PURPOSE
Alternative and complementary therapies are infrequently studied in pediatric populations. We performed a population-based survey to aid health care workers in identifying and counseling parents who may use these remedies.

PATIENTS AND METHODS
We retrospectively surveyed the parents of 583 pediatric patients diagnosed with cancer in British Columbia between 1989 and 1995. Prevalence and factors that influence the use and nonuse of alternative and complementary therapies were estimated.

RESULTS
Alternative and complementary therapies were used by 42% of 366 respondents. Herbal teas, plant extracts, and therapeutic vitamins were the most commonly used alternative therapies. Relaxation/imagery strategies, massage, and therapeutic touch were the most commonly used complementary techniques. Factors that influenced the use of alternative/complementary therapies were prior use (chi2 = 60.0, P < .0001), prior positive attitude towards these remedies (chi2 = 41.6, P < .0001), soliciting information from family and friends (chi2 = 70.5, P < .0001) or from alternative care givers (chi2 = 58.7, P < .0001), high risk of death at diagnosis (chi2 = 9.6, P < .002), and advanced education of the father (chi2 = 7.4, P < .006) or mother (chi2 = 8.6, P < .003). Parents who used alternative/complementary therapies did so in conjunction with conventional medicine (98%). Lack of knowledge and fear of interference with conventional therapies were the most common reasons cited for nonuse. No parent believed that the quality of life of their child deteriorated due to the use of alternative/complementary therapies.

CONCLUSION
Alternative and complementary therapy use in pediatric oncology patients is common. Factors have been identified that may be associated with undertaking their use.


A 73-year-old man was admitted to our hospital with a high fever and left paresis. A rapid diagnosis test was positive for influenza A was positive by rapid diagnosis test and diffusion-weighted MRI imaging of the brain showed a high intensity lesion of the right cerebral peduncle. The patient was therefore diagnosed as having influenza A virus infection complicated with lacunar infarction. In spite of initial treatment with oseltamivir and anticoagulant therapy, he lost consciousness eight hours after admission. The high intensity lesion of the cerebral peduncle enlarged and new lesions in the thalamus, hippocampus and calcarine cortex were detected with brain MRI. Additionally, an electroencephalographic study showed an entire slow wave and as the other causative pathogens of central nerve system infection were not detected, the likely diagnosis was influenza-associated encephalitis. We administered a high dose of intravenous immunoglobulin since the low-grade fever and mild unconscious state had continued in spite of the treatment with methylprednisolone pulse therapy. His consciousness was restored and body temperature became normal immediately. We could confirm the efficacy of our treatment by measurement of IL-6 levels in the serum and cerebrospinal fluid during the entire clinical course. In conclusion, a high dose of intravenous immunoglobulin therapy might be one of the effective treatments for influenza-associated encephalitis.


Hierarchical cell structure (HCS) has become a major trend in the design of 3G systems networks in order to support the high capacity demand required for multimedia traffic in 3G systems. In this type of network an efficient cell assignment scheme is required to improve the quality of service (QoS) of the system in terms of dropping probability, blocking probability, and channel utilisation. In this paper we propose a new channel assignment scheme which exploits the delay insensitive property of the non real-time data service to admit users to the preferred cell layer. We believe the new scheme is anticipated to improve the QoS of the realtime voice users for both blocking probability and channel utilisation parameters.


The remarkable evolution of wireless networks into the next generation to provide ubiquitous and seamless broadband applications has recently triggered the emergence of Wireless Mesh Networks (WMNs). The WMNs comprise stationary Wireless Mesh Routers (WMRs) forming Wireless Backbone Mesh Networks (WBMNs) and mobile Wireless Mesh Clients (WMCs) forming the WMN access. While WMCs are limited in function and radio resources, the WMRs are expected to support heavy duty applications : that is, WMRs have gateway and bridge functions to integrate WMNs with other networks such as the Internet, cellular, IEEE 802.11, IEEE 802.15, IEEE 802.16, sensor networks, et cetera. Consequently, WMRs are constructed from fast switching radios or multiple radio devices operating on multiple frequency channels. WMRs are expected to be self-organized, self-configured and constitute a reliable and robust WBMN which needs to sustain high traffic volumes and long "online" time. However, meeting such stringent service expectations requires the development of decentralized dynamic transmission power control (DTPC) approaches. This thesis addresses the DTPC problem for both single and multiple channel WBMNs. For single channel networks, the problem is formulated as the minimization of both the link-centric and network-centric convex cost function. In order to solve this issue, multiple access transmission aware (MATA) models and algorithms are proposed. For multi-radio multi-channel (MRMC) WBMNs, the network is modelled as sets of unified channel graphs (UCGs), each consisting of interconnected active network users communicating on the same frequency channel. For each UCG set, the minimization of stochastic quadratic cost functions are developed subject to the dynamic Link State Information (LSI) equations from all UCGs. An energy-efficient multi-radio unification protocol (PMMUP) is then suggested at the Link-Layer (LL). Predictive estimation algorithms based on this protocol are proposed to solve such objective functions. To address transmission energy and packet instabilities, and interference across multiple channels, singularly-perturbed weakly-coupled (SPWC) control problems are formulated. In order to solve the SPWC transmission power control problem, a generalized higher-order recursive algorithm (HORA) that obtains the Riccati Stabilizing Solutions to the control problem is developed. The performance behaviours of the proposed models and algorithms are evaluated both analytically and through computer simulations. Several simulations are performed on a large number of randomly generated topologies. Simulation and analytical results confirm the efficacy of the proposed algorithms compared to the most recently studied techniques


ABSTRACT The popularization of massive open online courses (MOOCs) has been shrouded in promises of disruption and radical change in education. In Canada, official partnerships struck by higher education institutions with platform providers such as Coursera, Udacity and edX were publicized by dailies and professional magazines. This print coverage of MOOCs captures the contemporary ideological struggle over the meaning of both technology and higher education. By means of a thematic analysis of the English Canadian print coverage of MOOCs (2012–2014), this paper shows that both online educational technologies and higher education are constructed through an economic frame. However, this frame does not go unchallenged. Where newspapers construct MOOCs as an easy fix for an allegedly inefficient and outdated higher education system, professional magazines question the relationship between technology, higher education and money. These different representations point to the efforts of academic communities to develop alternative social imaginaries of education as public good within a dominant neoliberal framing of MOOCs and of the higher education system. In conclusion, the paper reflects on how the academic community can create alternative discursive spaces by shifting the discussion of MOOCs from economic concerns to civic goals.


Background: Children with disabilities stand to gain from an array of services and interventions to support their development. However, relationships between parents of children with disabilities and professionals can be fraught, with the potential that professionals undermine the role of parents and overlook their agency.Aim: The aim of this study was to examine the nature of partnerships between parents of children with disabilities and professionals in the Early Childhood Development (ECD) sector, and the influences that shape partnerships within a particular context.Setting: This article documents the experiences of parents of children with disabilities from a national organisation, in respect of their partnerships with professionals.Methods: The research was a qualitative case study of a national organisation of parents of disabled children, the Disabled Children's Action Group (DICAG), that has engaged in many different partnerships within different provinces of South Africa. Data generation techniques were document analysis and focus group discussion with staff and provincial branch members of the national DICAG office in Cape Town.Results: The findings of the study provide a nuanced and contextually situated understanding of the complexity of parent–professional partnerships in the disability sector. A key issue that emerges is that to recognise and disrupt pervasive dominant discourses and their potential to weaken partnerships, professionals need to critically attune themselves to the situated experiences of those whom they seek to support.Conclusion: The findings suggest that there is a need for a rights-based social justice agenda to underpin parent–professional relationships, to address the power dynamics and pervasive discourses that oppress the parent actors.


An automatic-design methodology for designing high-tolerance modulator coefficients for high-order sigma-delta modulators (SDMs) from system specifications is presented. The methodology covers many design concerns including SDM coefficient tolerances for circuit component mismatch, stability, reduction of in-band tones, design tradeoffs among in-band noise suppression, oversampling ratio, and modulator order. Moreover, a high-order SDM synthesis tool (HOST) based on the methodology has been implemented in a C language program. Even for inexperienced designers, reliable and high-tolerance SDM coefficients for various applications can be automatically and efficiently generated using HOST. For synthesized SDM's with orders from three to eight and oversampling ratios from 32 to 256, coefficient variations within 2% (1% for the eighth order) are allowed and the resulting peak signal-to-noise ratio degradation is less than 3 dB. Several design examples synthesized by HOST are included.


Introduction Anatomical changes in pregnancy predispose women to asymptomatic bacteriuria (ASB). Current NICE guidance in the UK advises that a mid-stream urine (MSU) sample should be offered in early pregnancy to screen for and treat ASB. Aims To investigate how many women currently have an MSU in early pregnancy (<18 weeks gestation) in an inner-city maternity unit; to evaluate whether current screening practise affects pregnancy outcome. Methods This was a retrospective cohort study which examined notes of all delivered women who gave birth within a three-week period. Appropriate parametric and non-parametric tests were used to determine intergroup differences. Results 243 women delivered during this period. Although all had been booked before 18 weeks gestation, only 9% (n = 22) had been screened for ASB. Of the unscreened population, 18% (n = 40) subsequently developed a UTI in pregnancy, and these were more likely to deliver a LBW baby (18% <2500 g; OR 2.9, 95th CI 1.1–7.9). The screened population had rates of LBW (4%) which were the same as the unaffected cohort within the unscreened population (6%). Conclusion These data suggest that a policy of not screening for ASB may increase the chance of LBW babies being born. Although other confounding variables were not controlled for in this study, the evidence would suggest a policy of screening for ASB remains a reasonable option in pregnancy. (supported by Cerebra).


The extraosseous and intraosseous vascularity of the carpal scaphoid was studied in 15 fresh cadaver specimens byinjection and clearing techniques. The major blood supply to the scaphoid is via the radial artery. Seventy to eighty percent of the intraosseous vascularity and the entire proximal pole is from branches of the radial artery entering through the dorsal ridge. Twenty to thirty percent of the bone, in the region of the distal tuberosity, receives its blood supply from volar radial artery branches. There is an excellent collateral circulation to the scaphoid by way of the dorsal and volar branches of the anterior interosseous arteo,. An explanation for the cause of scaphoid necrosis on the basis of the vascular anatomy is proposed. The volar operative approach would be least traumatic to the proximal pole's blood supply.


Background Muscle wasting (Sarcopenia) is associated with poor outcomes in cancer patients. Early identification of sarcopenia can facilitate nutritional and exercise intervention. Cross-sectional skeletal muscle (SM) area at the third lumbar vertebra (L3) slice of a computed tomography (CT) image is increasingly used to assess body composition and calculate SM index (SMI), a validated surrogate marker for sarcopenia in cancer. Manual segmentation of SM requires multiple steps, which limits use in routine clinical practice. This project aims to develop an automatic method to segment L3 muscle in CT scans. Methods Attenuation correction CTs from full body PET-CT scans from patients enrolled in two prospective trials were used. The training set consisted of 66 non-small cell lung cancer (NSCLC) patients who underwent curative intent radiotherapy. An additional 42 NSCLC patients prescribed curative intent chemo-radiotherapy from a second trial were used for testing. Each patient had multiple CT scans taken at different time points prior to and post- treatment (147 CTs in the training and validation set and 116 CTs in the independent testing set). Skeletal muscle at L3 vertebra was manually segmented by two observers, according to the Alberta protocol to serve as ground truth labels. This included 40 images segmented by both observers to measure inter-observer variation. An ensemble of 2.5D fully convolutional neural networks (U-Nets) was used to perform the segmentation. The final layer of U-Net produced the binary classification of the pixels into muscle and non-muscle area. The model performance was calculated using Dice score and absolute percentage error (APE) in skeletal muscle area between manual and automated contours. Results We trained five 2.5D U-Nets using 5-fold cross validation and used them to predict the contours in the testing set. The model achieved a mean Dice score of 0.92 and an APE of 3.1% on the independent testing set. This was similar to inter-observer variation of 0.96 and 2.9% for mean Dice and APE respectively. We further quantified the performance of sarcopenia classification using computer generated skeletal muscle area. To meet a clinical diagnosis of sarcopenia based on Alberta protocol the model achieved a sensitivity of 84% and a specificity of 95%. Conclusions This work demonstrates an automated method for accurate and reproducible segmentation of skeletal muscle area at L3. This is an efficient tool for large scale or routine computation of skeletal muscle area in cancer patients which may have applications on low quality CTs acquired as part of PET/CT studies for staging and surveillance of patients with cancer.


We present a learning-based framework, recurrent transformer network (RTN), to restore heavily degraded old films. Instead of performing frame-wise restoration, our method is based on the hidden knowledge learned from adjacent frames that contain abundant information about the occlusion, which is beneficial to restore challenging artifacts of each frame while ensuring temporal coherency. Moreover, contrasting the representation of the current frame and the hidden knowledge makes it possible to infer the scratch position in an unsupervised manner, and such defect localization generalizes well to real-world degradations. To better resolve mixed degradation and compensate for the flow estimation error during frame alignment, we propose to leverage more expressive transformer blocks for spatial restoration. Experiments on both synthetic dataset and real-world old films demonstrate the significant superiority of the proposed RTN over existing solutions. In addition, the same framework can effectively propagate the color from keyframes to the whole video, ultimately yielding compelling restored films. The implementation and model will be released at https://github.com/raywzy/Bringing-Old-Films-Back-to-Life.


Summary form only given. Photonic crystals have inspired a lot of interest recently due to their potential for controlling the propagation of light. Photonic crystals with line defects can be used for guiding light. A conventional method for making a two-dimensional (2D) dielectric-core photonic crystal (or PBG) waveguide is to remove one row of air columns. This usually results in a multimode waveguide. We present a more systematic way of making single-mode dielectric-core 2D PBG waveguides. It was recently shown that the main guiding mechanisms in dielectric-core PBG waveguides are total internal reflection and distributed Bragg reflection (DBR). The confinement of the guided mode in the center slab of the waveguide suggests that the properties of such modes can be modified by modifying the guiding structure in the vicinity of the center slab.


PURPOSE
This work investigates how a direct bidirectional connection between brain and hand prosthesis modifies the bi-hemispheric sensorimotor system devoted to the movement control of the lost limb. Hand prostheses are often unable to satisfy users' expectations, mostly due to the poor performance of their interfacing system. Neural Interfaces implanted inside nerves of the stump offer the advantage of using the bidirectional neural pathways 'naturally' dispatching signals to control proper hand actions and feed-back sensations. Learning to control a neurally-interfaced hand prosthesis and decode sensory information was previously observed to reduce the inter-hemispheric asymmetry of cortical motor maps and the clinical symptoms of phantom limb syndrome.

METHODS
Electroencephalographic (EEG) data was analysed using Functional Source Separation (FSS), a semi-blind method that incorporates prior knowledge about the signal of interest into data decomposition to give access to cortical patch activities.

RESULTS
Bi-hemispheric cortices showed normalization of their activity (topographical and spectral patterns) and of functional connectivity between homologous hand controlling areas, during the delivery of the motor command to the cybernetic prosthesis.

CONCLUSIONS
The re-establishment of central-peripheral communication with the lost limb induced by a neurally-interfaced hand prosthesis produces beneficial plastic reorganization, not only restructuring contralateral directly-connected control areas, but also their functional balance within the bi-hemispheric system necessary for motor control.


The study seeks to evaluate the effect of the current tax regulatory regime on the sustainability of microfinance institutions (MFIs) in Masvingo urban.  Many governments raise public finance through the taxation of individuals and the business community. Undertaking of this study was mainly motivated by the increase in the number of microfinance institutions after the introduction of the multicurrency system in 2009, but the government is failing to meet its revenue targets. The study was done on 24 loan officers and 8 managers of MFIs. Data was collected using a Likert scale questionnaire. Quantitative data was presented using SPSS. This study found that a tax regulation can enhance the sustainability of MFIs if properly simplified to promote investment in microfinance business through provision of tax exemptions, tax incentives, free registration, simplified record keeping procedures, and reduced tax rates. The study recommends that MFIs should not be heavily taxed if they are to meet a major objective of poverty alleviation.


Norwegian offshore oil and gas exploration and production is moving into new and previously unexplored areas further north, such as the Barents Sea. This poses multiple new challenges in design, development and operation. Some challenges are due to the harsh arctic climate and conditions, others because this area is remote and undeveloped compared to the offshore fields further south. The distance between installations will be much greater and the overall infrastructure is far less developed. The industry standard risk model for ship-installation impacts (COLLIDE) relies heavily on operational elements and risk reducing measures commonly found throughout the North Sea and Norwegian Sea. These are presently not available in the Barents Sea. This implies that risk assessments will have to adapt the current methodology to account for the lack of data, quality of available data, and overall "modus operandi" as offshore operations in the Barents Sea may prove to be different from comparable operations in more established areas of the Norwegian Continental Shelf. The main operational barrier and risk reducing measure against ship-installation impacts in Southern Norway are two control centers that operates an integrated network of radars, VHF stations and AIS base stations. The same level of emergency resources, surveillance and communication coverage is not available in the Barents Sea. The lack of infrastructure and available resources affect core assumptions in collision risk assessment models and may cause otherwise minor incidents to have a significantly more serious outcome in such a remote area. This paper discusses the main challenges of using existing risk assessment tools and models in an area with significantly less infrastructure and available resources, and proposes alternatives to overcome these issues.


Ceramic-based wiring has been used in IBM in high-performance multi-chip module (MCM) carriers since the early 1980s. These types of carriers can provide very high wiring and power densities. Conductors are generally screened on individual ceramic sheets that are laminated and sintered at greater than 900/spl deg/ C. The high temperature process requires the use of copper paste metallization with higher resistivity than bulk copper and the punched-via fabrication imposes the use of meshed ground planes. Typical MCMs can have close to 100 layers [George Katopis (1998)] with 200-400 /spl mu/m via pitch. In the case of single-chip modules (SCM), hundreds of signal I/O's on 100-200 /spl mu/rn pitch redistribute to the coarser module wiring. The fan-out, the hollow shielding, and the sparse and long vias generate large signal distortion and crosstalk between signal layers and via columns. This paper describes the modeling and measurement of representative glass-ceramic based wiring for both SCM and MCM applications.


Garbage is one of the problems facing the Indonesian society. The production of garbage resulting from various individual activities is increasing each day. University of Ahmad Dahlan (UAD) Yogyakarta as one of the colleges in Yogyakarta has the potential to produce garbage of large amounts. Under the strategic plan of environmentally insightful campus development, garbage processing will be carried out by the institutions of University of Ahmad Dahlan and academic civitas. The average garbage produced by UAD 4 campus activities is 170 kg/day with an organic waste composition of 22.57 kg and non-organic 147.43 kg. During this time the garbage was directly distributed to the Piyungan landfill without being processed first, as the campus party had not been available garbage processing devices. The purpose of the study was to design organic garbage processing tools into compost fertilizers. The study used an ergonomic approach by utilizing anthropometric data in the determination of size from the design. Anthropometric data used in this study are Tinggi Bahu Duduk (TBD) or Shoulder High Sitting, Lebar Pinggul (LP) or Hip Width, Pantat Popliteal (PP) or Popliteal Butt, Tinggi Siku Berdiri (TSB) or Standing Elbow Height, Panjang Lengan Bawah (PLB) or Lower Arm Length, Lebar Bahu Atas (LBA) or Upper Shoulder Width, and Tinggi Lutut (TL) or Knee Height. The result of the study was an ergonomic Rotary Composter tool design operated by one person manually with dimensions 115 cm long, 148 cm wide, 115 cm tall, 60 cm barrel diameter, seat rest height 58.75 cm, 41.23 cm seat width, seat base length 45.39 cm, the distance between seats, tool height 114.94 cm, with tool 37.33 cm wide, seat rest 50 cm, 13 cm, seat width, and seat height 59.08 cm.


Optimal operation of heat exchanger networks is much less studied than optimal design. The control objective of a heat exchanger network is to control the temperature out of the heat exchanger network within a certain range. Often the control objective is to maximize the end temperature, and this is the focus of this study. A typical example is feed preheating in a crude oil fractionator. There seem to be no simple systematic ways to maximize the end temperature and the practical solutions are often suboptimal. Alternatively, RTO is used which is both challenging and expensive. This study investigates the performance of a self-optimizing control strategy proposed by PhD candidate Johannes Jaschke. The method maxmimizes the end temperature and relies only on cheap temperature measurements, i.e. no flow measurements or technical data (heat exchanger area, heat transfer coefficients, heat capacities etc.) are necessary. The method has been demonstrated in four different cases; two theoretical cases and two real cases. The real cases are from Perstorp in Perstorp, Sweden and Statoil Mongstad outside of Bergen, Norway. A dynamic model has been made for the Perstorp case. Also, it has been looked into if the same self-optimizing control strategy can be used for an LNG process. The self-optimizing control strategy perform well in all the cases investigated. At Perstorp it improves the performance, while at Statoil Mongstad the performance is just as good as the existing RTO. The results are presented for Perstorp and Statoil Mongstad which both are optimistic about the method.


We study the pattern of correlations across a large number of behavioral regularities, with the goal of creating an empirical basis for more comprehensive theories of decision-making. We elicit 21 behaviors, using an incentivized survey on a representative sample (n=1,000) of the US population. Our data show a clear and relatively simple structure underlying the correlations between these measures. Using principal components analysis, we reduce the 21 variables to six components corresponding to clear clusters of high correlations. We examine the relationship between these components, cognitive ability, and demographics. Common extant theories are not compatible with all the patterns in our data.


We analyse the effect of violence and rebellion on the evolution of household welfare. We collected new panel data for Burundi (1999-2007) in which we reinterviewed original as well as newly formed households (split-offs). We use several definitions of the household as unit of analysis and test for resource pooling between parental and split-off households. Focusing on the effect of civil war, we find that villagelevel violence, measured as the number of battle-related deaths or wounded reduces consumption growth by 9% for every 25 casualties. Joining an armed rebel group was a lucrative livelihood strategy: households of which at least one member joined an armed group experienced 41% higher growth in welfare over the study period. Results are robust to alternative variables of civil war shocks and model specifications, including household fixed effects and initial household fixed effects.


Recent studies have suggested that teachers" beliefs have a significant influence on actual classroom practice and, consequently, on students" achievements. However, little research has been done to investigate the influence of Indonesian language policy and teachers" beliefs. The study reported seeks to examine the influence of English language policy on pre-service teacher's beliefs about the teaching of English language grammar in Indonesian schools. The research participants were pre-service teachers who have taken the subjects of Structure, Teaching Methods, and Micro-teaching in three public and private universities in Central Java and Yogyakarta Special District. Due to time and scheduling limitations, the sampling method used in this study was convenient sampling. Documentation, survey schedules, interviews, focus group discussions were used to gather the data. The findings revealed that although the language policy in Indonesia has put English language teaching and learning within the framework of communicative competence since the enactment of the 2006 School-based Curriculum, the pre-service teachers still believed that traditional method of teaching grammar (explicit grammar instruction) was imperative to use. The pre-service teachers tended to exclude English language policy enacted by Indonesian government in their discussion about teachers" beliefs. Instead, the pre-service teachers constructed their beliefs about English language grammar teaching and learning process on their prior experiences in learning and teaching grammar.
Key words: language policy, teacher"s belief, pre-service/intraining teachers


Nursing is a profession that entails a high risk of burnout, so effective organizational management is needed to reduce its occurrence. This study aims to investigate the moderating effects of Nurse Manager caring behaviors and work environment in burnout syndrome among nurses. This study design uses exploratory descriptions with a cross-sectional approach and considers a sample of 485 nurses in the medical surgical wards at three general hospitals in East Java Province, Indonesia. Data collection was performed using three separate questionnaires: The Maslach Burnout Inventory-Human Service Survey (MBI-HSS) to identify burnout syndrome among nurses, Caring Assessment Tool: Administration (CAT: Admn) to identify caring behaviors in nurse managers, and My Relationship with Work test (MRW) to identify work environments. The data was analyzed using Partial Least Square analysis. Nurse manager caring behaviors have a direct effect on personal accomplishment among nurses. The caring behaviors of nurse managers influence control, workload, community, fairness, reward and value. Caring behaviors from nurse managers also affect emotional exhaustion and depersonalization through the mediation of rewards, controls and workload.


The grinding performance of wheel remarkably decreases by the loading of wheel surface in dry grinding of hard carbon parts. In this report, we propose the removal method of loaded carbon chips in which an adhesive tape is removed with carbon chips after putting on a loaded wheel surface by an elastic roller with the setting load . The removal characteristics are experimentally investigated by analyzing the projecting height of abrasive grains, removal force of adhesive tape and so on. The removal method results in the enough projecting height of abrasive grain.


This study investigates the distribution of math teachers with a major or certification in math using data from the National Center for Education Statistics' High School Longitudinal Study of 2009 (HSLS:09). The authors discuss the limitations of existing data sources for measuring teacher qualifications, such as the Schools and Staffing Survey (SASS), and show how HSLS:09 can be used to analyze the distribution of qualified teachers in mathematics. The results demonstrate that ninth-grade students in most need of a qualified math teacher are least likely to have one.


We investigate allocations of foreign aid by donors to the environment sector in Kenya covering the period 2001-12. Our data are largely obtained from official government and global aid databases complemented with donor interviews. We find that donor funding remained significant with emphasis on economic sectors such as agriculture, industry infrastructure and public debt. Allocations to environment have not been priority for donors in spite of several policy statements. Further, aid flows remained unpredictable, with huge disbursements occurring as emergency funds during disasters.


Background: Asthma and its associated phenotypes are under a substantial degree of genetic control. The common variant IL-13 gene polymorphism R130Q is reported to be associated with the risk of development of asthma in some populations. Objective: We sought to study the association of IL-13 genetic variant R130Q with bronchial asthma in Egyptian children and its relation to various clinical and laboratory phenotypes of the disease. Methods: IL13 gene polymorphism (R130Q) was detected by PCR amplification followed by sequencing using pure script total DNA in 20 asthmatic patients in acute exacerbation. The results were compared to 20 healthy age and sex matched children. Results: Asthmatic children had significantly higher frequency of distribution of R130Q genotype (50%) than controls (15%). The serum total IgE as percent of high normal for age was significantly higher in asthmatic patients as compared to controls with a mean of 208.77 ±237.06% and 14.21 ± 8.08% respectively. No significant difference was observed in the mean AEC(as a percent of high normal for age) of both groups (80.85 ± 116.4% and 82.50 ± 81.4% respectively). No significant differences were observed between patients with IL-13 polymorphism R130Q and those without such polymorphism as regards family history, relation of exacerbations to upper respiratory tract infections, history of food allergy or asthma grading. Serum total IgE was significantly higher in asthmatics with GA genotype as compared to those with GG genotype with a mean of 373.25 ± 238.11% and 44.28 ± 42.65% respectively. A similar finding was also observed among the control group with a mean of 28.03 ± 9.12% and 11.77 ± 5.00% respectively. Finally a significantly higher AEC was observed in controls with GA as compared to GG genotype with a mean of 250.00 ± 51.96% versus 52.94 ± 36.87% respectively. Conclusion: The common variant IL-13 gene polymorphism R130Q is frequently associated with pediatric asthma. This variant is more active than the wild type in inducing allergic inflammation as reflected by the higher serum total IgE and AEC. Hence, IL-13R130Q may be candidate for future gene therapy targeted at reducing the ill-effects of this polymorphism. Keywords: IL-13R130Q – bronchial asthma - pediatrics Egypt J Pediatr Allergy Immunol 2010;8(1):9-18


The applicability of anti-fibrin monoclonal antibody in detecting intra-circulatory blood clots was studied in 17 dogs in two groups: 13 dogs in the study group and 4 dogs in the control group. In the study group, dogs were punctured at the femoral artery and a thrombogenic coil was injected percutaneously to the iliac artery to induce blood clot. After 30 minutes, a dose of I-131 labeled anti-fibrin monoclonal antibody-3E6 (84-280 microCi) was injected intravenously. The dogs were imaged with a scinticamera at 6, 24 and 48 hours after antibody injection. In the control group, 3 dogs were studied with the same procedure but the I-131 labeled anti-fibrin monoclonal antibody was replaced with an I-131 labeled irrelevant monoclonal antibody. The remaining 1 dog for control was punctured and was injected with I-131 labeled anti-fibrin monoclonal antibody but no coil injection was performed. In the study group, 11 out of 13 dogs (85%) showed clot visualization at either 6 hours (4 dogs) or 24 hours (7 dogs) after anti-fibrin monoclonal antibody injection. There was no false positive results for the 4 dogs in the control group. Our studies showed that radiolabeled anti-fibrin monoclonal antibody may be a potential tool for noninvasive detection of intravascular blood clots.


The regular price for all courses will be $20.00 per hour. However, for those who pre-register by August 10, the charge will be $15.00 per hour ($5.00 discount). The hands-on computer courses are $25.00 per hour and no pre-registration discounts are available for hands-on computer courses. On-site registration will be at the full price of $20.00 per hour, with a fee of $25.00 per hour for hands-on computer courses.


Much due criticism has been directed at Levinas's images of the feminine and "the Woman" in Time and the Other and Totality and Infinity, but less attention has been paid to the metaphor of maternity and the maternal body that Levinas employs in Otherwise Than Being. This metaphor should be of interest, however, because here we find an instance in which Levinas uses a female image without in any way seeming to exclude women from full ethical selfhood. In the first three sections of this paper I explain how maternity functions in Otherwise Than Being. I argue that maternity is used as (1) an image of the vulnerability or passive sensibility that characterizes the relation with the Other, as well as (2) a metaphor for Levinas's account of ethical responsibility as substitution. In the final section of the paper, I defend the claim that Levinas's maternal metaphors are not disparaging to real, empirical women. I also discuss a remaining worry that feminists may have about the metaphor: namely, that it characterizes pregnancy and motherhood in ways that challenge some pro‐choice assumptions.


Organic geochemical and petrographic analyses of potential source rock samples taken from 30 drill holes penetrating Cenozoic basins of the Basin and Range province in eastern Nevada indicate two distinct trends in thermal maturity, as expressed by vitrinite reflectance equivalent (VRE). VRE is any coal rank or other thermal maturity parameter converted to its equivalent in vitrinite reflectance units using correlation charts. One trend is an increase with depth from about 2% VRE at 500 ft to 5% VRE at 12,000 ft, which is supermature with respect to oil generation. The other trend consists of mature rocks that have a nearly uniform VRE of about 0.7% ({plus minus}0.2%) from the near surface to a depth of 12,000 ft. Both the lower and the higher range geothermal gradients measured across the area, about 0.4 to 2.5F/100 ft (8 to 45C/km), correspond with the mature and supermature trends, respectively. The authors attribute these trends to two major thermal environments common within these Cenozoic basins. The supermature trend results from high geothermal gradients found near igneous intrusions, faulted contacts of uplifted metamorphic core complexes, or other heat sources. The mature trend characterized by near-zero VRE gradients results from groundwater recharge which produces cool more » temperatures at depth and low geothermal gradients. These generalizations should be applied with caution to any specific area because they are based on a composite VRE depth curve and, in some localities, may not represent realistic interpretation. However, VRE profiles within individual drill holes within the region generally follow one of these trends. « less


Theoretical models on herd behavior predict that under different assumptions, herding can bring prices away (or towards) fundamentals and reduce (or enhance) market efficiency. In this article, we study the joint effect of herding and momentum at the industry level. We find that the momentum effect is magnified when there is a low level of investor herding. Herd behavior in investors helps move asset prices towards fundamentals, enhance market efficiency and reduce the momentum effect. A trading strategy taking a long position in winner industries and a short position in loser industries when the herding level is low can generate significant returns.


Recently, the American Recovery and Reinvestment Act (ARRA) set aside $1.1 billion for comparative effectiveness research (CER) to investigate what healthcare strategies and interventions offer the greatest benefits to individual patients and the population as a whole. The Institute of Medicine has identified CER in cancer care as a high priority research focus for ARRA funding. The ability to measure quality of life will be central to CER in oncology because survival and disease-free survival do not adequately capture outcomes important to policy makers, physicians, and patients. There are two ways to measure quality of life: descriptive health status and patient preference weights (utilities). However, only patient preference weights can be incorporated into the economic analysis of medical resources and be used in the calculation of quality-adjusted life-years (QALYs). Some of the advantages and limitations inherent in measuring quality of life with descriptive health status and patient preference weights are discussed. Both types of measurements face health literacy barriers to their application in underserved populations, an important concern for CER in all medical fields.


This is a linguistic study on idiosyncrasy manifested through language use in Japanese monologues. For this purpose, we use speaker classification techniques as analytical tools. Focusing on Japanese particles, the subcategories of these particles, and interjections, we aim to find out to what extent Japanese speakers are idiosyncratic in selecting certain words above others in monologues. We are interested in how differently or similarly the individualising information of speakers is manifested between the subcategories of these particles, and also between particles and interjections. The genres of the monologues in this study vary from conference presentations on various topics covering humanities, social sciences, natural sciences and engineering to mock public speeches on a variety of general topics, such as "most pleasant memory," "about your community," etc. We demonstrate in this study that Japanese particles and interjections carry different degrees of individualising information. We also discuss what contributes to the identified differences between them.


The study was aimed at determini ng the antimicrobial activities of crude ethanolic extract of Al -Museiab propolis (EEMP) against some bacterial and fungal isolates by the method of disc diffusion and agar-well diffusion, respectively. MICs of propolis extracts using the two-fold agar dilution susceptibility method were also determined. Results revealed that Staphylococcus aureus was higher sensitive to EEMP than other Gram positive and Gram negative bacteria, while standard E. coli strain was highly sensitive to EEMP than other Gram negative bacteria. The effect of EEMP was elevated when the concentration increased to 20% and 30%. EEMP was not effective against C. albicans . Results of disc diffusion methods of crude EEMP at 10% concentration showed that S. aureus was highly sensitive to EEMP inhibition while C. albicans was resistant. Statistical analysis showed significant differences (P ≤ 0.05) between results of disc and agar diffusion methods of EEP at concentration of 10%, while there was no significant differences (P ≤ 0.05) at concentration s of 20% and 30% of extract, respectively. This study concluded that EEP was the most active of all propolis extracts, S. aureus was more sensitive to EEP and AEP than other bacteria, and agar diffusion method was better than disc diffusion method for detection of antimicrobial activity of propolis.


This article focuses on the work of enigmatic female gonzo director Mason, and examines her filmic negotiations of genre convention within the American pornographic industry. Close analyses of her films reveal a rich, textured set of filmic strategies which complicate conceptions of what mainstream gonzo pornography looks like and how it functions. The article presents an overview of her career to date, examines the articulation of her relationship with her female performers, and discusses her authorial tropes. It asks how her films differ from those we might have come to expect from male directors, and questions how we might account for her female gaze (as both producer and consumer) upon extremely hardcore scenes. In particular, the article demonstrates that as Mason navigates, negotiates, and negates a variety of gonzo conventions, her work is best understood as a series of responses to the norms of her chosen genre.


It is a conjecture of Colin and Honda that the number of Reeb periodic orbits of universally tight contact structures on hyperbolic manifolds grows exponentially with the period, and they speculate further that the growth rate of contact homology is polynomial on non-hyperbolic geometries. Along the line of the conjecture, for manifolds with a hyperbolic component that fibers on the circle, we prove that there are infinitely many non-isomorphic contact structures for which the number of Reeb periodic orbits of any non-degenerate Reeb vector field grows exponentially. Our result hinges on the exponential growth of contact homology which we derive as well. We also compute contact homology in some non-hyperbolic cases that exhibit polynomial growth, namely those of universally tight contact structures non-transverse to the fibers on a circle bundle.


AIM: To analyze efficiency of semi-quantitative fast D-dimer test in diagnosis of deep vein thrombosis (DVT) and thromboembolism of pulmonary artery (TPA). MATERIAL AND METHODS: The study enrolled 42 patients (26 males and 16 females) aged 25 to 86 years. 30 and 12 of them were suspected to have DVT and TPA, respectively. DVT was verified at ultrasound dopplerography and radionuclide phlebography in 16 of 30 suspects. TPA was verified by x-ray, perfusion scintigraphy of the lungs and at autopsy (one case) in 7 of 12 suspects. D-dimer levels in the blood were measured by latex parts agglutination reaction. The parts were covered with monoclonal antibodies to D-dimer. The reagents were provided by the kit Roche/Diagnostica Stago. RESULTS: The D-dimer test was positive in 20 of 23 DVT patients and negative in 3 cases (13%). Of 19 patients with rejected diagnosis of DVT/TPA the test was negative in 17(89.4%) and positive in 2 patients (10.6%). Thus, sensitivity and specificity of the D-dimer test was 87% and 89.4%, respectively. CONCLUSION: High sensitivity of the test allows to use it in screening for DVT/TPA. Negative D-dimer test rejects DVT, while positive test needs verification by other methods.


: A 32-year-old woman without preceding illness or significant cardiovascular risk factors was admitted to hospital because of a syncope after physical exertion. Transoesophageal echocardiography, performed to exclude aortic dissection, showed as an incidental finding a cystic space-occupying mass, 5 x 6 cm in diameter, dorsal to the aortic root and main pulmonary artery. Exercise ECG had S-T segment depressions of about 0.3 mV, associated with anginal symptoms, so that inadequate coronary artery flow on exertion was suspected. Subsequent coronary angiography demonstrated a funnel-shaped 80% stenosis at the origin of the main left coronary artery, while all other coronary arteries were normal and smooth-walled. A causal connection between the two findings was assumed and quickly undertaken surgical intervention revealed an intrapericardial bronchogenic cyst which, presumably as a result of its size and location, had pressed on the main stem of the left coronary artery and caused the stenosis of its ostium. The cyst was completely resected and angioplasty of the coronary artery ostium was performed to ensure its patency. 3 months postoperatively the patient underwent an exercise test of up to 125 Watt without signs of ischaemia. This case presents a previously unreported complication of a bronchogenic cyst.


The present study focuses on the definition of fungi and bacteria from the late period wooden coffin at Saqqara dating back to the 26 th dynasty (664–525 BC). It highlights the importance of the black resin layer in resisting microbial infection. This polychrome wooden coffin was covered by a ground layer and a painted layer externally and by a layer of black resin internally. The wooden coffin had a lot of deterioration factors, e.g. the loss of the painted layer and ground layers, as well as a thick layer of dust. Potato Dextrose Agar (PDA) was used for the cultivation of fungi, and nutrient agar was used to cultivated bacteria. Microbial infections were identified using light microscopy after their cultivation. The types of fungi and bacteria: The mold fungi were Trichoderma, Acremonium SP Aspergillus niger, Aspergillus flavus, and Penicillium SP , while the bacteria were Micrococcus sp. (G+), Micro Bacillus sp. (G+) and Short Bacillus sp. (G+(. The fungi and bacteria were on wood and color, while black resin any fungi, and bacteria were absent because the black resin contained anti-fungal and anti-bacterial materials.


Mental health counselors are facing increased demand to treat both adolescents and adults who present with repetitive non-suicidal self-injurious behaviors, yet there are few empirically supported treatments or general treatment guidelines available. I will review the research on problem-solving and dialectical behavior therapy, two cognitive-behavioral treatments that have the most empirical support for reducing self-injurious behavior. I conclude by providing specific treatment recommendations drawn from the literature that can be of use to mental health counselors working with individuals who self-injure.


This chapter was originally published in the book Handbook of Experimental Economics Results. The copy attached is provided by Elsevier for the author's benefit and for the benefit of the author's institution, for noncommercial research, and educational use. This includes without limitation use in instruction at your institution, distribution to specific colleagues, and providing a copy to your institution's administrator.


In 63 small pages of type, arranged in easily readable style and with 43 good color illustrations, modern knowledge of syphilis has been well summarized. Each stage of the disease is described succinctly and with the authority of thorough understanding and experience. Undoubtedly this is a reflection of the assistance of Sidney Olansky and Evan W. Thomas, as acknowledged in the book. William J. Brown, Chief of the Venereal Disease Branch of the Communicable Disease Center, in a foreword, calls attention to the reversal in 1955 of the decline of syphilis. Since 1958, the incidence of infectious early syphilis in many communities has doubled each year, although there has not been a parallel increase in the number of reported cases of gonorrhea. The decreasing rarity of infectious syphilis calls for greater action. As early stages of the disease increase, the likelihood of overlooked early infection increases with its certain incidence


Soot deposited in snow and ice lowers the albedo of the surface and affects the radiative balance. Soot's climatic forcing has received increased attention during the last decade, however, measurements of soot concentrations in Arctic snow are rare. This thesis investigates the horizontal variability of elemental carbon (EC), a proxy of soot, on a meter scale in surface snow from a site with limited regional pollution in Arctic Finland and a site with significant regional pollution near Stockholm, Sweden. A variability of EC in the sampled grid-nets was observed at both of the sites; however, the site with less pollution affecting it presented greater variation in comparison to the polluted site. In side-by-side ratios between neighboring samples, a ratio of as much as ~16 is observed, presenting the potential variation at the less polluted site. An important process that is partly responsible for the variation at this site is wind. The EC concentrations increased over time at both of the sites, which supports the hypothesis that EC remains at the snow surface even as snow melt occurs in the spring.


We studied apoptosis caused by porcine reproductive and respiratory syndrome virus (PRRSV) in vivo, focusing on the tissues that constitute the main targets for infection: lung and lymphoid tissues. Previous investigators have shown that the PRRSV glycoprotein p25, encoded by PRRSV open reading frame 5, induces apoptosis when expressed in COS-1 cells. Results of studies conducted in our laboratory indicate the simultaneous occurrence of PRRSV-induced alterations of spermatogenesis and apoptotic death of germinal epithelial cells in the testicle. In this study, the goal was to determine whether virus-induced apoptosis is a direct mechanism of cell death caused by PRRSV in infected pigs. Eight 3-week-old pigs were intranasally inoculated with PRRSV 16244B, a highly virulent field strain. Lung, tonsil, bronchial lymph node, spleen, and heart were assessed histologically at 4 and 7 days postinfection. To characterize PRRSV-infected cells and apoptotic cell death, we used immunohistochemical methods for detection of viral antigen, DNA electrophoresis for detection of DNA fragmentation, the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-fluorescein nick end labeling method for in situ detection of DNA strand breaks, and electron microscopy for ultrastructural morphologic studies. PRRSV infection resulted in widespread apoptosis in the lungs and lymphoid tissues of infected pigs. Virus infection-induced apoptotic cells were more abundant than PRRSV-infected cells in all tissues. DNA laddering was detected in lung and lymphoid tissues. However, double-labeling experiments demonstrated that the majority of apoptotic cells did not colocalize with PRRSV-infected cells. Our findings suggest the presence of an indirect mechanism in the induction of apoptosis for PRRSV.


Abstract. Small phytoplankton are anticipated to be more important in a recently warming and freshening ocean condition. However, little information on the contribution of small phytoplankton to overall phytoplankton production is currently available in the Amundsen Sea. To determine the contributions of small phytoplankton to total biomass and primary production, carbon and nitrogen uptake rates of total and small phytoplankton were obtained from 12 productivity stations in the Amundsen Sea. The daily carbon uptake rates of total phytoplankton averaged in this study were 0.42 g C m−2 d−1 (SD  =  ± 0.30 g C m−2 d−1) and 0.84 g C m−2 d−1 (SD  =  ± 0.18 g C m−2 d−1) for non-polynya and polynya regions, respectively, whereas the daily total nitrogen (nitrate and ammonium) uptake rates were 0.12 g N m−2 d−1 (SD  =  ± 0.09 g N m−2 d−1) and 0.21 g N m−2 d−1 (SD  =  ± 0.11 g N m−2 d−1), respectively, for non-polynya and polynya regions, all of which were within the ranges reported previously. Small phytoplankton contributed 26.9 and 27.7 % to the total carbon and nitrogen uptake rates of phytoplankton in this study, respectively, which were relatively higher than the chlorophyll a contribution (19.4 %) of small phytoplankton. For a comparison of different regions, the contributions for chlorophyll a concentration and primary production of small phytoplankton averaged from all the non-polynya stations were 42.4 and 50.8 %, which were significantly higher than those (7.9 and 14.9 %, respectively) in the polynya region. A strong negative correlation (r2 = 0. 790, p


The United Nations Food and Agriculture Organization and World Health Organization in 2001, made a clarion call for efforts to be made to make probiotic products more widely available, especially for relief work and populations at high risk of morbidity and mortality. This strong and direct request to governments, funding agencies, corporate pharmaceutical and food industries has so far not had any impact in sub-Saharan Africa, where people are mired in poverty and stricken with gastro-intestinal and an escalating epidemic of sexually transmitted diseases including HIV/AIDS.The ability of certain probiotic strains to prevent and treat some gut and urogenital conditions, and the relative low cost and practical means by which this can be achieved, provides a potential addition to the armamentarium of methods to lower the impact of disease and enhance the quality of life of people in this part of the world.Companies selling reliable probiotic products have not yet entered sub-Saharan Africa, perhaps due to logistical reasons and low pricing. Nevertheless, in order to make a significant impact on the health and wellbeing of this large population, ways must be found to provide access to this technology. A community kitchen project in Tanzania, initiated by our group, is one way of taking the concept to the grass roots.


This thesis examined the change in skeletal muscle architecture with contractile force production, the relationship of architecture with muscle strength parameters and if muscle tendinous tissue stiffness determines in vivo explosive strength (i.e. rate of torque development, RTD). Muscle and tendinous tissue adaptations to contrasting strength training regimes, and the potential capacity of these tissues to adapt following chronic strength training were also explored. Quadriceps femoris fascicle length (FL) decreased, while the pennation angle (PA) increased in a curvi-linearly manner from rest to maximal voluntary contraction (MVC) torque. Consequently, effective physiological cross-sectional area (effPCSA) during MVC was 27% greater than at rest, although effPCSA measured at rest and during MVC had similar correlations to maximal strength. In the earliest phase of contraction, FL, but not PA, was negatively related (R2=0.187) to voluntary RTD. Neither FL nor PA was related to maximal isometric or dynamic strength. Muscle-tendon unit (MTU) and patellar tendon (PT) stiffness were unrelated to voluntary and evoked RTD. Relative PT stiffness was also unrelated to relative RTD, although relative MTU stiffness was related to voluntary RTD (25-55%MVT, R2≤0.188) and evoked RTD (5-50%MVT, R2≤0.194). MTU stiffness increased after sustained-contraction (SCT, +21%), though not explosive-contraction strength training (ECT). PT stiffness increased similarly after ECT (+20%) and SCT (+16%), yet neither induced tendon hypertrophy. SCT produced modest muscle (+8%) and aponeurosis (+7%) hypertrophy. Chronic strength trained (CST: >3 years) males had substantially greater muscle and aponeurosis size, but similar tendon size as untrained controls (UNT) and short-term (12 weeks) strength trained (STT) individuals. Between these groups, at the highest common force, MTU stiffness was indifferent, while PT stiffness was similarly greater in STT and CST than UNT. These results suggest FL and PA have little influence on muscle strength and tendon stiffness has no influence on RTD. Maximum strength negated any qualitative influence of MTU stiffness on in vivo RTD. Component MTU tissues (muscle-aponeurosis vs. external tendon) adapt differentially depending on the strength training regime. Specifically, free tendon appeared to adapt to high magnitude loading, while loading duration is also an important stimulus for the muscle-aponeurosis. However, chronic strength training was not concordant with greater higher force MTU stiffness, and does not further increase higher force PT stiffness beyond the adaptations that occur after 12 weeks of strength training. Finally, no evidence was found for tendon hypertrophy in response to strength training.


Different dosages of aspirin were administered (by nasogastric tube) to 3 groups of 5 healthy adult horses to determine the minimal effective dosage needed to decrease serum thromboxane B2 (TxB2) concentrations and to determine the duration of this decrease. When compared with their base-line serum TxB2 concentrations, horses in group 1 (given 5 mg/kg) had a 71% decrease in TxB2 concentrations at 24 hours after aspirin was given and a 86% decrease at 48 hours; serum TxB2 concentrations were back to base-line values by 120 hours. Horses in group 2 (given 10 mg/kg) had a 60% decrease in TxB2 concentrations at 24 hours after aspirin was given, an 84% decrease at 48 hours, a 48% decrease at 96 hours, and an 18% decrease at 6 days. Horses in group 3 (given 20 mg/kg) had a 68% decrease in TxB2 concentrations at 24 hours, a 93% decrease at 72 hours, an 87% decrease at 96 hours, and a 70% decrease at 6 days after aspirin treatment was given. All groups had a statistically significant decrease in TxB2 concentrations (P less than 0.05) by 12 hours after aspirin was given, which persisted 96 hours for group 1 and throughout the study for groups 2 and 3. The maximal TxB2 decrease was similar among the 3 groups (90% decrease from base line), and there were no significant differences among the TxB2 concentrations between 24 and 72 hours after treatment was given.(ABSTRACT TRUNCATED AT 250 WORDS)


Mantle-derived serpentinized peridotites crop out in a belt approximately 2 km wide and 20 km long along the western median valley wall of the Mid-Atlantic Ridge just south of the Kane Transform in the MARK area. Serpentinites extend southward from extensive exposures of gabbroic rocks near the Kane Transform. The belt crops out along approximately half the length of a well-defined ridge segment parallel to a prominent neovolcanic ridge. It terminates in a segment boundary zone to the south marked by a bathymetric depression whose trace extends obliquely off axis northwestward into older crust where serpentinites have also been dredged. The serpentinites are considered to have been exposed by extreme lithospheric extension along a major crustal detachment, as suggested for mafic plutonic rocks that crop out as an oceanic core complex to the north. Gently dipping metamorphic fabrics and fault surfaces in the serpentinites suggest a similar structural history for these two adjacent areas. Consistently oriented high- and low-temperature fabrics along the length of the belt of serpentinized peridotites do not support diapiric uplift as a mechanism for the exposure of these exotic rocks. Gabbroic to diabasic intrusions and overlying basaltic lavas suggest that the serpentinites were exposed by uplift and faulting of upper mantle material that did not develop an extensive overlying magmatic crust as it rose beneath the ridge axis and spread laterally. These types of exposures of hydrated upper mantle material appear to be common elements of oceanic crust formed at slow-spreading ridges with low magma budgets.


Purpose: Orbital fractures are common facial fractures that can be challenging to repair and require careful attention to avoid unacceptable ophthalmic complications. Customized implants that are unique to an individual patient, or patient-specific implants (PSIs), have been increasingly used to repair orbital wall fractures. This systematic review summarizes the current evidence regarding custom-made orbital wall implants. Methods: A keyword search of published literature from January 2010 to September 2021 was performed using Ovid MEDLINE, PubMed, and the Cochrane Library databases. Original articles that included more than 3 human subjects with an orbital fracture repaired with a PSI were included. The search results were reviewed, duplicates were removed and relevant articles were included for analysis. Results: Fifteen articles meeting the inclusion criteria. The articles were categorized into 3 separate groups based on the method of PSI fabrication: manual molding of a PSI on a 3D-printed orbital model (53%), directly from a 3D printer (27%), or via a template fabricated from a 3D printer (20%). Three primary postoperative outcomes were assessed: rates of diplopia, enophthalmos, and orbital volume. Postoperative rates of diplopia and enophthalmos improved regardless of the PSI technique, and postoperative orbital volumes were reduced compared with their preoperative state. When PSIs were compared to conventional implants, patient outcomes were comparable. Conclusions: This review of existing PSI orbital implant literature highlights that while PSI can accurately and safely repair orbital fractures, patient outcomes are largely comparable to orbital fractures repaired by conventional methods, and PSI do not offer a definitive benefit over conventional implants. The systematic review demonstrates that while patient-specific implants can be used to successfully repair orbital fractures, their outcomes are not superior to cases repaired by conventional methods.


People telling stories of national identity, land and spirituality contribute to the local formation of the nation. I explore this view of nationhood in Aotearoa/New Zealand from Māori and Pākehā perspectives. Theorising this exploration, I form my own national identity concept for guiding analysis, that of locally narrated roots. Locally narrated roots is, essentially, a way of looking at national identity through the everyday narration of land, spirituality and history/ancestry by individuals. Supporting the production of this term is Smith's (2003) theory of revised ethnosymbolism, which links religion, nationalism, land and history/ancestry, and Thompson's (2001) grounded, everyday approach summed up as local production of national identity. Research methods draw upon Thompson's people-focussed approach in conjunction with a narrative approach inspired by life story and Kaupapa Māori Research practices, which informed the conducting of twelve semi-structured interviews. From these interviews, six Māori and six Pākehā stories of history, ancestry, spirituality, land and identity were generated. These narratives revealed that colonial settler society, romanticism and whakapapa (genealogy) are central to this research and vital for further exploration on national identity. I close with the suggestion that participants' stories enact a process of locally authenticating one's national identity. I also suggest this local authentication is a secular spirituality, an idea that combines both patent secularism and spirituality, and is expressed through land, history and ancestry in Aotearoa/New Zealand.


Recently, a new mathematical formulation of evolutionary game dynamics [1] has been introduced accounting for a finite number of players organized over a network, where the players are located at the nodes of a graph and edges represent connections between them. Internal steady states are particularly interesting in control and consensus problems, especially in a networked context where they are related to the coexistence of different strategies. In this paper we consider this model including self-loops. Existence of internal steady states is studied for different graph topologies in two-strategy games. Results on the effect of removing links from central players are also presented.


The vital signs monitoring is very useful to detect medical diseases. The paper presents an open, flexible, wireless and portable platform for monitoring vital signs in the healthcare scenarios, both indoor and outdoor. The platform has been designed in order to overcome the limitations of well-known technologies for mobile architectures, such as the battery lifetime and the lack of the open source codes. To reduce these issues the platform integrates the fast, easy-to-use, safe and low-power Near Field Communication protocol for data transmission in proximity, addressing the Internet of Things paradigm. The platform uses the Arduino NANO board and the related open source software libraries, so it could be possible to add new functionalities in a fast way. The first prototype of the platform has been customized for human body temperature measurement by using the digital TMP100 temperature sensor. However, a real "ecosystem" of portable devices could be prototyped with low-effort for the acquisition/transmission of other kind of clinical signs such as heart-rate, breath-rate, ECG.


The following five new species of Culicoides from Colombia are described, illustrated and placed to subgenus or species group: Culicoides antioquiensis, Culicoides gabrieli, Culicoides inermis, Culicoides micayensis and Culicoides nigrifemur. C. gabrieli is also known from Peru. When possible, their position in previously published keys is indicated and their features discussed in light of the most recent revisions. A list of 180 Culicoides species known (114) or suspected of being in Colombia (66) is given in a Table. Of these, 12 including the new species are recorded from Colombia for the first time.


Ovari an vein thrombosis (OVT) is an uncommon, life‐threatening complication of pregnancy. OVT clinical presentation is similar to that of acute appendicitis, and the latter is therefore the suspected diagnosis in most cases. We describe a case of a 36‐year‐old woman experiencing deep vein thrombosis and pulmonary embolism during the course of pregnancy and presenting to the emergency department with sudden pain in the right lower quadrant and severe abdominal pain. This case illustrates the difficulty in diagnosing OVT, which should be considered in any pregnant woman with unexplained lower abdominal pain suggestive of acute appendicitis.


Three pulmonary disease conditions result from the accumulation of phospholipids in the lung. These conditions are the human lung disease known as pulmonary alveolar proteinosis, the lipoproteinosis that arises in the lungs of rats during acute silicosis, and the phospholipidoses induced by numerous cationic amphiphilic therapeutic agents. In this paper, the status of phospholipid metabolism in the lungs during the process of each of these lung conditions has been reviewed and possible mechanisms for their establishment are discussed. Pulmonary alveolar proteinosis is characterized by the accumulation of tubular myelin-like multilamellated structures in the alveoli and distal airways of patients. These structures appear to be formed by a process of spontaneous assembly involving surfactant protein A and surfactant phospholipids. Structures similar to tubular myelin-like multilamellated structures can be seen in the alveoli of rats during acute silicosis and, as with the human condition, both surfactant protein A and surfactant phospholipids accumulate in the alveoli. Excessive accumulation of surfactant protein A and surfactant phospholipids in the alveoli could arise from their overproduction and hypersecretion by a subpopulation of Type II cells that are activated by silica, and possibly other agents. Phospholipidoses caused by cationic amphiphilic therapeutic agents arise as a result of their inhibition of phospholipid catabolism. Inhibition of phospholipases results in the accumulation of phospholipids in the cytoplasm of alveolar macrophages and other cells. While inhibition of phospholipases by these agents undoubtedly occurs, there are many anomalous features, such as the accumulation of extracellular phospholipids and surfactant protein A, that cannot be accounted for by this simplistic hypothesis.


Research initiated by a Florida Cabinet Resolution of August 6, 1974, has generated two models for the evaluation of the impact of marina development on coastal waters. One, a complex three-dimensional finite element model that takes dispersive as well as convective pollutant transport into consideration has been used extensively during the last five years. Experiences gained from the use of that model have been included in the newer, and simpler, second model that is one-dimensional and more limited in scope. Being mostly convective makes this model conservative; however, its results can be conclusive if convective transport alone can assure that the considered marina will be without serious environmental impact.


The aim of this paper is to present a probability analysis using the Monte Carlo simulation method of uncertainty (MCSM). The results of this method will be compared to all recognized method of slope stability such as Bishop simplified, Fellenuis, Janbu simplified and corrected, Spencer and Lowe-Karafiath which are in general in limit equilibrium. This study has been done by a normal frequency distribution relative for all the parameters taken into considerations. From the mean values and the standard deviations of the pore water pressure, cohesion and the internal angle of friction with the correlation relation between these parameters, a set of random values of pore water pressure, cohesion and internal angle of friction were generated by computing a Critical Probabilistic Slip Surface. The analysis of the obtained results indicates that the failure probability is affected by the standard deviation of the pore water pressure, cohesion, internal angle of friction and correlation coefficient. However, all methods of equilibrium limit are affecting the failure probability by taking into account one of these parameters following each case. Nevertheless, the probability of failure is not significantly affected by the standard deviation of the unit weight for all methods.


A windcatcher is a structure placed on the roof of a building for providing natural ventilation for interior space working by wind power. It draws out the inside stale air to the outside and supplies the outside fresh air for the building's interior space.In this paper, the effect of different types of windcatcher's inlet\outlet on the air flow, flow velocity and flowrate through a three-dimensional room fitted with a two-sided windcatcher is observed numerically, using a commercial computational fluid dynamics (CFD) software package. The standard RANS K-e CFD method is used in the simulations. The flow pattern, flow velocity and flowrate of the inside ventilation flow is considered for the six different types of a two-sided windcatcher's inlet\outlet.It is found that the shape of the inlet\outlet of windcatcher strongly affects flow pattern, flow velocity and flowrate and the performance of square windcatcher is higher than the circular one specially in ventilating the living area (lower part) of a room.© 2014 ASME


This paper presents algorithms for quadratic forms over a formally real algebraic function field K of one variable over a fixed real closed field k. The algorithms introduced in the paper solve the following problems: test whether an element is a square, respectively a local square, compute Witt index of a quadratic form and test if a form is isotropic/hyperbolic. Finally, we remark on a method for testing whether two function fields are Witt equivalent.


Abstract Myasthenia gravis (MG) is a neuromuscular autoimmune disease, where antibodies against the acetylcholine receptor destroy this receptor. The role of thymectomy in the treatment of MG remains controversial. Because of the frequent association with other autoimmune diseases, we hypothesized that patients with multiple autoantibodies (autoAbs) might have a lower chance of reaching complete stable remission after thymectomy. We analyzed sera of 85 MG patients who underwent a thymectomy between April 2004 and December 2012. We used four different immunodot kits (D-Tek, Mons, Belgium): ANA25 Quantrix, Synthetase 10 Diver, Myositis 7 Diver and Liver 10 profile Diver, all automatized on the BlueDiver Instrument (D-Tek). The Myasthenia Gravis Foundation of America (MGFA) postintervention status was used to determine the outcome after thymectomy. AutoAbs other than anti-acetylcholine receptor (AChR) antibodies were detected in 29.4% of the patients of whom 16.5% clinically had a second autoimmune disease. In none of the seronegative patients other autoAbs were detected. No significant difference was observed in the 3-years remission rate after thymectomy in patients with or without antibodies other than anti-AChR antibodies. Although these autoAbs do not predict outcome in our MG patient cohort, screening for multiple autoAbs in MG patients might be warranted to identify patients with additional autoimmune diseases.


As traditional legacy systems that run critical national infrastructures (CNI) are increasingly digitized for performance monitoring and efficiency, significant attention has been brought to improving their cyber security. Network and Information Systems Security (NIS) Directive is the first European-scale attempt to establish a high standard of cyber security among CNIs. NIS raises questions about defining scope, pro-viding evidence or mobilizing funding. Most importantly, there is the fundamental question whether it would become a tick-box exercise or lead to long-term improvements in security practices. We interviewed 30 cyber security practitioners in the UK to gather an in-depth understanding of NIS implementation and its probable futures. Our analysis found that the emerging field of Operational Technology Security is yet to formulate norms, standards and career trajectories. We are, therefore, at a critical junction, where the scope of the profession is shaping together with the need for evidence-based policy advice. Our findings are twofold: (1) a number of security tropes (e.g., "security solutions are the same across the sectors"), which may drive implementation of regulations such as NIS; (2) a classification of cyber security practices mapping the diversity of policy interpretations. We conclude with recommendations for policymakers and CNI operators.


It has been carried out the modification of Sandmeyer modification reaction by in-situ generated formaldehyde. The in-situ generated formaldehyde has been performed via heterogeneous phase reaction between 6.40 mL (0.10 mol) CH2Cl2 as organic phase with 40 mL 6.0 N KOH-alcoholic solution as aqueous phase and 2.56 g tetrabutylammonium perchlorate as phase transfer catalyst (PTC) by 40o C for 4 hours. Furthermore, 5.9 mL (0.05 mol) guaiacol 1 is dropwised to add to the reaction mixture. After the addition of guaiacol 1 finished, then reaction is allowed to run for 1 hour, so that the white crystal of vanillil alcohol 10 can be produced in 25.3%. Followed by oxidation of vanillil alcohol 10 with mixture of K2Cr2O7/conc. H2SO4 solution as oxidator, and 18-crown ether-6 as phase transfer catalyst (PTC) in heterogeneous phase at the room temperature for 5 hours, can be afforded vanillin 4 in 6.2% (calculated from starting material 1).


Objective
We examined whether high levels of internalized homophobia and low levels of openness about one's sexual identity ("outness") were enduring vulnerabilities for same-sex couples' relationship functioning.

Background
The vulnerability–stress–adaptation (VSA) model describes how stress can impact relationship functioning. This model has predominately been applied to the study of heterosexual couples, which leaves a dearth of literature on enduring vulnerabilities specific to same-sex couples' relationship functioning.

Method
Dyadic longitudinal data from a convenience sample of 81 same-sex couples were collected. Internalized homophobia and outness were assessed at baseline followed by 14-day daily diaries assessing external stress and relationship functioning (i.e., severity of conflict, relationship quality, and commitment). Hypotheses were tested using longitudinal actor–partner interdependence models and multilevel modeling.

Results
On days that individuals with high (but not low) levels of internalized homophobia reported greater daily stress, they also reported greater severity of conflict and poorer relationship quality. On days that individuals with low (but not high) outness had a partner report greater daily stress, the individual reported lower commitment.

Conclusion
Hypotheses were partially supported; high levels of internalized homophobia and low outness were shown to be potential enduring vulnerabilities for individuals in a same-sex relationship.

Implications
Helping same-sex couples cope with their own and their partner's daily stress, as well as working to decrease internalized homophobia while increasing openness about their sexuality, may help to promote relational functioning.


In this paper, TiN coating was deposited onto the nitrided 32Cr2MoVA by multi arc ion plating and proceeded line contact fatigue experiment to investigate the influence of hard coatings on the contact failure properties of nitriding steel. The results of experiment show that pitting is primary type of contact fatigue failure for TiN coated 32Cr2MoV and the pits on the TiN coated surface are shallower and smaller than that of the nitrided 32Cr2MoV. After TiN coating produce crisping and desquamation under higher contact fatigue loads, the exposed matrix surface begin to bear the contact load. The superficial microstructure of TiN coated 32Cr2MoV was more fine, and content of nitrides were higher than that of the nitrided, which insured the distribution of hardness gradient of subsurface was more rational than that of nitrided 32Cr2MoV. The contact fatigue strength of TiN coated 32Cr2MoV is greater about 200MPa than that of the nitrided 32Cr2MoV.


Recent advances in remote health monitoring systems have significantly benefited patients and played a crucial role in improving their quality of life. However, while physiological health-focused solutions have demonstrated increasing success and maturity, mental health-focused applications have seen comparatively limited success in spite of the fact that stress and anxiety disorders are among the most common issues people deal with in their daily lives. In the hopes of furthering progress in this domain through the development of a more robust analytic framework for the measurement of indicators of mental health, we propose a multi-modal semi-supervised framework for tracking physiological precursors of the stress response. Our methodology enables utilizing multi-modal data of differing domains and resolutions from wearable devices and leveraging them to map short-term episodes to semantically efficient embeddings for a given task. Additionally, we leverage an inter-modality contrastive objective, with the advantages of rendering our framework both modular and scalable. The focus on optimizing both local and global aspects of our embeddings via a hierarchical structure renders transferring knowledge and compatibility with other devices easier to achieve. In our pipeline, a task-specific pooling based on an attention mechanism, which estimates the contribution of each modality on an instance level, computes the final embeddings for observations. This additionally provides a thorough diagnostic insight into the data characteristics and highlights the importance of signals in the broader view of predicting episodes annotated per mental health status. We perform training experiments using a corpus of real-world data on perceived stress, and our results demonstrate the efficacy of the proposed approach in performance improvements.


This paper introduces a personalized content preparation and delivery framework for universal multimedia access. This framework has a wealth of potential applications in broadcasting, the World Wide Web and mobile telecommunication. Content preparation deals with the generation of summaries by automatic video analysis techniques, and with the annotation of content using MPEG–7 for search and retrieval and SMIL for interactive video. The use of open standards favors interoperability with third-party applications and upcoming hardware. Content delivery handles individual user preferences, content selection, real-time content adaptation and streaming in a seamless way. The proposed framework has been implemented in the EC–funded RD project PERSEO and tested by selected groups of end-users. Personalization, video summaries and the overall usability have been positively evaluated.


Nowadays, people from all around the world use social media sites to share information. Twitter for example is a platform in which users send, read posts known as tweets and interact with different communities. Users share their daily lives, post their opinions on everything such as brands and places. Companies can benefit from this massive platform by collecting data related to opinions on them. The aim of this paper is to present a model that can perform sentiment analysis of real data collected from Twitter. Data in Twitter is highly unstructured which makes it difficult to analyze. However, our proposed model is different from prior work in this field because it combined the use of supervised and unsupervised machine learning algorithms. The process of performing sentiment analysis as follows: Tweet extracted directly from Twitter API, then cleaning and discovery of data performed. After that the data were fed into several models for the purpose of training. Each tweet extracted classified based on its sentiment whether it is a positive, negative or neutral. Data were collected on two subjects McDonalds and KFC to show which restaurant has more popularity. Different machine learning algorithms were used. The result from these models were tested using various testing metrics like cross validation and f-score. Moreover, our model demonstrates strong performance on mining texts extracted directly from Twitter.


Background A recently introduced computerised physician order entry system (CPOES) in hospital and a primary care electronic record system help prescribing and provide information about patients' medicines. These tools should improve the reconciliation process and diminish potential errors associated with chronic medication. Purpose The aim of this study is to describe and analyse the discrepancies between chronic medication recorded on the electronic health record system and the prescription of this medication upon admission to hospital. Materials and methods From March through May 2011, information was collected about patients admitted older than 60 years with chronically-prescribed medication and an updated preadmission treatment file. The pharmacist compared the computerised prescriptions with the current chronic medication listed by the prescription program (e-Osabide). Chronic medication data were verified with the patient primary care electronic record system (GlobalClinic). If discrepancies were found the admission reports were checked to decide if they were justified. Unjustified discrepancies were reported and classified as reconciliation errors. Results Chronic treatment of 88 patients was analysed (average age: 73.3 years. 48 women, 40 men). 33 patients were admitted as emergencies (E), 26 to surgical wards (S) and 29 to medical wards (NS). The average number of chronically-prescribed medicines per patient prescribed at admission were 7.3 and 5.4, respectively. 32 unjustified discrepancies were found (26.1% of patients, 0.36 per patient). Classified by route of admission: E, 24.2% of patients (0.42/patient); S, 30.8% (0.38); NS, 24.1% (0.28). By reconciliation errors: dose/frequency incorrect (21), omission (6), added medicine (5). The acceptance of interventions made was 56.3% (18/32). Conclusions The integration of CPOES and the electronic healthcare record system makes the reconciliation process easier and reduces prescription errors. With recently introduced CPOES incomplete prescriptions are no longer a problem. However, preventable prescription errors associated with reconciliation occur due to not using the tools now available.


Introduction: Balint group is a method widely used for enhancing understanding of the relationship and communication between health professionals and their patients. Participants meet in small groups, on a regular basis, with a leader to discuss their experiences of problem cases. The method was originally developed in the 1950s for enhancing understanding of the doctor-patient relationship. No studies have focused on the Balint group and clinical teachers'. The aim of the present study was to describe and analyze clinical teachers' experiences of participation in the Balint group and its influence on their work life in clinical settings.
Method: Semi-structured, in-depth interviews were conducted with ten clinical teachers' working in Iran and Isfahan University of medical sciences, all participating in the Balint group. The participants were selected by purposive sampling. The interviews were recorded, transcribed and subjected to a qualitative analysis. Credibility, dependability, confirmability, and transferability of the data were confirmed.
Results: The clinical teachers perceived that their Balint group participation influenced their work life. Analyses revealed two interrelated themes: behavioral metamorphosis cycle and dimensions of professional interactions development, thus enabling the clinical teachers to rediscover the joy of being a teacher.
Conclusion: The results suggest that Balint group and sharing the experiences of others may be considered a way of enhancing understanding of the clinical teachers encounter in work life, possibly to the benefit of clinical teachers and their students. Further research is needed to evaluate the feasibility of teacher Balint groups in the clinical setting.


After catastrophic levee failures triggered by the 2005 Hurricane Katrina, concrete T-walls with batter piles are extensively used to enhance the integrity of levees in the New Orleans area. Since the foundation soils in this region typically include soft and compressible clays, T-walls with batter piles should be designed to account for bending moments and stresses induced by settlement. However, the current T-wall design procedure for estimating these settlement-induced bending moments (SIBMs) only takes a limited range of conditions into consideration. This paper presents results from a series of finite-difference numerical simulations to investigate the effects of various parameters on SIBM in pile-supported T-walls. The numerical model was first used to simulate a centrifuge test and upon comparison, a reasonable agreement was observed between the numerical simulation and experimental results. The numerical model was then used to investigate the effects of different parameters including pile connection fixity, batter, and stiffness of the pile on SIBM. The simulation results showed that the fixed connection greatly increases the bending moment compared to the pinned case. The difference in the maximum bending moment due to different pile batters can be approximated linearly. However, the results showed that changes in the maximum bending moment versus pile stiffness do not follow a linear pattern. Findings of this research can be used to validate or identify the need for possible adjustments in the current T-wall modelling and design methodologies.


Hagedorn states (HS) are a tool to model the hadronization process which occurs in the phase transition region between the quark gluon plasma (QGP) and the hadron resonance gas (HRG). These states are believed to appear near the Hagedorn temperature TH which in our understanding equals the critical temperature Tc. A covariantly formulated bootstrap equation is solved to generate the zoo of these particles characterized baryon number B, strangeness S and electric charge Q. These hadron-like resonances are characterized by being very massive and by not being limited to quantum numbers of known hadrons. All hadronic properties like masses, spectral functions etc. are taken from the hadronic transport model Ultra Relativistic Quantum Molecular Dynamics (UrQMD). Decay chains of single Hagedorn states provide a well description of experimentally observed multiplicity ratios of strange and multi-strange particles. In addition, the final energy spectra of resulting hadrons show a thermal-like distribution with the characteristic Hagedorn temperature TH. Box calculations including these Hagedorn states are performed. Indeed, the time scales leading to equilibration of the system are drastically reduced down to 2... 5fm/c.


This paper provides a comprehensive description of OSCAR v2.2, a simple Earth system model. The general philosophy of development is first explained, followed by a complete description of the model's drivers and various modules. All components of the Earth system necessary to simulate future climate change are represented in the model: the oceanic and terrestrial carbon cycles – including a book-keeping module to endogenously estimate land-use change emissions – so as to simulate the change in atmospheric carbon dioxide; the tropospheric chemistry and the natural wetlands , to simulate that of methane; the stratospheric chemistry , for nitrous oxide; 37 halogenated compounds; changing tropospheric and stratospheric ozone; the direct and indirect effects of aerosols; changes in surface albedo caused by black carbon deposition on snow and land-cover change; and the global and regional response of climate – in terms of temperature and precipitation – to all these climate forcers. Following the probabilistic framework of the model, an ensemble of simulations is made over the historical period (1750–2010). We show that the model performs well in reproducing observed past changes in the Earth system such as increased atmospheric concentration of greenhouse gases or increased global mean surface temperature.


Project Delivery System (PDS) defines the relationship and timing of involvement between different contracting parties. The main PDSs referred to in cited literature are: Design-BidBuild (DBB), Construction Management at Risk (CMR), Design-Build (DB), and Integrated Project Delivery (IPD). By applying statistical tests such as Analysis of Variance (ANOVA) F-test and Kruskal-Wallis H-test to a dataset of 109 projects, this paper compares the performance of the four PDSs. As a result, statistically significant performance differences among the examined PDSs were identified in five performance areas: cost, schedule, quality, communication, and change management. Furthermore, performing pairwise comparisons using post-hoc statistical tests to each pair of PDSs shows that DBB performs markedly worse than the other examined PDSs, especially IPD. The findings presented in this paper should encourage industry professionals to move away from the DBB model, and towards IPD and other synergic PDSs.


The National Cancer Institute demonstrated its new Cancer Clinical Trials Education Program (CCTEP) at the American Association of Social Workers annual meeting in San Diego, California, in May 1998. The goal was to develop a cadre of social workers who could facilitate community outreach and health professional training using CCTEP. This article is an abridged version of that presentation. It raises awareness of the important role social workers can play in clinical trials recruitment, gives an overview of clinical trials, and suggests ways social workers can help facilitate accrual to clinical trials. Clinical trials are the gold standard by which new therapies are tested (Fisher, 1966; Hill, 1962; Kramer & Shapiro, 1984; Shapiro & Louis, 1983). The relatively small number of patients who are willing and eligible to participate in clinical trials and the large number of trials competing to accrue those patients (Antman, Schnipper, & Frei, 1988; Ellis, 1996; Smith & Ho, 1996) delay the flow of innovative treatments to the public. Fewer than 5 percent of patients age 20 and over participate in clinical trials (Cheson, 1991; Taylor et al, 1994). Of patients age 50 and over, the age group with the greatest cancer incidence, only 1.5 percent participate in trials (Avorn, 1997; Bugeja, Kumar, & Banerjee, 1997; Giovanazzi-Bannon, Radamaker, Lai, & Benson, 1994; McNeely & Clements, 1994; Tejeda et al., 1996). It has been estimated that if adult patients participating in clinical trials for the most common cancers could be increased to 10 percent, accrual for most studies could be completed in a year instead of the three to five years now required (personal communication with V. T., DeVita, 1998, professor, internal medical oncology, Cancer Center, University of California, San Diego). Although clinical investigators despair over the slow pace of clinical research, social workers know only too well the despair experienced by patients, for whom time is running out. In a search for successful models to increase accrual to clinical trials, the pediatric model stands out. Cancer is comparatively rare in children, but nearly every child with cancer is evaluated for clinical trial eligibility, and up to 80 percent of pediatric patients are placed in trials (Cheson, 1991; Tejeda et al., 1996). As a result, dramatic progress has been made in the treatment of many pediatric cancers (Pediatric Oncology Group, 1992). One important difference in the pediatric environment is that the entire interdisciplinary health care team is focused on reducing the pediatric oncologic death rate through clinical research. As key members of the clinical team, social workers are uniquely positioned to facilitate patients' awareness and understanding of clinical trials. The social worker holds a trusted relationship with the patient in which the concept of clinical trials can be introduced and explored and the patient directed toward more in-depth sources of information (Deininger, 1990; Deininger, Collins, & Hubbard, 1989; Edwards, 1997; Johansen, Mayer, & Hoover, 1991). There are many common concepts inherent in all clinical trials that social workers can help patients understand and encourage them to explore (Macomber & Sadler, 1997). OVERVIEW OF CLINICAL TRIALS One way to compensate for the difficult-to-control variables in human research is a highly structured and rigidly followed clinical trial protocol. The exact treatments to be offered in each arm of the study, the timetable for administration of the experimental and control interventions, the exact data-collection points, the duration and points of follow-up, and many other disease-specific characteristics are clearly delineated in the study methodology and rigidly followed (Meili, 1991). Having a large sample, a randomized trial design, and a highly sophisticated statistical analysis of the outcome data are three other ways to compensate for these difficult-to-control variables (Barnett et al. …