A 51-year-old woman was seen with a 1-day history of continuous pain in the right upper abdominal quadrant and emesis. On physical examination she had tenderness in that area and was afebrile. The leukocyte count and results of liver function tests were within normal limits. Computed tomography (Fig. 1) demonstrated focal thickening in the wall of the gallbladder fundus. Ultrasonography, which was limited by her abdominal panus, showed 3 gallstones within the gallbladder. The patient's pain did not resolve when antibiotics were given intravenously. Cholecystitis in the absence of a leukocytosis was suspected, so radionuclide hepatobiliary scanning was done. It revealed a "hooked" gallbladder with delayed filling of the corpus and fundus (Fig. 2).

FIG. 1.

FIG. 2.

The patient underwent laparoscopic cholecystectomy. The operative specimen (Fig. 3) was folded in 2 locations, dividing it into 3 compartments, each containing a large gallstone. The pathologist noted chronic inflammatory changes. The woman was discharged from hospital on the first postoperative day.

FIG. 3.

The most common congenital anomaly of the biliary tract is a folded gallbladder.1 Boyden described this anomaly as a "Phrygian cap" deformity in 1935 because it resembled a bonnet worn by the ancient Phrygians,2 who lived in Asia Minor during the 12th century BC.3 This type of gallbladder is thought to empty at a normal rate and, in contrast to our patient's experience, is not thought to be of clinical importance.1

Gallbladder kinking is suggested on radionuclide hepatobiliary imaging when the gallbladder initially appears smaller than the size of the gallbladder fossa and then fills distally on delayed images obtained after 2 and 3 hours.4 This deformity may also be suspected when its characteristic appearance is seen on high-resolution ultrasonography.1 Recognition of a "Phrygian cap" gallbladder by nuclear scanning or sonography, with its potential for biliary stasis, cholelithiasis and cholecystitis, may warrant a prophylactic cholecystectomy.


During the low frequency electromagnetic casting process, the electromagnetic parameter plays an important role among the casting parameters. In this work, effects of electromagnetic parameters on the electromagnetic field and body force are analyzed by constructing a two-dimensional finite element model and using ANSYS software which is a kind of commercial FEM analysis software. The results show that the current frequency mainly influences the distribution of electromagnetic body force, the current intensity determines the intensity of electromagnetic body force, and the current frequency and intensity should be matched during the low frequency electromagnetic casting process.


Background Hashimoto's thyroiditis (HT) is the most common autoimmune thyroid disease. The actual mechanism by which the immunological factors lead to HT has remained obscure. Macrophage migration inhibitory factor (MIF) is recently recognized as a cytokine that has a broad range of inflammatory and immune effects. The aim of this study is to assess the role of MIF in the pathogenesis of HT. Patients and methods One hundred and twenty-nine patients were classified into three groups: (a) overt hypothyroidism, (b) subclinical hypothyroidism, and (c) the control group. A complete history taking, clinical examination, and laboratory investigations were done. Laboratory investigations included thyroid function tests [thyroid-stimulating hormone (TSH), triiodothyronine, and thyroxine], antithyroid antibodies (antithyroid peroxidase antibodies and thyroglobulin antibodies), and MIF level. Results There is highly statistically significant difference between the three groups regarding MIF, the highest level being in group 1>group 2>group 3. In both hypothyroid groups (1 and 2), there are statistically significant positive correlations between MIF with TSH, thyroid peroxidase antibodies, and thyroglobulin antibodies, but there is no statistically significant correlation between MIF with thyroid functions tests and antithyroid antibodies in the control group. Conclusion Serum MIF levels increased in overt and subclinical hypothyroidism and its levels were positively correlated to TSH and thyroid-specific autoantibodies. Serum MIF levels play a role in the pathogenesis of thyroid autoimmune responses in patients with HT. We recommend further larger studies to assess the MIF role in the prognosis of the HT and its treatment by a new strategy.


Radiotherapy is a frequently used method for treatment of cancer which is regarded as one of the top two diseases causing premature death worldwide. However, radiotherapy is known to have many side effects. In this study, we evaluated biologically and histologically the possible protective effects of edaravone, the free radical scavenger and neuroprotective agent used to treat amyotrophic lateral sclerosis, on lung and small intestine against radiation-induced early side effects of 15 Gy total body irradiation in single fraction. Thirty-two rats were divided randomly into four equal groups. Groups were administered 15 Gy of external ionizing radiation to the whole body after 30 minutes of EDA administration (a dose of 500 and 50 mg/kg). Rats were sacrified at 72 h of the experiment. Tissues were separated to investigate levels of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSHPX) and malondialdehyde (MDA); and evealuate histopathological changings. The protective effect of EDA showed statistically significant in MDA, SOD and GSHPX values of lungs except CAT and statistically significant effect was observed in MDA in small intestine. Also, we showed statistically significant values with histopathological changings. Pediatric cancer patients who have a longer life expectancy are as important as their recovery from their normal life. We are expecting that EDA as a modulator of free radical scavenging pathways in many organs can reduce the side effects of radiation damage on lungs and small intestine.


Elytrigia repens is a host of the wheat take-all pathogen Gaeumannomyces graminis var. tritici (Ggt). While E. repens does not suffer substantial damage from infection by Ggt, rhizomes and roots of this plant are potential carriers of Ggt and the infested residues are likely to provide sources of inoculum for wheat. The mycoflora of rhizomes and roots of E. repens collected from three arable cropping sites over six sampling occasions were examined. The possible causes of root and rhizome lesions, and fungi that might provide a level of biological control of Ggt in E. repens were identified. Ggt was not always associated with lesions, and other fungi may also cause lesions on E. repens. Most Ggt was isolated from E. repens collected from an area where severe take-all infection had previously been observed in wheat. Microdochium bolleyi co-occurred most frequently with Ggt, and the potential of M. bolleyi as a bio-control agent for take-all is discussed.


After a burst of enthusiasm through the middle part of this decade regarding the supermarket revolution, there now exists a broad consensus that this phenomenon is likely to proceed much more slowly than once thought in Sub-Saharan Africa. This is especially true in fresh produce supply chains, where both the promise and the perils of supermarket expansion have received greatest attention. In nearly the entire continent, the so-called traditional marketing sector – open air markets, dispersed informal vendors, and traditional shops – is expected to play a dominant role in fresh produce marketing for several decades. If true, this finding has profound policy implications. Specifically, it suggests that private investment in modern, integrated supply chains cannot be relied upon to solve the multitude of problems that increasingly plague these traditional production and marketing systems over a time frame acceptable to most policy makers and donors. Public engagement, preferably through meaningful public-private partnerships and an accompanying re-definition of public and private roles, will be central to improving these systems. This paper first reviews the evolution of thinking on the supermarket revolution in Africa and presents empirical evidence from Kenya and Zambia. It then lays out a set of stylized facts and key gaps in knowledge regarding traditional fresh produce production and marketing sectors on the continent, and closes by outlining priorities for research and for public and private investment to modernize these systems in the absence of rapid supermarket takeover.


In this paper, we propose a test for deciding whether the jump activity index of a discretely observed Itô semimartingale of pure-jump type (i.e., one without a diffusion) varies over a fixed interval of time. The asymptotic setting is based on observations within a fixed time interval with mesh of the observation grid shrinking to zero. The test is derived for semimartingales whose "spot" jump compensator around zero is like that of a stable process, but importantly the stability index can vary over the time interval. The test is based on forming a sequence of local estimators of the jump activity over blocks of shrinking time span and contrasting their variability around a global activity estimator based on the whole data set. The local and global jump activity estimates are constructed from the real part of the empirical characteristic function of the increments of the process scaled by local power variations. We derive the asymptotic distribution of the test statistic under the null hypothesis of constant jump activity and show that the test has asymptotic power of one against fixed alternatives of processes with time-varying jump activity.


© Cambridge University Press 2011. Hidden Markov models (HMMs) are a rich family of probabilistic time series models with a long and successful history of applications in natural language processing, speech recognition, computer vision, bioinformatics, and many other areas of engineering, statistics and computer science. A defining property of HMMs is that the time series is modelled in terms of a number of discrete hidden states. Usually, the number of such states is specified in advance by the modeller, but this limits the flexibility of HMMs. Recently, attention has turned to Bayesian methods which can automatically infer the number of states in an HMM from data. A particularly elegant and flexible approach is to assume a countable but unbounded number of hidden states; this is the nonparametric Bayesian approach to hidden Markov models first introduced by Beal et al. [4] and called the infinite HMM (iHMM). In this chapter, we review the literature on Bayesian inference in HMMs, focusing on nonparametric Bayesian models. We show the equivalence between the Polya urn interpretation of the infinite HMM and the hierarchical Dirichlet process interpretation of the iHMM in Teh et al. [35]. We describe efficient inference algorithms, including the beam sampler which uses dynamic programming. Finally, we illustrate how to use the iHMM on a simple sequence labelling task and discuss several extensions.


This book is intended for courses on the individual rights of workers in the employment relationship, independent of courses on the law governing collective bargaining or employment discrimination. It can be used for one three credit survey course on employment law, or for two related courses on employment law and employee benefits, each of two credits. The book covers the full range of employment law subjects from pre-employment screening, individual employment contracts, the employment at-will doctrine, exceptions to the employment at will doctrine, obligations of employees, monitoring and control of employees, the regulation of pay and hours of work (FLSA), the regulation of occupational safety and health (OSHA), state and federal regulation of workers compensation, unemployment compensation, and the regulation of employee benefits (ERISA). The book has been substantially updated from the last issue to facilitate teaching and to include such topics as: the Genetic Information Non-discrimination Act (GINA), employee privacy issues in the new information technology, the proposed restatement of employment law, and recent enactments in unemployment compensation and health care. Where appropriate, the book presents interdisciplinary discussions of employment law problems from historical, sociological and economic perspectives. Efforts were also made to include relevant empirical evidence on important employment law questions. A recurring theme in the book, especially in the introductory chapter and the chapters on individual employment contracts, is the historical tension in the United States between legal ideologies of "free labor," i.e., of the law as conducing toward freedom in the contracting which is indifferent to outcome or of the law as conducing toward outcomes that conduce toward equality and fairness.


As the threat of the Covid-19 pandemic intensified, displaced learners faced increasing challenges to accessing the learning online that they were attending offline before the start of the pandemic. It is these learners' and their teachers' dialogic relations which are at the core of the Covid-19, migration and multilingualism (CV19MM) project, run in partnership with stakeholders offering language lessons in Jordan. In our paper, we respond to the question 'Did the Covid-19 pandemic and lockdowns result in new types of community connections as refugee learners and teachers came together online?' We examine NGOs' shift to working online and the shift in data collection procedures when recording refugees' ability to navigate online spaces through the lens of New Literacy Studies which foregrounds the analysis of culture and identity in the literacy practices of migrants (Barton and Hamilton 2000). Darvin and Norton (2015) recognise that the spaces in which language socialisation takes place have become increasingly deterritorialised. We focus on the dialogic engagements which emerged from increased online interactions, the dialogic pedagogies which one NGO draws on in its work with displaced learners and teachers and the challenges faced when carrying out research with refugee communities during Covid-related restrictions. We end with discussion of how our findings shed light on working with stakeholders across borders and how this approach enhances research on language, dialogue and migration when carrying out impactful research which is of use to NGO stakeholders.


Members of the winged helix/forkhead family of transcription factors are believed to play a role in cell-specific gene expression. A cDNA encoding a member of this family of proteins, termed hepatocyte nuclear factor/forkhead homologue 4 (HFH-4), has been isolated from rat lung and rat testis cDNA libraries. This cDNA contains an open reading frame of 421 amino acids with a conserved DNA binding domain and several potential transactivating regions. During murine lung development, a single species of HFH-4-specific transcript (2.4 kb long) is first detected precisely at the start of the late pseudoglandular stage (embryonic day 14.5) and, by in situ hybridization, is specifically localized to the proximal pulmonary epithelium. The unique temporal and spatial pattern of HFH-4 gene expression in the developing lung defines this protein as a marker for the initiation of bronchial epithelial cell differentiation and suggests that it may play an important role in cell fate determination during lung development. In addition to expression in the pulmonary epithelium, RNA blot analysis reveals 2.4-kb HFH-4 transcripts in the testis and oviduct. By using mice with genetic defects in spermatogenesis, HFH-4 expression in the testis is found to be associated with the appearance of haploid germ cells and in situ hybridization studies indicate that HFH-4 expression is confined to stages I-VII of spermatogenesis. This pattern of HFH-4 gene expression during the early stages of differentiation of haploid germ cells suggests that HFH-4 may play a role in regulating stage-specific gene expression and cell-fate determination during lung development and in spermatogenesis.


Catalytic grown carbon nanofibers have been obtained from decomposition of ethanol over copper plate. Ferric chloride of different concentration was employed as the catalyst precursor. Scanning electron microscopy has shown that different morphologies of carbon nanofibers can be obtained by using different concentration of catalyst precursor solution. The results from the Raman spectroscopic characterization have also demonstrated that the graphitization of carbon nanofibers can be tailored by control of the concentration of catalyst precursor solution. When the information from these characterization are combined with that of the associated morphologies of the carbon nanofibers, it is possible to synthesize perfect carbon nanofibers.


We must be able to predict and mitigate against geomagnetically induced current (GIC) effects to minimize socio‐economic impacts. This study employs the space weather modeling framework (SWMF) to model the geomagnetic response over Fennoscandia to the September 7–8, 2017 event. Of key importance to this study is the effects of spatial resolution in terms of regional forecasts and improved GIC modeling results. Therefore, we ran the model at comparatively low, medium, and high spatial resolutions. The virtual magnetometers from each model run are compared with observations from the IMAGE magnetometer network across various latitudes and over regional‐scales. The virtual magnetometer data from the SWMF are coupled with a local ground conductivity model which is used to calculate the geoelectric field and estimate GICs in a Finnish natural gas pipeline. This investigation has lead to several important results in which higher resolution yielded: (1) more realistic amplitudes and timings of GICs, (2) higher amplitude geomagnetic disturbances across latitudes, and (3) increased regional variations in terms of differences between stations. Despite this, substorms remain a significant challenge to surface magnetic field prediction from global magnetohydrodynamic modeling. For example, in the presence of multiple large substorms, the associated large‐amplitude depressions were not captured, which caused the largest model‐data deviations. The results from this work are of key importance to both modelers and space weather operators. Particularly when the goal is to obtain improved regional forecasts of geomagnetic disturbances and/or more realistic estimates of the geoelectric field.


Antimicrobial resistance (AMR) is a global public health threat that warrants urgent attention. However, the multifaceted nature of AMR often complicates the development and implementation of comprehensive policies. In this study, we describe the policy context and explore experts' perspectives on the challenges, facilitators, and strategies for combating AMR in Singapore. We conducted semi-structured interviews with 21 participants. Interviews were transcribed verbatim and were analyzed thematically, adopting an interpretative approach. Participants reported that the Ministry of Health (MOH) has effectively funded AMR control programs and research in all public hospitals. In addition, a preexisting One Health platform, among MOH, Agri-Food & Veterinary Authority (restructured to form the Singapore Food Agency and the Animal & Veterinary Service under NParks in April 2019), National Environment Agency, and Singapore's National Water Agency, was perceived to have facilitated the coordination and formulation of Singapore's AMR strategies. Nonetheless, participants highlighted that the success of AMR strategies is compounded by various challenges such as surveillance in private clinics, resource constraints at community-level health facilities, sub-optimal public awareness, patchy regulation on antimicrobial use in animals, and environmental contamination. This study shows that the process of planning and executing AMR policies is complicated even in a well-resourced country such as Singapore. It has also highlighted the increasing need to address the social, political, cultural, and behavioral aspects influencing AMR. Ultimately, it will be difficult to design policy interventions that cater for the needs of individuals, families, and the community, unless we understand how all these aspects interact and shape the AMR response.


The purpose of this review study is to examine the psychological effects of the COVID-19 outbreak on individuals in different groups. When the literature is examined, it can be stated that this epidemic causes negative emotional reactions such as anxiety, fear, and anger in adults, increases stress levels, increases their susceptibility to psychological disorders such as anxiety disorders, depressive disorders, posttraumatic stress disorder, and causes suicidal thoughts and insomnia. It can be stated that fear and anxiety are experienced intensely in children and adolescents, anxiety disorders increase, and their parents need to make explanations appropriate to their children's cognitive levels to prevent these disorders. It is indicated that health workers struggling with the epidemic on the field have symptoms related to anxiety disorders, post-traumatic stress disorder, and depressive disorders. They experience sleep disorders and their effective problem-solving skills decrease due to the stress and conflicts they experience. In the light of this information, it can be thought that it is important that health authorities and the media emphasize issues such as raising awareness about symptoms related to psychological disorders, activities that support psychological health, and the importance of receiving psychological support when necessary. In the last part of the study, it was aimed to make suggestions for future research about pandemic related psychological disorders in our country. In this context, it has been suggested that studies can be carried out related to exposure to traumatic contents in the media, curfew, how being in certain age groups affect individuals, the effectiveness of primary and secondary prevention interventions and various psychological interventions, and the effective use of social support mechanisms in the pandemic process. Keywords COVID-19, psychological effects, psychological disorders, clinical psychology, post traumatic stress disorder


This document provides an overview of the most important results of the Intelligent Energy Europe (IEE) Project SELINA - Standby and Off-Mode Energy Losses In New Appliances Measured in Shops. Standby power is a general term commonly used to describe the low power modes in which many electrical and electronic products are, when not performing their main function. For more than a decade, it has been recognized that the energy consumption in low power modes for electrical and electronic products is an important issue because it represent permanent loads (sometimes up to 24 hours per day) of a huge number of products. With the 1 W standby initiative of the International Energy Agency (IEA), several low power mode measurement campaigns have been led on a regular basis in a number of countries outside and inside Europe Union (EU). Based on these results and on the Energy-using Products Study Lot 6, the EU has prepared new regulation to limit the standby and off-mode power consumption of non-networked household electronic and electrical equipment, which is being applied since January 2010. The IEE project SELINA carried out a large scale monitoring campaign in shops in order to characterise the low power modes of new appliances being sold in the EU market. In order to ensure consistency of the collected data, a common measurement methodology was developed and the same high resolution measurement equipment was used by all partners. This document analyzes the results of more than 6000 different equipments measured in the 12 EU countries involved in the project. Standby and off-mode values by product categories were analysed and compared with data from other regions of the World. The measurements were also benchmarked against the new 2010/2013 EU standby and off mode regulation thresholds and the impact of the EU regulation is discussed. It was found that 18.5% of the equipments, whose off-mode power was measured, do not respect the EU regulation threshold of 1 W. When the measurements are compared to the 2013 threshold of 0.5 W, this percentage raises up to 41.5%. Regarding standby mode input power, 31% of the measured products did not comply with EU regulation limit for the 2010 threshold. When the standby measured values are compared to the 2013 limit, the number of products over the EU regulation target increases to 66.4%. When comparing the 2009 and 2010 measurements, only a slight decrease of the share of appliances exceeding the EU regulation limits was observed. In parallel with the measurement campaign, an awareness study of the retailers was carried out. This survey helps to understand the customers' buying motivations and the influence of retailers' advice in their choices. The results of the survey show that, despite of retailer's consciousness about the energy consumption and energy labels of the products, other types of sales arguments like the appliance price or functionalities are more frequently used to sell a product. This could be due to lack of visible information in shops related to the equipment energy consumption. Furthermore, the results show that retailers try to adapt their advice to the customers' needs (price and product functionalities). The retailers admitted that publishing more information regarding the energy consumption of products and some kind of cost saving calculator/reference would make the clients to opt for more efficient equipments. Based on the survey results and on the analysis of different existing policies targeting electrical and electronic products in Europe, examples of policies to improve the low power modes situation of the EU market are reviewed. The survey on measures enhancing the market transformation towards more energy-efficient electrical appliances showed a wide range of actions and policy tools in the SELINA partner countries. In national workshops, which mainly took place in the late summer/early autumn 2010, these measures were presented and discussed with all relevant national stakeholders. In most countries, information campaigns (esp. brochures, leaflets, websites, and national labels) are the dominating measure type. In some countries, however, financial subsidies for very energy-efficient appliances, often paid by an energy utility and not by the government, play an important role, too (e.g. in the Czech Republic or Switzerland). In general, the impact of a financial programme is easier to quantify than the single impact of an information campaign, which often serves as an accompanying measure for regulations (labels, minimum efficiency standards) or fiscal and financial measures. International cooperation with key institutions outside the EU, involved in similar efforts, such as the IEA Implementing Agreement 4E (Efficient Electrical End-use Equipment) with an Annex on Standby, the Energy Star/EPA in USA, the Australia Standby Initiative and the Swiss Federal Office of Energy, were used to promote synergies in the definition of common approaches to characterize the market and to define realistic and cost-effective performance targets which can be achieved in a short time frame. Special care is required when promoting low standby consumption products (without consideration of other attributes) to ensure that there are no perverse effects such as the inadvertent promotion of products with low active mode efficiency and high energy consumption. It is desirable to follow a vertical approach to standby, where low power modes are combined with active modes to give total energy consumption. This approach is particularly preferable for products where the total energy consumption is significant. The definition of usage patterns under such a vertical approach is necessarily product specific and this could vary by region or country. The new technologies offer many opportunities for energy savings potential but there are also some threats which need to be recognized and understood. There is a strong need to ensure that energy saving paradigms and strategies become a core consideration in future product designs. It is recognized that equipments connected to networks are of growing importance. It is recommended that increased efforts to compile data and measurements, of networked products, from a variety of sources in order to obtain better information on networked product characteristics, needs to be made. An online database was created so that everyone can access the input power values, in the different equipment low power modes, of the more than 6000 equipments measured. A Standby Calculator Tool was also developed and can be accessed through the project website. It can be used to calculate the consumed energy, the annual cost and the equivalent CO2 emissions. In order to compare the results in an easy way, a diagram that shows the energy consumption of the different models is presented. Furthermore, the values for the most efficient device are also showed, in order to have an additional comparison. One of the main objectives of this project was to identify effective market transformation policies initiatives targeted at all the key stakeholders involved in the manufacture, distribution, sales, purchasing and operation of appliances with standby and off-mode losses. As a result of the future policy actions that may appear after the end of the project, considering loads in networked mode, it is expected to achieve very large cost-effective savings of electricity (80 TWh projected by 2020) and carbon emissions (30 MTons of CO2 by 2020).


Abstract: Hormones are important and necessary for the continuity of many vital functions in human body. Dopamine (DA) is a neurotransmitter affecting pain and pleasure perceptions, emotions, and movements. In the case of DA deficiency, severe discomforts such as Schizophrenia and Parkinsonism may happen. Thus, DA detection is an important subject. Electrochemical methods have been used in this work by developing a sensor for rapid and easy detection of DA. 3,4-Ethylenedioxythiophene (EDOT) monomer was polymerized on a platinum electrode using cyclic voltammetry method, and the film properties of the resultant polymer were investigated. Additionally, gold and copper coated PEDOT films, Pt/PEDOT/Au and Pt/PEDOT/Cu, respectively, were prepared to improve the sensitivity and stability of the films, compared to Pt/PEDOT electrode. The calibration curves were found to be linear in the concentration range of 50-1000 μM for DA in the presence of ascorbic acid (AA). The detection limits were determined as 18.46 μM, 13.33 μM and 6.80 μM for Pt/PEDOT, Pt/PEDOT/Cu and Pt/PEDOT/Au electrodes, respectively. Moreover, the electrodes demonstrated an electrochemical catalytic effect toward DA.


Recent data on the prevalence, mechanisms of development, clinical course, and methods of treatment of mitral insufficiency of ischemic origin are presented.


The mechanisms that link genotypes of hepatitis D virus (HDV) with clinical outcomes have not yet been elucidated. Genotypic variations are unevenly distributed along the sequences of hepatitis delta antigens (HDAgs). Of these variations, the packaging signal at the C‐terminus has a divergence of 74% between genotypes I and II. In this report, we address the issue of whether these high variations between genotypes affect assembly efficiency of HDV particles and editing efficiency of RNA. Viral package systems of transfection with expression plasmids of hepatitis B surface antigen and HDAgs or whole genomes of HDV consistently indicate that the package efficiency of genotype I HDV is higher than that of genotype II. Segment swapping of large‐form HDAg indicates that the C‐terminal 19‐residue region plays a key role for the varied assembly efficiencies. Also, the editing efficiency of genotype I HDV is higher than that of genotype II. The nucleotide and structural changes surrounding the editing site may explain why genotype II HDV has a low RNA editing efficiency. The findings of in vitro assembly systems were further supported by the observations that patients infected with genotype II had significantly lower alanine transaminase (ALT) levels, more favorable outcomes (P < .05), and a trend to have lower serum HDV RNA levels as compared with those infected with genotype I HDV (P = .094). In conclusion, genotype II HDV secretes fewer viral particles than genotype I HDV does, which in turn may reduce the extent of infection of hepatocytes and result in less severe hepatic inflammation.


Background Cephalosporins are the mainstay of recommended gonorrhoea treatment, and there is an urgent need for treatment options for cephalosporin-allergic patients or infections with suspected cephalosporin resistance. We evaluated the efficacy and tolerability of two novel combinations of existing antimicrobials for treatment of uncomplicated urogenital gonorrhoea. Methods We conducted a non-comparative trial, randomising patients with urogenital gonorrhoea to one of two regimens: gentamicin 240 mg intramuscularly plus azithromycin 2 g orally (GENT/AZI), or gemifloxacin 320 mg orally plus azithromycin 2 g orally (GEMI/AZI). The primary outcome was microbiologic cure of urogenital infections (negative follow-up culture) at 10–17 days post-treatment. All participants who returned for follow-up and had evaluable follow-up cultures were included in this per protocol analysis. Results For 401 evaluable participants (GENT/AZI-202; GEMI/AZI-199), the mean age of both groups was 30 years. Most participants were heterosexual men (GENT/AZI, 57%; GEMI/AZI, 51%), followed by men who have sex with men (GENT/AZI, 33%; GEMI/AZI, 39%), and women (GENT/AZI, 9%; GEMI/AZI, 11%). Microbiological cure was achieved by 100% (lower one-sided 95% confidence interval, 98.5%) of GENT/AZI participants, and 99.5% (lower one-sided 95% confidence interval, 97.6%) of GEMI/AZI participants. GENT/AZI cured 10/10 pharyngeal and 1/1 rectal infections; GEMI/AZI cured 15/15 pharyngeal and 5/5 rectal infections. In the GENT/AZI arm, the most common adverse events (AEs) were mild-moderate nausea (27% of participants), diarrhoea (19%), abdominal discomfort/pain and vomiting (both 7%). In the GEMI/AZI arm, the most common AEs were nausea (37% [8% moderate-severe]), diarrhoea (23%), and abdominal discomfort/pain (11%). Conclusions Both study regimens were highly effective. Gastrointestinal AEs, especially nausea and diarrhoea, were common. These results provide alternative gonorrhoea treatment options for patients who cannot be treated with cephalosporins.


Under the recent social situation, in the computer system, non-stop service all the year round and continuous evolution of the application have been required. This is not considered as an exception in railway control system that has very severe real-time restriction. The Autonomous Decentralized System (ADS) is known as the concepts that overcome these issues. In this paper, the online expansion technology in real-time system that applied the autonomous decentralized architecture is proposed, and the autonomous decentralized railway signal control system is proposed as a practical use.


BACKGROUND & AIMS
Acute ischemic diseases of the small bowel are lethal emergencies with no reliable diagnostic biochemical tests available. Experimental studies have suggested rat intestinal fatty acid-binding protein (I-FABP) as a serum marker reflecting bowel ischemia; the present study evaluates the human homologue (human I-FABP) as a serum marker for the diagnosis of acute ischemic diseases of the bowel.

METHODS
Enzyme immunoassay was applied to determine I-FABP levels in the sera of 96 subjects: 13 preoperative patients with ischemic bowel diseases (5 cases of mesenteric infarction and 8 cases of strangulated obstruction of the small bowel), 35 healthy subjects, and 48 hospitalized patients with acute abdominal pain.

RESULTS
Serum I-FABP levels were < 65 ng/mL in healthy subjects. In patients with acute abdominal pain, levels ranged from < 20 to 87 ng/mL (mean, 27.4 ng/mL), not significantly different from findings in healthy subjects. However, patients with ischemic bowel disease showed significantly higher I-FABP levels, ranging from < 20 to 1496 ng/mL (mean, 265.8 ng/mL). All 5 patients with mesenteric infarction showed I-FABP levels of > 100 ng/mL.

CONCLUSIONS
I-FABP is a useful biochemical marker for the accurate diagnosis of mesenteric infarction.


Background The World Health Organization WHO has estimated that in developed countries, up to 30% of the population may suffer from foodborne diseases each year, and that in developing countries up to 2 million deaths per annum can be attributed to cryptosporidiosis. Reports have already emphasized the role of immigrants in outbreaks of parasitic diseases especially those working in food processing industries. Methodology/Principal findings Herein we assessed Cryptosporidium spp. infections among immigrants in Qatar with a special focus on food handlers and housemaids. The overall prevalence of Cryptosporidium spp. by q-PCR among 839 asymptomatic subjects was 4.5%. Based on the Gp60 gene, the majority of isolates were identified as C. parvum subtype IIdA20G1b. The positive sample for C. hominis was subtyped as IeA12G3T3. Seven mixed infections were also identified (four C. parvum + C. hominis, and three C. parvum + C. meleagridis). The prevalence of Cryptosporidium spp. did not differ significantly between the sexes or age classes but varied significantly between subjects affiliated to different religions with the lowest prevalence among the Muslims. Multifactorial analysis retained also marked significance with education, income, and a house contents index. Conclusions/Significance Our results contribute to a better understanding of the epidemiology of cryptosporidiosis and the risk factors associated with the likelihood of carrying this infection among immigrant workers from developing countries.


Promoting students' ability to engage in discipline-specific practices is a central goal of chemistry education. Yet if instruction is to meaningfully foster such ability, we must first understand students' reasoning during these practices. By characterizing constraints on chemistry students' reasoning, we can design instruction that targets this constrained reasoning and ultimately promotes more sophisticated ways of thinking. For this study, we investigated reasoning used by 18 organic chemistry students at a large university in the United States as they evaluated the success of chemical syntheses through IR and 1H NMR spectral interpretation, a common task of practicing chemists. Students completed a series of interpretation tasks while having their eye movements tracked and then participated in semi-structured, cued retrospective think-aloud (RTA) interviews about their reasoning during spectral interpretation. RTA interviews were analyzed qualitatively to characterize invalid chemical assumptions and heuristic reasoning strategies used by participants, both of which science education literature identifies as fundamental constraints to learning. The most problematic assumptions and heuristics, i.e., those used more frequently by unsuccessful participants, were then identified through statistical analysis. Findings suggest that the most problematic constraints on students' reasoning during spectral interpretation constitute a combination of particular invalid chemical assumptions and heuristic reasoning strategies.


Objective Gamification is a non-evaluation and competition-based training methodology with high emotional involvement. The goal of this study was to evaluate gamification methodology as compared with other existing methodologies when teaching cardiopulmonary resuscitation (CPR) to secondary school students. Methods 489 secondary school students from two high schools in Spain participated in this randomised-block quasi-experimental study in February 2018. The students were classified into different groups. Each group received CPR training with a different methodology: GAM (gamification-based training as a compulsory but non-tested academic activity to learn by playing in teams, with instructor and visual feedback); EVA (training based on subsequent evaluation as a motivational incentive, with instructor and visual feedback); VFC (visual feedback complementary, training based on a non-compulsory and non-tested academic activity, with instructor and visual feedback); TC (traditional complementary, training based on a non-compulsory and non-tested academic activity, with instructor feedback). After a week, each student performed a 2 min hands-only CPR test and quality of CPR was assessed. Visual feedback in training and CPR variables in test were provided by the QCPR Instructor App using a Little Anne manikin, both from Laerdal (Norway). Results GAM (89.56%; 95% CI 86.71 to 92.42) methodology resulted in significantly higher scores for CPR quality than VFC and TC (81.96%; 95% CI 78.04% to 85.88% and 64.11%; 95% CI 58.23 to 69.99). GAM (61.77%; 95% CI 56.09 to 67.45) methodology also resulted in significantly higher scores for correct rate than VFC and TC (48.41%; 95% CI 41.15% to 55.67% and 17.28%; 95% CI 10.94 to 23.62). 93.4% of GAM methodology participants obtained >50 mm of compression mean depth which was a significantly higher proportion than among students in VFC and TC (78.0% and 71.9%). No differences between GAM and EVA were found. A confidence level of 95% has been assigned to all values. Conclusions GAM methodology resulted in higher CPR quality than non-tested methods of academic training with instructor feedback or visual feedback. Gamification should be considered as an alternative teaching method for Basic Life Support (BLS) in younger individuals.


The current study reports an integrated approach of machine learning and tryptophan fluorescence and photoacoustic spectral properties to assess the mitochondrial status under oral pathological conditions. The mitochondria in the study were isolated from oral cancer tissues and adjacent normal counterparts, and the corresponding fluorescence and photoacoustic spectra of tryptophan were recorded at 281 nm pulsed laser excitations. A set of features were selected from the pre-processed spectra and were used to classify the data using support vector machine (SVM) learning in the MATLAB platform. SVM analysis demonstrated clear differentiation between mitochondria isolated from normal and cancer tissues for fluorescence (sensitivity, 86.6%; specificity, 90%) and photoacoustic (sensitivity, 86.6%; specificity, 96.6%) measurements. Further investigation into the influence of change in protein conformation on the nature of tryptophan spectral properties was evaluated by 8-anilino-1-naphthalene sulfonic acid (ANS) fluorescence assay. The impact of protein structural changes on the mitochondrial functions was also estimated by mitochondrial membrane potential (MMP), reactive oxygen species (ROS), and cytochrome c oxidase (COX) assays, suggesting an altered mitochondrial function. The findings indicate that tryptophan fluorescence and photoacoustic spectral properties together with machine learning algorithms may delineate the mitochondrial functional status in vitro, indicating its translational potential.


Despite the success of practical solvers in various NP-complete domains such as SAT and CSP as well as using deep reinforcement learning to tackle two-player games such as Go, certain classes of PSPACE-hard planning problems have remained out of reach. Even carefully designed domain-specialized solvers can fail quickly due to the exponential search space on hard instances. Recent works that combine traditional search methods, such as best-first search and Monte Carlo tree search, with Deep Neural Networks' (DNN) heuristics have shown promising progress and can solve a significant number of hard planning instances beyond specialized solvers. To better understand why these approaches work, we studied the interplay of the policy and value networks of DNN-based best-first search on Sokoban and show the surprising effectiveness of the policy network, further enhanced by the value network, as a guiding heuristic for the search. To further understand the phenomena, we studied the cost distribution of the search algorithms and found that Sokoban instances can have heavy-tailed runtime distributions, with tails both on the left and right-hand sides. In particular, for the first time, we show the existence of \textit{left heavy tails} and propose an abstract tree model that can empirically explain the appearance of these tails. The experiments show the critical role of the policy network as a powerful heuristic guiding the search, which can lead to left heavy tails with polynomial scaling by avoiding exploring exponentially sized subtrees. Our results also demonstrate the importance of random restarts, as are widely used in traditional combinatorial solvers, for DNN-based search methods to avoid left and right heavy tails.


A nonlinear channel estimation scheme proposed by the authors in earlier work is shown to overcome the pilot contamination problem in massive multiple-input multiple-output (MIMO) systems. The method is based on a subspace projection using a singular value decomposition and is studied both by analytical and simulative means. The analysis presented in this paper is a refined version of an earlier work by the same authors. In addition, simulations based on a cellular network model show that the benefits of the proposed scheme are retained also in more realistic settings.


NR, NBR, and CR rubber were prepared by mixing filler in various ratios. Their vulcanization characteristics and thermal properties were studied. Vulcanization characteristics were investigated using cure curve that had been obtained from oscillating disk rheometer study. The Arrhenius law is known to describe the relationship between cure time and temperature of most elastomers. Curing could be done by the addition of sulfur, peroxides, and proper acceleratores. The optimum cure time that affects desirable values of modulus and tensile strength of the vulcanizate is taken as t90 as measured by a rheometer. Rubbers were cured in the rheometer at temperatures ranging from in order to check the validity of the curing system used. A linear relationship between ln(ts2) and ln(t90) was found for all elastomers. The term sensitivity has been used to describe the relationship between a change of ts2 to the corresponding change of t90 due to an increment of temperature. This is related to the formula of the compound.


. Our goal is for pre-service teachers to create a robotic earthquake simulator that can promote the fundamentals of computational thinking (CT) while learning science concepts. The lesson plan we developed promotes the use of fundamental CT skills while using a hands-on inquiry-based approach. To accomplish this goal, we planned and designed a project utilizing robotics that can simulate earthquakes using the LEGO Mindstorms EV3 software. We constructed a LEGO model, then programmed the robot to display the impact of an earthquake. To incorporate an inquiry-based approach to instruction, we built different types of Lego buildings using several designs (e.g., different heights and widths) to be loaded on the cart to determine the structural integrity of those buildings relative to varying magnitudes of earthquakes. Through this experience we learned basic computational skills that can be implemented in future educational settings. The lesson plan we developed incorporated Next Generation Science Standards (NGSS), Common Core State Standards (CCSS), Science and Engineering Practices (SEP), and Cross Cutting Concepts (CCC) through a 5E lesson design. Pre-service educators will be able to use this lesson as the foundation for creating inquiry-based lessons in their future classrooms.


This paper compares the investment policies and returns for portfolios of stocks and bonds with and without up to three categories of real estate. Both a domestic and a global setting are examined, with and without the possibility of leverage. The portfolios were generated via the dynamic investment model on the basis of the empirical probability assessment approach applied to past (joint) realizations of returns, both with and without correction for smoothing in the real estate data series. Our principal findings are: 1) the gains from adding real estate on a semi-passive (equal-weighted) basis to portfolios of either U.S. or global financial assets were relatively modest; in contrast, 2) the gains from adding real estate to the universe of U.S. financial assets under an active strategy were rather large (in some cases highly statistically significant), especially for the very risk-averse strategies; 3) the gains from adding (U.S.) real estate to a universe of global financial assets under an active strategy were mixed, although generally favorable for the highly risk- averse strategies; 4) correcting for second-moment smoothing in the real estate returns series had a relatively small impact for the more risk-tolerant strategies; and 5) there was some evidence that de-smoothing resulted in improved probability estimates.


Kinematic redundancy of robot will lead to the existence of an infinite number of inverse kinematics solutions which makes it possible to select a "best" solution according to an optimization criterion. In this paper, two optimization objective functions are proposed aiming at either minimizing extra degrees of freedom (DOFs) or minimizing potential energy of a multi-link redundant robot. Physical constraints, either equality or inequality types, are taken into consideration in the objective functions. Since the closed-form solutions do not exist in general for highly nonlinear and constrained optimization problems, we selected and developed two numerical methods which are verified to be effective and precise in solving the two optimization problems associated with the redundant inverse kinematics. We first verify that the well established trajectory following method can precisely solve the two optimization problems, but takes certain amount of computation time. To speed up, sequential method that combines the sequential quadratic programming and iterative Newton-Raphson algorithm is developed. A 4 DOFs FUJITSU HOAP-1 humanoid robot arm is used as the prototype to validate the effectiveness of the proposed optimization solutions.


Nowadays, pharmaceutical waste has been considered as an environmental micro pollutant due to its unavoidable occurrence in the ecosystem and has become a major health issue. Pharmaceutical products are formulated to therapeutically influence the physiological systems, however, their potential health concerns which contribute in increasing environmental pollution like other most potential environmental pollutants still needs to be taken under consideration by the healthcare professionals and environmental experts. So, the contamination of treated wastewater by pharmaceutical waste and outcome of these compounds in the agricultural environment are of increasing concern and potential risk for the ecosystem. With increasing utilization of treated wastewater and biosolids in agriculture, residues of pharmaceutical and personal care products in these reused resources may contaminate the food produced via plant uptake, constituting a route for human exposure. In this article, the occurrence and behavior of pharmaceuticals waste have been briefly reviewed. Moreover, major concerns associated with exposure of biological systems of both plant and animal origin to the pharmaceutical wastes contaminating the ecosystem have also been discussed here which concluded that standard procedures and protocols should be followed to dispose of the leftovers of pharmaceuticals and/or pharmaceutical wastes.


The influences of deformation temperature on microstructure dynamic recrystallization of 7A04-T6 ultra-high strength aluminium alloy by isothermal compression experiments in different deformation temperature on the 6300KN extrusion press. The experimental results show that both tensile strength and elongation increased with deformation temperature increasing. At 480°C, tensile strength reached 582Mpa and elongation increase to 9%. In the experiment, dynamic recrystallization of 7A04 aluminium alloy is mainly grain boundary nucleation and second phase particle nucleation. The grain size of 7A04-T6 aluminium alloy gradually refined with the deformation temperature increasing. Fracture morphology showed that rupture is belong to mixed rupture of intergranular and transgranular. With the deformation temperature increase to 480°C, grain size become small, the dimple in the fracture increase gradually, and existing the second phase particle in the dimple.


Recently, sensor and biosensor applications have become widespread and are now significant tools in the biomedical field and other areas. Since quartz tuning fork (QTF) resonance frequency depends on the mass adsorbed to its prongs, it is generally used to measure minor mass change and detect target analyte in picogram levels. This study is undertaken to design and fabricate a sensor device for the measurement of QTF transducers. When QTF sensor studies were investigated, it was found that explanations on the details of instrumentation part were limited, and in addition, there was no compact commercial products. In this study, a novel, low-cost, portable quartz tuning fork sensor device with ability to work with any kind of display is presented in detail. Moreover, the effect of the ambient temperature during the measurements was checked. Six other QTF transducer types, 32, 32.768, 40, 65.536, 75, and 100 kHz, have been studied as the other novel part of the research. As a result, a QTF sensor device was fabricated that has further advanced features when compared with its alternatives and works with a more accurate measurement method. Owing to this advancement, using biosensor/chemical sensor which consists of QTF transducers with features that can take sensitive analyte measurement in picogram level will be able to spread.


The application of the analytic hierarchy process (AHP) to help select the best option for the long-term design and capacity expansion of a water distribution network is described and applied to a sample network. The main criteria used are: reliability-based network performance; present value of construction, upgrading, failure and repair costs; and social and environmental issues. The AHP has been applied elsewhere on various problems, but not on the long-term upgrading of water distribution networks as proposed in this paper. The pipes are sized to carry maximum entropy flows using linear programming while the best upgrading sequence is identified using dynamic programming. The example demonstrates the effectiveness of the AHP as a systematic tool for assessing pareto-optimal designs based on the trade-offs between multiple criteria. The results demonstrate that the cheapest option is not necessarily the best when other factors e.g. performance and socio-environmental concerns are considered in an explicit way.


Movement of invertebrates among large rivers, tributaries, and floodplain lakes or dispersal of adult aquatic insects from riverine or floodplain habitats may provide important subsidies to food webs in receiving habitats. Intensive sampling at habitat interfaces and artificial labelling are two approaches to assess freshwater invertebrate dispersal, but these are difficult to implement at a landscape scale. Natural chemical tracers have been used to track dispersal of fishes and marine invertebrates, but the potential applicability of stable isotope ratios as natural tracers of invertebrate dispersal in freshwater environments has not been assessed. We evaluated stable hydrogen and oxygen isotopes (δD and δ18O) as natural markers of source environment and dispersal of macroinvertebrates in the middle Mississippi River, tributaries and floodplain wetlands. Water and invertebrates were collected from 12 sites during 2007–2008. Water δD and δ18O differed among the river, its tributaries, and floodplain wetlands and were strongly correlated with invertebrate δD and δ18O. Variability in invertebrate δ18O rendered it ineffective as an indicator of invertebrate source environment. Mean δD of Mississippi River invertebrates differed from δD of invertebrates from floodplain wetlands; δD distinguished invertebrates from these two environments with >80% accuracy. Neither δD nor δ18O of aquatic insects changed following emergence from their natal site. Preservation method (ethanol or freezing) did not affect invertebrate δD or δ18O. Invertebrate δD may be a useful natural tracer of natal environment and dispersal in the Mississippi River‐floodplain ecosystem and other freshwater systems where spatial variation in water δD is present. Copyright © 2010 John Wiley & Sons, Ltd.


Abstract Research on educational leadership emphasizes the importance of having institutional leaders heavily involved with advanced instructional programming. Best practices for developing educational leadership in higher education health care and medical faculties have to be better understood. Within the framework of a seminar series, researchers and practitioners were involved in a dialogical process of inquiry, coupled with an explicit activity-oriented approach emphasizing empowerment among educational leaders. In a reflective paper, 10 participants of the seminar series elaborated on what it meant to develop and to 'take' leadership in your professional role and which factors that were identified as adding value to the development of professional leadership expertise. Qualitative content analysis was conducted resulting in thirteen categories reported in relation to Wenger's theory of communities of practice. The findings show that educational leadership involves processes on the levels of students, teachers as community and at the organizational level. The individuals created a place for backstage conversations at which they got opportunity to develop their thinking and inspiration to break new ideas into their own educational communities. In addition, a systemic approach is essential for the effective implementation of educational leadership to reach all levels via interaction and communication across an organization.


Previous research has shown that animals possess considerable numerical abilities. However, this work was based on experiments involving extensive training, a small number of captive subjects and relatively artificial testing procedures. We present the results of experiments on over 200 semi–free–ranging rhesus monkeys using a task which involves no training and mimics a natural foraging problem. The subjects observed two experimenters place pieces of apple, one at a time, into each of two opaque containers. The experimenters then walked away so that the subjects could approach. The monkeys chose the container with the greater number of apple slices when the comparisons were one versus two, two versus three, three versus four and three versus five slices. They failed at four versus five, four versus six, four versus eight and three versus eight slices. Controls established that it was the representation of number which underlay their successful choices rather than the amount of time spent placing apple pieces into the box or the volume of apple placed in the box. The failures at values greater than three slices stand in striking contrast to other animal studies where training was involved and in which far superior numerical abilities were demonstrated. The range of success achieved by rhesus monkeys in this spontaneous–number task matches the range achieved by human infants and corresponds to the range encoded in the syntax of natural languages.


This study aimed to develop and implement an intervention, delivered via a website and Web app, to increase the uptake of sexual health services by young people. The intervention was co-designed with a group of 10 young people. Intervention mapping was used to guide development. To identify barriers and facilitators of access to sexual health services, three focus groups with 24 young people aged 13 to 19 years, and interviews with 12 professionals recruited from across a range of health and social services, were conducted. Data were analyzed using content analysis. Evidence was supplemented through a literature review. Barriers and facilitators were categorized as theoretical determinants and then suitable behavior change techniques (BCTs) for targeting them were selected. Targeted determinants were attitude, subjective norm, perceived behavioral control, and knowledge. Selected BCTs included "information about others' approval," "framing/reframing," and "credible source." The website/app enable users to search for services, access key information about them, watch videos about what to expect, and have key concerns removed/addressed. This is the first known digital evidence-based intervention to target this behavior described in the literature. A clear and full description of intervention development and content, including of theorized causal pathways, is provided to aid interpretation of future outcome evaluations.


The aim of this study is to determine the mediating role of psychological well-being in the effect of core self-evaluation on job satisfaction. The data of the research were collected from the employees of a district municipality in Istanbul. The data were obtained from a total of 207 white-collar employees with a convenience sampling method. Confirmatory factor analysis was used to test the validity of the scales. Bootstrap regression analysis was used to determine the mediating role. According to the obtained findings, it was found that psychological well-being played a partial mediating role in the effect of core self- evaluation and job satisfaction on each other. In addition, significant and positive effects were found between core self- evaluation, job satisfaction, and psychological well-being variables. Findings determined in this direction were discussed within the framework of academic literature and various suggestions were made.


To evaluate the efficacy and safety of intrauterine insemination (IUI) in moderate to severe endometriosis patients, a systematic review and meta-analysis was conducted since the role of this treatment strategy in these patients is a matter of debate in the literature. Systematic searches were performed in PubMed, EMBASE, Cinahl, and The Cochrane Library from inception to September 1, 2016. Studies including moderate to severe endometriosis patients reporting pregnancy rates after IUI were selected. The primary outcome was live birth after IUI treatment compared to expectant management. Secondary noncomparative outcomes were live birth and clinical pregnancy, which were presented as weighed mean pregnancy rates. Nineteen articles (2 unclear design, 11 retrospective, 6 prospective) were included for the analysis. Our primary outcome measure was only addressed by one study, showing an odds ratio of 1.77 (95% confidence interval [CI], 0.86–3.63) on live birth favoring IUI versus no treatment. The calculated weighed mean live birth and clinical pregnancy rate per patient was 20.3% (95% CI, 11.2–29.4) and 32.7% (95% CI, 21.3– 44.0), respectively. This meta-analysis of observational data showed that IUI could be a feasible treatment in moderate to severe endometriosis. Whether this treatment should be structurally offered prior to in vitro fertilization needs to be investigated in a randomized, controlled trial, including time-to-pregnancy, safety, and cost-effectiveness.


This paper extends an epistemologically grounded biological theory of organization and knowledge based on Karl Popper's evolutionary epistemology and three worlds ontology, amalgamating concepts from evolutionary biology, emergence and hierarchy theory, autopoiesis, and military affairs. We discuss how this body of theory is being used to guide and inform KM research and development in a geographically extended industrial and project management organization. Applicability of the biological and epistemological framework is demonstrated in a study of the emergence and sustainment of communities of practice, in the development of a methodology for improving business processes, and in the implementation of managing engineering knowledge over the lifecycles of fleets of ships and vehicles.


This paper examines the impact of ownership on product and international diversification. While ownership concentration has received considerable attention from agency theorists we argue that a more nuanced analysis is necessary. We consider how the identity of owners moderates the impact of ownership concentration on diversification strategies. We develop a framework that explains how the combination of different motivations, resources and capabilities associated with different types of owners results in significantly variable relationships between ownership concentration and both product and international diversification. From a theoretical perspective this suggests a social contextualization and extension of the agency theoretic approach that characterizes the field. Based on a study of 222 European firms between 1994 and 2007 we show that family ownership concentration has a positive impact on product and a negative impact on international diversification while the impact of institutional and state ownership concentration is negative on product diversification and positive on international diversification compared with family ownership. This is the first study to provide a comprehensive framework explaining how ownership concentration and identity interact and affect both international and product diversification.


Sir, We report our assessment of a new enzyme immunoassay to detect herpes simplex virus (HSV), the IDEIA HSV test (Boots-Celltech Diagnostics, Slough, Berkshire, UK), compared with the results obtained with a culture amplified enzyme immunoassay (CAEIA). The CAEIA has been shown to be reliable for detecting`2 and typing34 HSV. Clinically suspect lesions were rubbed with a cotton tipped swab, which was immediately inoculated into virus transport medium (VTM). On receipt, the samples were inoculated into Vero tissue culture tubes and stored at 20C until tested by the IDEIA. Results of the IDEIA were reported as positive, negative, or inconclusive, according to the manufacturer's instructions. A 0.5 ml volume of vortexed VTM was inoculated into Vero tissue culture tubes and incubated for seven days at 37C, after which the tubes were vortexed for 15 seconds and frozen at 20C to lyse the culture cells. Next day the samples were thawed at room temperature and enzyme immunoassay performed on the lysates according to the method of Smith et al.' A Biotek EL-310 microplate reader (Biotek Instruments, Burlington, USA) was used to measure the optical densities of the microwells. We tested 65 samples for the presence of HSV by CAEIA and IDEIA, and the table shows the results of these assays. All samples positive by CAEIA were also positive for cytopathic effect, whereas those negative by CAEIA had negative cytopathic effect. The sensitivity of the new assay was comparable with that of other commercial assays for detecting HSV.2 When the IDEIA was used in conjunction with the CAEIA, we could report positive results within two days after collecting specimens in 85% of cases, and could confirm them by culture within a further seven days. False positive and false negative IDEIA results were probably due to the presence of non-viable HSV or low levels of HSV antigen. With reduction of culture time for IDEIA positive samples, confirmation and typing can be completed within five days after specimen collection. IDEIA negative samples need to be cultured for seven days to ensure growth of HSV from specimens with low antigen levels. Saving Table Results ofCAEIA and IDEIA assays for HSV in 65 specimens


Recently, the features of a group of strains isolated from Dead Sea enrichments obtained in 1936 by one of us (B. E. Volcani) were described. They were gram-positive, moderately halophilic, spore-forming rods, and were placed in a new species, Bacillus marismortui. At the same time, the new genus Salibacillus was proposed for the halophilic species Bacillus salexigens. B. marismortui and Salibacillus salexigens have similar phenotypic characteristics and the same peptidoglycan type. Phylogenetic analysis based on 16S rRNA sequence comparisons showed that they are sufficiently closely related (96.6% similarity) as to warrant placement in the same genus. However, DNA-DNA hybridization experiments showed that they constitute two separate species (41% DNA similarity). Therefore the reclassification of Bacillus marismortui as Salibacillus marismortui comb. nov. is proposed.


"This set of articles captures decades of in-the trenches experience across a broad spectrum of software topics. Joe Marasco has the scars and the smarts to articulate patterns of success that can satisfy a broad audience. He uses mathematics, physics, common sense, and storytelling along with a no-candy-coating style to provide unique perspectives on significant problems in delivering software results as a business. Whether you are a computer science theoretician, a frustrated software project manager, a successful businessman, or a skeptical programmer, you will learn a lot from this compilation." -Walker Royce, Vice President, IBM Software Services-Rational, and author of Software Project Management (Addison-Wesley)"Joe Marasco's readable essays on managing successful projects show that software development managers-no different from all managers-must embrace the fundamentals of management if they are to succeed: working through people and process to be decisive, dealing with politics, keeping on schedule, and, yes, shipping a well-developed product. Marasco uses plain English to explain many integrated skills, ranging from estimating the time it will take to really do things, to negotiating effectively, even to eloquently describing three distinct phases of our personal development. He frequently uses a 'can we talk?' conversation with a fictional colleague, Roscoe Leroy, in a Socratic dialogue to illustrate the two sides to a point in many areas (reminiscent of Galileo's writings to explain his then-heretical views); in this case, Marasco's advice will help technology professionals escape the clutches of pervasive Dilbertian incompetence, and enable readers to be more effective in our ever-changing world." -Carl Selinger, author of Stuff You Don't Learn in Engineering School: Skills for Success in the Real World (Wiley-IEEE Press), and contributing editor of IEEE Spectrum magazineThe new software management classic: in-the-trenches wisdom from legendary project leader Joe MarascoOver the course of a distinguished career, Joe Marasco earned a reputation as the go-to software project manager: the one to call when you were facing a brutally tough, make-or-break project. Marasco reflected on his experiences in a remarkable series of "Franklin's Kite" essays for The Rational Edge, Rational and IBM's online software development magazine. Now, Marasco collects and updates those essays, bringing his unique insights (and humor) to everything from modeling to scheduling, team dynamics to compensation. The result: a new classic that deserves a place alongside Frederick Brooks' The Mythical Man-Month in the library of every developer and software manager. If you want to ship products you're proud of... ship on time and on budget... deliver real customer value... you simply must read The Software Development Edge.Highlights include How software projects resemble other projects-and how they're different The iterative problem-solving clock: ending the day with real solutions The realities of scheduling: How late are you going to be? Trade-offs, estimating, project rhythm, and getting products out the door Understanding what you're seeing, hearing, and feeling as a software manager The human element: politics, negotiation, compensation, culture, and growth Avoiding crises before they happen... and mitigating them when they do Thinking laterally: original ideas in software project management© Copyright Pearson Education. All rights reserved.


The effect of mandrel with the structure of ball and socket on the cross section quality of thin-walled tube numerical controlled(NC) bending was studied by numerical simulation method, combined with theoretical analysis and experiment. Influencing factors of the mandrel include the count of mandrel heads, the diameter of mandrel and its position. According to the principle of NC tube bending, quality defects possibly produced in thin-walled tube NC bending process were analyzed and two parameters were proposed in order to describe the cross section quality of thin-walled tube NC bending. According to the geometrical dimension of tube and dies, the range of mandrel protrusion was derived. The finite element model of thin-walled tube NC bending was established based on the DYNAFORM platform, and key technological problems were solved. The model was verified by experiment. The effect of the number of mandrel heads, the diameter of mandrel and the protrusion length of mandrel on the cross section quality of thin-walled tube NC bending was revealed and how to choose mandrel parameters was presented.


Abstract This article offers an original contribution to the literature on coal communities and the history of the coal industry in Britain by examining changes and contested interests within Britain's coal territories since nationalisation in 1947. The analysis is organised around three distinct but over-lapping meanings of coal community: economic locality, ideological communality and occupational group. As economic localities mining communities became stronger in the 1960s, even as the coal industry itself was shrinking, but then less viable as all forms of industrial employment dwindled in the 1980s. In ideological terms coal communities were divided by gender as well as class, but became more cohesive with social change and greater opportunities for women. A network of increasingly solid localities contributed—despite the divisions of 1984–1985 and subsequent job losses—to the strengthening of a national occupational community, partly because deindustrialisation was a common working class disaster that transcended regional boundaries.


Context The prescription of IV fluids is a commonplace task on the paediatric ward and its importance is often underestimated. National Patient Safety Agency (NPSA) has issued an alert in 2007 advising clinicians about the risk of hyponatraemia in children receiving intravenous (IV) fluids. Accurate prescription of IV fluids and careful monitoring are crucial in preventing fluid induced hyponatraemia in children. Hence, a local IV fluid prescription guideline was developed and a patient safety improvement project was set up to ensure that the guideline is adhered to. Problem A prospective audit was performed in November 2012, looking at all children who were admitted to a busy district general children hospital and prescribed IV fluids over a 2 week period. Prescription of IV fluid rate, type of fluid used, potassium content as well as monitoring of patient's renal function, fluid balance and daily weight were audited. Assessment of problem and analysis of its causes The results of this audit show that type of fluid, rate of fluid and daily monitoring of UEs are done relatively well. Weight monitoring and fluid balance was poorly done. Intervention We took few actions to improve the outcome. Further education of junior doctors, nurses and allied health care professionals was provided. Fluid prescription chart was updated to act as a visual cue and to enable accurate calculation of fluid rate and renal function monitoring. Strategy for change Our strategy to improve the compliance to the standards was by focussing on the targeted education package for both medical and nursing team. We designed an IV fluid teaching booklet with assessments to be carried out by all junior doctors during the departmental induction followed by a seminar every few months. Awareness regarding the standards was created among nursing colleagues. Measurement of improvement A similar prospective reaudit was performed in November 2013 on all children admitted over a 2 week period in the same hospital. Effects of changes The prescription of type of fluid, rate of fluid and daily monitoring of UEs are done relatively well. Prescription of potassium containing fluids, monitoring of daily weights and fluid balance which were badly done on the initial audit with compliance rate of 40%, 40% and 58% respectively improved to 71%, 71% and 61% during the reaudit. Lessons learnt This project highlights the importance of education and enhanced training for staff. We are highlighting the results to all clinician as well as nursing staff during departmental meetings to raise awareness and identify solutions to barriers identified on a regular basis. Message for others Targeted staff education and training are paramount important in improving the quality of care. These can be cost effective and by effective organisation, can successfully implement locally.


British local newspapers are said to be in a state of crisis due to a dramatic downturn in revenue caused by the increase in competition from alternative advertising and news platforms online. Yet the same news companies that produce these newspapers are reaching more people than ever before through their investment in online technology and through the development of websites and social media networks. Meanwhile Web 2.0 is enabling audiences to play a more active role in the news process by creating user generated content, sharing news stories online and by responding to news stories on websites. Audience participation online is not only a vital source and resource for local newspapers at a time of dramatic cutbacks but is also an invaluable tool to create collaborative journalism and enhance the civic obligations of journalism. Through case study research at two local British newspapers this thesis explores how Web 2.0 is changing the relationship between British local newspaper journalists and their audiences and the extent to which a new form of collaborative journalism is emerging. The findings illustrate that audience participation is on the increase and the role of the journalist is changing but traditional notions of gatekeeping remain partially in-tact. Furthermore due to the commercial constraints faced by the newspapers the potential for audience participation to enhance participation for democratic purposes is limited. Economic restrictions are ultimately holding back collaborative journalism and creating an environment where there are confused and contradictory notions of what the role of a journalist is within Web 2.0. This thesis concludes that with better resources, a clear strategy and independence to innovate, journalists would be able to facilitate audience participation for non-economic purposes to create better journalism which could in turn enlighten and educate their readers and enable them to reach mutual understanding of the common good.


Propolis has been used by humans as a nutraceutical agent with therapeutic benefits for many centuries. The chemical composition and biological activities of propolis depend on its botanical and geographical origins. The aim of this study was to characterize Korean propolis by quantitating their chrysin content using an ultra high performance liquid chromatography (UPLC). Methanol extracts of propolis were comprehensively analyzed by UPLC for the isolation and quantification of chrysin in propolis from different origins. The reproducibility of the method was 1.9% to 6.0%, and accuracy was confirmed with average recovery ranging from 98.2% to 101.0%. The chrysin content in propolis samples was successfully determined within 13.299 min. All propolis samples, except those from Jeju Island, contained chrysin. There were some variations in the concentration of chrysin among propolis samples from different locations. The chrysin of the analyzed propolis samples confirmed their affiliation to the Korean propolis except those from Jeju Island, and the proposed UPLC method yielded good sensitivity, linearity, repeatability, and accuracy.


Elastic fields, generating by precipitates, cracks, dislocations and other defects of the structure, influence the diffusion processes. It leads to the alteration of the phase transformation kinetic, segregation formation and changes of the alloy properties. However, understanding the effects of strain on diffusion in solids is now limited. One of the chief aims of our approach is to obtain the general equations for the diffusion fluxes under strain that give the possibility of using these equations at low temperatures, as in this case, the strain influence on the diffusion fluxes is manifested in maximal degree. Recently some important generalization of our approach was done and equations for the vacancy fluxes in cubic metals were obtained. Now we have made the next step in the development of approach: general equations for the fluxes in interstitial alloys are obtained for different kinds of jumps in bcc and fcc structures. We are going to discuss the main features of the theory of diffusion under stress, to compare the equations for the fluxes and to present results of theory applications that are obtained with the help of computer simulations.


Wear behaviours of micro-arc oxidation (MAO) coatings on pure aluminum in a phosphate based electrolyte were investigated. The surface morphology, cross-section morphology and elements distribution of coatings were observed by scanning electron microscopy (SEM) equipped with energy dispersive spectroscopy (EDS). Wear test was proceeded with improved pin-on-disk tester under the dry sliding friction condition at load of 10 N. The results show that coatings structure are poly-porous and uniform, the components in the phosphate electrolyte do not participate in the formation of coatings, coatings are oxidized and sintered intrinsically. Wear weight loss of MAO coatings decrease by a factor of 20 in compare with the pure aluminum substrate, and abrasive wear assisted stripping from micro-cracking is predominant wear mechanism.


Transforming growth factor (TGF)-β family proteins are synthesized as precursors that are cleaved to generate an active ligand. Previous studies suggest that TGF-β activity can be controlled by lysosomal degradation of both precursor proteins and ligands, but how these soluble proteins are trafficked to the lysosome is incompletely understood. The current studies show that sortilin selectively co-immunoprecipitates with the cleaved prodomain and/or precursor form of TGF-β family members. Furthermore, sortilin co-localizes with, and enhances accumulation of a nodal family member in the Golgi. Co-expression of sortilin with TGF-β family members leads to decreased accumulation of precursor proteins and cleavage products and this is attenuated by lysosomal, but not proteosomal inhibitors. In Xenopus embryos, overexpression of sortilin leads to a decrease in phospho-Smad2 levels and phenocopies loss of nodal signaling. Conversely, down-regulation of sortilin expression in HeLa cells leads to an up-regulation of endogenous bone morphogenic protein pathway activation, as indicated by an increase in phospho-Smad1/5/8 levels. Our results suggest that sortilin negatively regulates TGF-β signaling by diverting trafficking of precursor proteins to the lysosome during transit through the biosynthetic pathway.


Simultaneous temperature and velocity measurements were made in the near- field region of the surface thermal discharge at the Point Beach Unit 1 and Palisades Nuclear Power Plants on Lake Michigan. Data collected include measurements of temperature and velocity at the 0.5-, 1.0-, 1.5-, 2.0-, 2.5-, and 3.0-m depths, along with measurements of ambient lake and metenrological conditions. Bottom depth was also measured at variouss locations. four such surveys were made at the Point Beach plant, three at the Palisades plant. To examine the jet features from the abpve surveys and facilitate a comparison with analytical model predictions, a computer program was written to smooth the data, extracting such jet characteristics as trajectory, centerline temperature decay and temperature half-widths, centerline velocitv decay and velocity half-widths, temperature and velocity half-depths, and isotherm areas. Four near-field analytical models often used in environmental impact evaluations of power-plant surface discharges are compared to the jet characteristics determined from the smoothed jet data. The Pritchard model compares rather well with these limited data and is often conservative when model-data discrepancies exist. The Stolzenbach -Harleman and Prych models predict too rapid a temperature and velocity decay accompanying too great a lateral spread. The Motz --Benedict modelmore » is too sensitive to an entrainment coefficient E with little consistent data available for its determination for accurate prediction. Recommendations for future research, encompassing the field-data acquisition, the smoothing procedure, and the presently available models are included. (30 references) (auth)« less


This work investigates the effects of high-energy neutrons and γ-rays on multiple-gate FETs with different geometries (notably gate lengths down to 50 nm). The impact of radiation on device behavior is addressed through the variation of parameters such as threshold voltage, subthreshold slope, transconductance maximum and DIBL. It is shown that degradations caused by γ-rays and high-energy neutrons with similar doses are largely similar. It is revealed that, on the contrary to the generally-believed immunity to irradiation, very short-channel FinFETs can become extremely sensitive to the total dose effect. The possible reasons are discussed.


Game theoretic methods are used to model the dynamics of cellular populations (tissues) in which it is necessary to account for changes in cellular phenotype (usually proliferation) resulting from cell-cell interaction. Results include prediction of long-term steady-state "equilibria" and transient dynamics. These results can be useful for predicting relapse after cytoreduction, assessing the efficacy of alternating combination therapy, and interpreting biopsy specimens obtained from spatially heterogeneous tissues. Mathematical tools range from simple systems of differential equations to computational techniques (individual-based models).


Purpose:Bismuth breast shields have been promoted as a means for selectively reducing the radiation dose to the breast by about 30% in CT studies, while maintaining image quality. A study was performed to compare imagenoise and CT number accuracy with the shields to an alternative dose reduction method of employing 30% less mAs. Method and Materials: A humanoid thorax phantom with simulated breasts was imaged on a GE VCT scanner using: 1) a standard lungcancer screening protocol, 2) the same protocol but with a commercial bismuth breast shield, and 3) 30% less mAs without the shield. Regions‐of‐interest (ROIs) were placed in the images and the mean CT numbers and standard deviations of the CT numbers were compared. Results: Relative to the mean CT numbers in images for the standard technique, use of the breast shield resulted in increases of about 9HU, 19HU, 6HU, and 57HU in ROIs in the heart, anterior left lung, posterior left lung, and right breast, respectively. Corresponding changes for 30% mAs reduction were 1HU, −3HU, −2HU, and 0HU. Ratios of the standard deviations of the CT numbers in the dose reduced images to those in the images using the standard technique for the above ROIs were 1.4, 1.2, 0.9, and 1.8 for the breast shield and 1.3, 1.0, 1.0, and 1.2 for 30% mAs reduction. Conclusion: mAs‐reduction is preferred over bismuth breast shields because: 1) mAs‐reduction has much less effect on mean CT numbers, which is important for quantitative studies such as lung density and coronary calcification assessment, 2) noise in the mA‐reduced images is less, and 3) the images do not suffer from streak artifacts arising from the shields. Additional comparisons in images of human subjects undergoing IRB‐approved coronary calcification studies with the breast shield vs. 30% reduced mAs will be presented.


This paper presents a novel approach for fault classification and section identification in a series compensated transmission line based on least square support vector machine. The current signal corresponding to one-fourth of the post fault cycle is used as input to proposed modular LS-SVM classifier. The proposed scheme uses four binary classifier; three for selection of three phases and fourth for ground detection. The proposed classification scheme is found to be accurate and reliable in presence of noise as well. The simulation results validate the efficacy of proposed scheme for accurate classification of fault in a series compensated transmission line.


Resilience can be defined as an individual's capacity to navigate their ways to resources that help to sustain well being.  Resilience is the ability to steer through serious life challenges and find ways to bounce back and to thrive. Emotional Intelligence is a dimension that addresses self-regulatory processes of emotions that enable one to make adjustments to achieve individual and group goals; Emotional Intelligence is strongly correlated with individual advancement and success in an academic setting and with a child's academic performance. Teaching resilience to children is utmost essential to help them prepare for challenges. It is a character trait which can help them build self-awareness and self-advocacy skills. It can also help them develop new strategies and tools for solving problems and boost their motivation and self-esteem. Taking into consideration the relevance of both of these variables in the academic life of students, the present study is undertaken to assess the level of resilience and emotional intelligence among the school students of Government and private schools of Sonapur area of Assam.


. We present three generations of prototypes for a contactless admission control system that recognizes people from visual features while they walk towards the sensor. The system is meant to require as little interaction as possible to improve the aspect of comfort for its users. Especially for people with impairments, such a system can make a major difference. For data acquisition, we use the Microsoft Kinect 2, a low-cost depth sensor, and its SDK. We extract comprehensible geometric features and apply aggregation methods over a sequence of consecutive frames to obtain a compact and characteristic representation for each individual approaching the sensor. All three prototypes implement a data processing pipeline that transforms the acquired sensor data into a compact and characteristic representation through a sequence of small data transformations. Every single transformation takes one or more of the previously computed representations as input and computes a new representation from them. In the example models presented in this paper, we are focusing on the generation of frontal view images of peoples' faces, which is part of the processing pipeline of our newest prototype. These frontal view images can be obtained from colour, infrared and depth data by rendering the scene from a changed viewport. This pipeline can be modelled considering the data flow between data transformations only. We show how the prototypes can be modelled using modelling frameworks and tools such as Cinco or the Cinco-Product Dime. The tools allow for modelling the data flow of the data processing pipeline in an intuitive way.


Background and Aims: The purpose of the present research was to compare the effect and follow up of eight-week corrective exercises with and without the myofascial release forward head and forward shoulder deformity in young adults. Methods: A total of 45 male students suffering from abnormal forward head more than 46° and forward shoulder more than 52° deformity with the Mean±SD age of 22.12±2.88 years, height of 175.44±6.80 cm, and weight of 71.21±7.31 kg were selected and randomly distributed in three groups: corrective exercises, combinational exercises (corrective and myofascial release), and control. These groups performed the exercises for eight weeks under the direct observation of the researcher. Prior to starting the exercises, after the end of eighth week, and four weeks after the end of the exercises, the angles of the forward head and forward shoulder of the participants were measured using a photography method. Then, the collected data was analyzed using the variance analysis tests with repeated measurements and ANCOVA. Results: The results showed that the degree of forward head and forward shoulder after eight weeks of exercises in both training groups in post-test and follow-up test was significantly lower than those of the pretest. The ANCOVA test results also demonstrated that the forward shoulder degree in corrective exercises group with myofascial release in post-test and follow-up test was significantly lower than that of the corrective exercises (P≤0.05). However, the forward head degree did not show a significant difference between the intervention groups in post-test and follow-up tests (P≥0.05). Conclusion: According to the results, it can be stated that the corrective exercises program with myofascial release is more effective than the corrective exercises in correcting the forward shoulder deformity.


We introduce a collection of convex polytopes associated to a torus-equivariant vector bundle on a smooth complete toric variety. We show that the lattice points in these polytopes correspond to generators for the space of global sections and we relate edges to jets. Using the polytopes, we also exhibit toric vector bundles that are ample but not globally generated, and toric vector bundles that are ample and globally generated but not very ample.


Regions of disc galaxies with widespread star formation tend to be both gravitationally unstable and self-shielded against ionizing radiation, whereas extended outer discs with little or no star formation tend to be stable and unshielded on average. We explore what drives the transition between these two regimes, specifically whether discs first meet the conditions for self-shielding (parametrized by dust optical depth, τ) or gravitational instability (parametrized by a modified version of Toomre's instability parameters, Qthermal, which quantifies the stability of a gas disc that is thermally supported at T = 104 K). We first introduce a new metric formed by the product of these quantities, Qthermalτ, which indicates whether the conditions for disc instability or self-shielding are easier to meet in a given region of a galaxy, and we discuss how Qthermalτ can be constrained even in the absence of direct gas information. We then analyse a sample of 13 galaxies with resolved gas measurements and find that on average galaxies will reach the threshold for disc instabilities (Qthermal 1). Using integral field spectroscopic observations of a sample of 236 galaxies from the Mapping Nearby Galaxies at APO (MaNGA) survey, we find that the value of Qthermalτ in star-forming discs is consistent with similar behaviour. These results support a scenario where disc fragmentation and collapse occurs before self-shielding, suggesting that gravitational instabilities are the primary condition for widespread star formation in galaxy discs. Our results support similar conclusions based on recent galaxy simulations.


Background: Psychosocial factors are not routinely identified in physical therapy assessments, although they can influence the prognosis of patients with low back pain. The "STarT Back Screening Tool" (SBST) questionnaire aids in screening such patients for poor prognosis in the primary care setting and classifies them as high, medium, or low risk based on physical and psychosocial factors. Objectives: This study sought to translate and cross-culturally adapt the SBST to the Brazilian Portuguese language and test the reliability of the Brazilian version. Method: The first stage of the study consisted of the translation, synthesis, and back-translation of the original version of the STSB, including revision by the Translation Group, pretest of the translated version, and assessment by an expert panel. The pre-final Brazilian version was applied to 2 samples comprising 52 patients with low back pain; these patients were of both genders and older than 18 years of age. To assess the instrument's reliability, an additional sample comprising 50 patients was subjected to 2 interviews, and the results were assessed using the quadratic weighted kappa value. The instrument's internal consistency was assessed using Cronbach's alpha (n=105), and the standard error of measurement was also calculated (n=50). Results: Translation and back-translation attained consensus, and only item 6 required changes; the reformulated version was applied to an additional sample comprising 52 individuals who did not report any doubts related to this item. The reliability of the SBST-Brazil was 0.79 (95% confidence interval: 0.63-0.95), the internal consistency was 0.74 for the total score and 0.72 for the psychosocial subscale, and the standard error of measurement was 1.9%. Conclusion: The translated and cross-culturally adapted SBST-Brazil proved to be reliable for screening patients according to their risk of poor prognosis and the presence of psychosocial factors.