The relationship between institutional fragmentation of urban regions and inequality in government service levels is subject to a long-running debate. On the one hand, neo-progressive reformers argue that fragmented municipal institutions produce a systematic mismatch between fiscal resources and public needs and thereby perpetuate income inequality. On the other hand, public choice scholars hold that polycentric government is more responsive to residents' needs, and that issues of income distribution can be addressed by intergovernmental coordination. However, the role of this multi-level intergovernmental compound of metropolitan governance in tackling territorial inequalities remains unclear. This paper aims to contribute to the further development of this debate, by drawing on a comprehensive analysis of social policy efforts at the municipal level in the seven largest metropolitan areas in Switzerland. We explore the effect of social segregation, municipal resources, residents' political preferences, as well as intergovernmental grants on per capita social expenditures in metropolitan municipalities. The results show that, while multi-level intergovernmental cooperation and fiscal equalization between rich and poor municipalities do play a moderating role, institutional fragmentation is an obstacle to matching fiscal resources with social policy needs. In the fragmented setting of the Swiss metropolis, social policies at the municipal level appear as an act of political voluntarism by the rich, rather than as a matter of redistribution oriented by principles of social justice.


Purpose: The aim of this study was to investigate the effect of performance transparency and individualized feedback on pharmacy technician compliance with barcode verification technology during inpatient order preparation. Methods: Following the incorporation of barcode scanning technology into the workflow of pharmacy staff, a multiphasic intervention was employed to promote its use. The intervention included verbal feedback and publically posting performance metrics to increase accountability. An interrupted time-series analysis was conducted to ascertain trends and levels in the percent of orders that were dispensed using barcode verification, before and after the study intervention. Analyses were conducted by shift and overall for pharmacy workers in a single satellite pharmacy. Results: A significant increase in percent scanned orders was observed immediately following the intervention in our analysis of all pharmacy workers (+14.4%; P = .045; 95% confidence interval [CI]: 0.35-28.4). In the analysis of each shift, statistically significant increases in percent scanned orders were observed immediately following the intervention for both the evening shift (+5.1%; P = .024; 95% CI: 0.70-9.6) and the night shift (+29.9%; P = .025; 95% CI: 3.9-55.9), but not the day shift (+2.6; P = .707; 95% CI: −11.1 to 16.2). Conclusion: Increasing transparency of individual and team performance metrics in conjunction with targeted feedback is an effective intervention to improve compliance with barcode scanning technology.


Water, in the liquid or vapor phase, injected at various locations into the gas turbine cycle has frequently been employed to improve engine performance while simultaneously reducing NOx emissions. Commercial steam injected gas turbines have been designed to inject small amounts of steam (less than 15% of air flow), generated in a heat recovery boiler, into or downstream of the combustor. Recently, it has been proposed to inject larger amounts of water (as high as 50% of air flow) and operate combustors near stoichiometric conditions. All these methods increase turbine mass flow rate without increasing air flow rate and consequently increase specific power. The increase in specific power for naval applications means smaller intake and exhaust stacks and therefore less impact on topside space.The present paper presents a new concept, in naval propulsion plants, to decrease NOx production and increase specific power with a water fog (droplet spray) injected (WFI) directly into the inlet of the engine compressor. The simulated performance of a simple-cycle gas turbine engine using WFI is reported. The paper describes the computer model developed to predict compressor performance resulting from the evaporation of water passing through the stages of an axial flow compressor. The resulting effects are similar to those of an intercooled compressor, without the complications due to the addition of piping, heat exchangers, and the requirement for a dual spool compressor. The effects of evaporative cooling on compressor characteristics are presented. These results include compressor maps modified for various water flow rates as well as estimates of the reductions in compression work and compressor discharge temperature.These modified compressor performance characteristics are used in the engine simulation to predict how a WFI engine would perform under various water injection flow rates. Estimates of increased output power and decreased air flow rates are presented.Copyright © 1998 by ASME


– Thermal contact resistances between a silver metallized SiC chip and a direct bonded copper (DBC) substrate have been measured in a heat transfer experiment. A novel experimental method to separate thermal contact resistances in multilayer heat transfer path has been demonstrated. The experimental results have been compared with analytical calculations and also with 3D computational fluid dynamics (CFD) simulation results. A simplified CFD model of the experimental setup has been validated. The results show significant pressure dependence of the thermal contact resistance but also a pressure independent part.


RNA polymerase III (Pol III) is responsible for the production of small non-coding RNA species, including tRNAs and 5S rRNA. Pol III-dependent transcription is generally enhanced in transformed cells and tumors, but the underlying mechanisms remain not well understood. It has been demonstrated that the BRF1 subunit of TFIIIB is essential for the accurate initiation of Pol III-dependent transcription. However, it is not known whether BRF1 undergoes ubiquitin modification and whether BRF1 ubiquitination regulates Pol III-dependent transcription. Here, we show that RNF12, a RING domain-containing ubiquitin E3 ligase, physically interacts with BRF1. Via direct interaction, RNF12 catalyzes Lys 27 and Lys 33 -linked polyubiquitination of BRF1. Furthermore, RNF12 is able to negatively regulate Pol III-dependent transcription and cell proliferation via BRF1. These findings uncover a novel mechanism for the regulation of BRF1 and reveal RNF12


In order to determine the distribution and composition of freshwater amphipod species of the Lake District Region of Turkey, detailed samplings were conducted between 1998 and 2001. Among these materials, those from Pinar Pazari and Yukari Gokdere villages (Isparta Province, Turkey) were studied in the present study. Because of having different character combinations, the author believes that they belong to a new species, Gammarus deryae sp. nov. The new species is a typical member of the Gammarus pulex -group having setose third and fourth pereopod and uropod 3 where dense plumose setae exist. Elevated urosomal segments and sharply pointed third epimeral plate are the most distinct characters of the species. In addition, the palp of right maxilla 1 has 1 seta on the outer margin. These encountered characters are commonly observed in the G. pulex -group but the combination of these characters is specific for the newly identified species. All the extremities of the holotype male and allotype female are illustrated and described in detail. The similar and different morphological characters of the new species are compared with those of related species.


Antarctic sea-ice formation plays a key role in shaping the abyssal overturning circulation and stratification in all ocean basins, by driving surface buoyancy loss through the associated brine rejection. Changes in Antarctic sea ice have therefore been suggested as drivers of major glacial-interglacial ocean circulation rearrangements. Here, the relationship between Antarctic sea ice, buoyancy loss, deep-ocean stratification, and overturning circulation is investigated in Last Glacial Maximum and preindustrial simulations from the Paleoclimate Modelling Intercomparison Project (PMIP). The simulations show substantial inter-model differences in their representation of the glacial deep-ocean state and circulation, which is often at odds with the geological evidence. We argue that these apparent inconsistencies can largely be attributed to differing (and likely insufficient) Antarctic sea-ice formation. Discrepancies can be further amplified by short integration times. Deep-ocean equilibration and sea-ice representation should, therefore, be carefully evaluated in the forthcoming PMIP4 simulations.


Aim: The aim of this study is to detect in vitro adherence of Enterococcus faecalis to the infected dentinal tubules of human extracted teeth using confocal laser scanning microscope. Subjects and Methods: Roots from human premolar teeth (n = 40) were infected with E. faecalis strain the American Type Culture Collection 29212 in brain heart infusion for 21 days. After the experimental period, specimens were divided into two groups, Group A (n = 20), Group B (n = 20), and Group A specimens were stained with fluorescein diacetate dye for the detection of viability and adherence Group B were stained with acridine orange dye for detection of metabolic activity and adherence. Samples were washed, thoroughly sectioned and examined by confocal laser scanning microscopy. Computer-assisted determinants of fluorescence, bacterial viability, metabolic activity, and adherence were compared statistically. Results: E. faecalis was able to invade the dentinal tubules to a depth of 1–400 μm and adhere to 1–200 μm depth. Adherence (90%) was significantly higher in 1–100 μm using fluorescein diacetate and acridine orange dye. Conclusion: Adherence of E. faecalis as evaluated by confocal laser scanning microscope was highest at the depth of 1–100 μm which may have an impact on the shaping and cleaning procedures on the root canal.


Emerging technologies offer an opportunity for the development, at the institutional level, of quality processes with greater capacity to enhance learning in higher education than available through current quality processes. These systems offer the potential to extend use of learning analytics in institutional-level quality processes in addition to the widespread focus on business analytics, and to deliver well-constructed mixes of information from different data sources. Borrowed from music amplification, the term fold-back is proposed as a way to describe such a mix. This paper begins the design-research project of designing effective fold-back systems by expanding the theoretical assumptions about learning embedded in higher education quality processes. A number of theories building on Vygotsky's cultural-historical approach are discussed to imagine quality in higher education in terms of what students actually do and how they engage in addition to what the institution does. The discussion is summarised in a fold-back matrix capturing the sorts of evaluation questions the systems might address. The paper concludes by providing two initial design sketches for re-purposing emerging technologies with the capacity to support expanded quality processes in education. These sketches are based on the Experience Application Programming Interface (xAPI) and Dedoose technologies.


ABSTRACT In this study we describe the immunogenicity results from a subset of older people (N = 5187) who participated in a Phase 3 randomized, observer-blinded trial of AS03-TIV versus TIV (Fluarix™) (ClinicalTrials.gov, NCT00753272). Participants received one dose of AS03-TIV or TIV in each study year and antibody titers against the vaccine strains were assessed using hemagglutination-inhibition (HI) assay at 21 d and 180 d post-vaccination in each vaccine group in the 2008/09 (Year 1) and 2009/10 (Year 2) influenza seasons. Manufacturing consistency of 3 lots of AS03-TIV for HI antibody responses in Year 1 was a co-primary objective. In a post-hoc analysis, a statistical regression model included 4830 subjects in whom immunogenicity and laboratory-confirmed attack rate data were available; the analysis was performed to assess HI antibody titers against A/H3N2 as a correlate of protection for laboratory-confirmed A/H3N2 influenza. AS03-TIV and TIV elicited strong HI antibody responses against each vaccine strain 21 d post-vaccination in both years. The manufacturing consistency of 3 lots of AS03-TIV was demonstrated. In both years and each vaccine group, HI antibody responses were lower for A/H1N1 than the other vaccine strains. Day 180 seroconversion rates (proportion with ≥4-fold increase in titer compared with pre-vaccination titer) in Year 1 in the AS03-TIV and TIV groups, respectively, were 87.7% and 74.1% for A/H3N2, 69.7% and 59.6% for influenza B, and 58.3% and 47.4% for A/H1N1. The post-hoc statistical model based on A/H3N2 attack rates and HI antibody titers estimated that a 4-fold increase in post-vaccination titers against A/H3N2 was associated with a 2-fold decrease in the odds of A/H3N2 infection.


This note is devoted to the asymptotic normality of Hill's estimator when data are weakly dependent in the sense of Doukhan. The primary results on this setting rely on the observations being strong mixing. This assumption is often the key tool for establishing the asymptotic behavior of this estimator. A number of attempts have been made to relax the assumption of stationarity and mixing. Relaxing this condition, and assuming the weak dependence, we extend the results obtained by Rootzen and Starica. This approach requires less restrictive conditions than the previous results.


The electrostatic influence of the central cavity and pore alpha helices in the potassium ion channel from Streptomyces lividans (KcsA K+ channel) was analyzed by solving the finite difference Poisson equation. The cavity and helices overcome the destabilizing influence of the membrane and stabilize a cation at the membrane center. The electrostatic effect of the pore helices is large compared to that described for water-soluble proteins because of the low dielectric membrane environment. The combined contributions of the ion self-energy and the helix electrostatic field give rise to selectivity for monovalent cations in the water-filled cavity. Thus, the K+ channel uses simple electrostatic principles to solve the fundamental problem of ion destabilization by the cell membrane lipid bilayer.


A molecular rotor was designed that rotates 7 orders of magnitude faster upon protonation. The quinoline rotor is based on a rigid N-arylimide framework that displays restricted rotation due to steric interaction between the quinoline nitrogen and imide carbonyls. At rt (23 °C), the rotor rotates slowly (t(1/2) = 26 min, ΔG(‡) = 22.2 kcal/mol). However, upon addition of 3.5 equiv of acid the rotor rotates rapidly (t(1/2) = 2.0 × 10(-4) s, ΔG(‡) = 12.9 kcal/mol). Mechanistic studies show that this dramatic acid catalyzed change is due to stabilization of the planar transition state by the formation of an intramolecular hydrogen bond between the protonated quinoline nitrogen (N(+)-H) and an imide carbonyl (O═C). The acid catalyzed acceleration is reversible and can be stopped by addition of base.


A novel isocratic HPLC method had been developed for rapid simultaneous separation and determination of cinnarizine and Piracetam in pure form or in pharmaceutical formulations within less than 10 minutes. Separation was carried out on a Hypersil gold C18 (10μm, 100x4.6mm) column. Effect of pH and composition of mobile phase in addition to flow rate was studied. Calibration was obeyed in the range of (10-80) μg/ml for cinnarizine or (160- 960) μg/ ml for Piracetam. The method was applied for the simultaneous determination of these drugs in both bulk and pharmaceutical forms and this is the first published method that uses isocratic HPLC method for cinnarizine and piracetam determination in combined formulation and the method were validated according to ICH parameters.


The Morphologi G3-ID combines the capabilities of a Morphologi G3 particle analyzer with the Kaiser RamanRxn 1 spectrometer, resulting in a single platform measuring particle size, shape, and chemical identity. In addition to reporting the standard morphological parameters, the Raman capability on the Morphologi G3-ID enables the chemical identification of particulates in a dispersed sample. The extra chemical information permits creation of chemical classifications from which component-specific particle size distributions are determined. In order to show that a generic drug is bioequivalent to an innovator drug it must display comparable bioavailability when studied under similar experimental conditions. The particle size distribution of each of the active pharmaceutical ingredients upon tablet disintegration was investigated, as this would be expected to have a significant effect on the subsequent bioavailability of the drug.


The red nucleus is located in the rostral midbrain of the vertebrate brain and controls motor coordination during locomotion. It receives input from the cerebellum and sends its output to the spinal cord. The presence of the red nucleus is well established in tetrapods, and its existence has also been suggested in teleosts but its presence and position has still been under discussion. By using wheat germ agglutinin (WGA) as a genetically encoded anterograde tracer, we recently identified contralateral projections from the cerebellum to a putative red nucleus in the zebrafish midbrain tegmentum. In this report we further revealed red nucleus derived from this contralateral afferent from the cerebellum using WGA and contralateral projections to the hindbrain-spinal cord junction site using DiI-mediated retrograde tracing. Thus the structure that we have identified by anterograde and retrograde tracing fulfills the anatomical demands for the red nucleus: the location in the midbrain tegmentum, contralateral afferent from the cerebellum (cerebello-ruber projection) and contralateral efferent to the spinal cord (rubro-spinal projection).


In sum, community participation was central from the inception of this project and throughout the four phases. Participants were involved in trainee selection, curriculum development and modification and negotiation of clinical practicum and evaluation. Their contributions significantly influenced the content and process of the workshops on a daily basis. For the in situ training the indigenous trainers used a similar process of participation and planning, and adapted the workshops specifically to the island culture. Evaluation methods were similarly adapted to the specific communities. High success rate of returns resulted from the evaluators' careful sensitivity to the culture and the adaptation of the Western research process. The team involvement in the participant's transformation and self-reliance created a productive mutual experience.


This book deals with survival and the resistance to assimilation. The federally recognized Round Valley Indian Tribes are a small, confederated people whose members today come from twelve indigenous California tribes. In 1849, during the California gold rush, people from several of these tribes were relocated to a reservation farm in northern Mendocino County. Fusing Native American history and labor history, William Bauer Jr. chronicles the evolution of work, community, and tribal identity among the Round Valley Indians in the nineteenth and twentieth centuries that enabled their survival and resistance to assimilation. Drawing on oral history interviews, Bauer brings Round Valley Indian voices to the forefront in a narrative that traces their adaptations to shifting social and economic realities, first within unfree labor systems, including outright slavery and debt peonage, and later as wage laborers within the agricultural workforce. Despite the allotment of the reservation, federal land policies, and the Great Depression, Round Valley Indians innovatively used work and economic change to their advantage in order to survive and persist in the twentieth century. "We Were All Like Migrant Workers Here" relates their history for the first time.


Air Pollution: The Study of Its Impacts and Control Me-asures . Fresh air is absolutely needed as long as sustainable life is concerned. The sort needed is that of fresh and cleans. So far, however, as a result of science and technology advancement, healthy air is hard to gain, because of air pollution. Polluted air brings about some negative impacts on human and animal lives, plants, objects, sights, and even on the entire global earth. To take some required measures on it, a good teamwork is needed. This kind should involve many parties or institutions, through some approaches of technical, plans, administrative and educative.


The study surveyed the use of e-journals by academic staff of Rufus Giwa Polytechnic, Owo, Ondo State, Nigeria. Questionnaire was designed to gather information on the use of e-journals by the academic staff. Data gathered from the respondents were analyzed through the use of frequency table and percentage. From the analysis, it was discovered that all the academic staff use e-journals and it is used for different academic purposes. All the academic staff agrees to the use of e-journals for research purpose. It was also observed from the findings that most of the academic staff uses e-journals occasionally. The advantages derived from the use of e-journals were also revealed in the study. These include good source of information, currency and timeliness of information, ease of access, ease of storage and time saving. The study also identified some problems encountered by the academic staff while accessing e-journals. Among these problems were slow internet connectivity, frequent power outage and high cost of journal subscription. Recommendations were therefore given, this include increase of internet bandwidth, reduction in prize of articles on e-journals, payment of subscription fee for e-journals by the management of the institution and making it available to their academic staff.

 Key words: Use, e-journals, academic staff, polytechnic.


In parliamentary systems, the need to preserve the political agreement that sustains the executive often motivates legislative involvement in policymaking. Institutional arrangements regulating executive–legislative relations and ministerial autonomy also structure parliamentary participation. However, empirical evidence of these effects remains limited to a few policies and countries. European Union legislation provides the opportunity to test expectations about legislative involvement for different types of measure across various institutional arrangements, across multiple policy areas, and across time. In this article, we investigate legislative involvement in the transposition of 724 directives in 15 member states from 1978 to 2004. Our results confirm that involvement increases as conflict between the responsible minister and her coalition partners intensifies. The discretionary scope embedded in the directive further inflates this effect. Additionally, parliamentary involvement decreases as the government's institutional advantage over the legislature increases, especially if intracoalitional conflict deepens.


The appendicular origin of an intermesenteric abscess is rarely suspected prior to surgery, due to atypical clinical presentation and poor sensitivity of exploratory methods. A 43-year-old male was admitted for recent pain and mild tenderness in the epigastrium, slight emesis, leucocytosis (C-reactive protein was not determined), with no pathological findings on simple abdominal radiological examination (Rx). Abdominal ultrasound (US) and endoscopy were irrelevant. The abdomen became moderately tender, distended; diffuse enteric gas, slightly impaired bowel movement could be demonstrated by a new Rx. CT (oral contrast) was performed in the 3 day: edematous infiltration of the mesentery and of a left-flank digestive loop (jejunal, sigmoidian?), small-size fluid collection (with extraluminal air-level) and paretic loops in the proximity, but normal wall-appearance of the caecum and its surrounding fat; the CT result was inconclusive (perforated diverticulosis or malignancy?). Barium enema: normal, including the caecum. Installation of vesperal fever, progressive mid-abdominal pain, tenderness and formation of a mass were the rationale for open mid-line laparotomy, discovering a large intermesenteric abscess, secondary to perforated gangrenous intermesenteric appendicitis. Surgical outcome of appenIntermesenteric Appendicular Abscess, a Diagnostic Challenge; Case Report and Review I.N. Mateæ, S. Constantinoiu "St. Mary" Department of General and Esophageal Surgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania Image Quiz for Surgeons Chirurgia (2014) 109: 275-279 No. 2, March April Copyright© Celsius Corresponding author: Ioan Nicolae Mateæ, MD, PhD "St. Mary" Department of General and Esophageal Surgery no. 37-39 blv. Mihalache Ion, 011172 sector 1, Bucharest, Romania E-mail: firstname.lastname@example.com


Defining the molecular genetics of diabetes gives new insight into the underlying etiology and so should help improve treatment. The genetic etiology is now known for most patients with beta-cell monogenic diabetes, allowing genetic classification. We review how this genetic knowledge alters treatment. Patients with a glucose-sensing beta-cell defect due to glucokinase mutations have regulated, mild, fasting hyperglycemia. Oral hypoglycemic agents or low-dose insulin rarely improve glycemic control. Patients with hepatic nuclear factor-1alpha (HNF1alpha) mutations have progressive beta-cell deterioration and require treatment. HNF1alpha patients are 4 times more sensitive to sulfonylureas than matched type 2 diabetic patients. This is partly due to greater insulin secretion, reflecting the fact that the defect in HNF1alpha deficiency precedes the K(ATP) channel where sulfonylureas act. HNF1beta is expressed in pancreatic stem cells before differentiation into endocrine or exocrine cells, so patients with HNF1beta mutations have reduced pancreatic development, resulting in early-onset diabetes and exocrine dysfunction. These patients usually rapidly require insulin and are not sensitive to sulfonylureas. Thirty-five to 50% of patients diagnosed with diabetes before 6 months have a mutation in Kir6.2. The mutated KATP channel in these patients does not close in response to increased ATP concentrations, but can be closed when sulfonylureas bind to the sulfonylurea receptor 1 subunit of the channel by an ATP-independent route. These patients are usually insulin dependent, but have excellent glycemic control on high-dose sulfonylureas tablets. In conclusion, the defining of molecular genetic etiology in monogenic diabetes has identified several specific beta-cell defects, and these are critical in determining the response to treatment.


According to Christopher Alexander's theory of centers, a whole comprises numerous, recursively defined centers for things or spaces surrounding us. Wholeness is a type of global structure or life-giving order emerging from the whole as a field of the centers. The wholeness is an essential part of any complex system and exists, to some degree or other, in spaces. This paper defines wholeness as a hierarchical graph, in which individual centers are represented as the nodes and their relationships as the directed links. The hierarchical graph gets its name from the inherent scaling hierarchy revealed by the head/tail breaks, which is a classification scheme and visualization tool for data with a heavy-tailed distribution. We suggest that (1) the degrees of wholeness for individual centers should be measured by PageRank (PR) scores based on the notion that high-degree-of-life centers are those to which many high-degree-of-life centers point, and (2) that the hierarchical levels, or the ht-index of the PR scores induced by the head/tail breaks, can characterize the degree of wholeness for the whole: the higher the ht-index, the more life or wholeness in the whole. Three case studies applied to the Alhambra building complex and the street networks of Manhattan and Sweden illustrate that the defined wholeness captures fairly well human intuitions on the degree of life for the geographic spaces. We further suggest that the mathematical model of wholeness be an important model of geographic representation, because it is topological oriented, which enables us to see the underlying scaling structure. The model can guide geodesign, which should be considered as the wholeness-extending transformations that are essentially like the unfolding processes of seeds or embryos, for creating built and natural environments of beauty or with a high degree of wholeness.


While embedding Academic Language and Literacies (ALL) instruction in discipline-specific courses is known to be effective, it is difficult to enact across the siloed university. Moreover, the move to online/ remote delivery during COVID-19 has necessitated greater focus on the development of online supports. This article reports on an effort to embed digital ALL support in a mandatory social research methods course, which we argue is particularly suited to academic literacies instruction. A series of digital videos were created to complement a literature review assignment, and were evaluated using video analytics, end-of-course student surveys, and individual interviews with tutors. Quantitative analysis of viewing patterns demonstrated that the majority of students accessed the videos multiple times, while qualitative data suggest that students generally had positive responses to the videos. However, thematic analysis of interviews with tutors showed that while they considered the content helpful, they also had reservations about the length and use of the videos. These findings clearly demonstrate the extent of the unmet need to integrate these types of approaches into undergraduate courses. We also argue that if universities wish to maintain currency in a shifting, globalised world, they must do more to foster the types of collaborative partnerships that facilitate effective ALL instruction in undergraduate coursework. These findings carry particular relevance for teaching and learning literacies in the wake of COVID-19, because digital video has become even more integral to higher education. © 2021, University of Wollongong. All rights reserved.


The computational model of the temperature sensors integrated on the IC chip with power transistors is developed. The 2D/3D problem of sensor placement is mathematically described by the classic heat transfer equation coupled with the equation for current density distribution. It is shown that parasitic effects of sensor current displacement and thermo-emf generation resulting from a temperature gradients (Seebeck effect) must be taken into account. For this purpose the special differential equation is introduced. The examples of point- and strip-like temperature sensors modeling for power BJTs and ICs are demonstrated.


One of the prerequisites for high safety in laboratories for chemical and microbiological research is a well-functioning ventilation system. The most typical safety measure in these laboratories is to use a fume hood as a place for activities that can cause dangerous emissions to the room air. The protective function of fume hoods must never be jeopardised. One of the prerequisites for this is that the exhaust air flow through the fume hood must be kept stable. It is known that the pressure fluctuations in the ventilation system can cause leakage of contaminated air from the fume hood. The laboratory ventilation systems have ductworks for air supply and air exhaust. In order to achieve good stability in the exhaust system, the airflows in both systems and the premises should be well-controlled and the correct air flow balance must prevail in the laboratory space. Most of the contemporary laboratories are multi-storey buildings with the centralised VAV ventilation systems. A principal layout of their ductwork can vary. In traditional systems the ducts to individual floors are routed separately. An alternative design, which is common vertical duct instead of multiple separated ducts, is attractive due to somewhat decreased need of space and has been applied in a few new laboratories. This thesis presents a comparison of these design alternatives based on computerised isothermal empirical models of the systems. The models were developed in an internal fluid flow network simulation software (Flowmaster) and the verified. The verification procedure was carried out in two stages: first a test rig with a single fume hoodwas tested and simulated, then the ventilation system in a large functioning chemical laboratory was investigated. The software provided satisfactory prediction of the transient processes that were the consequences of system's excitation with fume hoods during the field experiments session. The field tests proved also that rigid duct model provides a good estimation of pressure wave propagation in the ventilation systems. After the verification of the model, a sensivity analysis of various design, tuning and operation disturbances that might occur in the exhaust systems was performed. As the total number of factors was 10, a fractional factorial design of two levels of the simulation runs was applied. The sensivity analysis showed that an exhaust system with separated vertical ducts and that with common vertical ducts have no significant differences in their performance. Furthermore, the air volume in the common duct has a damping effect and increases the stability of the system. Also the complexity of the control system must be in accordance with the size of the ventilation system. In large systems, a partition of the system into multiple control levels is recommended.


Constipation and obstruction are distressing problems which not promptly treated can lead to dangerous complications. A common and potentially dangerous gastrointestinal problem is faecal impaction. Early diagnosis and prompt treatment avoids complications. Apart from manual extraction proximal and distal washout are the available options. However, the key lies in identifying the etiology of the problems and nipping it in the bud. We here present a first-of-its-kind case in which a female pulled out about 2 feet of her large intestine from her anal orifice after experiencing constipation for a period of two days. Damage control surgery was done and the patient was left with a permanent illeostomy.


In recent years, data service has been gaining popularity in embedded system and general packet radio service (GPRS).GPRS is one of the next-generation wireless communication technologies. This paper takes advantage of seamless GPRS data coverage and its good capacity to combine GPRS technology and GPS system, realizing real-time positioning of vehicles. This paper describes structure of the system using GPRS and GPS technology for real-time data acquisition and transmission. It transmits the data through GPRS network to the background system for centralized data processing and analysis. The analysis results are given back to administrator rapidly and timely through the wireless network. This module not only saves development and maintenance costs of a private network, and takes full advantage of the unique advantages of GPRS. Finally, this paper summarizes characteristics and advantages of the system in practical application and has good prospects.


The Cloud-computing paradigm was considered as a revolution. Thanks to the abstraction of computing resources "in the clouds" this paradigm provides "anything" as a service, on a pay-as-you-go basis. Unfortunately, there is no reference software that one can use to properly compare a cloud approach against others. We propose the SENSAPP platform to tackle this challenge. SENSAPP is designed as a prototypical cloud application and is provided as an open-source service-based application used to store and exploit data collected by the Internet of Things. We propose SENSAPP as a reference implementation to compare different cloud approaches. In this paper we present initial experiments about scalability based on this platform.


The discovery and the use of insulin more than 80 years ago is considered one of the greatest medical breakthroughs of the 20th century. Very rapid progresses led to disposition of very pure and human insulins with different pharmacokinetic profiles. Nevertheless the pharmacokinetics of those conventional rapid and long acting insulin where very far away from the physiological pattern of insulin secretion. It is thus very difficult, using those conventional insulins to obtain a good metabolic control without a very high risk of hypoglycemia. To obtain a good metabolic control and to limit frequent hypoglycemia is essential, on one hand to avoid the apparition and evolution of micro and macroangiopatic complications as well for type 1 as for type 2 diabetic patients, and, on the on the other hand to allow good quality of life for people with diabetes. The use of rapid acting analogues lispro, aspart and glulisine (quicker and shorter action when compared to classical rapid acting insulin) and of long acting analogues glargine and detemir (pharmacokinetic profile without peak of action and very low intra subject coefficient of variability) allowed to reach more easily a good metabolic control with a low risk of hypoglycemia. Progresses are of course still needed to ameliorate the situation of insulin treated diabetic people.


The optimal design of degradation experiments under the cost restraint is studied. The performance degradation process of products is defined with the degradation data distribution. Whether the total experiment cost exceeds the predetermined budget or not is set as the constraint condition, the objective is to minimize pth quantile variance of the degradation data, an optimal model for degradation experiment is established. A Monte Carlo simulation program is developed to obtain the optimal experiment scheme. An example of a metal crack degradation data is used to verify the efficiency of the method.


ABSTRACT Ventilator-associated bacterial pneumonia (VABP) is a difficult therapeutic problem. Considerable controversy exists regarding the optimal chemotherapy for this entity. The recent guidelines of the Infectious Diseases Society of America and the American Thoracic Society recommend a 7-day therapeutic course for VABP based on the balance of no negative impact on all-cause mortality, less resistance emergence, and fewer antibiotic treatment days, counterbalanced with a higher relapse rate for patients whose pathogen is a nonfermenter. The bacterial burden causing an infection has a substantial impact on treatment outcome and resistance selection. We describe the baseline bronchoalveolar lavage (BAL) fluid burden of organisms in suspected VABP patients screened for inclusion in a clinical trial. We measured the urea concentrations in plasma and BAL fluid to provide an index of the dilution of the bacterial and drug concentrations in the lung epithelial lining fluid introduced by the BAL procedure. We were then able to calculate the true bacterial burden as the diluted colony count times the dilution factor. The median dilution factor was 28.7, with the interquartile range (IQR) being 11.9 to 53.2. Median dilution factor-corrected colony counts were 6.18 log10(CFU/ml) [IQR, 5.43 to 6.46 log10(CFU/ml)]. In a subset of patients, repeat BAL on day 5 showed a good stability of the dilution factor. We previously showed that large bacterial burdens reduce or stop bacterial killing by granulocytes. (This study has been registered at ClinicalTrials.gov under registration no. NCT01570192.)


ABSTRACT This research aims to examine transprejudice in the Turkish cultural context and identify its socio-political and morality-based correlates. To that end, we report two studies. In Study 1, we manipulate the gender identity of a hypothetical victim in a violent criminal scenario. We find that people (N = 116) put greater social distance towards a transwoman compared to a ciswoman victim, yet do not distinguish between the two in terms of responsibility attributions. In Study 2 (N = 175), we explore the socio-political and moral underpinnings of transprejudice by focusing on the role of right-wing authoritarianism (RWA) and social dominance orientation (SDO) in different forms of transprejudice through the mediating functionof moral foundations. RWA predicts greater social distance and less positive affect towards transwomen through the purity foundation; while SDO predicts lower positive affect through the care foundation. The findings show that transprejudice does exist to some extent and that RWA seems to be a potent socio-political predictor of transprejudice in Turkey. The moral foundations, on the other hand, do not seem to play the mediator role that has been shown for other prejudice domains and different cultural contexts.


Active power cycling is a standardized and well-established method for reliability assessment and product qualification in power electronics technologies. Repetitive pulses of load current are applied to cause cyclic thermal swings in the p-n junction and in the whole semiconductor device. They induce thermo-mechanical stresses, which ultimately leads to the typical interconnect failure in the 'devices under test'.
 However, these tests are insensitive with respect to new automotive system architectures, in which power electronics devices are exposed to additional loads besides the intrinsic thermal swings. The trends in power electronics towards miniaturization, higher power density, heterogeneous system integration, and the deployment of power electronics in harsher environments combined with longer lifetime and higher uptime requirements strongly increase the reliability demands in general and the need for more improved reliability assessment methodologies in particular. The new testing methods shall be more comprehensive and more efficient, i.e., they shall simultaneously cover the real service conditions better and reduce testing time. One promising approach is the combination of loading factors — such as the superposition of active power cycling by passive thermal cycles. Both loading factors are well-known to cause most relevant failure mechanisms in power electronics. In reality, the power electronic devices are exposed to both factors simultaneously. Hence, this load case should also be replicated in the test.
 The paper will report a systematic investigation of such superimposed test schemes, which cover the case of self-heating and passive heating (from neighboring elements) of the power electronics devices under real service conditions. Typical discrete power electronics components in TO-200 packages are selected as test vehicles as they are likewise relevant for the domains of consumer or automotive electronics. The paper details the test concept and discuss the quantitative and qualitative test results.


Claims for Drugs SIR,-You have no doubt seen a letter in the issue of Pulse of May 23 from a doctor signing himself "Jocundus." Under the heading "Conflicting Drug Evaluations," the anonymous writer complains about an alleged disagreement between Prescribers' Journal and your feature, " To-day's Drugs," over the usefulness of a proprietary drug whose name is not stated. The drug concerned seems to be the tranquillizer chlormezanone (" trancopal," Bayer Products). The important point, in my view, is that there is no real disagreement in fact between your report (April 28. p. 12101) and the report in Prescribers' Journal (February, 1962). The latter states that "the weight of evidence suggests that ' trancopal ' has no action in relieving muscle spasm in man"; whereas you confine your remarks to the opinion that " though it has received extensive clinical investigation in conditions where spasm of muscle is thought to be the cause of symptoms, the drug should be regarded is primarily a tranquillizer." It is interesting to note that Prescribers' Joturnal was also attacked in a letter in your columns of May 12 (p. 1345), and that here the drug in question, although not named, mtust be "lobak." This also contains chlormezanone and is marketed by Bayer Products. Independent drug evaluations are bound to lead, on occasion, to honest differences of opinion between them. Nevertheless Prescribers' Journal and your own feature "To-day's Drugs" are valuable, and I particularly deplore unjustified attempts to discredit them. It happens that The Medical Letter (November 24, 1961) has already expressed an opinion on trancopal (which is quoted by Prescribers' Jouirnal) in substantially the same terms as your own.-1 am, etc.,


Mortality rates in the United States are higher for men than women as a result of chronic diseases such as heart disease, cancer, and diabetes. Although men suffer from chronic diseases at higher rates than women, few health interventions are targeted to men. Limited knowledge exists regarding the specific components needed to design Internet applications to appeal to men. The purpose of this quantitative study was to examine the relationship between Internet applications and the influence on participation of men in healthy lifestyle behaviors. A quasi-experimental design was used to analyze data collected from the Health Information National Trends Survey (HINTS) (N = 990). A group of men (n = 323) that used Internet applications was compared to a control group of men (n = 667) that did not use Internet applications. The study results are generalizable to men in the United States because of the use of data from HINTS. Results from the regression analysis indicated that Internet applications for self-management of health behavior had a significant effect upon participation in healthy lifestyle behavior t (49) = -2.212, p < .05. There was no significant effect upon men not using Internet applications t (49) = 1.023, p >.05. This study supports the United States federal government's Healthy People 2020 objective to increase the proportion of people who use Internet applications for health management.


Abdominal aortic aneurysm(AAA) is a common problem encountered which leads to
dilation of the abdominal aorta. One novel way of treating AAA is using endovascular
aortic repair (EVAR) where a polymer stent graft (SG) is used to redirect
blood flow. Post operative concerns are common with EVAR like stent graft migration
that are caused due to displacement forces acting on the ends of the SG.
In this thesis, the aim is to correlate experimental results with a developed computational
model which is used to evaluate forces acting on the ends of an iliac limb
stent graft. Chosen liquid for the experiment was water as pressure is said to be
the main driving force and viscous effects are negligible. Displacement forces are
numerically evaluated using a finite volume approach for fluid-structure interaction
(FSI) with the open source tool OpenFOAM for different pressures (145/80, 170/90,
195/100 mm.Hg) and different stroke rates (60, 80 and 100 BPM). Further, different
blood viscosity models are studied and a comparison of forces for Newtonian and
non-Newtonian blood models are presented. Wall shear stress(WSS) and velocity
contours are presented for both blood models and complex flow phenomenon like
secondary flow structures are explained. Viscous forces are found to be negligible
and pressure is the main cause of displacement forces which is consistent with the
experiment and justifies the usage of water in the experiment. Newtonian and non-
Newtonian models yielded similar results for displacement forces as that of water
and small variations were observed in velocities and WSS.


Key figures in packaging can be used to obtain and document various insights about packaging. Previous research showed that a weight/content ratio can give insights in the used amounts of packaging material related to the amount of contained product. Other research showed that higher performing packaging are often expected to create benefits appreciated by the end users, resulting in higher value and willingness-to-pay. The aim of this study is to integrate these two methods and to develop a design approach to get insight in how much packaging material is applied to gain a specific consumer benefit. The paper integrates the link between key figures and consumer benefits into a design method that provides designers an opportunity to gain insights in the key figures of their final design early in the development process. The design method is developed by adapting existing product development tools to give insight in the link between consumer benefits and key figures. These tools are combined to form method guidelines for innovation-, new product development- and routine projects. For a case to detail the approach, tomato packaging was used. The current market situation for these products in the Netherlands is used as fundament for the key figure results and database. Guidelines are provided by a key figure database and by adjusting development tools so that the design method can also be used for other products than tomato packaging, or other markets than the Netherlands and Finland. Based on the developed design method, it can be concluded that the integration of key figures and consumer benefits gives designers insight in key figures early in the development process, but also provides an overview of where in the process decisions were made with large impact on the final design. This insight early in the process is useful as starting point towards efficient material use in packaging designs that at the same time provide benefits for consumers.


I discuss several recent highly accurate theoretical predictions for masses of baryons containing the b quark, especially Ωb (ssb) very recently reported by CDF. I also point out an approximate effective supersymmetry between heavy quark baryons and mesons and provide predictions for the magnetic moments of Λc and Λb. Proper treatment of the color-magnetic hyperfine interaction in QCD is crucial for obtaining these results.


With the development of mechanized civilization, transportation of goods and people has become fast and convenient, at the expense of transportation noise which has become a serious problem. This paper aims at comparing the acoustical environment of a modern multi-million city (Tokyo) with the situation one to three centuries ago in the corresponding old city (Edo); also at that time one of the largest cities in the world. Attempts are made to explore traffic noise of Edo through historical records and to compare Edo and Tokyo in this respect. Naturally, as the noise in Edo was not quantified, this study is only qualitative. Edo was a highly developed city in the 17th-19th centuries with a unique system of distribution and ecology and was considered to be an unusually clean city of those times. It is concluded that traffic in Edo was intensive; yet relatively quiet as it was dominated by other modes of transportation than today and with non-motorized vehicles. Yet, sound from people who operated the road vehicles or who carried other people and goods must have been quite loud. At nighttime Edo was closed to traffic and was a quiet city, only interrupted by sound from night watches and fire guardians. Tokyo, on the other hand, is noisy both day and night.


Network distance estimation through Euclidean embedding of Internet hosts has been extensively studied as a scalable approach. In this method, each Internet host is assigned a computed co-ordinate where the distance between any two arbitrary hosts is approximated by their Euclidean distance. In this paper, we investigate whether such co-ordinate based method can be leveraged in designing efficient overlay based routing path for peer-to-peer streaming. Specifically we explore the usage of co-ordinate based estimation with well known Delaunay Triangulation (DT) based routing path design for peer-to-peer streaming. We devise algorithms for this combined approach that we refer as e-DT. Using real measurement data sets, we show that e-DT improves the overlay based routing significantly over purely DT based approach. The comparison with other well known overlay based routing approaches indicates that e-DT is able to construct similar overlay paths with smaller average forwarding degree requirements at each peering node. In addition, e-DT can support both point-to-multi point and multi point to multi point streaming requirements.


Species whose geographical distribution encompasses both mainland and island populations provide an ideal system for examining isolation and genetic divergence. In this study, paternally transmitted chloroplast DNA (cpDNA) and maternally transmitted mitochondrial DNA (mtDNA) were used to estimate population structure and phylogeography of Pinus luchuensis, a species found in eastern China (ssp. hwangshanensis), Taiwan (ssp. taiwanensis), and the Ryukyu Archipelago (ssp. luchuensis). Gene genealogies of both mtDNA and cpDNA reveal two major lineages. Molecular dating indicates that these lineages diverged before the colonization of P. luchuensis subspecies in Taiwan and the Ryukyu Archipelago. Both mtDNA and cpDNA show a lack of correspondence between molecular phylogeny and subspecies designation. Phylogeographical analysis suggests that paraphyly of the subspecies is the result of recent divergence rather than secondary contacts. In spite of the short divergence history of P. luchuensis on islands, the island populations show the same degree of genetic divergence as mainland populations. Low levels of genetic diversity in the mainland ssp. hwangshanensis suggest demographic bottlenecks. In contrast, the high heterogeneity of genetic composition for island populations is likely to be associated with a history of multiple colonization from the mainland. The spatial apportionment of organelle DNA polymorphisms is consistent with a pattern of stepwise colonization on island populations.


Case Presentation: A 78-year–old man with atrial fibrillation, hypertension, and a history of ischemic stroke 2 years earlier presents to the emergency department with hematemesis and melena. He is taking dabigatran (150 mg twice daily) for stroke prevention, and his last dose was taken 12 hours earlier. His hemoglobin is 5.9 g/dL, platelet count is 185×109/L, and calculated creatinine clearance is 26 mL/min. The activated partial thromboplastin time (aPTT) is 83 s and the thrombin time (TT) is >150 s. How would you manage this patient?

The Randomized Evaluation of Long-Term Anticoagulant Therapy trial conducted in 18 113 patients with atrial fibrillation demonstrated that, compared with warfarin, dabigatran at a dose of 150 mg twice daily reduced the risk of stroke or systemic embolism by one third and was associated with a similar rate of major bleeding; at a dose of 110 mg twice daily, the risk of stroke or systemic embolism with dabigatran was similar to that with warfarin, but dabigatran reduced the risk of major bleeding by one fifth.1 Both doses of dabigatran reduced the risk of intracranial bleeding by two thirds compared with warfarin. The risk of stroke was consistently reduced in all of the patient subgroups, but in those over the age of 75 years, the higher dose of dabigatran was associated with an increased risk of extracranial bleeding.2

Prescribing guidelines for dabigatran vary by country and should be reviewed before starting the drug. The majority of atrial fibrillation patients with ≥1 additional risk factor for stroke are eligible for dabigatran. Absolute contraindications are uncommon, but include impaired renal function with a calculated creatinine clearance <15 mL/min in the United States or <30 mL/min in the rest of the world. Dabigatran has not been evaluated in patients with valvular atrial fibrillation or …


Popular intuitions, scholarly works and legal doctrines reveal an embedded tension in property legal theory between testamentary freedom and family protection. The article works through this tension and offers a novel theory of property allocation after death. It introduces the value of continuity to property legal scholarship. This value is drawn from various disciplines such as philosophy, psychology, and anthropology. Continuity embodies a double perspective, combining two interests: the desire to be continued in the world, and the need for roots, to belong to a person or a group. Similarly, the law of inheritance today cannot be correctly characterized solely by reference to testamentary freedom, which addresses only the interest to be continued in the world. There is not just one central focal point, the owner of property, I contend, but actually two focal points, which correspond with the two dimensions of continuity. These two focal points are not independent interests that should be correctly balanced one against the other. Rather, the interests of the owner and her receivers are intertwined, co-dependent, and guided by the same rationale. This argument is supported by a legal analysis of American inheritance law.


Ensure an efficient and orderly Warehouse Management implementation with this comprehensive guide to SAP WM in SAP ERP! Learn to customize and use critical functionalities, like goods receipt and goods issue, as well as advanced technologies such as RFID, EDI, and mobile data entry. Covering everything from stock management to picking strategies, you'll master SAP WM. This new edition includes ITSmobile, connections with SAP ERP PP and QM, the Warehouse Activity Monitor, and more. * Configure SAP WM in SAP ERP for your warehouse requirements * Use basic and advanced warehouse functionalities for moving stock in, out, and around your warehouse * Employ ITSmobile and new planning and monitoring tools SAP WM Processes Grasp the essentials of warehouse management, including goods receipt, goods issue, replenishment, and putaway. Then master advanced topics such as hazardous materials management, cross-docking, and value-added services. SAP WM Configuration Understand the configuration details necessary to optimize your SAP WM implementation, from storage bins to yard management. Real World Scenarios Explore concrete business cases and examples to help you put expert tips into practice in your own warehouse. * Stock management * Goods receipt and goods issue * Replenishment * Picking strategies * Putaway strategies * Inventory management * Yard management * Electronic Data Interchange (EDI) * Radio frequency identification (RFID) * ITSmobile


The implications of (public or private) pre-play communication and information revelation in a labour relationship is not well understood. We address these implications theoretically and experimentally. In our baseline experiments, the employer offers a wage to the worker who may then accept or reject it. In the public and private treatment, workers, moving first, make a non-binding private or public wage proposal. Our theoretical model assumes that wage proposals convey information about a worker's minimum acceptable wage and are misreported with a certain probability. It predicts that, on average, wage proposals lead to higher wage offers and acceptance rates, with the highest wages under private proposals. While both, public and private, proposals increase efficiency over the baseline, private proposals generate higher worker incomes. Broad support for the theoretical predictions is found in the laboratory experiments. Our work has important implications for recent policies promoting public information on wage negotiations. We find that while wage proposals promote higher wages, efficiency, and income equality, public information on wage negotiations is likely to benefit firms more than workers.


included in all cases and a short reference list is available directly after several cases. Most scans, in the chapter of gynecology, are made with static ultrasound equipment and are of a rather good, but not excellent quality. The following chapters of obstetrics and the breast have a similar design, and the only complaint is that the image quality. especially in the part of normal fetal anatomy, is not compatible with what is possible to obtain with modern ultrasound equipment. The chapter of the neonatal head is still more suffering from the inferior image quality, but is otherwise well written. with the cases selected to show the most common lesions and malformations. An atlas should be easy to read and mainly focused on the illustrations. This book is no exception from that rule. In summary this atlas gives the reader a glimpse of a large variety of normal and abnormal findings in the pregnant and nonpregnant woman and her child. The text is concise, clearly written, and easily read. The major drawback is the poor image quality which suffers when compared with state-of-the-art realtime scanners. Torbjorn Andersson


Background: Breast cancer is a malignant proliferation of epithelial cells that lining the ducts or lobules of the breast. It is the second common cancer, after lung cancer in women. Since growth inhibition is an important strategy in cancer treatment, many at-tempts are in program to find new apoptotic inducer agents. Today there is some reports about effect of metabolites of Pseudomonas on cancer cells, hence, metabolites of Pseudomonas sp. UW4, were isolated and anti-cancer and anti-microbial activity of these metabolites was studied. Methods: This experimental study was performed in cellular and developmental biology of Shahrekord Islamic Azad University from April 2015 to August 2015. Antimicrobial activity of metabolites of Pseudomonas sp. UW4 was tested against a patho-genic bacteria, including Escherichia coli , Bacillus cereus and Staphylococcus aureus . For anti-cancer activity, in this study SKBR3 cells and normal fibroblast cells (HU-02) were cultured in DMEM medium with 10% fetal bovine serum (FBS). The cells were treated by various concentrations of these metabolites 5, 10, 15 and 20 mg/ml for 24, 48 and 72 h. Cell viability was assessed by MTS assay. Cells were seeded at 5×10 3 cells/ml in 96 well plates and incubated for 24 hr. Then metabolites of bacteria were added, after indicated times MTS (20 µl) was added and the absorbance was measured at 492 nm using ELISA plate reader. Results: Pseudomonas sp. UW4 was able to produce antimicrobial metabolites against Staphylococcus aureus . Metabolites decreases the viability of SKBR3 cell line in a time and dose dependent manner, so that the most effective concentration of this substance was 20 mg/ml and 72 h after treatment (P< 0.01). While Pseudomonas sp. UW4 in various concentrations had no significant effect on normal fibroblast cells (P= 0.24). Conclusion: Bioactive compounds produced by of Pseudomonas sp. UW4 could be used for elimination of infections and treatment of breast cancer SK-BR3. Abstract


This edition of the food law update will address recent events that may serve as bellwether signs that significant, long sought changes to the food and agricultural production system may be on the horizon. The first section of the update focuses on several general food safety initiatives. These efforts may, in the near term, coalesce into comprehensive food safety legislation. The second section analyzes two food safety actions relating to specific product categories: oysters and eggs. Section three provides a brief overview of poultry production contracts that may signal a broader restructuring of the legal relationships between farmers and the upstream corporations, which heavily influence production practices. Although none of the events alone create drastic change, combined they reveal a political atmosphere primed for larger restructuring of the food system. Finally, section four discusses two significant jury verdicts in the on-going genetically engineered rice litigation that imposes liability on the developer of genetically engineered seed that became commingled in the international rice supply chain.As in previous editions of this update, necessity dictates that not every change is included; rather, the authors limited their analysis to significant changes within the broader context of food production, distribution, and retail. The intent behind this series of updates is to provide a starting point for scholars, practitioners, food scientists, and policymakers determined to understand the shaping of food law in modern society. Tracing the development of food law through these updates also builds an important historical context for the overall development of the discipline.


According to the Ahlowalia hypothesis (1995), the growth of total factor productivity (TFP) beside infrastructure investments of government lead to income inequality decrease in rural areas of countries. The main objective of this study is to investigate the effects of public investments such as agricultural R&E, road, education and irrigation on income inequality in rural areas of Iran. In order to get results, we used ARDL method and time series data of 1980 to 2008. However, this research attempts to survey the direction of causality between the income inequality and total factor productivity (TFP) in Iran. Empirical results show there is a negative relation between income inequality and agricultural TFP in rural areas of Iran. Hence, additional investments on rural education and agricultural R&E have significance and different impacts on income inequality. Findings showed Ahlowalia hypothesis developed for the relation among income inequality, TFP and investment in electricity is not rejected in case of Iran`s rural areas.


Background: The global policy focus of today's HIV efforts and strategies is to reverse the spread of HIV/AIDS and provide care, treatment and support. A key component of this strategy is to increase individual HIV status awareness through expansion of HIV testing and counselling (HTC). However, the numbers tested still remain low and evidence suggests that there are significant missed opportunities for HIV testing in clinical settings. One key strategy to expand HTC in clinical settings has been to implement a policy of 'provider initiated counselling and testing' (PITC) in which all patients accessing health facilities for treatment are routinely offered a HIV test.
The introduction of PITC has brought with it a 'dilution' of the previously lengthy and stringent testing process by doing away with signed informed consent and extensive pre and post test counselling. The previous process was recognised as a barrier to public health gains of HIV testing expansion, particularly as it differentiated an HIV test from other routine medical tests resulting in a sense of HIV exceptionalism. In its place, the PITC policy recommends an opt-out approach and replaces the extensive pre test counselling with an information giving session placing more emphasis on post test counselling in cases where the result is positive. This change has given rise to debates about the potential for PITC to infringe patients' rights to informed consent and counselling especially in developing countries.
Emerging evidence from the exploration of the PITC process within antenatal settings in the Sub Saharan Africa has revealed some of the complexities of implementing PITC guidelines in different cultural and healthcare contexts. These studies suggest that information giving and consent are difficult to apply in contexts characterized by healthcare worker dominance, lack of sufficient resources and time constraints. This study aimed to specifically investigate how patients and counsellors co-construct informed consent and perform counselling during the PITC consultation. It examined 'real time' patient-counsellor interaction within hospital outpatient and inpatient settings in Kenya, explored the patient's experience of a routine HIV test and evaluated how stigma and patient – provider interaction norms influence the PITC process in this context.
Methods: In order to explore the context of the routine testing consultation and the way the interaction played out, a qualitative research approach was adopted, utilizing multiple data collection methods (interviews, observations and audio recording of consultations). The study was carried out in two government run health facilities in Kenya's capital, Nairobi. The intention was to follow patients through the PITC process, i.e. before testing, during the HIV test and (whenever possible) after the HIV test. To get a broader picture of the events during the routine HIV testing consultation, additional interviews were conducted with five nurse-counsellors whose consultations had been observed. Ethical approval was obtained from the Kenya National Research Council, Kenya Medical Research Institute and the Aga Khan University Ethics Committee. The data were analysed using Charmaz's constructivist grounded theory approach which allowed for a systematic yet flexible approach to analysis. This method facilitated immersion and engagement with the data, and provided a means of managing the different data sets in the study and undertaking a process of constant comparison within and between data sets.
Findings: Results from the study suggest that HIV remains a highly stigmatised illness in Kenyan society and is associated with death and immorality. This is still the case in spite of years of health promotion and high profile media campaigns raising awareness about HIV and the availability and effectiveness of treatment. The context of stigma shaped the consultation so that both patients and counsellors worked together to help patients to maintain a 'moral face'. Patients tended to withhold information on risky sexual behaviour whilst the counsellors avoided inquiring into this domain. The PITC consultation was characterised by a counsellor dominated approach to communication and health promotion. Counsellor inputs were generic, highly scripted and didactic rather than patient-centred. As a result, the counsellors' style of communication allowed little space for personalised risk assessment or for patients to ask questions or to express concerns. The findings suggest that informed consent enabling explicit refusal of the test offer was difficult to achieve in an environment where the HIV test was not framed as a choice and patients came to the health facility expecting to be told what to do. Nevertheless, in spite of the obvious lack of explicit informed consent and the counsellor dominated interaction, post test interviews revealed that patients were satisfied with the nature of the interaction.
The study concludes that there is a considerable distance between the policy recommendations and their implementation on the ground due to the complexity of real world practice. Lay constructions about HIV (HIV stigma) and the existing norms of patient-provider interaction that are characterised by a passive patient and a dominant health care provider shape the way the consultation unfolds. PITC training programs and manuals need to include skills and strategies that can support counsellors manage an uncomfortable interaction and emphasis the need to ensure an individualized post test counselling is carried out.
The thesis makes several contributions to knowledge. The study pays attention to the operationalization of PITC recommendations thus illuminating how the PITC policy is translated into practice within a developing country like Kenya. It informs the existing debates on how informed consent and counselling should be implemented. The study findings suggest that in spite of the global debates on what constitutes ideal informed consent and counselling, in practice, sociocultural norms shape how these issues are translated and implemented. However, the study indicates that diversion from the PITC policy recommendations does not necessarily constitute a disregard for the recommendations but, rather, is an attempt to adapt to the prevailing environment. The study methodology enabled unique insights to be gained on how counselling and consent are constructed and managed in the PITC setting through the use of observations / audio recording to examine 'real time' interactions. The research study has been able to illuminate barriers that are posed by sociocultural and organisational structures in the real world implementation of the PITC policy. Therefore, my study suggests that the national PITC policy needs to consider the practical problems faced on the ground in developing contextually appropriate recommendations for the conduct of PITC and implementation of key guidelines.


Background Behcet's disease (BD) is an inflammatory disease characterised by recurrent oral aphthous ulcers and numerous potential systemic manifestations. Purpose To describe the experience of our centre with the use of adalimumab, etanercept and infliximab for the treatment of severe clinical manifestations in patients with BD in whom immunosuppressive treatment had failed. Material and methods Retrospective review of medical records of 36 months (January 2010–December 2013) from patients with BD treated with adalimumab, etanercept or infliximab as compassionate use. Demographic and clinical data included age, sex, previous treatment, indication, side effects, concomitant drugs and clinical outcome. Results 12 patients were included (5/7 women/men) 3/12 treated with infliximab, 2/12 etanercept, and 7/12 adalimumab; with a mean age of 36 years (range 21–55). We decided to start treatment due to the lack of response in the control of symptoms (3/12 patients had cutaneous lesions), and ocular involvement (9/12 patients with uveitis of repetition and visual deterioration). The patients had received conventional treatment: 4/12 had received two drugs, 4/12 three drugs, 2/12 four drugs, 1/12 five drugs and one had received six drugs previously. The most prescribed drugs were corticosteroids, azathioprine and cyclosporine. 1/12 patient had received previous treatment with infliximab before adalimumab with relapse of symptoms. We did not detect any adverse effects in patients treated. In all patients, clinical improvement was evident from the first administration. 8/12 patients showed reduction of symptoms, while 4/12 patients became asymptomatic. They continue in treatment. Conclusion Anti-TNF agents are a good option for patients with severe BD who are resistant to steroid and immunosuppressive treatment, with a good safety profile. The benefit of this treatment supports the hypothesis that TNF-a is an important factor in the pathogenesis of BD. Moreover, no adverse effects were detected in the treated patients, in agreement with the few cases described in the literature reviewed. References and/or Acknowledgements No conflict of interest.


This paper focuses on identifying the most important factors affecting audit quality in Jordanian Commercial Banks (JCBs). The perceptions of JCBs' internal and external auditor's in addition to financial managers have been investigated. In general it was found that the respondents believe that audit quality in the Jordanian banking sector ranges from satisfactory to very good. The results indicate a positive and significant correlation between audit quality and audit efficiency, the reputation of auditing office, auditing fees, the size of audit firm, and the proficiency of auditor. The results of this study make a contribution to existing literature in the area of factors affecting audit quality in eastern developing countries such as Jordan. In addition, this research adds further evidence to the value of studying auditing efficiency, the reputation of audit firm, auditing fees, the size of auditing office, and the proficiency of auditor on the quality of auditing.


The study was conducted with an objective of measuring the effects of green human resource management (green HRM) practices on employee on-the-job and off-the-job green behavior within the context of garments industry in Bangladesh. Moreover, the study tested the moderating effects of employee environmental knowledge on the relationship between green HRM practices and employee on-the-job and off–the-job green behavior. A self-administered questionnaire survey was conducted in order to collect data from the participants. Two hundred and seventy employees working at the managerial level of garments factories in Bangladesh participated in the survey. Moderated regression analysis was employed to test the proposed research model. The study findings revealed that green HRM practices positively and significantly influenced employee on-the-job and off-the-job green behavior. This findings suggest that employee green behavior displayed both inside and outside the organization stem from the learnings and experiences inside the organization. Employee environmental knowledge was also found to moderate the effects of green HRM practices on employee on-the-job and off-the-job green behavior indicating that green HRM effects are stronger in case of environmentally concerned employees. The study findings provide HR professionals and policy makers with the guidance regarding the promotion of employee green behavior for improving environmental performance.


Background: Since December 2019, a severe novel coronavirus (SARS-CoV-2) infection (Coronavirus Disease 2019,COVID-19) has occurred in Wuhan, China, and has rapidly spread to the country and around the world. This study intends to investigate the epidemiological and clinical characteristics of patients with COVID-19 in a surrounding city of Wuhan.Methods: A retrospective study was conducted on 208 cases of COVID -19 patients from February 11, 2020 to February 29, 2020 in Xiaogan dongnan Hospital, collected basic information, history of exposure, medical history, clinical symptoms, laboratory indicators and pulmonary imaging Data, and analyzed the epidemiological and clinical characteristics of all patients. According to the clinical classification criteria, 208 patients were divided into light group and ordinary group, and the epidemiological and clinical characteristics of the two groups were compared.Results: Among 208 patients in this study, with a median age of 50.5 years (IQR,36-64.7,range,10-91 years), among which 107 (51.4%) were males and 101 (48.6%) were females. 51 (24.5%) had a clear exposure to COVID-19 infection within 2 weeks before admission, and 40 (19.2%) had a history of residence or exposure in Wuhan within 2 weeks before admission. Among all the patients, there were 16 (7.7%) with pulmonary diseases, 41 (19.7%) with hypertension, 11 (5.3%) with coronary heart disease, 13 (6.3%) with diabetes, 12(5.8%) with a history of alcohol consumption, and 12(5.8%) with a history of smoking. Among all clinical symptoms, 146 cases (70.2%) of fever, the highest temperature range was 37.3℃-41℃ before admission, 115 (55.3%) cases of cough, and 57 (27.4%) cases of chest tightness, 47 (22.6%) cases of fatigue, 28 (13.5%) cases of inappetence, 9 (4.3%) cases of diarrhea, 7 (3.4%) cases of nasal congestion or runny nose , and 5 ( 2.4%) cases of pharyngalgia. Analysis of the laboratory results of 208 patients showed that 42 (20.2%) cases had decreased white blood cell count, and 61 (29.3%) cases had decreased lymphocyte count. There were 154 (74%) cases with elevated CRP, 50 (24%) cases with elevated fasting blood glucose, and 23 (11.1%) cases with elevated LDH (>245U/L). The comparison of clinical characteristics between the light group and the common group showed that the median age of the light group was 44.8 years (IQR 30-58), the median age of the common group was 53.1 years (IQR 38.8-67) (P<0.01). The symptoms of fever [53(80.3%) vs 93(65.5%),P<0.05], fatigue [53(80.3%) vs 93(65.5%),P<0.05] and inappetence [4(6.1%) vs 24(16.9%),P<0.05] in the light group were less than those in the common group. The white blood cell count (5.48 vs 6.37, P<0.05), lymphocyte count (1.40 vs 1.61, P<0.05) and HDL-C (1.5 vs 1.3, P<0.05) of the common group were lower than that of the light group, while CRP (26.5 vs 22.1, P<0.01), AST (22.9 vs 18.5, P<0.05), fasting blood glucose (5.8 vs 5.6, P<0.05), LDH (196.8 vs 157.9, P<0.001) of the common group were higher than that of the light group.Conclusion: COVID-19 infection is mainly in middle-aged and elderly patients, patients with other diseases are more susceptible to infection. The main symptoms of COVID-19 infection were fever, cough, chest tightness, fatigue, and inappetence. Decreased lymphocyte count, increased CRP concentration, increased LDH concentration and decreased HDL-C concentration were the laboratory features of COVID-19 infection, and were important indicators to assess the severity of COVID-19 disease.


Donor natural killer (NK) cells can destroy residual leukemic cells after allogeneic hematopoietic stem cell transplantation. This effect is based on the interaction of killer-cell immunoglobulin-like receptors (KIR) of donor NK cells with ligands of the major histocompatibility complex found on the surface of the target cells. HLA-C1 subtypes provide the ligand for KIR2DL2 and KIR2DL3 and the HLA-C2 subtypes for KIR2DL1. We have studied the probability of relapse (PR) after single-unit unrelated cord blood transplantation (UCBT) in relation to the potential graft-vs.-leukemia effect mediated by NK cells present in the umbilical cord blood (UCB) by analyzing KIR-ligand and HLA-C typing of the receptor. Data from 33 consecutive patients given a single unit UCBT were included. We have considered two groups of patients based on the absence or the presence of one of the C-ligands for inhibitory KIR and the incompatibility HLA-C1/2 between UCB and patients. Group 1 (n = 21): the patient lacks a C-ligand for inhibitory KIR present in UCB NK cells, i.e., patients homozygous C1/C1 or C2/C2. Group 2 (n = 12): patients heterozygous C1/C2 in which KIR-mediated graft-vs.-leukemia effect is not expected (presence of both C ligands for inhibitory KIR in the receptor). With a median follow-up post-UCBT of 93 months, patients with absence of a C-ligand for inhibitory KIRs (Group 1) showed a lower actuarial PR than patients with both C-ligands (group 2): 21 ± 10 vs. 68 ± 18% at 2 year and 36 ± 13 vs. 84 ± 14% at 5 years (p = 0.025), respectively. In patients with acute lymphoblastic leukemia, the 2-year PR was 36 ± 21% for group 1 and 66 ± 26% for 2 (p = 0.038). Furthermore, group 1 had a lower incidence of grades II–IV acute graft-vs.-host disease (p = 0.04). In the setting of UCBT, the absence of a C-ligand (C1 or C2) of inhibitory KIR in the patient is associated with lower PR, which is probably due to the graft-vs.-host leukemia effect caused by UCB NK cells that lack a ligand for the inhibitory KIR 2DL1/2DL2/2DL3.


Since Deng Xiaoping introduced a market economy in the mid-1970s, China has achieved great progress and its citizens have greater incomes. Yet, current research documents an increase in organized crime and corruption in China. The focus of this research is on the use of the "strike hard" crime campaigns (yanda and da hei in Mandarin) against organized criminals and economic corruption in China. Crime control campaigns are ongoing and are widely criticized for abuses of power. One of the most frequently mentioned examples of the official abuse of authority is the da hei (strike black) campaign, instigated by former Chongqing mayor and prominent politician Bo Xilai. In 2012, Bo Xilai was detained in a political scandal that continues to engulf Chinese politics. This article discusses whether increasing crime and corruption, growing prosperity, internal migration of rural migrants, and modernization can be viewed as factors that support the use of crime control campaigns. The Chinese view disorder as a threat to stability. This article examines how yanda or strike hard campaigns are used as China contends with threats to its social order.


Non-destructive Fourier Transform InfraRed (FTIR) mapping of Eocene aged fossil reptile skin shows that biological control on the distribution of endogenous organic components within fossilized soft tissue can be resolved. Mapped organic functional units within this approximately 50 Myr old specimen from the Green River Formation (USA) include amide and sulphur compounds. These compounds are most probably derived from the original beta keratin present in the skin because fossil leaf- and other non-skin-derived organic matter from the same geological formation do not show intense amide or thiol absorption bands. Maps and spectra from the fossil are directly comparable to extant reptile skin. Furthermore, infrared results are corroborated by several additional quantitative methods including Synchrotron Rapid Scanning X-Ray Fluorescence (SRS-XRF) and Pyrolysis-Gas Chromatography/Mass Spectrometry (Py-GC/MS). All results combine to clearly show that the organic compound inventory of the fossil skin is different from the embedding sedimentary matrix and fossil plant material. A new taphonomic model involving ternary complexation between keratin-derived organic molecules, divalent trace metals and silicate surfaces is presented to explain the survival of the observed compounds. X-ray diffraction shows that suitable minerals for complex formation are present. Previously, this study would only have been possible with major destructive sampling. Non-destructive FTIR imaging methods are thus shown to be a valuable tool for understanding the taphonomy of high-fidelity preservation, and furthermore, may provide insight into the biochemistry of extinct organisms.


Density Functional Theory (DFT) based models have been widely applied towards investigating and correlating the reaction mechanism of CO2 electroreduction (ER) to the activity and selectivity of potential electrocatalysts. Herein, we examine the implications of the theoretical choices used in DFT models that impact the stability of the reaction intermediates and the limiting potential (UL) of the activity/selectivity determining steps in CO2 ER across transition metals. Three theoretical choices are considered: (i) the type of exchange-correlation (XC) functional, (ii) the surface facet of the metal electrocatalyst, and (iii) the effect of solvation. The impact of the theoretical choices is also studied in the context of deriving scaling relationships for electrocatalyst screening. The analyses reveal that the choice of XC functional (PBE versus RPBE) can alter binding energies of CO2 ER intermediates by 0.30 eV, but have little impact on surface reaction energetics. Surface termination has greater impact, as OH*-terminated adsorbates bind weaker on average by 0.26 eV on stepped facets. Including explicit local solvation stabilizes the OH*-terminated adsorbates, preferentially decreasing the UL for CO* → COH* reduction. Trends in CO2 ER selectivity across metals predicted using scaling correlations differ signficantly from explicitly calculated values due to deviations from the linear binding energy correlations. The difference is most pronounced when the effect of explicit solvation is considered.


Nowadays laparoscopic surgery is the standard procedure for many abdominal diseases. Compared with open surgery, laparoscopic surgery offers several advantages, such as reduction of postoperative pain, faster postoperative recovery and shorter admission times to the hospital. The continuous drive to further improve the surgical technique resulted in the development of new less invasive techniques like single-port laparoscopy. Single-port laparoscopic procedures are laparoscopic procedures using only one incision, which is usually transumbilical. At the site of this single incision a multiport device is placed, instead of multiple incisions with multiple ports through which the surgical instruments can be introduced. All instruments can be introduced in the abdomen through this multiport device. By using only one incision surgical trauma is further minimized and thereby further reducing postoperative pain and fasten postoperative recovery which is accompanied by a better cosmetic result. The first single-port laparoscopic procedure, an appendectomy, was performed in 1992. Five years later the first single-port laparoscopic cholecystectomy was performed. After several years the technique was introduced in the Netherlands. In 2010 the first single-port laparoscopic procedure was performed in the Jeroen Bosch Hospital. In the first three studies (Chapter II, III and IV) of this thesis the results of single-port laparoscopic procedures during the first years of its use in the Jeroen Bosch Hospital are described. The single-port technique was primarily introduced in less complex procedures. The fourth study presented in this thesis (Chapter V) describes the results of a cost-analysis of single-port laparoscopic procedures in the treatment of malignant colorectal diseases. Not only the single-port technique has been introduced to minimize surgical trauma, also robotics have been introduced. In the last study (Chapter VI) the results of the use of robotics in single-port laparoscopic cholecystectomies are presented. The use of robotics is feasible, but is encountered by technical challenges. Also high rates of incisional herniation were seen. The use of robotics is quite expensive. With the lack of convincing benefits and the high costs, the use of robotics cannot be justified for single-port laparoscopic cholecystectomies. Further research is needed for the use of robotics in more complex procedures. Single-port laparoscopy is becoming more accepted in the treatment of various diseases. The influence of single-port laparoscopy on cosmetic outcome and quality of life should be investigated as well as the cost effectiveness technique. In our strive to minimize surgical trauma single-port laparoscopy is a promising technique.


Despite the emerging popularity of diary studies, until now little attention has been paid to the psychometric properties of measures used in diary studies. When the time frame of questionnaires in diary studies is adapted, it is important to examine whether the factor structure remains the same. The aim of this article is to introduce a method to examine the factor structure of daily variables. This method will be illustrated by performing a multilevel confirmative factor analysis on the questionnaire used to measure daily work engagement. The results showed that daily work engagement can be measured by adapting the time frame of the questionnaire to measure enduring work engagement, although it is eligible to replace one of the nine items.


Introduction Screening for hepatocellular carcinoma (HCC) is only deemed cost-effective in patients at high risk. However, the criteria for identifying patients at risk, particularly in relation to non-cirrhotic hepatitis B, remains ill defined and different international guidelines are not consistent. Recent NICE guidelines proposed offering surveillance to patients with significant fibrosis (≥F2) or age >40 with either high viral load or family history of HCC. The aim of this study was to evaluate how the new NICE guidelines can impact on current practice and on the effectiveness of our surveillance program. Methods All patients who underwent an abdominal ultrasound for HCC surveillance from 1st September 2012–31st August 2013 were identified and the indications evaluated. In a subgroup of these patients with hepatitis B the appropriateness of screening was assessed according to the 2013 NICE guidelines. From the same period, all HCC diagnosed were identified and cross matched with our surveillance list. Results In the period under study, 1280 surveillance ultrasounds (606 in cirrhosis, 628 in non cirrhotic hepatitis B or C, 46 other) led to 5 diagnoses of HCC. All HCC were found in cirrhotic patients (annual incidence 1.65%). Seventeen further HCC were diagnosed from emergency admissions or referred from elsewhere. One patient had non cirrhotic hepatitis B (78yr old male with a long history of hepatitis B) whilst all the remaining were cirrhotic (2 with hepatitis B). In a randomly selected sample of 200 patients undergoing surveillance ultrasounds, 62% (n = 124) had hepatitis B and 76 had cirrhosis of other aetiology. Of the patients with hepatitis B, an assessment of specific risk factors, particularly level of fibrosis, was not documented in 50 (40%). A further 48 (39%) patients were retrospectively deemed low risk according to NICE guidance. Conclusion The number of HCC diagnosed through surveillance was low, but still cost effective in cirrhotic patients. The main risk factor for HCC in this cohort was cirrhosis (96.5%). In fact, only 1 non cirrhotic patient with hepatitis B developed HCC and this was on a background of likely advanced fibrosis. None of the HCC from surveillance would have been missed if NICE criteria were used. It is important that patients with chronic hepatitis B all undergo assessment of fibrosis, along with clear documentation of other known risk factors in order to enable better risk stratification. In our experience following NICE guidance to identify high risk patients for surveillance will pick up all cases of HCC and decrease cost by reducing the number of unnecessary ultrasound scans being carried out. Reference NICE clinical guideline 165 – Hepatitis B (chronic) June 2013 (http://www.nice.org.uk/nicemedia/live/14191/64234/64234.pdf) Disclosure of Interest None Declared.


It is indicated that new developments of promise for automation of military electronics have yet to reach actual production. A plea is made for a self-instituted program of standardization and mechanism. The various types of semi-automatic mechanized, and programmed varieties of automation machinery for electronic assembly, are described, and commented upon at some length. A tabulation of their numerous characteristics is contributed. Two graphs present short-run production rates of the eight basic types of machines, when used to assemble 24 or 48 component parts to printed-wiring boards; the number of units to be made are plotted from 0-100. Two other graphs amplify the lower portion and are plotted from 0-10 units. Considerable comment is included. Indexes show cost, manpower and space requirements for batches of 30, 1OO, and 1000 units, and are tabulated against each of the eight varieties of automation. Suggestions are made for the adoption of mechanization. The importance of design modification, modular conversion, and standardization of component parts, are stressed. The results of a specific redesign are cited. Emphasis is placed upon the thesis, that before being submitted to production, the development of a mechanically-producible electronic system must have arrived at a more complete stage of design than one to be manually assembled. Several benefits to be obtained from automation, and some problems, are listed. It is concluded that military electronics development and production can be improves substantially by the action that is suggested.


INTRODUCTION
Efforts are needed to improve palliative care in rural communities, given the unique characteristics and inherent challenges with respect to working within the physical aspects of residential settings. Nurses who work in rural communities play a key role in the delivery of palliative care services. Hence, the purpose of this study was to explore nurses' experiences of providing palliative care in rural communities, with a particular focus on the impact of the physical residential setting.

METHODS
This study was grounded in a qualitative approach utilizing an exploratory descriptive design. Individual telephone interviews were conducted with 21 community nurses. Data were analyzed by thematic content analysis.

RESULTS
Nurses described the characteristics of working in a rural community and how it influences their perception of their role, highlighting the strong sense of community that exists but how system changes over the past decade have changed the way they provide care. They also described the key role that they play, which was often termed a 'jack of all trades', but focused on providing emotional, physical, and spiritual care while trying to manage many challenges related to transitioning and working with other healthcare providers. Finally, nurses described how the challenges of working within the physical constraints of a rural residential setting impeded their care provision to clients who are dying in the community, specifically related to the long distances that they travel while dealing with bad weather.

CONCLUSIONS
These study findings contribute to our understanding of the experiences of nurses working in rural communities in terms of the provision of palliative care and the influence of the physical residential setting that surrounds them. These findings are important since nurses play a major role in caring for community-dwelling clients who are dying, but they are confronted with many obstacles. As such, these results may help inform future decisions about how to best improve access to important services and ways to support them while providing palliative care to rural individuals.


The commodities that are being produced by cottage industries are basically consumable ones and are produced through the utilization of the traditional techniques. Cottage Industry especially started its function in the country sides of a country where unemployment along with under-employment are prevalent. Thus, this industry helps the economy by absorbing a huge amount of surplus labor of the rural economy. Another glaring feature of Cottage Industry is that it is not a mass producer of commodities. The main risk that is being faced by this industry is from the factory based medium or large industries which are again capital intensive in nature. This is because of the fact that these large industries utilize all sorts of cost effective technologies which enable them to supply the products at low price. On the other hand, The Cottage Industry is basically labour intensive and utilizes traditional techniques in production process which are generally not cost effective in nature which escalates the price of their product. The products supplied by the Cottage Industry thus face risk of extinction if they don"t receive enough financial or other form of support from the government.