The health sciences sector uses work integrated learning to prepare professionals for practice and has done so predominately using a traditional apprenticeship model. Over the past two decades there has been an increasing focus on integrating peer coaching into this learning environment. While peer coaching can occur informally, failure to formalize the process and train participants can negatively impact rapport-building, trust and learning outcomes. Hence, clinical educators often need some guidance in supporting this placement model. As a result, this research examines the best practices of 31 highly experienced clinical educators within a peer coaching placement model by capturing their explicit and tacit supervisory knowledge.


Marketed brands of honey in our country do not have much more standardization. Even pharmacopeia standards of honey far from complete. The present study assessed parameters to determine appropriate identification and quality of three brands honey sold in India market. For this purpose, honey of three popular brands of Indian market was selected for evaluation purpose and investigated for following parameters such as macroscopic evaluation, ash value, loss on drying, chemical tests and viscosity. In result study based on macroscopic parameters all three brands were found complies with Indian Pharmacopeia 1996. But in physical evaluation sample of brand D1 was found complies pharmacopeia standards and other two brands S1 and B1 fail in this evaluation even not about near to official minimum standards. On the basis of chemical tests evaluations, we found all three brands complies the official standards as shown in results. As per our overall observations brand D1 found good and most effective of different types of parameters of evaluations.


Winifred Knights, 1899-1947, was a student at the Slade School of Art from 1915, where she developed a decorative manner of rhythmic, repetitive forms, one form of cautious modernism. In 1920 she was the first woman to win the Rome Prize in Decorative Painting. The award was for three years at the British School at Rome. Knights often chose to base her paintings on biblical subjects, or the lives of saints. She was not religious and I argue that these stories, which were well-known in Britain at the time, were vehicles to represent the lives of women and families in the unsettled years during and after WWI. Many women artists have depicted domestic scenes, but Knights chose the exterior and multi-figure compositions, including many self-portraits. She used these compositions to explore women"s vulnerability, rebellion against male control, maternity and the self-sufficiency of a women"s community. Personal material is present in all her work and much of it deals with the traumas she suffered. My thesis argues that her paintings" engagement with the viewer is not restricted by this material: the themes she explored resonated with contemporaneous viewers, as they do today. The argument closely examines Winifred Knights" paintings, including their art historical sources. It draws on her correspondence and on the social conditions of Britain and Italy. The small number of her oil paintings is no measure of Knights" success as artist and woman. Indeed, the many dimensions of life as artist, woman, mother and wife were important to Knights. While previous studies of women artists have regarded biography as artistic source material or distraction, I argue that it is central to understanding Knights and her contexts. This thesis therefore argues that the many aspects of a complete life fed into Knights" painting and can be seen in her sensitive depictions of women"s lives.


By, in effect, rendering pharmacokinetics an experimentally adjustable parameter, the ability to perform feedback-controlled dosing informed by high-frequency in vivo drug measurements would prove a powerful tool for both pharmacological research and clinical practice. Efforts to this end, however, have historically been thwarted by an inability to measure in vivo drug levels in real time and with sufficient convenience and temporal resolution. In response, we describe a closed-loop, feedback-controlled delivery system that uses drug level measurements provided by an in vivo electrochemical aptamer-based (E-AB) sensor to adjust dosing rates every 7 s. The resulting system supports the maintenance of either constant or predefined time-varying plasma drug concentration profiles in live rats over many hours. For researchers, the resultant high-precision control over drug plasma concentrations provides an unprecedented opportunity to (1) map the relationships between pharmacokinetics and clinical outcomes, (2) eliminate inter- and intrasubject metabolic variation as a confounding experimental variable, (3) accurately simulate human pharmacokinetics in animal models, and (4) measure minute-to-minute changes in a drug's pharmacokinetic behavior in response to changing health status, diet, drug-drug interactions, or other intrinsic and external factors. In the clinic, feedback-controlled drug delivery would improve our ability to accurately maintain therapeutic drug levels in the face of large, often unpredictable intra- and interpatient metabolic variation. This, in turn, would improve the efficacy and safety of therapeutic intervention, particularly for the most gravely ill patients, for whom metabolic variability is highest and the margin for therapeutic error is smallest.


The performance optimization of cognitive radio is a multi-objective optimization problem. Existing genetic algorithms are difficult to assign the weight of each objective when the linear weighting method is used to simplify the multi-objective optimization problem into a single objective optimization problem. In this paper, we propose a new cognitive decision engine algorithm using multi-objective genetic algorithm with population adaptation. A multicarrier system is used for simulation analysis, and experimental results show that the proposed algorithm is effective and meets the real-time requirement.


We present ARCH++, an image-based method to reconstruct 3D avatars with arbitrary clothing styles. Our reconstructed avatars are animation-ready and highly realistic, in both the visible regions from input views and the unseen regions. While prior work shows great promise of reconstructing animatable clothed humans with various topologies, we observe that there exist fundamental limitations resulting in sub-optimal reconstruction quality. In this paper, we revisit the major steps of image-based avatar reconstruction and address the limitations with ARCH++. First, we introduce an end-to-end point based geometry encoder to better describe the semantics of the underlying 3D human body, in replacement of previous hand-crafted features. Second, in order to address the occupancy ambiguity caused by topological changes of clothed humans in the canonical pose, we propose a co-supervising framework with cross-space consistency to jointly estimate the occupancy in both the posed and canonical spaces. Last, we use image-to-image translation networks to further refine detailed geometry and texture on the reconstructed surface, which improves the fidelity and consistency across arbitrary viewpoints. In the experiments, we demonstrate improvements over the state of the art on both public benchmarks and user studies in reconstruction quality and realism.


Research in safety management has been inhibited by lack of consensus as to the definitions of the terms with which it is concerned and, in general, the lack of an agreed theoretical framework within which to collate and contrast empirical findings. This thesis sets out definitions of key terms (hazard, risk, accident, incident and safety) and provides a theoretical framework. This framework has been informed by many sources but especially the Management Oversight and Risk Tree (MORT), cybernetics and the Viable System Model (VSM). Fieldwork designs are proposed for the empirical development of an analytical framework and its use to assist study of the development of safety management in organisations.


The main purpose of this dissertation was to highlight and address seven challenges related to the measurement of youth cognition, understanding the role of cognitive constructs in anxiety and school refusal, and the examination of cognitive mediators of cognitive-behavioural treatment outcomes. The studies presented in this dissertation contributed to the empirically valid assessment of constructs of cognitive processing in youth which were until now only present in cognitive theories of Aron Beck. Now, constructs of cognitive processing coming from the cognitive theories of depression and anxiety of Beck and colleagues can be assessed in youth using one single measure. Further, cognitive dimensions of cognitive products and cognitive processes from Beck and colleagues cognitive theories of emotional disorders were found to be important in the etiology of school refusal. The belief that positive treatment outcomes can be achieved through changes in cognition received support. Using innovative statistical approaches to mediation, it was found that enhanced levels of self-efficacy following cognitive-behavioural treatment for school refusal were associated with increased levels of school attendance and decreased levels of school fear.


Since the beginning of commodity culture, products have been marketed with images reflecting racist concepts of otherness. Using the prominent examples of three companies - Uncle Ben's, Sarotti, and Banania - this book examines how racist trademark figures were established in the U.S., Germany, and France, and built on nation-specific processes of racial stereotyping. While it finds that the three figures mirror their national histories of slavery, Orientalism, and colonialism, the book reveals that their paths through popular culture also followed strikingly similar patterns. Conceived in an era of overt racism, each symbol was challenged by social movements over the course of the 20th century and became increasingly marginalized in promotional activities. In the early 2000s, however, all three figures were relaunched with supposedly new makeovers, hitting once again at the heart of commodity culture and illustrating the subtle prevalence of racist stereotypes. (Series: Racism Analysis - Series A: Studies - Vol. 3)


The author received his medical and psycho analytical training in Chicago and now specializes in the psychotherapy of homosexuals. The book is divided into three parts, entitled The Nature of Polarity, The Psychological Defenses and The Creative Process. There are no references. The style is opaque, at times almost to the point of Blakeian obscurity. Certain key words and phrases recur without there ever being any attempt to explain their precise meanings—e.g., mated union, power, celebration. Two short extracts must suffice to illustrate these points: †̃¿ Thechild's acceptance of clearly defined obligations to conform in the family power structure has spared him from a celebrative intrusion into his power relationships, but at puberty his strong celebrative needs stand in marked contrast to his inner preparation for the mated use of power' (p. so), and †̃¿ Intensitybecomes sexual when danger is dissipated through idealization, and vigor becomes celebrative when obstructiveness is converted into opportunity through the exploitative capacities' (p. 119). The author's concept of polarity is hardly original, going back at least to 500 B.C.with the enantiodromia of Heraclitus, so beautifully elaborated by Jung. He lacks any historical perspective and seems to ignore all previous work. He neither illuminates the complexities of creativity nor furthers our under standing of homosexuality or of possible relationships between them. The pretentions of the publisher's blurb are not met, for on closer scrutiny any possible enlightenmentis rapidly lost in a morass of pseudo profundity. F. E. KENYON.


Transpiration rate (TR) of a slow-wilting soybean [Glycine max (L.) Merr.] line, PI 416937, is constant with increasing vapor pressure deficit (VPD) at high VPD (> ?2 kPa). The basis of such a limitation on TR was recently linked to limited leaf hydraulic conductance. It was hypothesized that this genotype may lack an AgNO3-sensitive protein-mediated water pathway in the leaf, possibly involving aquaporins (AQPs), causing it to have a low hydraulic conductance. The possibility of genetic variability for sensitivity of derooted plants exposed to 200 iM AgNO3 was investigated among 12 soybean genotypes including progeny of PI 416937. Segregation among genotypes in their response to AgNO3 was observed. Genotype PI 416937 and two of its progeny lines were insensitive to the AgNO3 treatment indicating that they lacked a protein-mediated water pathway that is sensitive to this inhibitor. The remaining nine genotypes were sensitive to the AgNO3 treatment, and the decrease in TR indicated that the AgNO3 sensitivity accounted for 25 to 50% of the usual hydraulic pathway in the leaves. Among the AgNO3-sensitive lines, the genotypes could be further segregated based on previous observations in the response of intact plants to increasing VPD. It is hypothesized that this additional segregation might be a result of a difference in hydraulic limitation in their roots.


Background Artificial intelligence (AI) for gastric cancer diagnosis has been discussed in recent years. The role of AI in early gastric cancer is more important than in advanced gastric cancer since early gastric cancer is not easily identified in clinical practice. However, to our knowledge, past syntheses appear to have limited focus on the populations with early gastric cancer. Objective The purpose of this study is to evaluate the diagnostic accuracy of AI in the diagnosis of early gastric cancer from endoscopic images. Methods We conducted a systematic review from database inception to June 2020 of all studies assessing the performance of AI in the endoscopic diagnosis of early gastric cancer. Studies not concerning early gastric cancer were excluded. The outcome of interest was the diagnostic accuracy (comprising sensitivity, specificity, and accuracy) of AI systems. Study quality was assessed on the basis of the revised Quality Assessment of Diagnostic Accuracy Studies. Meta-analysis was primarily based on a bivariate mixed-effects model. A summary receiver operating curve and a hierarchical summary receiver operating curve were constructed, and the area under the curve was computed. Results We analyzed 12 retrospective case control studies (n=11,685) in which AI identified early gastric cancer from endoscopic images. The pooled sensitivity and specificity of AI for early gastric cancer diagnosis were 0.86 (95% CI 0.75-0.92) and 0.90 (95% CI 0.84-0.93), respectively. The area under the curve was 0.94. Sensitivity analysis of studies using support vector machines and narrow-band imaging demonstrated more consistent results. Conclusions For early gastric cancer, to our knowledge, this was the first synthesis study on the use of endoscopic images in AI in diagnosis. AI may support the diagnosis of early gastric cancer. However, the collocation of imaging techniques and optimal algorithms remain unclear. Competing models of AI for the diagnosis of early gastric cancer are worthy of future investigation. Trial Registration PROSPERO CRD42020193223; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=193223


OBJECTIVE
To determine the long-term hearing preservation rate for spontaneous vestibular schwannoma treated by primary radiotherapy.

DATA SOURCES
The MEDLINE/PubMed, Web of Science, Cochrane Reviews, and EMBASE databases were searched using a comprehensive Boolean keyword search developed in conjunction with a scientific librarian. English language papers published from 2000 to 2016 were evaluated.

STUDY SELECTION
Inclusion criteria: full articles, pretreatment and posttreatment audiograms or audiogram based scoring system, vestibular schwannoma only tumor type, reported time to follow-up, published after 1999, use of either Gamma Knife or linear accelerator radiotherapy.

EXCLUSION CRITERIA
case report or series with fewer than five cases, inadequate audiometric data, inadequate time to follow-up, neurofibromatosis type 2 exceeding 10% of study population, previous treatment exceeding 10% of study population, repeat datasets, use of proton beam therapy, and non-English language.

DATA EXTRACTION
Two reviewers independently analyzed papers for inclusion. Class A/B, 1/2 hearing was defined as either pure tone average less than or equal to 50 db with speech discrimination score more than or equal to 50%, American Academy of Otolaryngology-Head & Neck Surgery (AAO-HNS) Hearing Class A or B, or Gardner-Robertson Grade I or II. Aggregate data were used when individual data were not specified.

DATA SYNTHESIS
Means were compared with student t test.

CONCLUSIONS
Forty seven articles containing a total of 2,195 patients with preserved Class A/B, 1/2 hearing were identified for analysis. The aggregate crude hearing preservation rate was 58% at an average reporting time of 46.6 months after radiotherapy treatment. Analysis of time-based reporting shows a clear trend of decreased hearing preservation extending to 10-year follow-up. This data encourages a future long-term controlled trial.


In this paper, the researcher-author relates the applications and benefits of Lao Tzu's three greatest treasures: simplicity, patience and compassion – to motivation and leadership. This paper includes a research model, research methodology and its findings, discussions as well as an analysis with its concluding remarks. The use of the three treasures of Lao Tzu is really useful for a leader in terms of motivating oneself and one's followers as well as those whom one leads and cares for. Here, the university don has, in most ways, turned the Chinese philosophy of Taoism into leadership and management lessons and their applications.


matics is entirely based on immediate knowledge, or that the deductive theories will faithfully reproduce a part of this knowledge. It seems more reasonable to suppose with Bernays that mathematics is the result of a rational organization of certain fundamental principles originating from our immediate knowledge. There would be, therefore, a strong analogy between mathematical and physical theories." HUGO RIBEIRO


With the rapidly increasing deployment of sensor networks, large amounts of time series data are generated. One of the main challenges when dealing with such data is performing accurate predictions in order to address a broad class of application problems, ranging from mobile broadband network (MBN) optimization to preventive maintenance. To this end, time series prediction has been widely addressed by the statistics community. Nevertheless, such approaches fail in performing well when the data are more context-dependent than history-dependent. In this paper, we investigate how latent attributes can be built upon the time series in order to define a spatio-temporal context for predictions. Moreover, such attributes are often hierarchical, leading to multiple potential contexts at different levels of granularity for performing a given prediction. In support of this scenario, we propose the Lattice-Based Spatio-Temporal Ensemble Prediction (LBSTEP) approach, which allows modeling the problem as a multidimensional spatio-temporal prediction. Given an ensemble prediction model, we propose a solution for determining the most appropriate spatio-temporal context that maximizes the global prediction metrics of a set of the time series. LBSTEP is evaluated with a real-world MBN dataset, which exemplifies the intended general application domain of time series data with a strong spatio-temporal component. The experimental results shows that the proposed contextual and multi-granular view of the prediction problem is effective, in terms of both several optimization metrics and the model calculation.


In this paper, we analyze the impact of several labor reforms in Spain on its equilibrium unemployment rate. To this end, we analyzed the behavior of the observed unemployment rate in Spain during the 1976-2012 period, thereby assessing whether that rate is better characterized as a hysteresis process or, on the contrary, as a stationary process with fluctuations around an equilibrium unemployment rate (NAIRU). In order to achieve this aim, we employed unit root contrasts with structural change. Similarly, in order to calculate the equilibrium unemployment rate, we applied the methodology of multiple structural changes proposed by Bai & Perron (1998, 2003a). This method allows the estimation of breaking dates and the values of unemployment rates for each of the selected regimes. Lastly, we compare the direction in the changes of the equilibrium unemployment rate, as well as the dates of those breaking points, with the dates in which different labor reforms were enacted in Spain. This will allow us to determine whether those reforms had any effect on the Spanish labor market. The obtained results suggest that only the reforms of 1980, 1997 and 2006 had some influence on the equilibrium unemployment rate level in combination with changes in inflation and sectorial employment structure.


Airway management is one of the mayor tasks of the anaesthetist, either in or outside the operating theatre. A secured airway can be achieved by placing a tracheal tube (TT) between the vocal cords of the patient. The most common way to do this is to perform direct laryngoscopy (DL), achieving a direct view of the vocal cords and thus placing the TT under direct sight. In this thesis, we describe the development of airway management from early history until today. Centuries ago, one only had the deposition of bulky instruments to get an indirect view of the glottis. Instruments lacked a direct light source, so illumination of the oral cavity and glottis was the biggest obstacle. Only when a direct light source was developed, many different endoscopes were designed. Laryngoscopy improved with the development of flexible fibreoptic cables enabling a much better visualization and illumination of the larynx for both direct and indirect laryngoscopy. In the early 21st century, there has been a return to indirect laryngoscopy via videolaryngoscopy using different videolaryngoscopes (VLS). VLS can differ greatly; they can roughly be divided into two groups: channelled and non-channelled. The non-channelled devices can then further be divided in angulated and non-angulated. To find an answer concerning the added value of videolaryngoscopy for anaesthetists confronted with patients with a known difficult airway, a systematic review and meta-analysis is presented. This meta-analysis shows that videolaryngoscopy has an added value for experienced anaesthetists. Also, a very wide range of devices was tested across different key groups. Not one single device was best for all caregivers and this points out that a balance between the advantages of VLS and the disadvantage of new skill requirements can be found in VLS with a classic-shaped Macintosh blade. These results underline the importance of variability in device performance across individuals and staff groups. The intensity of illumination from the light source of different VLS was also compared. Illumination was poor with all VLS tested, except for one when used in the operating theatre. It is important that clinicians are aware of these possible shortcomings and differences between devices. Further exploring the advantages of videolaryngoscopy, we confirmed that the forces applied to teeth are reduced when using VLS. Based on this result, it is strongly recommended to use videolaryngoscopy in patients with poor dentition, dental crowns and/or fixed partial denture, needing intubation. Finally, a new successful intubation technique is presented, combining a Macintosh blade videolaryngoscope with a Bonfils® intubation endoscope (BIE). The combined intubation technique provides the anaesthetist with an alternative option when confronted with difficult intubation conditions.


Infection with the parasite Toxoplasma gondii causes foetal abnormalities during pregnancy and encephalitis in immunocompromised individualsin both developed and
developing countries. Inside the host cell, Toxoplasma resides in a protective parasitophorous vacuole (PV), allowing it to survive and replicate. Following
infection, the cytokine interferon gamma (IFNγ) upregulates the p47 immunity-related GTPases (IRGs) and the p65 guanylate-binding proteins (GBPs). Both IRGs and GBPs are highly expressed in IFNγ-induced cells in vitro and accumulate at the PV of avirulent type II and III, but not virulent type I strains of Toxoplasma, mediating the disruption of the avirulent PV. Autophagy, the process targeting intracellular cargo for degradation by the lysosome, has been shown to be a key player in cell-autonomous resistance to Toxoplasma. Inflammasomes, the signalling platforms of the innate immunity detecting pathogenic and danger molecules, have been reported to regulate non-cell-autonomous restriction of Toxoplasma. However, the mechanisms involved in these two defence responses and what happens once the vacuole is disrupted remain unclear.
In this work, I investigate the role of ubiquitin in IFNγ-dependent resistance against Toxoplasma infection. I identified the E3 ubiquitin ligase TRIM21 as a novel
interaction partner of GBP1. TRIM21 and GBP1 were co-recruited to the PV of avirulent but not virulent Toxoplasma. I show that avirulent, but not virulent
Toxoplasma, is ubiquitinated in an IFNγ- and TRIM21-dependent manner, with TRIM21 partly mediating Lys63 ubiquitin linkages. TRIM21 differentially regulated
the transcriptional and protein levels of GBP1 and GBP2, which were identified as substrates of the E3 ligase. TRIM21 also substantially upregulated the biosynthesis of
8 cholesterol, for which Toxoplasma is auxotroph. TRIM21-/- mice were highly susceptible to Toxoplasma infection and exhibited decreased levels of proinflammatory cytokines in their serum associated with higher parasite burden in the periphery and later in the brain. These findings suggest TRIM21 is a crucial, novel
restriction factor during acute Toxoplasma infection.


In Dhara et al 2014 Nanotechnology 25 225202, the authors reported on the synthesis of Eu-doped ZnO nanowires (NWs) and investigated the influence of Eu doping on the second harmonic generation (SHG). Maximum SHG was found to correlate strongly with the structural deformation attributed to Eu3+ doping. In this comment, we show the deformation of interest is due to the presence of Eu2+ dopants, based on both the experimental data presented by Dhara et al and ab-initio density functional theory calculations.


Targeted activist strategies propel social justice movements to devise creative mechanisms in an effort to gain momentum. This discussion paper will analyze if cyberactivism can effectuate global political change. Varying views will be illustrated demonstrating the efficacy and the lack of efficacy of cyberactivism in its attempt to impact global political change. Comparisons and data analyses will assess the impact of communication media and the Internet, Internet connectivity of people, and impact of online technology on social movements. Research studies will gauge online communication tools, benefits/wins and challenges of cyberactivism, and future assumptions. Examples of cyberactivism strategies will illustrate how online technology has impacted political change in different regions of the world. The available evidence suggests that cyberactivism has created new ways for people to connect for the purpose of change despite where they live or identity differences. Although researchers may disagree about the efficacy of cyberactivism on global political change, the Internet still provides the essential platform for debate and information sharing.


BACKGROUND
Intestinal parasites are very common in developing countries including Nigeria. There are diverse ways of their transmission; the study attempts to determine the level of intestinal parasitic contamination on vegetables sold in Jos.

METHODS
Sample of 200 each of Tomatoes (Lycopersium sativus), Letus (Loctus satival) Carrot (Davcus carota L) Cabbage (Brassica Denceal) and Green leafy vegetables were analyzed using standardized Centrifugal-floatation technique methods.

RESULTS
Of the 1250 samples of vegetables examined, 450 (36.0%) were positive for intestinal parasites, cabbage recorded the highest prevalence of 64% while tomatoes had the least prevalence of 20%.

CONCLUSION
Vegetables in Jos are heavily contaminated with intestinal parasites and there is need for public enlightenment campaign on the danger of consuming inadequately washed and prepared vegetables.


Background & Aim: Pregnancy and childbirth is one of the most important stages of women's life. Sexual satisfaction may change during pregnancy. These changes could lead to negative long effects on mother's sexual and mental health. This study was conducted with the aim of assessing sexual satisfaction of primigravidas and its related factors. Material & Methods: It was a descriptive cross-sectional study. The sample consisted of 230 primigravid women admitted to hospitals affiliated with Tehran University of Medical Sciences. Data was collected by the adjusted version of Hudson's Index of Sexual Satisfaction (ISS) and were analyzed using SPSS-PC (v.14). Results: The mean score for sexual satisfaction was 133.6±11.2. The findings indicated that there is a significant relationship between women's age, their husbands' age, length of marriage, occupation, planned/ unplanned pregnancy, type of family, consultant with midwives, having pregnancy complication and concerning about fetus and sexual satisfaction(p<0.0001-0.006) Conclusion: Helping primigravidas to get more sexual pleasure during pregnancy would be accomplished by taking their sexual histories and resolve their misconceptions about sexual satisfaction.


OBJECTIVE: To identify the risk factors for pulmonary complications after thoracotomy for the resection of pulmonary nodules in patients with sarcoma. METHODS: A retrospective cohort study involving 68 consecutive patients diagnosed with sarcoma and submitted to a total of 174 thoracotomies for the resection of pulmonary nodules. The dependent variable was defined as the occurrence of any postoperative pulmonary complications. The independent variables were related to the patient, underlying diagnosis, and type of surgical procedure. We analyzed the data using a multivariate generalized estimating equations model with logistic link function and a symmetric correlation structure. RESULTS: Complications were observed in 24 patients (13.8%, 95% CI: 9.0-19.8), and there was one death. The mean length of hospital stay was twice as long in the patients with postoperative complications as in those without (18.8 ± 10.0 days vs. 8.6 ± 6.0 days; p < 0.05). The variables that correlated with the outcome measure were the type of resection (wedge vs. anatomic; OR = 3.6; 95% CI: 1.5-8.8), the need for blood transfusion (OR = 9.8; 95% CI: 1.6-60.1), and the number of nodules resected (OR = 1.1; 95% CI: 1.0-1.1). The multivariate model showed an area under the ROC curve of 0.75 (95% CI: 0.65-0.85). CONCLUSIONS: Postoperative pulmonary complications were common after pulmonary nodule resection in patients with sarcoma, occurring in approximately 10% of the procedures. The occurrence of such complications can be expected when techniques other than wedge resection are employed, when blood transfusion is required, and when a great number of nodules are resected. Therefore, it is possible to identify patients at risk for pulmonary complications, who should be closely monitored in the immediate postoperative period. In such patients, all preventive measures should be taken.


The article characterises the formation and development of the Estonian book science during the years 1918–1944 and gives an overview about the research on the period in the second half of the 20th century. Book science as an independent field of research started to develop in Estonia in the 1920s. Friedrich Puksoo and Richard Antik became the most significant researchers. F. Puksoo is the author of the first general overview of the history of the Estonian book, published in 1933. R. Antik made a major contribution to retrospective bibliography and book statistics. 138 publications treating the field of book science were published in Estonian language in 1918–1944. The analysis of these publications demonstrates a considerable rise in the number of publications on book history during the Year of the Book which was celebrated in 1935–1936. By the 1930s book studies had become an independent field of research which tackled both historical and contemporary issues. The article also includes a thematic analysis of the publications, which are divided into eight groups: general treatments, research on printing, publishing, book dissemination, book art, studies of a concrete book, statistical analysis and works on bibliophilism. As to the thematic structure of the publications, general treatments were the most numerous (34), history of printing, book dissemination, studies on a concrete book and book art were also popular topics of research whereas the smallest number of publications (8) were devoted to bibliophilism. The researchers of that time have made a valuable contribution in the development of book research by gathering rich factual data, elaborating the basic principles of book statistics, compiling the first general treatments of book history. During the first post-war decade, the Stalinist era, research on the book history of the the period of independence in 1918–1940 was discontinued. The treatment of the topics connected with publishing and distribution of books in 1918–1940 enlivened only during the 1970s. The leading researcher Mare Lott has written articles published in Estonian and in foreign languages. The results of her reasearch are presented most completely in her unpublished dissertation. For the larger public they are available in the collective monograph "The Estonian Book 1525–1975", issued in 1978. Numerous diploma works and Bachelor's thesis have been written on this period under her guidance, but the results of these works have not been published. Since perestroika the ideological constraints in the treatment of the period disappeared, but the research of the book branch of this era has not been very intensive. Among the most outstanding achievements are the collections of articles dedicated to the two leading book reserachers Fr. Puksoo and R. Antik. A research group has been formed in the Tallinn University to prepare a comprehensive work on the book branch of that period which would tackle the topic from the contemporary viewpoint.


How to engage culturally and linguistically diverse students in learning science is a relatively new field of study. Researchers have begun to address this question using a range of theoretical perspectives, including: (a) a cognitively based perspective, (b) a cross-cultural perspective, and (c) a sociopolitical perspective. Although proponents of these perspectives share the belief that connecting students' cultural and linguistic experiences to the practices of science is central to student engagement, the specific approaches proposed to best achieve this goal differ. The authors explain each perspective using examples from representative research programs and discuss the unique ways that each perspective addresses the challenge of providing engaging and equitable learning opportunities for culturally and linguistically diverse students in science classrooms. They offer implications for instructional strategies that teachers can use to make their classrooms more engaging and equitable science learning environments for diverse student groups.


This guide compares emerging diagnostic software tools that aid detection and diagnosis of operational problems for large HVAC systems. We have evaluated six tools for use with energy management control system (EMCS) or other monitoring data. The diagnostic tools summarize relevant performance metrics, display plots for manual analysis, and perform automated diagnostic procedures. Our comparative analysis presents nine summary tables with supporting explanatory text and includes sample diagnostic screens for each tool.


Design of robotic systems and their control for inspection and maintenance tasks is highly complex activity involving coordination of various sub-systems. In application like inspections in fusion reactor vessels and deep-mining works, a regular off-line maintenance is necessary in certain locations. Due to the hostile environments inside, robotic systems are to be deployed for such internal observations. In this regard, current work focuses on the methodology for maintenance of the first wall blanket modules in a fusion reactor vessel using a manipulator system. A design is proposed for wall tile inspections in an ideal environment in which vacuum and temperature conditions are not accounted and wall surface curvature is not accounted initially. The entire design has four important modules: (i) mathematical modelling (ii) control system design (iii) machine vision and image processing, (iv) hardware development and testing.
A five- axis articulated manipulator equipped with a vision camera in eye-to-hand configuration is designed for performing the pick and place operations of the defected tiles in a systematic manner. Kinematic and dynamics analysis of the system are first carried-out and a scaled prototype is fabricated for testing various operating issues. Forward kinematics of manipulator allows in estimation of robot workspace and in knowing the singular regions during operation, while the inverse kinematics of the manipulator would be needed for real time manipulator control task. Dynamics of manipulator is required for design of model-based controllers. Interactive programs are developed in Matlab for kinematics and dynamics and three-dimensional manipulator assembly configuration is modelled in SolidWorks software. Motion analysis is conducted in ADAMS software in order to compare the results obtained from the classical kinematics. Two types of model-based control schemes (namely Computed Torque Control and Proportional Derivative-Sliding Mode Control approach) with and without external disturbances are implemented to study trajectory tracking performance of the arm with different input trajectories. A disturbance observer model is employed in minimizing the tracking errors during the action of external disturbances such as joint friction and payload.
In order to experimentally understand the inspection and replacement activities, a test set-up is developed using vision camera and microcontroller platform to guide the robot joint servos so as to perform defected object replacement activity. Presence of crack and the coordinate of the region are indicated with the use of image-processing operations. Using a high resolution Basler camera mounted at fixed distance from the tile surface, the surface images are acquired and image processing module identifies the crack details using edge detection algorithms. Necessary motion of the end-effector will be provided based on the pose calculations using coordinate transformations. Both visual inspection and joint guidance are combined in a single application and the results are presented with a test case of tile replacement activity. The results are presented sequentially using a test surface with uniform rectangular tiles.


A novel approach to autonomous navigation for small UAVs was recently introduced by the authors. An abridged description of this approach can be found in present paper, with its main contribution being further evaluation of effects of wind on navigation performance. The vehicle dynamic model (VDM) serves as the main process model within the introduced navigation filter. The proposed method exploits the knowledge of physical properties of the UAV together with control input with the goal to significantly increase the accuracy and reliability of autonomous navigation. This is especially relevant for small UAVs with low-cost IMUs on-board and no extra sensor added to the conventional INS/GNSS setup. The improvement is of special interest in case of GNSS outages, where inertial coasting drifts very quickly. In the proposed architecture, the solution to VDM equations provides the estimate of position, velocity, and attitude, which is updated within the navigation filter based on available observations, such as IMU data or GNSS measurements. The filter is capable of estimating wind velocity and dynamic model parameters, in addition to navigation states and IMU sensor errors. Robustness and scalability of the navigation system against random changes in wind velocity are investigated via Monte Carlo simulations using real 3D wind velocity data. In case of GNSS outages of a few minutes, position and attitude accuracy experiences improvements of orders of magnitude compared to conventional kinematic modeling in INS/GNSS integration. Simulations also reveal that navigation errors are almost doubled as wind velocity doubles, which gives an estimation of the scalability of the navigation system.


There is a growing demand for subnational population projections for informing potential demographic influences on many aspects of society and the environment at the scale at which interactions occur and actions are taken. Existing US subnational population projections have not fully accounted for regional variations of demographic rates and therefore under-estimate the uncertainties in and heterogeneity of population trends. We present a first set of population projections for US states that span a wide but plausible range of population outcomes driven by changing state-level demographic rates consistent with the widely used SSP scenario framework. The projections are carried out for all 50 states integrated through bilateral gross migration flows. They update the original national-level SSP population projections based on recently available data and introduce more plausible assumptions on long-term international migration. We project a national population ranging from about 250–650 million by 2100, somewhat lower than the SSP projections due mainly to updated base year data. Utah and other states in the Rocky Mountain region see the largest increases in population in proportional terms, while the Northeast and Great Lakes regions see the slowest growth or most decline, along with individual states like Alaska, California, Louisiana, and Mississippi. Aging occurs in all states and scenarios, but is most prominent in the Northeast, Florida, and in some cases states in the West and the Great Lakes region. The relative contributions of fertility, mortality, and migration to population change varies substantially across states.


INTRODUCTION
The exact prevalence of constipation in India is unknown. To know this, first it has to be properly defined based on stool frequency and form (as in western definition) in Indian patients, data on which is scarce. There may be difference with the western definition also.

AIM
To determine the stool frequency and form in patients consulting doctor for the complaint of constipation and compare these with the Western definition of constipation.

MATERIALS AND METHODS
This was a prospective cross-sectional study on 331 consecutive patients seeking medical advice for their complaint of constipation. They were administered a questionnaire containing Rome III criteria points of functional constipation and constipation predominant irritable bowel syndrome and the Bristol stool chart to report their predominant stool form. Organic bowel diseases were excluded by further history taking, physical examination and appropriate investigations. The data on stool frequency and form thus obtained were compared with the existing Indian population data.

RESULTS
A total of 65% patients were above 60 years of age. The predominant stool types were 1-3 according to Bristol stool form scale present in 93.8% patients and conformed to Asian criteria of constipation by stool form. Only 67.9% patients passed Bristol Stool Scale (BSS) type 1 and 2 stool which is the western definition. 51.5% reported a frequency of 3-4 motions/week, 19.8% had normal stool frequency by Indian standard (i.e. at least 1 motion/day) and only 35.4% had constipation by Western criteria (less than 3 motions/week). Hence subjective feeling varied widely from observed rate and Western definition was invalid in about twothird of patients. Feeling of incomplete evacuation was universal and this was referred to as constipation by patients. Functional constipation was diagnosed in 69.1% (of whom most were elderly with co-morbidities) and constipation predominant irritable bowel syndrome in 13.8% by Indian standard. Only 2.1% had colonic cancer.

CONCLUSION
A stool frequency of <5 motions/week appears more appropriate in Indian definition of constipation where the subjective feeling of incomplete evacuation should also be given due weightage. Asian criteria based on stool form holds true in India.


We propose a method for adding visual details to fluid animation while reducing noisy appearances. In grid-based fluid simulations, an issue is that while highly detailed fluids with small eddies can be obtained by increasing the number of grid cells, it costs much more computational time. To address this, various methods for adding details (or up-scaling resolutions) have been proposed. Those methods can generate fine animations quickly by adding high-frequency noises or external forces to coarse simulation results. However, those methods typically generate tiny eddies on a whole surface of fluid and the result appears too noisy. In this paper, we consider the distribution of kinetic energy in the spatial frequency domain and then apply it to two existing methods for adding details. By using our method, noises or external forces can be added to the appropriate positions of fluids and consequently natural-looking details can be achieved.


Some basic properties of collisionless, trapped-electron mode turbulence in tokamaks are investigated by means of massively parallel gyrokinetic Vlasov simulations. In particular, the spatial structure and wave number spectra of various fluctuating plasma quantities are presented and discussed. An analysis of several cross phase relations supports the view that the transport-dominating scales may be interpreted in terms of remnants of linear modes. In a few test cases, zonal flows are artificially suppressed, demonstrating that their influence on the transport level is small. Finally, the dependence of the latter on several plasma parameters is studied.


We estimate the height of various European populations in the first half of the 18th century. English and Irish male heights are estimated at c. 65 inches (165 cm), and c. 66 inches (168 cm) respectively. These values are below those obtained from the only other sample available for the period pertaining to British and Irish men, namely those of runaway indentured and convict servants in colonial North America, whose height is estimated as between 66.4 and 67.0 inches (168,7 and 170,2 cm). At c. 64.5 inches (164 cm) Saxon, German and Scotch military heights appear to be near the bottom of the European height distribution in this period. The English were about as tall as Bohemians and French, but shorter than the Irish and Hungarians. A large decline in English heights is evident among the birth cohorts of 1725-29, suggesting that the subsistence crisis of this period must have had a substantial lasting impact on the nutritional status of the cohort born during a time of nutritional deprivation.


This paper presents greedy gossip with eavesdropping (GGE), a novel randomized gossip algorithm for distributed computation of the average consensus problem. In gossip algorithms, nodes in the network randomly communicate with their neighbors and exchange information iteratively. The algorithms are simple and decentralized, making them attractive for wireless network applications. In general, gossip algorithms are robust to unreliable wireless conditions and time varying network topologies. In this paper, we introduce GGE and demonstrate that greedy updates lead to rapid convergence. We do not require nodes to have any location information. Instead, greedy updates are made possible by exploiting the broadcast nature of wireless communications. During the operation of GGE, when a node decides to gossip, instead of choosing one of its neighbors at random, it makes a greedy selection, choosing the node which has the value most different from its own. In order to make this selection, nodes need to know their neighbors' values. Therefore, we assume that all transmissions are wireless broadcasts and nodes keep track of their neighbors' values by eavesdropping on their communications. We show that the convergence of GGE is guaranteed for connected network topologies. We also study the rates of convergence and illustrate, through theoretical bounds and numerical simulations, that GGE consistently outperforms randomized gossip and performs comparably to geographic gossip on moderate-sized random geometric graph topologies.


The Rosetta mission to delivered images of comet 67P's nucleus at unprecedented
resolution which indicate the presence of a global layering system. By
merging techniques of structural geology, statistical image processing, and solar
system science, this thesis aims to contribute to the understanding of the
formation of the layerings, and consequently the formation of cometary nuclei
as a whole.
I describe the two distinctive approaches I used to study the layerings' orientation
on both lobes of comet 67P's nucleus. First, I mapped layering-related
linear features on a 3D shape model of the nucleus, onto which I projected
high-res OSIRIS images. I selected only lineaments of substantial curvature,
and used a plane-fitting algorithm to find the normals to the layering planes
represented by these lineaments. I used the normals to confirm previous authors'
results, including that the layering systems on the comet's two lobes are
geometrically independent from each other. My results rule out the proposal
that 67P's lobes represent collisional fragments of a much larger, layered body.
Second, I developed a Fourier-based image analysis algorithm to detect lineament
structures at pixel-precision. I analysed the layering-related, sub-parallel
linear features exposed on the Hathor cliff on the comet's Small Lobe. I found
my algorithm to be a broadly applicable, powerful tool for automating the detection
of layerings in images where conventional edge-detection algorithms
are not effective. When correctly configured to the target conditions, I found
the algorithm to have a higher signal-to-noise detection sensitivity than a human,
while also reducing over-interpretation due to bias.
In summary, I studied the layerings in the nucleus of comet 67P using several
unconventional approaches and constrained their lateral extent, curvature,
and to a degree also their thickness. Ultimately, I nominated two mechanisms
that could have formed these layerings in cometary nuclei.


Microanalytical trace element techniques (such as ion probe or laser ablation ICP-MS) are hampered by a lack of well characterized, homogeneous standards. Two silicate glass reference materials produced by National Institute of Standards and Technology (NIST), NIST SRM 610 and NIST SRM 612, have been shown to be homogeneous and are spiked with up to sixty one trace elements at nominal concentrations of 500 μg g-1 and 50 μg g-1 respectively. These samples (supplied as 3 mm wafers) are equivalent to NIST SRM 611 and NIST SRM 613 respectively (which are supplied as 1 mm wafers) and are becoming more widely used as potential microanalytical reference materials. NIST however, only certifies up to eight elements in these glasses. Here we have compiled concentration data from approximately sixty published works for both glasses, and have produced new analyses from our laboratories. Compilations are presented for the matrix composition of these glasses and for fifty eight trace elements. The trace element data includes all available new and published data, and summaries present the overall average and standard deviation, the range, median, geometric mean and a preferred average (which excludes all data outside ± one standard deviation of the overall average). For the elements which have been certified, there is a good agreement between the compiled averages and the NIST data. This compilation is designed to provide useful new working values for these reference materials.


Devil facial tumor disease (DFTD) is a transmissible cancer that has killed most of the Tasmanian devil (Sarcophilus harrissii) population. Since the first case appeared in the mid-1990s, it has spread relentlessly across the Tasmanian devil's geographic range. As Tasmanian devils only exist in Tasmania, Australia, DFTD has the potential to cause extinction of this species. The origin of DFTD was a Schwann cell from a female devil. The disease is transmitted when devils bite each other around the facial areas, a behavior synonymous with this species. Every devil that is 'infected' with DFTD dies from the cancer. Once the DFTD cells have been transmitted, they appear to develop into a cancer without inducing an immune response. The DFTD cancer cells avoid allogeneic recognition because they do not express MHC class I molecules on the cell surface. A reduced genetic diversity and the production of immunosuppressive cytokines may also contribute.


Direct steam injection (DSI) is a sterilization technique which is often used for high viscosity fluid food when the preservation of the quality characteristics and energy efficiency are the priority. In this work an apparatus for the sterilization of tomato concentrate has been analyzed by means of multidimensional CFD (Computational Fluid Dynamics) models, in order to optimize the quality and safety of the treated food. A multidimensional two-phase model of steam injection inside a non-newtonian pseudoplastic fluid was adopted to evaluate the thermal history of the product and the steam consumption during the target process. Subsequently CFD analysis has been extended to examine the effects of the different process parameters (sterilization temperature, steam flow rate, radial and axial temperature profiles, nozzle geometry) on the resulting product. Result obtained are in agreement with available data acquired in industrial plant.


The three dimensional growth of the mouse isocortex was examined by plotting the variations in intermediate layer depth on orthogonal projections of the telencephalic surface at successive periods of development; a histological status was assigned to each depth. Thus portrayed, the development of the isocortex was seen as a propagated sequence of histological change, commencing at a rostral focus coextensive with the caudatopallial angle and thence spreading across the telencephalic wall. Growth was asymmetric about the focus of origin and terminated in a rostrocaudal direction as the spread of neuron production reached and extinguished a growth zone along the sagittal perimeter of the hemisphere. The possibility of mouse isocortical histogenesis representing a variation of a general mammalian pattern was noted, as was the evolutionary and methodological significance of the apparent coincidence of the origin of the gradient of isocortical neuron release with the region of cortex representing oropharyngeal structures. An alternative form of representation of the isocortical gradient, as the summation of a number of radial strips of tissue each with a similar history of neuron release and migration, was used to lay a foundation for a three dimensional model.


STUDY OBJECTIVE
To identify the prognostic factors for pneumothorax in patients in the ICU.

DESIGN
Retrospective cohort study.

SETTING
ICU at a university-based teaching hospital.

PATIENTS AND METHODS
Sixty patients developed pneumothoraces in the ICU during a period of 36 months. Medical records relating to patients' age, sex, underlying diseases, associated medical conditions, reasons for admission, acute physiology and chronic health evaluation (APACHE) II scores, procedures performed before the development of pneumothorax, occurrences of tension pneumothorax, duration of chest tube placement, chest tube removal, duration of ICU stay, and patient outcomes all were analyzed. A multivariate logistic regression model was applied with variables that were significantly associated with survival in the univariate analysis. The probabilities of chest tube removal were calculated using the Kaplan-Meier method.

RESULTS
Thirty-five patients (58%) had procedure-related pneumothoraces. The procedure that most commonly caused pneumothoraces was thoracentesis (n = 19; 54%), followed by central vein/pulmonary artery catheterization (n = 14; 40%) and bronchoscopy/transbronchial lung biopsy (n = 8; 23%). A multivariate logistic regression analysis also showed that pneumothorax due to barotrauma (p = 0.001), tension pneumothorax (p = 0.0023), and concurrent septic shock (p = 0.0476) were significantly and independently associated with death. The log-rank test revealed that the success rate of chest tube removal was higher in patients with procedure-related pneumothoraces (p = 0.0055).

CONCLUSIONS
Patients with procedure-related pneumothoraces had better outcomes. Patients with pneumothoraces occurring in the ICU due to barotrauma, or a complicating tension pneumothoraces, carry a higher risk of mortality.


The effective use of embedded radial expanding micro-channels with micro-pin fields for two phase cooling of semiconductor dies has been demonstrated [1, 2]. In this second part of a two part paper, the functional results of integrating this approach into a high performance server are presented. First, a number of microprocessor modules were fully characterized within a high performance server utilizing both an idle state and a workload designed to drive maximum processor power. These characterizations were done across a wide operating frequency range of 2.2 to 4.3 GHz. After modification to incorporate embedded radial expanding micro-channels for two phase flow, the microprocessor modules were reinstalled in the server supported by a two phase liquid cooling pump and condenser system with flow, temperature and pressure drop measuring capabilities. The modules were then characterized again over the same operating frequency range for a range of coolant flow rates and resulting average vapor qualities. The results show full processor function and excellent thermal behavior across a wide range of coolant flow rates, directly demonstrating the feasibility of this technology for cooling actual high power electronic devices.


This second article of the series "An Overview of Research Designs Relevant to Nursing" presents qualitative research designs. Phenomenological, ground theory, ethnography, narrative inquiry, and other related qualitative-related research methodologies are described. In addition, the importance of qualitative research as groundwork for quantitative studies is discussed. This link between qualitative and quantitative research is fundamental to promote evidence-based nursing practice.


Air pollution is a major health risk factor worldwide. Regular short- and long-time exposures to ambient particulate matter (PM) promote various diseases and can lead to premature death. Therefore, in Germany, air quality is assessed continuously at approximately 400 measurement sites. However, knowledge about this intermediate distribution is either unknown or lacksa high spatial–temporal resolution to accurately determine exposure since commonly used chemical transport models are resource intensive. In this study, we present a method that can provide information about the ambient PM concentration for all of Germany at high spatial (100 m × 100 m) and hourly resolutions based on freely available data. To do so we adopted and optimised a method that combined land use regression modelling with a geostatistical interpolation technique using ordinary kriging. The land use regression model was set up based on CORINE (Coordination of Information on the Environment) land cover data and the Germany National Emission Inventory. To test the model's performance under different conditions, four distinct data sets were used. (1) From a total of 8760 (365 × 24) available h, 1500 were randomly selected. From those, the hourly mean concentrations at all stations (ca. 400) were used to run the model (n = 566,326). The leave-one-out cross-validation resulted in a mean absolute error (MAE) of 7.68 μg m−3 and a root mean square error (RMSE) of 11.20 μg m−3. (2) For a more detailed analysis of how the model performs when an above-average number of high values are modelled, we selected all hourly means from February 2011 (n = 256,606). In February, measured concentrations were much higher than in any other month, leading to a slightly higher MAE of 9.77 μg m−3 and RMSE of 14.36 μg m−3, respectively. (3) To enable better comparability with other studies, the annual mean concentration (n = 413) was modelled with a MAE of 4.82 μg m−3 and a RMSE of 6.08 μg m−3. (4) To verify the model's capability of predicting the exceedance of the daily mean limit value, daily means were modelled for all days in February (n = 10,845). The exceedances of the daily mean limit value of 50 μg m−3 were predicted correctly in 88.67% of all cases. We show that modelling ambient PM concentrations can be performed at a high spatial–temporal resolution for large areas based on open data, land use regression modelling, and kriging, with overall convincing results. This approach offers new possibilities in the fields of exposure assessment, city planning, and governance since it allows more accurate views of ambient PM concentrations at the spatial–temporal resolution required for such assessments.


Intersectional insights and frameworks are put into practice in a multitude of highly contested, complex, and unpredictable ways. We group such engagements with intersectionality into three loosely defined sets of practices: applications of an intersectional framework or investigations of intersectional dynamics; debates about the scope and content of intersectionality as a theoretical and methodological paradigm; and political interventions employing an intersectional lens. We propose a template for fusing these three levels of engagement with intersectionality into a field of intersectional studies that emphasizes collaboration and literacy rather than unity. Our objective here is not to offer pat resolutions to all questions about intersectional approaches but to spark further inquiry into the dynamics of intersectionality both as an academic frame and as a practical intervention in a world characterized by extreme inequalities. At the same time, we wish to zero in on some issues that we believe have occupied a privileged place in the field from the very start, as well as on key questions that will define the field in the future. To that end, we foreground the social dynamics and relations that constitute subjects, displacing what often seems like an undue emphasis on the subjects (and categories) themselves as the starting point of inquiry. We also situate the development and contestation of these focal points of intersectional studies within the politics of academic and social movements—which, we argue, are themselves deeply intersectional in nature and therefore must continually be interrogated as part of the intersectional project.


The primary way in which directors obtain necessary information is by attending board meetings. Bank directors, in particular, are strongly urged to attend meetings by regulators. We investigate whether such pressure is sufficient for bank directors to have good attendance records. Using data on whether directors were named in proxy statements as attending fewer meetings than they were supposed to, we find that a) bank directors appear to have worse attendance records than their counterparts in nonfinancial firms, b) their attendance behavior is related to explicit and implicit incentives for attendance, and c) past attendance records are not related to the likelihood a director departs the board. Our results suggest that explicit and implicit incentives may provide important complements to regulatory pressure in influencing director behavior.


Near Field Communication (NFC)-based mobile phone services offer a lifeline to the under-appreciated multiapplication smart card initiative. The initiative could effectively replace heavy wallets full of smart cards for mundane tasks. However, the issue of the deployment model still lingers on. Possible approaches include, but are not restricted to, the User Centric Smart card Ownership Model (UCOM), GlobalPlatform Consumer Centric Model, and Trusted Service Manager (TSM). In addition, multiapplication smart card architecture can be a GlobalPlatform Trusted Execution Environment (TEE) and/or User Centric Tamper-Resistant Device (UCTD), which provide cross-device security and privacy preservation platforms to their users. In the multiapplication smart card environment, there might not be a prior off-card trusted relationship between a smart card and an application provider. Therefore, as a possible solution to overcome the absence of prior trusted relationships, this paper proposes the concept of Trusted Platform Module (TPM) for smart cards (embedded devices) that can act as a point of reference for establishing the necessary trust between the device and an application provider, and among applications.


Objective: Short-term cultures of epithelial and stromal endometrial cells offer a model of endometrial biologic changes. Optimal conditions for short-term culture of eutopic endometrial cells and the analysis of proliferation and differentiation patterns of epithelial and stromal cells have been studied. Methods: Twenty specimens of normal endometrium and five of endometrial carcinoma were used. Ephithelial cells were separated from stromal cells by mesh filtration and cultured in four different in vitro systems: a) culture of epithelial cells in contact with basement membrane extract (BME, Matrigel); b) culture of stromal cells without BME; c) co-culture of epithelial and stromal cells in contact each other and with BME; d) co-culture of epithelial and stromal cells in contact with BME, but separated each other by a Millipore insert. Results: Culture in presence of BME evidenced a significant difference in proliferation index (p< 0.05) and differentiation pattern of epithelial and stromal cells. When grown without BME, after 48 hours in vitro stromal cells showed an enhanced proliferation index (p< 0.005) and assumed a fibroblastic-like shape; after six days in culture they underwent necrosis. In co-cultures of stromal and epithelial cells without the Millipore insert, stromal cells proliferated after 48 hours; in contrast, they showed a better spatial organization when cultured alone or co-cultured with epithelial cells using the Millipore insert. Epithelial cells grown without stromal cells proliferated and aggregated in clusters. Cells harvested from endometrial carcinomas displayed a huge pleomorphysm, and a longer survival in culture (15 days) as compared to controls (6 days).


Summary. A comparison was made between two types of obstetric organization: total hospitalization as in Denmark, and a system that allows a choice between hospital and home delivery, provided there are no medical contra‐indications, as in The Netherlands. Until the end of the 1950s, the current Dutch view prevailed in Denmark; Denmark changed its organization in the late 1960s and followed the international preference for total hospitalization. This change was not caused by disappointing obstetric results, nor was it the result of strong pressure from pregnant women. The change was associated with a considerable increase in instrumental deliveries. In both countries the perinatal mortality rate decreased continuously but in Denmark the improvement in early neonatal mortality was slightly faster. This difference may have occurred because of insufficient referral in The Netherlands of high‐risk pregnancies and deliveries to the fully equipped obstetric departments. The Dutch acceptance of a high proportion of home‐confinements is unlikely to be the explanation.


ABSTRACT Background Complementary food supplementation enhances linear growth and may affect body composition in children. Objective We aimed to determine the effect of complementary food supplements provided from the age of 6 to 18 mo on fat-free mass (FFM) and fat mass (FM) gain among children in rural Bangladesh. Methods In an unblinded, cluster-randomized, controlled trial we tested the effects of 4 complementary food supplements for 1 y [chickpea, rice lentil, Plumpy'doz, and wheat-soy-blend++ (WSB++)] compared with no supplements on linear growth. Body composition was estimated using weight-length-based, age- and sex-specific equations at 6, 9, 12, 15, and 18 mo and postintervention aged 24 mo. Generalized estimating equations (GEEs) were applied to estimate the effect of each complementary food on mean FFM and FM from 9 to 18 and 24 mo compared with the control, adjusting for baseline measures. Sex interactions were also explored. Results In total, 3592 (65.9% of enrolled) children completed all anthropometric assessments. Estimated FFM and FM (mean ± SD) were 5.3 ± 0.6 kg and 1.4 ± 0.4 kg, respectively, at the age of 6 mo. Mean ± SE FFM and FM from 9 to 18 mo were 75.4 ± 14.0 g and 32.9 ± 7.1 g, and 61.0 ± 16.6 g and 30.0 ± 8.4 g, higher with Plumpy'doz and chickpea foods, respectively, than the control (P < 0.001). Estimated FFM was 41.5 ± 16.6 g higher in rice-lentil-fed versus control (P < 0.05) children. WSB++ had no impact on FFM or FM. A group-sex interaction (P < 0.1) was apparent with Plumpy'doz and rice-lentil foods, with girls involved in the intervention having higher estimated FFM and FM than control girls compared with no significant effect in boys. At 24 mo, FFM and FM remained higher only in girls eating Plumpy'doz compared with the controls (P < 0.01). Conclusions In this randomized trial, supplementation effected small shifts in apparent body composition in rural Bangladeshi children. Where seen, FFM increments were twice that of FM, in proportion to these compartments, and more pronounced in girls. FFM increased in line with reported improvements in length. This trial was registered at clinicaltrials.gov as NCT01562379.


We study various number theoretic problems that arise from cryptographic protocols. Our results are used to prove the security of new and existing protocols. The thesis is divided into five parts. We begin by studying algebraic algorithms which are a weak model of computation suitable for modeling number theoretic algorithms. We prove a hardness criteria for algebraic algorithms and present several number theoretic consequences of this result. Next we study black box fields and show how they can be used to break algebraically homomorphic encryption schemes. These algorithms show that over the group of points of an elliptic curve the hardness of computing discrete-log implies the security of the Diffie-Hellman protocol. We go on to study the security of portions of the Diffie-Hellman secret. We show that $\sqrt{{\rm log}\ p}$ bits of the Diffie-Hellman secret are as hard to compute as the whole secret. Furthermore, in some cases the individual most significant bit is sufficient. These results lead us to suggest a new variant of the Diffie-Hellman protocol for which the most significant bit of the secret is hard to compute. The fourth part generalizes the Coldreich-Levin theorem to arbitrary finite groups and describes some applications to learning. Finally in the last chapter we study a coding theory problem which arises from the problem of fingerprinting digital data.


A method of estimating the mass, the location of center of mass, and the moments of inertia of each rigid body link of a robot during general manipulator movement is presented. The algorithm is derived from the Newton-Euler equations, and uses measurements of the joint torques as well as the measurement and calculation of the kinematics of the manipulator while it is moving. The identification equations are linear in the desired unknown parameters, and a modified least squares algorithm is used to obtain estimates of these parameters. Some of the parameters, however, are not identifiable due to the restricted motion of proximal links and the lack of full force/torque sensing. The algorithm was implemented on the MIT Serial Link Direct Drive Arm. A good match was obtained between joint torques predicted from the estimated parameters and the joint torques computed from motor currents.


Greenhouse and field studies were conducted to determine the relative activity and persistence in soils of dinitramine (N⁴,N⁴-diethyl-α,α,α-trifluoro-3,5-dinitrotoluene-2,4-diamine), GS 38946 (N-ethyl-N-tetrahydrofurfuryl-4-trifluoromethyl-2,6-dinitroaniline), oryzalin (3,5-dinitro-N⁴,N⁴-dipropylsulfanilamide), trifluralin (α,α,α-trifluoro-2,6-dinitro-N,N-dipropyl-p-toluidine), profluralin [N-(cyclopropylmethyl)-α,α,α-trifluoro-2,6-dinitro-N-propyl-p-toluidine], nitralin [4-(methylsulfonyl)-2,6-dinitro-N,N-dipropylaniline], fluchloralin [N-(2-chloroethyl)-2,6-dinitro-N-propyl-4-(trifluoromethyl) aniline], benefin (N-butyl-N-ethyl-α,α,α-trifluoro-2,6-dinitro-p-toluidine), chlornidine [N,N-Bis(2-chloroethyl)-2,6-dinitro-p-toluidine], isopropalin (2,6-dinitro-N,N-dipropylcumidine), butralin [4-(1,1-dimethylethyl)-N-(1-methylpropyl)-2,6-dinitrobenzenamine], and AC 92390 (N-sec-butyl-2,6-dinitro-3,4-xylidine). For all plant species tested, dinitramine was most toxic and butralin was least toxic. These herbicides were considered moderately persistent, but dinitramine and butralin were less persistent than the others, a fact which may be of some practical significance. At normal use rates none of the herbicides showed residual activity to wheat (Triticum aestivum L.) planted 5 months after application, or to corn (Zea mays L.) planted 12 months after application.


In D v East Berkshire Community Health NHS Trust the House of Lords held that healthcare and local authorities owed no duty of care in negligence to parents who were being investigated in cases of suspected child abuse. In Lawrence v Pembrokeshire County Council and L v Reading Borough Council attempts to distinguish or circumvent the D decision failed, leaving serious doubts as to whether there is now much scope left to develop this area of law in the future.


ABSTRACT Companies increasingly use micro-celebrities for product endorsement. However, there are concerns around the self-presentation and credibility of this source of information online. This study examines the relationships between source credibility, self-presentation, and consumer behavior towards micro-celebrity endorsements. In-depth interviews were conducted with 38 female active users of Instagram, from Russia, to explore the impact of micro-celebrities' credibility and self-presentation upon consumer purchase decisions. This study attempts to construct an extended source credibility framework applicable to the online context. The findings show that users deem micro-celebrities credible if they follow certain criteria of online behavior and self-presentation.


Background: Visceral obesity is independently associated with hypovitaminosis D. Perirenal fat is a visceral fat type active in performing endocrine functions. However, the relationship between perirenal fat thickness (PrFT) and serum 25-hydroxy vitamin D [25(OH)D] is unclear. The aim of this study is to investigate the relationship between serum 25(OH)D and PrFT in patients with metabolic syndrome (MS) in the community. Methods: From May to September 2020, 332 MS subjects in Qinfengyuan and Dongfang communities in Taiyuan City, China were enrolled in an MS survey. All the participants completed the questionnaire survey and physical examination, and their fasting blood samples were collected for biochemical examination. Abdominal ultrasonography was performed to measure the perirenal fat thickness. Results: The mean serum 25(OH)D level for the 332 MS subjects was 13.5 ng/mL, the proportions of vitamin D deficiency [serum 25 (OH)D < 20 ng/mL] and insufficiency [serum 25(OH)D = 20–29.9 ng/mL] were 60.8% (202) and 24.4% (81), respectively. Among the hypovitaminosis D [serum 25(OH)D < 30 ng/mL] subjects, the prevalence of abdominal obesity (waist circumference ≥ 90cm for men and ≥ 80cm for women) is 61.1%. Pearson correlation analysis showed that lg25(OH)D was significantly and negatively associated with body mass index (BMI), waist circumference (W), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), insulin resistance index (HOMA-IR), uric acid (UA)) and PrFT (all P<0.05), and positively correlated with high-density lipoprotein cholesterol (HDL-C) (P<0.05). Multivariate analysis showed that PrFT and HOMA-IR were independently correlated with 25(OH)D. Conclusion: In screening MS patients, approximately 85% of the community MS patients in Taiyuan had hypovitaminosis D; in which 3/5 is abdominal obesity. PrFT is an independent risk factor for hypovitaminosis D in MS subjects. 2 or a waist circumference ≥ 90 cm for men and 80 cm for women. Vitamin D deficiency was defined as serum 25 (OH)D < 20 ng/mL, vitamin D insufficiency was serum 25(OH)D = 20–29.9 ng/mL, and vitamin D sufficiency was defined as serum 25(OH)D ≥ 30 ng/mL. 16 Hypovitaminosis D was defined as 25(OH)D < 30 ng/mL.


Abstract:It is already known that one of the ways in which colonialism operates and exerts harm is by dehumanizing Black, Indigenous, and other racially minoritized populations. Less attention has been paid, however, to the ways in which this dehumanization erodes relations among those colonized. Colonial logics designed to separate and alienate the colonized from each other have been internalized for centuries, preventing communities and individuals from recognizing how they connect. In this piece, the authors draw on their experiences as racially minoritized women in the U.S. academy to reflect on how this colonial legacy has shaped not only their identities but also their identifications—how and with whom they identify. The authors demonstrate what they refer to as a love letter approach that enables them to foster connection, healing, and transformation through dialogue. Most importantly, they highlight the radical potential of finding and articulating love for one another as a form of resisting the very colonial logics that would keep them apart. They conclude the piece with guidance on how to use this approach to connect individuals, communities, and organizations.


This paper introduces the Migrant Populations Equity Extension for Ontario's Health Equity Impact Assessment (HEIA) initiatives. It provides a mechanism to address the needs of migrant populations, within a program and policy framework. Validation of an equity extension framework using community leaders and health practitioners engaged in HEIA workshops across Ontario. Participants assessed migrants' health needs and discussed how to integrate these needs into health policy. The Migrant Populations Equity Extension's framework assists decision makers assess relevant populations, collaborate with immigrant communities, improve policy development and mitigate unintended negative impacts of policy initiatives. The tool framework aims to build stakeholder capacity and improve their ability to conduct HEIAs while including migrant populations. The workshops engaged participants in equity discussions, enhanced their knowledge of migrant policy development and promoted HEIA tools in health decision-making. Prior to these workshops, many participants were unaware of the HEIA tool. The workshops informed the validation of the equity extension and support materials for training staff in government and public health. Ongoing research on policy implementation would be valuable. Public health practitioners and migrant communities can use the equity extension's framework to support decision-making processes and address health inequities. This framework may improve policy development and reduce health inequities for Ontario's diverse migrant populations. Many countries are now using health impact assessment and health equity frameworks. This migration population equity extension is an internationally unique framework that engages migrant communities.


Unlike the formation of Solar-type stars, the formation of massive stars (M>8 Msun) is not yet well understood. For Solar-type protostars, the presence of circumstellar or protoplanetary disks which provide a path for mass accretion onto protostars is well established. However, to date only few cases of young massive stars show the evidence of circumstellar disks which support the idea that a scaled-up version of low-mass star formation could be applied to young massive stars. To what extend this hypothesis can be applied is still unclear and more observational evidences are required to characterize the physical properties of the disk-like structures around massive stars in order to understand how exactly massive stars gain their masses in the equatorial regions. In this thesis, we present high-resolution (sub)millimeter interferometric and single-dish observations of massive star-forming cores. We suggest that massive stars may form via disk accretion in some relatively isolated star-forming cores, while massive stars may form through competitive accretion in the central part of massive star-forming clusters. Our studies serve as the basis for the coming Atacama Large Millimeter/submillimeter Array (ALMA) studies at very high angular resolution.


We present a series of 9 fractures of a C-Stem femoral component (6 long stems and 3 conventional stems) that had been implanted with the use of impaction bone grafting (IBG). The length of the long fractured stems was 240 mm in 4 cases and 200 mm in 2. The patients presented had an average BMI of 26.5 and an average of 2.7 previous hip surgeries (range 2-5 surgeries) before the stem fracture. A total of 5 cases presented with a metal mesh fracture in addition to the fractured stem. Bending of the stems or stem defects was not observed in any case. Typical fracture waves consistent with fatigue failure were clearly visible on all the cut surfaces, starting anterolaterally and propagating to the medial side. Although fatigue fracture of a modern cemented tapered polished femoral stem is a rare event, stress due to the absence of proximal femoral bone support could be sufficient to put this stem at a higher risk for fatigue fracture in non-obese patients.


The proteins harboring double-stranded RNA binding domains (dsRBDs) play diverse functional roles such as RNA localization, splicing, editing, export, and translation, yet mechanistic basis and functional significance of dsRBDs remain unclear. To unravel this enigma, we investigated transactivation response RNA binding protein (TRBP) consisting of three dsRBDs, which functions in HIV replication, protein kinase R(PKR)–mediated immune response, and RNA silencing. Here we report an ATP-independent diffusion activity of TRBP exclusively on dsRNA in a length-dependent manner. The first two dsRBDs of TRBP are essential for diffusion, whereas the third dsRBD is dispensable. Two homologs of TRBP, PKR activator and R3D1-L, displayed the same diffusion, implying a universality of the diffusion activity among this protein family. Furthermore, a Dicer–TRBP complex on dsRNA exhibited dynamic diffusion, which was correlated with Dicer's catalytic activity. These results implicate the dsRNA-specific diffusion activity of TRBP that contributes to enhancing siRNA and miRNA processing by Dicer.


Abstract. The Mediterranean Sea is a prominent climate-change hot
spot, with many socioeconomically vital coastal areas being the most
vulnerable targets for maritime safety, diverse met-ocean hazards and marine
pollution. Providing an unprecedented spatial and temporal resolution at
wide coastal areas, high-frequency radars (HFRs) have been steadily gaining
recognition as an effective land-based remote sensing technology for
continuous monitoring of the surface circulation, increasingly waves and
occasionally winds. HFR measurements have boosted the thorough scientific
knowledge of coastal processes, also fostering a broad range of
applications, which has promoted their integration in coastal ocean
observing systems worldwide, with more than half of the European sites
located in the Mediterranean coastal areas. In this work, we present a
review of existing HFR data multidisciplinary science-based applications in
the Mediterranean Sea, primarily focused on meeting end-user and
science-driven requirements, addressing regional challenges in three main
topics: (i) maritime safety, (ii) extreme hazards and (iii) environmental
transport process. Additionally, the HFR observing and monitoring regional
capabilities in the Mediterranean coastal areas required to underpin the
underlying science and the further development of applications are also
analyzed. The outcome of this assessment has allowed us to provide a set of
recommendations for future improvement prospects to maximize the
contribution to extending science-based HFR products into societally
relevant downstream services to support blue growth in the Mediterranean
coastal areas, helping to meet the UN's Decade of Ocean Science for
Sustainable Development and the EU's Green Deal goals.


For a long time, the lecture dominated performatively presented scientific communication. Given academic traditions, it is possible to make a connection between the lecture and classical rhetoric, a highly differentiated instrument of analysis. The tradition of the lecture has been perpetuated in the presentation of research results, first in the use of transparencies and subsequently through computer-based projections. Yet the use of media technology has also allowed new practices to emerge, including mediation practices hitherto neglected in the theory of rhetoric.


Delineating the nature and extent of ground-water inputs is necessary to understand the hydrochemistry of large lakes. Characterizing the interaction between ground water and large lakes (e.g., the Great Lakes) is facilitated by the use of geochemical and isotopic data. In this study, pore waters were extracted from sediment cores collected from Saginaw Bay and the surrounding Saginaw lowland area; the geochemistry and stable isotope signature of these pore waters were used to identify sources for the water and solutes. Cores from Saginaw Bay and the Saginaw lowland area yielded strong vertical gradients in chloride concentrations, suggesting that a high-chloride source is present at depth. The spatial distribution of cores with elevated chloride concentrations corresponds to the regional distribution of chloride in ground water. Most of the Saginaw lowland area cores contain water with significantly lower δ 18 O values than modern meteoric water, suggesting that the water had been recharged during a much cooler climate. The δ 18 O values measured in pore waters (from Saginaw Bay cores) containing high chloride concentrations are similar to modern meteoric water; however, values lighter than modern meteoric water are encountered at depth. Chloride:bromide ratios, used to distinguish between different chloride sources, identify formation brine as the likely source for chloride. Transport models indicate that a combination of advection and diffusion is responsible for the observed Saginaw lowland area pore-water profiles. Pore-water profiles in Saginaw Bay sediments are produced primarily by diffusion and require significantly less time to evolve. An upward flux of solutes derived from formation brine could occur elsewhere within the Great Lakes region and significantly affect the geochemical cycling of chloride and other contaminants (e.g., trace metals).


ABSTRACT This paper analyses the role of sectarian identity in foreign policy making by bringing sub-state sectarian actors into foreign policy studies. The paper takes Lebanon and the Syrian Civil War as a case study through a close scrutiny of the emergence and the consolidation of foreign policy orientations, preferences and behaviour of the Maronite, Sunni, Shia and Druze leaders in Lebanon. By doing so, it asks how sectarian groups behave as sub-state foreign policy actors in countries where society is divided along sectarian identities and how sectarian identities matter in terms of the definition of the self and the other and the ally and the enemy in weak states. It further questions to what extent sectarian groups can be considered as sub-state foreign policy actors with their own perceptions based on their identities. Building its main findings on various fieldworks in Lebanon conducted in 2016 and 2017, interviewing leaders of major sects; this study concludes that in the absence of a cohesive foreign policy stance in a weak state, the role of sectarian identity in defining self and other becomes central for understanding the foreign policy choices of sectarian leaders faced with an existential challenge.


This study analyzes the case study of a deconstruction project called the 'Whole House Reuse' (WHR) which aimed, firstly, to harvest materials from a residential house, secondly, to produce new products using the recovered materials, and thirdly, to organize exhibition for the local public to promote awareness on resource conservation and sustainable deconstruction practices. The study applies characterization of recovered materials through deconstruction. In addition to the material recovery, the study assesses the embodied energy saving and greenhouse gas emissions abatement of the deconstruction project. Around twelve tons of various construction materials were harvested through a systematic deconstruction approach, most of which would otherwise be disposed to landfill in the traditional demolition approach. The study estimates that the recovered materials could potentially save around 502,158 MJ of embodied energy and prevent carbon emissions of around 27,029 kg (CO2e). The deconstruction could eventually contribute to New Zealand's national emission reduction targets. In addition, the project successfully engages local communities and designers to produce 400 new products using the recovered materials and exhibits them to the local people. The study concludes that there is a huge prospect in regard to resource recovery, emission reduction, employment, and small business opportunities using deconstruction of the old house. The sociocultural importance of the WHR project is definitely immense; however, the greater benefits of such projects are often ignored and remain unreported to wider audiences as most of the external and environmental costs are not considered in the traditional linear economy. It is acknowledged that under a favorable market condition and with appropriate support from local communities and authorities, deconstruction could contribute significantly to resource conservation and environmental protection despite its requirement of labor-intensive efforts.


Over the past decade, the ventilation of domestic buildings in hot climates has been dominated by the mechanical systems with its centralized and standalone forms. The domination was initially sparked by the global warming thread, but it was later promoted by a financial incentive to the landlords which is the increased leasable areas due to reduced floor-to-floor height and absence of vertical stacks, shafts or Atriums. Other triggers for the mechanical domination were the elevated standard of living, absence of firm regulations in the hot countries that enforces the consideration of natural ventilation and lack of Architects who understand the fluid dynamics and can design an effective naturally ventilated building in hot climate, which is much more complicated in design than mechanically ventilated buildings, from the architectural point of view. However, the Natural ventilation strategies have recently been brought back to the scene by various local and international sustainability rating systems as potential tool for energy saving and clean indoor air quality. Due to the absence of local regulations and NV design guidelines, the sustainability ratings systems had to reference other codes and standards that were initially developed for cold and warm climates to set out their rules and targets. In this study, four common design standards were explored and applied on a case study in hot climate to stand upon the level of effectiveness of such scheme. According to ASHRAE (2016), the hot climate has an annual cooling degree day between 3500 °C to 5000 °C for a base temperature of 10°C. The study also tested some additional strategies on the case study to understand the potential enhancements. The study found that one standard only was able to achieve the targeted air flow rate, however, this air flow was achieved only at the window location and it was insufficient to achieve thermal comfort inside the room. The single sided enhancement strategies have indicated a potential improvement of 250% while the cross-ventilation strategies have indicated a potential improvement over the 1000%. These findings suggest the need for a climate specific design standard that provides full guidance on all system parameters, including the internal clear heights, facades treatments, design of system components such as stack, atrium and air ducts.


Objective:The impact of a contributive result of open-lung biopsy on the outcome of patients with acute respiratory distress syndrome (ARDS) has not been extensively investigated. The aim of this study was therefore to determine the rate of contributive open-lung biopsy and whether it improved the prognosis of ARDS patients. Design:Prospective study conducted during an 8-yr period. Setting:A 14-bed medico-surgical intensive care unit and a 12-bed medical intensive care unit from the same hospital. Patients:One hundred open-lung biopsies were performed in 100 patients presenting ARDS. Interventions:Open-lung biopsy was performed after ≥5 days of evolution of ARDS when there was no improvement in the respiratory status despite negative microbiological samples cultures and potential indication for corticosteroid treatment. Measurements and Main Results:Ten patients presented a mechanical complication following open-lung biopsy (two pneumothoraces and eight moderate air leaks). The unique independent factor associated with this complication was the minute ventilation when open-lung biopsy was performed (odds ratio, 1.20; 95% confidence interval, 1.03–1.41; p = .02). Fibrosis was noted in 53 patients but was associated with an infection in 29 of these 53 patients (55%). A contributive result of open-lung biopsy (defined as the addition of a new drug) was noted in 78 patients. Simplified Acute Physiology Score II was the only independent predictive factor of a contributive open-lung biopsy (odds ratio, 0.96; 95% confidence interval, 0.92–0.99; p = .04). Survival was higher in patients with a contributive open-lung biopsy (67%) than in patients in whom open-lung biopsy results did not modify the treatment (14%) (p < .001). The factors predicting survival were a contributive result of open-lung biopsy, female gender, and the Organ System Failures score the day of open-lung biopsy. Conclusions:The present study shows that open-lung biopsy provided a contributive result in 78% of ARDS patients with a negative bronchoalveolar lavage. Survival of ARDS patients improved when open-lung biopsy was contributive.


Introduction: Farmers markets (FM) have been hypothesized to be a potential community-level obesity prevention strategy for populations at risk for chronic diseases because they provide a mechanism for communities to purchase healthy locally grown produce. This study aimed to identify county-level factors associated with FM availability in an effort to determine if disparities in availability exist in the US.

Hypothesis: Increased FM availability will be associated with higher median household income, lower % minority residents, lower % obese residents and a higher number of grocery stores and recreation centers per 100,000 residents.

Methods: An ecological study was conducted using 2009 data from the USDA Food Environment Atlas on 3,135 US counties. Crude and multivariable adjusted logistic regression models where used to determine associations between having at least one FM available and county-level variables such as % African American (AA) residents, % Hispanic residents, median household income, % WIC participants, % adults obese, % adults with diabetes, per capita grocery stores, per capita supercenters and per capita recreation centers. All analyses were stratified by metro county status and adjusted to address data clustering at the state-level.

Results: There were 1,088 and 2,047 counties labeled metro and non-metro respectively. Metro Results : Median household income (p = 0.002) and per capita recreation centers (p < 0.0001) were positively associated with FM availability while % WIC residents (p = 0.008), per capita grocery stores (p = 0.02) and % adults with diabetes (p < 0.0001) showed a negative association. Non-Metro Results: Median household income (p < 0.0001), per capita recreation centers (p < 0.0001) and per capita supercenters (p < 0.0001) were positively associated with FM availability while % WIC residents (p = 0.02), per capita grocery stores (p < 0.0001) and % adults with diabetes (p < 0.03) showed a negative association. The % AA residents appeared to be negatively associated with FM availability but did not achieve statistical significance. County obesity prevalence was not associated with FM availability in both metro and non-metro counties.

Conclusion: Results showed that counties with more recreation centers and a higher median household income have increased FM availability while counties with more WIC participants and residents with diabetes have less availability. More information on the association between FM access, diet and obesity in at risk populations should be collected at the individual level.