade use (n = 4) had higher FIO2 (0.65 vs. 0.44, p = .006), minute ventilation (14.6 vs. 9.9 L/min, p = .005), positive end-expiratory pressure (7.5 vs. 4.8 cm H2O, p = .05), oxygenation index (15.7 vs. 6.0, p < .001), and LIS scores (3.3 vs. 1.0, p = .036) and were more sedated, with higher suppression ratios (3.5 vs. 0.6, p = .05) and lower SAS scores (1.5 vs. 4, p = .035). The average BIS values correlated well with SAS (r2 = .21, p < .001).

CONCLUSIONS
SAS and BIS work well to describe the depth of sedation for ventilated ICU patients. Deeper sedation and intermittent neuromuscular blockade were used for patients with greater ventilatory requirements and more severe lung disease. The correlation between subjective and objective scales varied in medical, surgical, and trauma patients. Further research with SAS and BIS may facilitate the development of quantitative sedation guidelines for the ICU.


As technology and science progresses, the methodology behind observing, monitoring, and sampling marine mammals advances as well. One such technique is environmental DNA or eDNA, which entails extracting organismal DNA from water samples without ever handling or disturbing the organism. It is a cost-efficient and noninvasive method that can be utilized in the sampling of seal haulout sites as is its purpose for this research. Another method, using the DNA analysis of seal fecal samples, is a less invasive method that can also be utilized to monitor and assess marine mammals. Through collecting both fecal and water samples from gray seal haulout sites in Cape Cod, Massachusetts, these two differing, but equally progressive methods can be compared to one another. The water samples collected from the seal haulout sites were paired for DNA analysis with the fecal samples collected from the beaches where gray seals are hauled out in Cape Cod. DNA was then extracted from both the water samples and fecal samples, followed by sequencing a portion of the gray seal mitochondrial control region in all the samples. This allowed for the comparison of the haplotypes detected in fecal samples to those detected in water samples as a comparison of these two non-invasive approaches for assessing marine mammal genetic diversity. We obtained sequences from 25 fecal samples. Sequences from all but 2 of the 25 samples were found to match with one of the sequences in the reference dataset. Our study identified 2 new haplotypes that had not been previously identified in the population. When compared to the water sample sequences, we found 19 matches out of the 25 fecal sample sequences. In all of these cases, the fecal haplotype was detected in water samples collected during the same survey (at the same haulout on the same day), though in many cases a given fecal haplotype was also detected in water samples from multiple surveys. Although future studies are needed to further confirm the efficiency and non-invasiveness of the eDNA approach, our study suggests that it can provide similar information to a fecal sample sequence analysis, but in a less invasive way.


Academic literature on media events is increasingly concerned with their global dimensions and the applicability of Dayan and Katz's theoretical concept in a post-national context. This article contributes to this debate by exploring the Eurovision Song Contest (ESC) as a global media event. In particular, we employ a perspective from 'inside the media event', drawing upon empirical material collected during the 2014 Eurovision final in Copenhagen and focusing on the experiences of fans attending the contest. We argue that the ESC as a media event is experienced by its fans as a cosmopolitan space, open and diverse, whereas national belonging is expressed in a playful way tied to the overall visual aesthetics of the contest. However, the bounded and narrow character of participation render this cosmopolitan space rather limited.


With fast advance digital technology image processing is fastest and secure area of research and technology. To hiding a data and repairing with generation of authentication signal are big challenges. To overcome a problem of security a new method is used a secret data hiding and repairing of grayscale document images with generation of authentication signals. An authentication signal is generated for each 2x3 block of input grayscale document image. For generation of authentication signal a grayscale document image content need to binarize. These binaries content transferred into number of share by using Shamir secret sharing scheme. A new plane is used for data hiding called alpha channel plane. This plane adding input grayscale document image to form a Portable Network Graphics (PNG) image which is easy to communication in network. At the time of embedding computed secret value called share mapped with range of alpha channel plane values. At the receiver side process of image authentication one of the block of image marked as tampered if authentication signal of extracted from not match with the current block content. So need to repair data by applied reverse Shamir secret sharing scheme.


Many economists have argued convincingly that automated systems employing present-day artificial intelligence have already caused massive technological displacement, which has led to stagnant real wages, fewer middle- income jobs, and increased economic inequality in developed countries like Canada and the United States. To address this problem various individuals have proposed measures to increase workers' living standards, including the adoption of a universal basic income, increased public investment in education, increased minimum wages, increased worker control of firms, and investment in a Green New Deal that will provide substantial employment in transitioning to green energy, buildings, and agriculture. In this paper I argue that both left-wing and right-wing positions in political philosophy, such as John Rawls's Justice as Fairness and Robert Nozick's Entitlement Theory, are committed to the conclusion that we should take political action to counteract the effects of technological displacement by undertaking such measures to increase workers' living standards.


Alzheimer's disease (AD), a severe neurodegenerative disorder, causes more than half of dementia cases. According to the popular "Aβ hypothesis" to explain the mechanism of this disease, amyloid β-peptides (Aβ) of 39-43 amino acid residues aggregate and deposit onto neurons, igniting the neurotoxic cascade of the disease. Therefore, researchers studying AD would like to elucidate the mechanisms by which essentially water-soluble but hydrophobic Aβ aggregates under pathological conditions. Most researchers have investigated the aggregation of Aβ in aqueous solution, and they concluded that the final aggregation product, the amyloid fibrils, were less toxic than the component peptide oligomers. They consequently shifted their interests to more toxic "soluble oligomers", structures that form as intermediates or off-pathway products during the aggregation process. Some researchers have also investigated artificial oligomers prepared under nonphysiological conditions. In contrast to these "in solution" studies, we have focused on "membrane-mediated" amyloidogenesis. In an earlier study, other researchers identified a specific form of Aβ that was bound to monosialoganglioside GM1, a sugar lipid, in brains of patients who exhibited the early pathological changes associated with AD. This Account summarizes 15 years of our research on this topic. We have found that Aβ specifically binds to GM1 that occurs in clusters, but not when it is uniformly distributed. Clustering is facilitated by cholesterol. Upon binding, Aβ changes its conformation from a random coil to an α-helix-rich structure. A CH-π interaction between the aromatic side chains of Aβ and carbohydrate moieties appended to GM1 appears to be important for binding. In addition, as Aβ accumulates and reaches its first threshold concentration (Aβ/GM1 = ∼0.013), aggregated β-sheets of ∼15 molecules appear and coexist with the helical form. However, this β-structure is stable and does not form larger aggregates. When the disease progresses further and the Aβ/GM1 ratio exceeds ∼0.044, the β-structure converts to a second β-structure that can seed aggregates. The seed recruits monomers from the aqueous phase to form toxic amyloid fibrils that have larger surface hydrophobicity and can contain antiparallel β-sheets. In contrast, amyloid fibrils formed in aqueous solution are less toxic and have parallel β-sheets. The less polar environments of GM1 clusters play an important role in the formation of these toxic fibrils. Membranes that contain GM1 clusters not only accelerate the aggregation of Aβ by locally concentrating Aβ molecules but also generate amyloid fibrils with unique structures and significant cytotoxicity. The inhibition of this aggregation cascade could be a promising strategy for the development of AD-modulating therapies.


Designed for kinesiology students, this guide takes you through the Library's resources to improve your research. This is a short guide on search strategies for websites and databases.


This paper applies the concept of Value-at-Risk (VaR) to Indian Capital Markets and examines the different computational approaches to VaR and their relative differences in measuring the downside of the risk involved in the investment of equities by applying the concept of VaR on a portfolio comprising of the stocks listed on the Indian Capital Market Index - the BSE SENSEX; by testing the model on time series data i.e. historical daily returns of the Index over a two month horizon and back testing the results of the Monte-Carlo Simulation against historically obtained VaR estimates.


Supplemental Digital Content is available in the text Purpose of review Ocular manifestations of leprosy do occur despite advances in the areas of leprosy research. Understanding the nuances in the domain shall guide the clinician for effective patient-centered care. Recent findings Despite the existence of microbiologic cure for leprosy, ocular manifestations of this disease do occur. Advances in genetic and genomic studies have better characterized the interaction that the bacteria has with the host. The ocular features vary with the spectrum of the disease. Its careful correlation can help to predict the bacillary load of the patient. Investigations are particularly relevant in multibacillary cases. The WHO suggests a treatment duration longer than the 2 years in ocular involvement. Summary The isolation of lepra bacilli from the iris biopsy in negative skin smear patients and multidrug therapy completion highlights the potential role of bactericidal agents in the planned intraocular treatment. Lepra reactions need careful titration of oral steroids and appropriate antibacterial agents. Advances in phacoemulsification with in the bag implantation of intraocular lenses is a game changer in the management of the most common cause of blindness of leprosy. Advances in vaccine research in leprosy are promising.


OBJECTIVE
To compare a clinical nurse specialist/neonatal practitioner (CNS/NP) team with a pediatric resident team in the delivery of neonatal intensive care.

DESIGN
Randomized, controlled trial.

SETTING
A 33-bed tertiary-level neonatal intensive care unit.

PATIENTS
Of 821 infants admitted to the neonatal intensive care unit between September 1991 and September 1992, 414 were randomized to care by the CNS/NP team, and 407 were randomized to care by the pediatric resident team.

INTERVENTION
Infants assigned to the CNS/NPs team were cared for by CNS/NPs during the day and by pediatric residents during the night. Infants assigned to the pediatric resident team were cared for by pediatric residents around the clock. Neonatologists supervised both teams.

MEASURES
Outcome measures included mortality; number of neonatal complications; length of stay; quality of care, as assessed by a quantitative indicator condition approach; parent satisfaction with care, measured using the Neonatal Index of Parent Satisfaction; long-term outcomes, measured using the Minnesota Infant Development Inventory; and costs.

RESULTS
There were 19 (4.6%) deaths in the CNS/NP group and 24 (5.9%) in the resident group (relative risk [RR], 0.78; confidence interval [CI], 0.43 to 1.40). In the CNS/NP group, 230 (55.6%) neonates had complications, in comparison with 220 (54.1%) in the resident group (RR, 1.03; CI 0.91 to 1.16). Mean lengths of stay were 12.5 days in the CNS/NP group and 11.7 days in the resident group (difference in means, 0.8 days; CI, -1.1 to 2.7). The performance on the indicator conditions was comparable in the two groups except for two instances, jaundice and charting, both of which favored the CNS/NP group. Mean scores on the Neonatal Index of Parent Satisfaction were 140 in the CNS/NP group and 139 in the resident group (difference in means, 1.0; CI, -3.6 to 5.6). In the CNS/NP group, 6 (2.6%) infants performed 30% or more below their age level in the Minnesota Infant Development Inventory, in comparison with 2 (0.9%) in the resident group (RR, 2.87; CI, 0.59 to 14.06) The cost per infant in the CNS/NP group was $14,245 and in the resident group $13,267 (difference in means, $978; CI, -1303.18 to 3259.05).

CONCLUSIONS
CNS/NP and resident teams are similar with respect to all tested measures of performance. These results support the use of CNS/NPs as an alternative to pediatric residents in delivering care to critically ill neonates.


Background: Advance directives have widely been regarded as playing a pivotal role in end-of-life care for patients. This study sought to evaluate the current value and perspective on advance directives in patients greater than 60 years of age visiting outpatient clinics.
Methods: A cross-sectional survey study was performed at four different departmental outpatient clinics at Texas Tech University Health Sciences Center in Amarillo, Texas for patients over the age of 60 years who presented during a three-month time frame. In addition to demographic data, the survey collected data on patients' perspective on and completion of advance directives.
Results: 314 patients completed the survey. Non-Hispanic white patients were significantly more likely than those of other racial or ethnic groups to have an advance directive in place (58.8% vs. 28.8%, p<0.001). Married and widowed patients were more likely to have advance directive than those single or separated (57.2% and 63.1% vs. 30.8% and 35.5%, p=0.002). Those with greater than 12 years of education were also more likely to have an advance directive in place than those with 12 or fewer years of education (59% vs. 48%, p=0.042). Patients who received education from their primary care provider about advance directives were more likely to have an advance directive than those who had not received any education (64.7% vs. 44.9%, p=0.01).
Conclusion: Education from physicians about the value of having an advance directive is a powerful intervention that can results in a significant increase in completion of advance directives. Specific demographic groups that could benefit from education about the value of advance directives include patients of different racial or ethnic backgrounds, patients who are single or divorced, and patients with limited education. We recommend that physicians work to initiate discussions about end-of-life care with all patients over 60 years of age.


We consider the problem of building a state representation model for control, in a continual learning setting. As the environment changes, the aim is to efficiently compress the sensory state information without losing past knowledge, and then use Reinforcement Learning on the resulting features for efficient policy learning. To this end, we propose S-TRIGGER, a general method for Continual State Representation Learning applicable to Variational Auto-Encoders and its many variants. The method is based on Generative Replay, i.e. the use of generated samples to maintain past knowledge. It comes along with a statistically sound method for environment change detection, which self-triggers the Generative Replay. Our experiments on VAEs show that S-TRIGGER learns state representations that allows fast and high-performing Reinforcement Learning, while avoiding catastrophic forgetting. The resulting system has a bounded size and is capable of autonomously learning new information without using past data.