A spacetime singularity is a breakdown in the geometrical structure of space and time. It is a topic of ongoing physical and philosophical research to clarify both the nature and significance of such pathologies. Because it is the fundamental geometry that is breaking down, spacetime singularities are often viewed as an end, or "edge," of spacetime itself. However, numerous difficulties arise when one tries to make this notion more precise.

Our current theory of spacetime, general relativity, not only allows for singularities, but tells us that they are unavoidable in some real-life circumstances. Thus we apparently need to understand the ontology of singularities if we are to grasp the nature of space and time in the actual universe. The possibility of singularities also carries potentially important implications for the issues of physical determinism and the scope of physical laws.

Black holes are regions of spacetime from which nothing, not even light, can escape. A typical black hole is the result of the gravitational force becoming so strong that one would have to travel faster than light to escape its pull. Such black holes contain a spacetime singularity at their center; thus we cannot fully understand a black hole without also understanding the nature of singularities. However, black holes raise several additional conceptual issues. As purely gravitational entities, black holes are at the heart of many attempts to formulate a theory of quantum gravity. Although they are regions of spacetime, black holes are also thermodynamical entities, with a temperature and an entropy; however, it is far from clear what statistical physics underlies these thermodynamical facts. The evolution of black holes is also apparently in conflict with standard quantum evolution, for such evolution rules out the sort of increase in entropy that seems to be required when black holes are present. This has led to a debate over what fundamental physical principles are likely to be preserved in, or violated by, a full quantum theory of gravity.


Tissue inhibitor of metalloproteinase (TIMP)-1 is a multifunctional peptide that has been implicated in the ovulatory process. To assess the function of TIMP-1 during the periovulatory period in vivo, mice incapable of expressing the TIMP-1 gene product were utilized. Twenty-three-day-old TIMP-1-deficient (n = 59) and wild-type (n = 61) female mice were injected with 5 IU eCG, followed 48 h later by an ovulation-inducing dose of hCG (5 IU). Animals were killed at the time of hCG injection (0-h hCG), at 12 h (12-h hCG), or at 24 h post-hCG (24-h hCG) administration. Serum was collected for the assessment of estradiol-17beta (0-h hCG groups) or progesterone content (12- and 24-h hCG groups), while ovaries were removed for either histological preparation or Northern analysis of TIMP-1, TIMP-2, and TIMP-3. The number of healthy and atretic follicles was determined in the 0-h hCG groups, as was the number of oocytes released in the 24-h hCG group. TIMP-1-deficient females in the 0-h hCG group showed reduced levels of ovarian TIMP-2 (0.29-fold decrease, p < 0.05) and TIMP-3 (3.0-fold decrease, p < 0.05) expression compared to wild-type counterparts. No significant difference was detected between genotypes in the 0-h hCG group for number of healthy or atretic follicles or for serum estradiol-17beta concentrations. Additionally, no significant differences were detected between genotypes in the 12- and 24-h hCG groups for serum progesterone concentrations, ovarian TIMP-2 and TIMP-3 expression, or number of oocytes released (24-h hCG group). To assess the effect of TIMP-1 on steroidogenesis in vitro, granulosa cells were obtained from 23-day-old, eCG-primed TIMP-1-deficient and wild-type females. Addition of recombinant human TIMP-1 significantly increased conditioned media estradiol-17beta concentrations in cell cultures from both mutant (1.32-fold over controls; p = 0.02; n = 4) and wild-type females (1.16-fold over controls; p = 0.04; n = 3). It is concluded from this study that TIMP-1 may modulate ovarian TIMP-2 and TIMP-3 mRNA expression during folliculogenesis. In addition, TIMP-1 exhibits steroidogenic activity in vitro, but no evidence was found for regulation of steroidogenesis in vivo.


Disease Control and Prevention amended their screening guidelines to include one-time HCV testing for all persons born during 1945 to 1965 (also referred to as the "Baby Boomer" or birth-cohort) regardless of other risk factors. We conducted a retrospective study to report the prevalence of HCV in an urban minority "Baby Boomer" population and identify awareness of HCV birth-cohort testing recommendations among primary care providers. positive for HCV antibody. Methods: Th is retrospective study was performed at an urban community hospital. Patients referred by primary care providers to gastroenterology clinic for endoscopic procedures were randomly included into the study. Exclusion criteria comprised patients with known history of hepatitis B, HCV, HIV, or with signs and symptoms of liver failure. Subjects were divided into two groups according to age: "Baby Boomers" and "non-Baby Boomers." Laboratory data were reviewed to identify HCV status. Results: 360 patient charts were reviewed. 111/360 (30.8%) were male and 249/360 (69.2%) were female. Th ere were 193/360 (53.6%) patients in the "Baby Boomers" birth-cohort group and 167/360 (46.4%) patients in the "non-Baby Boomers" group. 142/193 (73.5%) patients in the birth-cohort group were not screened for HCV. Of the 51 birth-cohort patients who were screened, 5/51 (9.8%) tested HCV antibodypositive compared to the "non-Baby Boomers" group of which 35 screened, 2/35 (5.7%) tested positive for HCV antibody. Conclusion: Baby boomers from minority population without any other known risk factor for HCV infection have higher prevalence of hepatitis C. Despite the availability of new and highly eff ective treatments for HCV, there still exists a considerable lack of awareness among primary care providers regarding HCV birth-cohort testing recommendations.


Gut microbiomes make major contributions to the physiological and immunological development of the host, but the relative importance of their bacterial and fungal components, and how they interact, remain largely unknown. We applied carefully controlled experiments in gnotobiotic mice colonized with defined communities of bacteria, fungi, or both to differentiate the direct role of fungi on microbiome assembly, host development, and susceptibility to colitis and airway inflammation. Our results revealed that fungal colonization alone was insufficient to promote the intestinal anatomic and physiological changes seen in mice colonized by bacteria, and had limited impact on the fecal metabolome. However, fungal colonization promoted major shifts in bacterial microbiome ecology, and had an independent effect on the innate and adaptive immune development in young mice. Fungi further exacerbated some aspects of the inflammatory effects of the bacterial community during OVA-induced airway inflammation by promoting macrophage infiltration in the airway. Our results demonstrate a dominant ecological and physiological role of bacteria in gut microbiomes, but highlight fungi as an ecological factor shaping the assembly of the bacterial community and a direct capacity to impact immune system and modulate disease susceptibility. These findings demonstrate that studies focused on bacteria alone provide an incomplete portrayal on microbiome ecology and functionality, and prompt for the inclusion of fungi in human microbiome studies.


Background The aim of the current study is to compare quinagolide with cabergoline in prevention of ovarian hyperstimulation syndrome (OHSS) among high risk women undergoing intracytoplasmic sperm injection (ICSI). Materials and Methods This randomized clinical trial study was performed from March 2015 to February 2017. One hundred and twenty six women undergoing ICSI who were at high risk of developing OHSS (having over 20 follicles of >12 mm), were randomized into two groups. The first group received cabergoline 0.5 mg and the second group received quinagolide 75 mg every day for 7 days commencing on the day of gonadotropin-releasing hormone (GnRH) agonist administration. Then OHSS symptoms as well as their severity were assessed according to standard definition, 3 and 6 days after GnRH agonist administration. Ascites were determined by trans-vaginal ultrasound. Other secondary points were the number of oocytes and the number of embryos and their quality. Quantitative and qualitative data were analyzed using Student's t test, and Chi-square or fisher's exact test, respectively. A P<0.05 was considered statistically significant. Results The incidence of severe OHSS in the quinagolide-treated group was 3.1% while it was 15.8% in cabergolinetreated subjects (P<0.001). Ascites were less frequent after treatment with Quinagolide as compared to cabergoline (21.9 vs. 61.9%, respectively) (P=0.0001). There was no significant statistical deferences between the two groups in terms of mean age, number of oocytes, metaphase I and metaphase II oocytes, and germinal vesicles. There was a significant difference between cabergoline and quinagolide groups regarding the embryo number (P=0.037) with cabergoline-treated group showing a higher number of embryos. But, the number of good quality embryo in quinagolide-treated individuals was significantly higher than that of the cabergoline-treated group (P=0.001). Conclusion Quinagolide seems to be more effective than Cabergoline in prevention of OHSS in high-risk patients undergoing ICSI (Registration number: IRCT2016053128187N1).


Recent years have witnessed a proliferation of weather-index insurance (WII) pilot programs in developing countries. However, the uptake of this novel insurance turns to be generally low despite that most WII programs are heavily subsidized by central and local government. Although basis risk is widely referred to as the most serious drawbacks to the effectiveness of index-based insurance, the impact of basis risk on the potential benefits of adopting weather index insurance is rarely documented. This paper designs a weather index contract for cotton in Shandong province and examines impact of two components of basis risk, covariate risk and idiosyncratic risk, separately. The findings of this paper underscores the importance of minimizing covariate risk in designing weather index insurance contracts and sheds lights on the different impacts of basis risk components on potential benefits of WII.


When examining consumer behavior using household level data, it is typical in many applications to find that consumers consume only a subset of the available goods, setting their demand to zero for the remaining goods. Examples of this include labor supply and food demand, as well as the demand for Leisure Studies; In multiple site recreation demand data sets, one usually observes that individuals visit only a subset of the available recreation sites, yet visit these sites multiple times during a season. Theoretically, these corner solutions are effectively modeled using non-negativity constraints in the utility maximization problem. Empirically estimating such a model is more challenging however, since most econometric techniques rely on the assumption of an interior solution;This dissertation examines estimation of generalized corner solution models of consumer choice as they apply to recreation demand. The emphasis is on providing utility consistent characterizations of the demand for recreation, which can then be used to perform welfare analysis. Specifically, the Kuhn-Tucker model of Wales and Woodland (1983) and the dual approach of Lee and Pitt (1986) are estimated for a four site recreation model. Welfare measurement techniques are developed for each, relying on Monte Carlo integration to arrive at consistent estimates of the compensating variation associated with changes in site attributes or the elimination of a site;The application focuses on the demand for fishing in the Wisconsin Great Lakes region. Data is available describing angler behavior during the 1989 fishing season, including both users and non-users of the Great Lakes fishery. Variables describing catch rates for the major sport fishing species, as well as pollution levels in the lakes, are included in the estimation. Welfare experiments are conducted by analyzing the effects of hypothetical changes in the quality variables;This research will be of interest not only to those working in recreation demand and resource valuation, but also those working in other areas of consumer choice, where the use of household level data is becoming more prevalent and operational methods for dealing with corner solutions are necessary.


ABSTRACT The Dalmatian coast (Croatia) represents the second largest Archipelago within the Mediterranean area and contributes considerably to the Mediterranean biodiversity. The islands of the Vis Archipelago, in particular, contain an exceptional richness of endemic and rare plant taxa. The aim of this paper is to provide a phytosociological description of the rare plants communities occurring in the Vis Archipelago and define their syntaxonomic position in the Mediterranean context. A data-set consisting of 90 phytosociological relevés was subjected to cluster analysis (Ward's method on a Chord distance matrix) and non-metric multidimensional scaling ordination. The Indicator Species Analysis was used to identify the diagnostic taxa of the main clusters of relevés. The occurrence of the Anthyllidion barbae-jovis in Croatia was documented with new relevés. Four new associations of the Crithmo-Staticetalia and four further new ones of the Helichrysetalia italici were described for the first time. A endemic alliance to the Vis archipelago (Croatia) and Tremiti islands (Italy), Capparo orientalis-Aurinion leucadeae, was validated in order to include plant communities of coastal rocky cliffs which are not directly exposed to sea-borne salt-spray but are still under the influence of sea-born salt due to the intense offing storms, in the middle Adriatic. The results were discussed in the light of the European syntaxonomic framework of the EuroVegChecklist. Several syntaxonomic interpretative problems regarding the interface between the Helichrysetalia italici and the Centaureo-Campanuletalia have arisen and they have been only partially solved with the validation of the Capparo-Aurinion. New investigations are required on this topic.


A Newtonian (vectorial) approach is used to develop the governing differential equations of motion for a three layer sandwich beam in which the uniform distribution of mass and stiffness is dealt with exactly. The model allows for each layer of material to be of unequal thickness and the effects of coupled bending and longitudinal motion are accounted for. This results in an eighth order ordinary differential equation whose closed form solution is developed into an exact dynamic member stiffness matrix (exact finite element) for the beam. Such beams can then be assembled to model a variety of structures in the usual manner. However, such a formulation necessitates the solution of a transcendental eigenvalue problem. This is accomplished using the Wittrick-Williams algorithm, whose implementation is discussed in detail. The algorithm enables any desired natural frequency to be converged upon to any required accuracy with the certain knowledge that none have been missed. The accuracy of the method is then confirmed by comparison with five sets of published results together with a further example that indicates its range of application.  A number of further issues are considered that arise from the difference between sandwich beams and uniform single material beams, including the accuracy of the characteristic equation, co-ordinate transformations, modal coupling and the application of boundary conditions.


To Serve and Protect reveals, for the first time, the sensational details behind the South African Apartheid government's clandestine funding of Mangosuthu Buthelezi's Inkatha Freedom Party, as well as the events that led up to the so-called 'Inkathagate Scandal.' The book is all the more remarkable in identifying the entire expose as the work of one man - a white conscript - who served in the South African police's Security Branch. Brian Morrow's account provides graphic and disturbing details of how the South African police embarked on a 'dirty tricks' campaign with the aim of harassing anti-Apartheid activists. Morrow spent his years in the Security Branch, gathering files that conclusively proved that the government was funding Inkatha to fuel black-on-black political infighting. The book outlines how the police's 'brotherhood of silence' code was prevalent in the force and how it was frequently used to subvert the course of justice. To Serve and Protect also provides a unique insight into the murky world of espionage, outlining the elaborate schemes devised to recruit South African agents for the British Intelligence agencies MI5 and MI6. "The man who may have changed the course of South African History" is how a Weekly Mail headline described Brian Morrow in 1995, when he revealed his identity as the Inkathagate whistleblower.


Invasive species pose an enormous threat to native species and imposes substantial costs on the US economy. Although the threat of exotic species is well recognized, the general ecological mechanisms that underlie these invasions remain elusive. Predictions both for invasion success and the success of biological control remain poor. In this dissertation, I harness plant competition theory to predict the success of invasions and biocontrol, using a model system composed of invasive purple loosestrife (Lythrum salicaria), native broad-leaved cattail (Typha latifolia), and Galerucella calmariensis, a leaf-feeding beetle widely released to control loosestrife. In chapter 1, I introduce the problem and summarize my results. In chapter 2, I extend resource competition theory to competition for light: species coexistence is possible if one species is sufficiently taller and with less dense foliage than its competitor. This integrated model of competition for light is easily parameterized through measurements of light availability in monoculture and thus can easily be tested in the field. In chapter 3, I test the ability pf three models of plant competition (response to resource availability, plant size, and resource reduction) to predict competitive outcomes between loosestrife and cattail. My experimental design included monoculture mesocosms in which to measure plant traits, and mixture mesocosms in which to determine competitive outcomes. Surprisingly, while loosestrife was, on average, negatively affected by the presence of cattail, cattail was not, on average, negatively affected by loosestrife. Indeed, at high fertility, cattail was strongly negatively affected by loosestrife in the absence of insect herbivores of both species, yet was strongly facilitated when herbivores of both species were present. The facilitation of cattail by loosestrife was likely due to density dependent predation by cattail's natural enemies. Cattail abundance in mixture was not predicted by any of the three models, which is not surprising considering the lack of an overall competitive effect of loosestrife on cattail. In contrast, loosestrife abundance in mixture was well predicted by species height, as predicted by the plant size model. These results suggest that competitive traits may predict invasion success and biocontrol, but only when species interact only through competition for resources.


It has long been argued that developing distributed software is a difficult and error-prone activity. Based on previous work on design patterns and skeletons, this paper proposes a template-based approach for the high-level design and implementation of distributed virtual environments (DVEs). It describes a methodology and its associated tool, which includes a user interface, a performance analyser and an automatic code generation facility. It also discusses some preliminary results on a surgical training system.


Objective: The purpose of this study was to evaluate the feasibility of a flipped classroom progamme, designed and implemented by medical students, in communicating nutrition education to fourth-grade school students aged 9–10 years and to characterise teachers' assessments of the progamme, which was designed to minimise the burden placed on teachers. Design: Each student–participant served as control before and as case after exposure to the novel healthSLAM (hS) curriculum. The results on the pre-tests and post-tests were matched and compared. Teachers completed a one-time survey after observing the new curriculum. Setting: The study was conducted in 2013 in the fourth-grade classrooms of an elementary school in Derry Township, Pennsylvania, USA. Methods: The hS progamme included a web-based video that delivered nutrition education didactics and a classroom portion in which medical students guided exercises to reinforce nutrition concepts discussed in the video. A pre-test and post-test were given to students, and teachers completed a survey to determine the effects of the curriculum on nutrition knowledge, and teacher surveys were administered to assess the appropriateness and acceptability of the curriculum. In all, 166 students' pre- and post-tests from nine different classrooms were analysed. Results: Significant improvements in nutrition knowledge in both median and mean test scores were found (p < .001), and the raw pre-test and post-test score distributions were found to be homogeneous across the nine different classrooms studied. Teachers reported the new curriculum to be feasible and grade-appropriate. Conclusion: The hS programme, rooted in flipping pedagogy using a video didactic lecture and an activity-based classroom session to reinforce concepts, appeared to communicate nutrition information successfully and was seen as both feasible and acceptable by teachers.


The emergence of social conflict and violence that uses religion as justification has become a problem that adorns the history of violence today. Social conflicts which are followed by acts of violence that use religious issues in Indonesia, certainly do not occur in empty space and apart from some socio-political phenomena that follow. Putting religion as a variant of the potential trigger of social conflict is not easy. This is so, because religion is considered a teaching that is always associated with teachings that are full of values of peace and safety. The emergence of social conflict in various regions such as, in Ambon, Mataram, Situbondo, Tasikmalaya, Regasdengklok, and other areas, selayang in view can be seen as  religious conflict, but when examined more deeply cannot be separated from the role of the political elite, both at the central level and local. Likewise with the violence experienced by Ahmadiyah congregation groups, it is not too difficult to state that the area of religion has been made as a means of legitimacy and legitimacy in carrying out acts of violence. In this regard, religion has been used as a shield for violent behavior, in the interests of a group of people or an elite.


Visceral leishmaniasis is a protozoan disease which infects the macrophages of body and Kupffer cells (KCs) in the liver resident macrophages, which constitute 80% of tissue macrophages of the body. KCs are the first cellular protective line in liver sinusoid, which come into contact with gut-derived pathogenic microbes, microbial debris and senescent erythrocytes and impede the exogenous materials by producing cytokines and directly phagocytosing and degrading them. Visceral leishmaniasis (VL) is a vector-borne disease and it is widely accredited that the frequency as well as transmission dynamics of VL is closely interrelated to socioeconomic, climatic, and environmental factors. Macrophages act so as to secrete IL-1, TNF and IL-6 at the time of injury and infection, and process and present antigen to help T cells. Mononuclear phagocytic system consists of monocytes circulating in the blood and macrophages in tissue. Macrophages are dispersed throughout the body and take up residence in some tissues. Human leishmanial infections may manifest in any of the four most common forms. Depending on the causative species, it can manifest as cutaneous leishmaniasis mucocutaneous leishmaniasis, visceral leishmaniasis or diffused cutaneous leishmaniasis. The cutaneous form of the disease accounts for more than 50% of new cases of leishmaniasis. The current method of VL diagnosis involves evaluating clinical symptoms that include fever for more than 2 week, the presence of splenomegaly and a positive serological rK39 immunochromatographic rapid diagnostic test (RDT). The rK39 RDT is used to detect the presence of antibodies against the Leishmania antigen K39 that contains a repetitive 39 amino acid sequence from the kinesin protein.


Autonomous technology in agriculture offers many products that reduce distractions and fatigue experienced by machinery operators, including automatic path guidance, variable rate product delivery, and precision seed placement. However, the size and complexity of modern mechanical harvesting operations have limited the ability of autonomous technology to significantly reduce total negative effects on grain combine operators. Combine operators are highly susceptible to fatigue because several tasks must be performed simultaneously to ensure safe machine operation. These duties include monitoring internal threshing and crop flow intake, maintaining row alignment, avoiding foreign material intake, and overseeing unloading grain. The primary goal of this project was to design a decision support system for autonomous unloading of combines. When unloading grain on-the-go, operators divert more attention away from critical tasks to focus on grain delivery to the adjacent cart. An autonomous system eliminating the need for combine operators to focus on unloading on-the-go potentially reduces operator stress and grain spillage. Critical to the decision support system for autonomous unloading was the input of a twodimensional fill grid used to describe the grain height in the cart. The inverse distance weighting method, an estimation technique common to spatial data modeling, was used to estimate points in the fill grid of a grain cart prone to being immeasurable or highly variable. This method was successful in estimating missing points in a grain cart under difficult delivery conditions to within 15 cm of underestimation and 25 cm of overestimation. A model to predict the weight of grain in a grain cart was developed using the average grain height measured in the cart. The model demonstrated high robustness by producing mean errors that changed by less than 2% of the total cart volume when the delivery conditions strayed from typical conditions to highly biased conditions. The decision support system that was developed exhibited robust performance when critical features of the system were tested at typical levels. Field testing validated the potential to apply the decision support system to autonomous combine unloading systems by producing predictable and consistent final cart volumes that were within 5% of the total volume.


A glass-polymer film can cool structures by radiating heat, even under direct sunlight The cold universe is a vast but freely available heat sink that has been largely neglected in the past and has a great potential to store and dissipate the enormous waste heat we generate every day on Earth. On page 1062 of this issue, Zhai et al. develop a metamaterial—a class of engineered material with exotic properties not found in nature—to cool room-temperature objects perpetually by dumping heat to outer space through infrared (IR) thermal radiation (1).


When criminal justice investigators (police officers, lawyers, prosecutors, judges, juries, and so on) assess statements made by suspects, victims and witnesses, they are almost always confronted with an age old dilemma: how to distinguish between those who are telling the truth and those who are not. One way to examine this is by observing people's behaviour and analysing their speech content. This chapter reviews research findings on (i) differences in behaviour and speech content between liars and truth tellers, and (ii) people's ability to detect deceit while observing someone's behaviour and analysing someone's speech. The first part of this chapter addresses the relationship between behaviour and deception. This part will demonstrate that, although no single pattern of behaviour is uniquely related to deception (Pinocchio's nose does not exist), some behaviours are more likely to occur during deception than others. Also, it shows that people are generally not very good at detecting deceit when paying attention to someone's behaviour. Several reasons to explain this poor lie detection ability and some ideas how to improve behavioural lie detection will be discussed. The second part considers the relationship between speech content and deception. Although analyses of non-verbal behaviour are never formally used as evidence in criminal courts, verbal assessments sometimes are. This part of the chapter discusses the most popular verbal detection technique used in court to date: Statement Validity Assessment (SVA). Research has shown that some of the speech content criteria that SVA experts examine do differentiate between liars and truth tellers. Also, we will see that experts who employ this technique are able to detect lies and truths above the level of chance. However, their lie detection skills fall short to the level required for using their assessments as reliable evidence in criminal courts. Some limitations of SVA and ideas how to improve speech content lie detection will be discussed. Throughout this chapter methodological problems in deception research will be addressed. These are important as they raise questions about the generalisability of the research findings to legal settings. I will conclude with discussing some implications of the research findings for lie detection in legal settings.


Vegetation flammability remains poorly defined and involves many intercorrelated components and metrics. Schwilk (2015) proposed a flammability framework with only two axes: total heat release and rate of spread. Pausas et al. (2017) modified this framework by standardizing the heat release axis by fuel load, and adding a third axis of fuel ignitability. We tested these frameworks using data from a field experiment that quantified flammability metrics and survival of Callitris intratropica saplings in relation to fuel type (grass, litter, and mixed grass and litter, all air-dried) and fuel load. Principal components analysis showed PC1 was closely aligned with rate of combustion, flame height and temperature, and PC2 was aligned with duration of combustion. The Schwilk framework separated the fuel types according to rate of spread, and fuel loads according to total heat release. The Pausas framework was less useful in describing community-scale flammability because it removed the effects of fuel load, and there was no support for adding the ignitability axis. Both frameworks successfully predicted sapling mortality, an indicator of fire severity. In addition, the three flammability strategies proposed by Pausas et al. were not well-supported because they assumed unrealistically low heat release by 'fast-flammable' fuels. We conclude that the Schwilk framework is useful for conceptualizing community-scale flammability and facilitates modelling for fire management purposes, and exploration of evolutionary relationships.


During the last 2 decades, the effects of the physical and social environment on the healing process, recovery and well-being of patients, families and staff in hospitals have been proved.There is a growing recognition that healthcare architecture could do more by promoting overall wellness, and this requires expanding the focus to healing.The research on evidence-based design (EBD) has demonstrated the power of environmental design,but EDDmost links between design and outcome such as safety and efficiency, while there is a difference between efficient environment and pleasing humanized environment.Humanization is the result of user-centered concept in design. The present study aimed to evaluate the perceived environmental quality indicators thataffect the degree of humanization in hospital design. In this descriptivecross-sectional study, first, the user-centered level of the hospital environment (humanization) was determinedin three selected hospitals in the city of Tehran by two hospital designing and planning experts,and then,with the data collected from patients, staff, and visitors (n=184) the relationship between the variableshas been found. Analysis of the data was performed in SPSS V.19 software using standard tests.The results of the study showed that there was asignificant relationship between the user-centered levels of hospitals and the users' comments on perceived environment quality of a hospital from various aspects. Out of 12 quality indicators, 10 were meaningfullyrelated with the user-centered level of hospitals, and 4 had asignificant relationship with the user type. The results indicated that the group of patients was more sensitive to the changes in environmental quality conditions than other groups of users.


Written through the lens of the practitioner-scholar, this paper integrates first-hand experience with theory to explore the tension between positive scholarship and the Metamorphosis Model proposed by Boje (2005) in the context of the emerging workplace practice of systematically applying story/telling. In particular it examines the importance of shadow stories, potent stories from the liminal spaces of the organization, and their implication for organizational practitioners who are latching on to the emerging trend to formally or systematically integrate story/telling into their practice. It draws on the practical experience blended with the qualitative research of the author on the systematic use of stories in for-profit organizations. It does not problematize systematic, performed storytelling as a strategic process, but for the purposes of this paper accepts it as a popular contemporary trend. A preliminary set of reflective questions for practitioners who have chosen to participate in systematic storytelling are included with the intent of challenging practitioners to widen the angle of their listening lens and deepen their practice through an understanding and inclusion of liminal stories.


Background: Undiagnosed CD may lead to unstable blood glucose levels, weight loss, growth failure, osteopenia. The primary objective of the study was to review CD screening practices in one center, describe symptoms at the time of diagnosis, and implement screening guidelines. The secondary objective was to carry out an educational intervention, to review practices after screening guidelines were established. Methods: A total of 532 charts of patients with T1D treated in our center from 2007-2009 were reviewed. Data collected included times of screenings for CD, results of serologic tests, symptoms, and intestinal biopsy results. Two hundred and fifty charts from 2010-2012 were reviewed after an educational intervention with the same group of physicians. Results: After the educational intervention to encourage implementation of screening guidelines, there was a statistically significant reduction in the interval between the diagnosis of T1D and first screening for CD. The majority were diagnosed in the first year after T1D diagnosis, only 30% were symptomatic. Conclusion: Our results suggest that patients with T1D should be screened within the first several months after diagnosis, on an annual basis thereafter, even in the absence of gastroenterologic symptoms of CD. This will allow early dietary intervention and reduce morbidities in this high-risk population.


This article presents the historical context of the emergence of capitalism, and then socialism and specifically Marxism, in Japan, China and Korea. It shows the profound influence in the region of the Prussian "late developer" model in both the economy and in the intelligentsia, which set the stage for the introduction of Marxism, first in Japan and then in Korea and China. Anarchism actually had more influence than Marxian socialism in the three countries until the early 1920's. But by importing a superficial, partial vision of Marx from pre-1914 European (and above all German) Social Democracy, the East Asian left was ultimately as statist as the German-influenced modernizers building the region's capitalism. The resulting century of statist "Marxism" was to have profound consequences.


Background: Human face is highly vascular region and vascularity to the skin and other organs is an important indicator of health and disease. Change in blood flow is affected by aging, diabetes, high blood triglycerides, cigarette smoking etc. With so many factors that can alter blood flow in the skin, normal blood flow is important to know for comparison to diseased state. Blood flow in superficial arteries of face has not yet been described, therefore this study was designed to establish baseline blood flow values in arteries of face.
Materials and Methods: Blood flow of right and left side was assessed at level of facial and infraorbital artery. Categorical variables were presented in form of frequency and percentages was done by using Mann-Whitney U. Wilcoxon Signed Ranks test was used to compare left and right facial and infra orbital arteries.
Results: Peak systolic velocity of right and left facial artery had a significant difference having right side mean of 67.02±12.48 and left side mean as 72.67±11.69. Facial artery diameter of right and left side also had significant difference with mean of 0.14±0.02 and 0.15±0.02 respectively.
Conclusion: No difference was found between vascularity in male & female and left or right side. The study might be useful to establish normal baseline values of various parameters on both sides of face in male and female adults. This study may become important reference for future studies measuring blood flow and even progression of vascular diseases may be assessed by indexes developed on the basis of these studies.


Motion control systems are gaining importance as more and more sophisticated developments arise in technology. Technological improvements enhance incorporation of different research areas into the same framework while trying to make systems function in unstructured environments renders the design of control systems increasingly complex. Since motion systems are complex, they have complex forward or inverse kinematics, or interactions with other systems. In this study, motion of the systems is decomposed into the tasks, so called "functions". Independent controllers are designed for these functions in the function space. It is proven that motion systems will be controlled in the original space if function based control outputs are superposed. Applicability of this method is demonstrated on bilateral systems and parallel mechanisms. Bilateral systems application proved that function based control can be used in controlling systems with interactions while establishing desired functional relation between them. Moreover, investigation of a pantograph and a three-legged manipulator, which come from the parallel mechanisms family and have nonlinear and coupled system dynamics, showed that creating an appropriate reference configuration to realize the task of motion control helps decouple system dynamics. Satisfactory simulation results show that functional control can be implemented and its characteristics promise successful future designs for motion control systems.


BACKGROUND: Osteoarthritis, a widespread chronically disabling disorder primarily affecting articular cartilage is said to be irreversible. Researchers have however, been examining processes and methods of promoting articular cartilage repair for some time. QUESTIONS : Can a case be made for the possibility of restoring osteoarthritic cartilage? How advanced is this undertaking? What barriers exist in translating basic studies in the clinical realm? What physical modalities are deemed efficacious in promoting cartilage structure? METHODS: All relevant publications detailing articular cartilage repair themes in the leading databases were examined. Specific emphasis was placed on a broad array of efforts and observations concerning articular cartilage and its repair. Articles of historic significance and more current strategies designed to foster cartilage repair were focused on, and reported in narrative form. Ideas extracted from the voluminous literature were those that answered one or more of the key questions driving this research. RESULTS: Numerous attempts have been made over time to foster cartilage repair, using a variety of approaches such as creating artificial cartilage, and transplanting stem cells into damaged cartilage to promote repair. Most current strategies are forged in laboratories and do not always account for the complex disease process, and the importance mechanical and inflammatory determinants play in the disease. However, manipulating biophysical, and biomechanical stimuli favorably is likely to hold promise for attenuating destruction of/or for fostering cartilage viability and repair, even in the presence of adverse osteoarthritic cartilage tissue changes.  CONCLUSION: More work is needed to examine the key upstream determinants leading to articular cartilage destruction, and to enhancing the viability of the tissue. Employing carefully construed therapeutic strategies known to impact articular cartilage homeostasis safely and  effectively can potentially preserve chondrocyte homeostasis, either alone or in conjunction with new technologies.


The popularization of mobile devices worldwide and their constant improvement in communicability, portability, navigation and content creation, opens up many possibilities for integration in the learning process. On the other hand the new educational approaches that focus on the student, promoted through the Personal Learning Environments (PLE) show evidence that it can be done successfully in most cases studied. However, these educational innovations have not yet been implemented in some Latin American countries, so the present research searches to introduce the PLE approach in Ecuadorian university, taking advantage of the functionalities offered by mobile devices not only for leisure but for learning activities in informal environments and which are recognized and valued in the academy. Similarly it is intended that students identify with these new Mobile Personal Learning Environments as ecosystems of lifelong learning.


We present two methods for determining the significance of a stochastic gravitational-wave (GW) background affecting a pulsar-timing array, where detection is based on evidence for quadrupolar spatial correlations between pulsars. Rather than constructing noise simulations, we eliminate the GWB spatial correlations in the true datasets to assess detection significance with all real data features intact. In our first method, we perform random phase shifts in the signal-model basis functions. This phase shifting eliminates signal phase coherence between pulsars, while keeping the statistical properties of the pulsar timing residuals intact. We then explore a method to null correlations between pulsars by using a "scrambled" overlap-reduction function in the signal model for the array. This scrambled function is orthogonal to what we expect of a real GW background signal. We demonstrate the efficacy of these methods using Bayesian model selection on a set of simulated datasets that contain a stochastic GW signal, timing noise, undiagnosed glitches, and uncertainties in the Solar system ephemeris. Finally, we introduce an overarching formalism under which these two techniques are naturally linked. These methods are immediately applicable to all current pulsar-timing array datasets, and should become standard tools for future analyses.


In this randomized control study the changes in Transtheoretical Model (TTM; Prochaska and DiClemente, 1983) constructs (Self-Efficacy, Decisional Balance) after a tailored stagebased education program to increase calcium consumption in 40-65-year-old women were investigated. Postintervention, significantly more of the experimental group in comparison to the control group improved their calcium consumption stage of change. In the experimental group self-efficacy and pros of calcium consumption increased and cons decreased for those who had positive progression in stages of change but these constructs remained unchanged in individuals in the control group. The tailored education based on the TTM is an effective method of assisting women to progress through the calcium-rich foods consumption stages of change and can cause more actualized results for self-efficacy, pros and cons in the manner predicted by TTM.


Saline waters treatment has become increasingly important for drinking
water supply in a greater part of the world. However, some serious limitations
had recently been discovered during water treatment, among them the boron problem
seems to have a critical meaning. According to the WHO regulations (2011), the
boron concentration should be reduced to less than 2.4 mg/L for
drinking water. The purpose of this study is to investigate the feasibility of
electrocoagulation (EC) as a pretreatment process to remove boron from saline
waters. To optimize the experimental conditions of boron removal, the effects
of some parameters were studied such as inter-electrode distance (die), electrode connection
mode, (S/V) ratio, pHi and
initial conductivity of the solution (σi). Subsequently, an experimental design methodology was implemented
to evaluate statistically the most significant operating parameters. The
effects of current density, EC time and initial boron concentration and their
mutual interaction were investigated using 23 full factorial design.
At optimal conditions, boron removal from synthetic aqueous solutions
containing initial boron concentrations of 5 and 50 mg/L reached 81% and 79%,
respectively. Applied to boron removal from seawater samples, EC reduces boron
concentration to less to 2.4 mg/L with excessive energy consumption under
optimal parameters.


The aims of this chapter are to review the current state of knowledge regarding the viscoelastic behavior of cardiovascular tissues. We begin with a brief, general discus‐ sion of measurement and modeling of cardiovascular tissue viscoelasticity. We then review known viscoelastic behavior of arteries, veins, capillaries, blood components, the heart, and lymphatics. For each tissue type, we highlight tissue-specific measure‐ ment methods, the cellular and extracellular components responsible for tissue viscoelasticity, and the clinical implications of energy loss due to viscoelasticity. We conclude with a summary and suggestions for future research.


Noah Feldman's most recent publication seeks to explain the apparently paradoxical rise of grassroots political movements in the Islamic world (and especially the Arab Middle East) demanding the resurrection of an Islamic state, movements often broadly referred to as "Islamist." In a field that is dominated by specialists who usually write for specialists, his book is a welcome addition to the literature on the modern idea of an Islamic state. It gives a highly readable and accessible account of the history of Islamic law, its relationship to Islamic ideals of governance and why that history and those ideals remain relevant to large numbers of politically active Muslims in the modern world. Its policy recommendations, specifically, the need for the United States to engage positively with Islamic movements committed to the democratized version of Islamic law he describes may be controversial, but he argues for them with some force: a democratized version of Islamic law is being developed by indigenous Muslim elites that on its own terms can reasonably be viewed as a progressive development in the governance of those societies, and that to the extent such movements enjoy democratic legitimacy, U.S. opposition to their political success represents a betrayal of U.S. values, and potentially, U.S. interests as well. While features of his account of the classical Islamic state and the history of governance in the Arab/Islamic world in last 150 years are highly problematic (as discussed below), it nevertheless fills an important gap in the non-specialist literature on the history of the idea of an Islamic state.


This article analyzes proposed accounting for financial instruments using Boston Chicken's financial report from 1997. The example shows how the proposal would cause Boston Chicken to reduce the carrying value of debt and to recognize a gain as its credit quality deteriorated. Several important financial ratios—debt‐to‐equity, return‐on‐equity, and interest‐coverage—based on reported numbers are consistent with the company's negative performance. When the same ratios are restated to reflect the proposed accounting, 1997 appears to be a good year for Boston Chicken. A discussion of the example raises several issues to be considered in the policy debate over when to recognize the gain from a decline in the debtor's own credit quality.


In recent years, photoelectrochemical (PEC) water splitting has become an attractive approach for the production of renewable hydrogen by utilizing solar energy. Achieving high-efficiency hydrogen production via solar water splitting requires a semiconductor with a suitable band gap. Generally, a wide band gap results in an ideal open-circuit voltage for solar water splitting devices, but it makes the devices incapable of absorbing and utilizing the near-infrared (NIR) portion of sunlight. To further improve the utilization efficiency for solar energy, we employ rationally designed core–shell or core–shell–shell structured upconversion nanoparticles (UCNPs) as "nanotransducers" that enable the conversion of NIR light into visible light; thus, NIR light can be indirectly absorbed by visible light-responsive photocathodes. Upon doping with different lanthanides, our prepared UCNPs gain the ability to convert NIR light (980 nm) into blue, green, or red light. Although the Cu2ZnSnS4 (CZTS) photocathode shows an excellent response to visible light, it is almost unable to absorb NIR light beyond 860 nm. After addition of UCNPs into the buffer solution, the CZTS-based photocathode exhibits an appreciable photocurrent density of −4 mA cm−2 at 0 VRHE under 980 nm irradiation. This work demonstrates that the solar-to-hydrogen conversion efficiency of the photoelectrode can be further boosted with the involvement of UCNPs as a NIR energy converter.


This paper proposes a method for classifying true papers of a set of focal scientists and false papers of homonymous authors in bibliometric research processes. It directly addresses the issue of identifying papers that are not associated ("false") with a given author. The proposed method has four steps: name and affiliation filtering, similarity score construction, author screening, and boosted trees classification. In this methodological paper we calculate error rates for our technique. Therefore, we needed to ascertain the correct attribution of each paper. To do this we constructed a small dataset of 4,253 papers allegedly belonging to a random sample of 100 authors. We apply the boosted trees algorithm to classify papers of authors with total false rate no higher than 30% (i.e., 3,862 papers of 91 authors). A one-run experiment achieves a testing misclassification error 0.55%, testing recall 99.84%, and testing precision 99.60%. A 50-run experiment shows that the median of testing classification error is 0.78% and mean 0.75%. Among the 90 authors in the testing set (one author only appeared in the training set), the algorithm successfully reduces the false rate to zero for 86 authors and misclassifies just one or two papers for each of the remaining four authors.


Abstract Objectives: Most studies of orthostatic hypotension (OH) have focused on community-dwelling and institutionalized patient populations. Less is known about OH in hospitalized patients. Moreover, a comprehensive review of OH in internal medicine wards has not been published in the English literature. Our purpose is to provide current information regarding OH in internal medicine inpatients. Methods: A comprehensive search of medical databases was performed for potentially relevant articles, using the following keywords: postural or orthostatic hypotension, with the combination of hospitalization or internal medicine. Inclusion criteria were: population of patients hospitalized for acute disorders in internal medicine or geriatric wards with a sample size of ≥50 and publication as an original full-length article in the English language. Data from 14 selected studies are reviewed, including: pathophysiology, evaluation, prevalence, manifestations, risk factors, prognosis, and management. Results: OH is a common and often symptomatic disorder in elderly internal medicine patients. The prevalence of OH in this population ranges from 22–75%. There are substantial discrepancies between the studies reviewed regarding definitions and means of evaluating OH. OH in internal medicine wards is largely non-neurogenic and multifactorial. The main predisposing factors for OH are prolonged bed rest, hypertension, and heart failure. OH in internal medicine wards is managed mainly with non-pharmacologic interventions, and is frequently reversible. Conclusions: In internal medicine inpatients, OH warrants attention because this disorder is common, potentially dangerous, and treatable. In the hospital setting, OH should be routinely assessed on ambulation, following the current guidelines for OH definition and meaning.


Weeds can cause significant problems to natural ecosystems. Although there have been numerous studies on the economics of weed control, relatively few of these studies have focused on natural ecosystems. This paper addresses this gap in the literature by assessing the cost-effectiveness of a comprehensive range of control strategies for blackberry (Rubus anglocandicans) in natural environments in Australia. We developed a stochastic dynamic simulation model and a deterministic dynamic optimisation model. The stochastic model calculates the expected net present value (NPV) of a range of control strategies, including any combination of treatment options. The optimisation model identifies the treatment combination that maximises NPV. Both models represent the costs and efficacies of control options over 25 years. The results indicate that using rust (Phragmidium violaceum) as a biological control agent only marginally increases NPV and excluding rust does not affect the optimal choice of other control options. The results also show for a wide range of parameter values that a strategy which combines the herbicide grazon (Triclopyre and picloram) and mowing is optimal. If chemical efficacy decreases by 20 percent it becomes optimal to include grazing blackberry by goats in the control strategy.


In this paper, we present our work on vehicle classification with omnidirectional cameras. In particular, we investigate whether the combined use of shape-based and gradient-based classifiers outperforms the individual classifiers or not. For shape-based classification, we extract features from the silhouettes in the omnidirectional video frames, which are obtained after background subtraction. Classification is performed with kNN (k Nearest Neighbors) method, which has been commonly used in shape-based vehicle classification studies in the past. For gradient-based classification, we employ HOG (Histogram of Oriented Gradients) features. Instead of searching a whole video frame, we extract the features in the region located by the foreground silhouette. We use SVM (Support Vector Machines) as the classifier since HOG+SVM is a commonly used pair in visual object detection. The vehicle types that we worked on are motorcycle, car and van (minibus). In experiments, we first analyze the performances of shape-based and HOG-based classifiers separately. Then, we analyze the performance of the combined classifier where the two classifiers are fused at decision level. Results show that the combined classifier is superior to the individual classifiers.


We show how an appropriate stationary crystalline structure of the magnetic field can induce a partial fragmentation of the accretion disk, generating an axial jet seed composed of hot plasma twisted in a funnel-like structure due to the rotation of the system. The most important feature we outline is the high degree of collimation, naturally following from the basic assumptions underlying the crystalline structure. The presence of nonzero dissipative effects allows the plasma ejection throughout the axial jet seed and the predicted values of the accretion rate are in agreement with observations.


We study the charged lepton electric dipole moment which is induced by the scalar unparticle mediation and we predict the appropriate range for the free parameters appearing in the effective Lagrangian which drives the unparticle-standard model lepton interactions. We observe that the charged lepton electric dipole moment is strongly sensitive to the scaling dimension du of the unparticle and the new couplings in the effective interaction. Furthermore, we see that the current experimental limits of charged lepton electric dipole moments can ensure an appropriate range for these free parameters.


In the course of theorising, it can be appropriate to replace one concept—a folk concept, or one drawn from an earlier stage of theorising—with a more precise counterpart. The best-known account of concept replacement is Rudolf Carnap's 'explication'. P.F. Strawson famously critiqued explication as a method in philosophy. As the critique is standardly construed, it amounts to the objection that explication is 'irrelevant', fails to be 'illuminating', or simply 'changes the subject'. In this paper, I argue that this is an unfair characterisation of Strawson's critique, spelling out the critique in more detail and showing that, fully understood, it is not undermined by extant responses. In light of both the critique and extant responses, I close by making some substantive comments about what explication can, and cannot, be used to do in philosophy.


This paper presents a case study chronicling the development of WebAIRS, an Australasian national anaesthetic incident reporting database for health care practitioners. WebAIRS is an example of the multidisciplinary nature of the IS discipline, incorporating IS theories, tools and principles in the creation of an IT artefact with significant real world application. This case study introduces the background of the project and the motivations for its conception including the need for critical incident reporting in anaesthesia, the process of its development using IT students and the problems identified following its national release among the anaesthetic community. The paper demonstrates the evolution of contemporary IS research and the IT artefact, and how each can be crucial foundations for hospitals of the future


Phytoplankton composition and abundance were analyzed in the period January – September 2006, along the NE coastal Adriatic. In 2006, the Po River discharge was twice as low as the 90 year average. The maximum riverine water inflow did not appear in spring but in September, resulting in a shift of phytoplankton maximum from spring to autumn. Diatoms provided most abundant phytoplankton with an annual maximum of 6 x 10^5 cells/L in the west Istrian coastal region (in September-October). The annual average abundance of diatoms was low (5.1 x 10^4 cells/L), but bigger than that of dinoflagellates (28x), coccolithophorids (13x), cryptophytes (6x) and green nanoflagellates (9x), respectively. A comparison was made between phytoplankton seasonality in the dry year 2006, and the year 2001 characterized by greater freshwater inputs. The drought period was characterised by the small cell size diatoms Cyclotella and Thalassiosira. Po River discharge from the west, the north-westerly ingoing current (Eastern Adriatic current) and oligotrophic karstic waters discharging along the eastern coast, strongly influence phytoplankton dynamics in the NE coastal Adriatic Sea.


Purpose

Migration shapes our societies, values, markets, consumption and even the notion of self. The purpose of this paper is to investigate the effect of migration in the perception-of-self and if differences in the perception-of-self influence the perception of brands from the immigrants' home country – which immigrants often use as a cultural anchor.

Design/methodology/approach

Using Aaker's (1997) brand personality scale as a measure of brand image, the authors gather data from Mexico City and the Dallas/Fort Worth metropolitan area. Respondents to an interviewer-administered questionnaire were asked to evaluate the brand image of two TV media Mexican brands and their perception-of-self based on Aaker's 42 brand personality traits.

Findings

The results of this paper indicate that the perception-of-self is different for Latinos residing in their home country and immigrant Latinos living abroad. Further, these differences in the perception-of-self appear to influence the way immigrants perceive brands from their home country.

Practical implications

Brands from emerging markets making inroads into developed markets, targeting their country's diasporas as their first target group, should understand whether people's perception-of-self differs significantly from their home country counterparts, the direction of such a difference and the effect of such differences on the perceptions of brands from their home country.

Originality/value

This paper is a contribution to the brand personality, brand image and self literature and presents an innovative approach to analyzing the possible brand image implications of the expansion of multinational companies and immigration.


Abstract. The first record of dust deposition events on Mt. Elbrus, Caucasus Mountains derived from a snow pit and a shallow firn core is presented for the 2009–2012 period. A combination of isotopic analysis, SEVIRI red-green-blue composite imagery, MODIS atmospheric optical depth fields derived using the Deep Blue algorithm, air mass trajectories derived using the HYSPLIT model and analyses of meteorological data enabled identification of dust source regions with high temporal (hours) and spatial (ca. 20–100 km) resolution. Seventeen dust deposition events were detected; fourteen occurred in March–June, one in February and two in October. Four events originated in the Sahara, predominantly in northeastern Libya and eastern Algeria. Thirteen events originated in the Middle East, in the Syrian Desert and northern Mesopotamia, from a mixture of natural and anthropogenic sources. Dust transportation from Sahara was associated with vigorous Saharan depressions, strong surface winds in the source region and mid-tropospheric southwesterly flow with daily winds speeds of 20–30 m s−1 at 700 hPa level. Although these events were less frequent than those originating in the Middle East, they resulted in higher dust concentrations in snow. Dust transportation from the Middle East was associated with weaker depressions forming over the source region, high pressure centred over or extending towards the Caspian Sea and a weaker southerly or southeasterly flow towards the Caucasus Mountains with daily wind speeds of 12–18 m s−1 at 700 hPa level. Higher concentrations of nitrates and ammonium characterised dust from the Middle East deposited on Mt. Elbrus in 2009 indicating contribution of anthropogenic sources. The modal values of particle size distributions ranged between 1.98 μm and 4.16 μm. Most samples were characterised by modal values of 2.0–2.8 μm with an average of 2.6 μm and there was no significant difference between dust from the Sahara and the Middle East.


This paper studies the problem of fair clustering on heterogeneous information networks (HINs) by considering constraints on structural and sensitive attributes. We propose a Prerequisite-driven Fair Clustering (PDFC ) algorithm to solve this problem. Specifically, we define the structural constraint on the connection among nodes in HINs by combining meta-paths and prerequisite meta-paths and introduce Fairlets as the balance constraint. Under two constraints, we learn node embeddings based on graph models and perform theCholesky decomposition to obtain their orthogonal embeddings. We fuse node embeddings under constraints, define the loss function of PDFC, and perform k-means to achieve clustering. In addition, we design an update strategy of the adjacency matrix to achieve dynamic PDFC over time. Compared with several fair clustering algorithms on three real-world datasets, our experimental results verify the effectiveness and efficiency of PDFC.


Hazardous alcohol use is considered the most prevalent public health issue on university campuses in the UK. This pattern of alcohol use is associated with risks including interpersonal violence, sexual assault and death. Despite knowledge of the risks and attempts to intervene, the majority of UK students continue to drink at hazardous levels. This resistance to change suggests that for students, there are powerful incentives operating around this particular behaviour. However, there is limited knowledge of the positive consequences which may influence student alcohol use. This thesis aimed to explore the positive factors which might shape students' hazardous alcohol use, in particular, the role of social factors in student alcohol consumption.

A mixed methods approach was adopted, with three interconnected studies. In study one, a large cross-sectional study, it was established that positive relationships exist between alcohol consumption and the key social factors of social belonging and need for popularity. Students categorised as hazardous, harmful and dependent drinkers possessed significantly higher social belonging and need for popularity scores than low-risk drinkers. In study two, qualitative interviews with an information rich group (student-athletes) provided more information on these relationships and situated them within the context of student-athletes' social lives. Alcohol use was subject to cultural rules within sports teams, where social benefits were available for athletes who adhered to the drinking rules. Not all students wanted to drink at the culturally prescribed levels, but those who challenged the drinking rules by not drinking endured social costs. When making decisions about their alcohol use, student-athletes were aware of and weighed up the social costs and benefits. Despite the heaviest drinkers being seen as the most popular, there were also some hidden social costs to drinking heavily. Students secretly avoided the heaviest drinkers and saw them as a burden on a night out. In study three, a sociometric approach enabled further exploration of hidden social costs. With a more sensitive measure of popularity, it was found that the heaviest drinkers were afforded social status and prestige but were not necessarily liked. In contrast, student-athletes who drank at lower levels, were well liked and socially accepted.

Overall, this thesis has challenged traditional approaches to student alcohol consumption by exploring the potential incentives associated with hazardous alcohol use. Findings suggest that alcohol is central to the social lives of students, and they make strategic decisions about their alcohol use to avoid social costs and achieve social benefits. Of importance, this thesis uncovered a group of students who did not want to drink at culturally prescribed levels and that there are hidden social costs to drinking. Future research should devote attention to identifying students who are conflicted about drinking and therefore may be ripe for intervention. In addition, more research is needed into hidden social costs.


We present a theoretical study of rough photonic surfaces and disordered photonic crystal wire and hole (slab) geometries as a scattering entrance layer to enhance the absorption in thin-film photovoltaic solar cells. One commonly accepted gold standard for scattering enhanced absorption in solar films is given by the Lambertian limit, which results in an optical path length enhancement of 4n2, where n is the refractive index. However, this limit is often an idealized upper limit and hard to realize in practice. Exploiting finite-difference time-domain simulations of realistic rough surfaces, we first explore the limitations and potential practical implementation of this ideal enhancement. A practical rough film, characterized by the RMS height (σRMS) and correlation length (Lx,y) of the random peaks, is numerically optimized for different substrate thicknesses over an optical wavelength range of 400–1100 nm. This optimized surface reflects one practical solution for Lambertian slab thicknesses above 500 nm and wavelengths in the near-UV, but performs worse in the near-IR (∼80%). The physical total height of the optimal rough surfaces is found to be of the order of 2 μm, which contradicts the common assumption that absorption losses within the rough film are negligible. We also investigate photonic crystal wire and slab holes structures with positional and radial disorder, for a fixed height of 1 μm with reflective Ag substrates, considering both GaAs and c-Si semiconductors. We show that the best performing GaAs nanowires give the largest total short-circuit current density (Jsc) of 30  mA/cm2. Relative to the unpatterned slabs of the same height, the greatest photonic crystal enhancements in absorption were seen for c-Si nanoholes and GaAs nanowires (enhancement factors of 1.65 and 1.33, respectively). The inclusion of lattice disorder is shown to increase the absorption enhancement in all photonic crystal structures by 4%–15%, except GaAs nanoholes, which remained within 1% of the ordered structure. Using an analysis of the computed local density of photon states, which is strongly dependent on the complex dielectric constant of the semiconductor, we demonstrate that, due to the higher inherent material losses in GaAs, the useful effects of disorder-induced broadening are minimized in GaAs, compared to c-Si.


This report describes meibomian adenoma (MA) and moll gland adenoma in a female, 1.5-months- old, crossbreed calf. Macroscopically, the mass was 3 × 1.5 × 0.5 cm in size and 5.35 g in weight; its shape was gray-reddish and it was localized on the right lower eyelid. Microscopically, the mass was composed of lobules of various sizes separated with a septum, which included well-differentiated sebaceous cells and apocrine secretory epithelium, with no an association of both gland types.


Indoxyl sulfate (IS), a uremic toxin, causes chronic kidney disease (CKD) progression via its tubulotoxicity. After cellular uptake, IS directly induces apoptotic and necrotic cell death of tubular cells. Additionally, IS increases oxidative stress and decreases antioxidant capacity, which are associated with tubulointerstitial injury. Injured tubular cells are a major source of transforming growth factor-β1 (TGF-β1), which induces myofibroblast transition from residual renal cells in damaged kidney, recruits inflammatory cells and thereby promotes extracellular matrix deposition in renal fibrosis. Moreover, IS upregulates signal transducers and activators of transcription 3 phosphorylation, followed by increases in TGF-β1, monocyte chemotactic protein-1 and α-smooth muscle actin production, which participate in interstitial inflammation, renal fibrosis and, consequently, CKD progression. Clinically, higher serum IS levels are independently associated with renal function decline and predict all-cause mortality in CKD. The poor removal of serum IS in conventional hemodialysis is also significantly associated with all-cause mortality and heart failure incidence in end-stage renal disease patients. Scavenging the IS precursor by AST-120 can markedly reduce tubular IS staining that attenuates renal tubular injury, ameliorates IS-induced oxidative stress and rescues antioxidant glutathione activity in tubular epithelial cells, thereby providing a protective role against tubular injury and ultimately retarding renal function decline.


In the past years, face recognition technologies have shown impressive recognition performance, mainly due to recent developments in deep convolutional neural networks. Notwithstanding those improvements, several challenges which affect the performance of face recognition systems remain. In this work, we investigate the impact that facial tattoos and paintings have on current face recognition systems. To this end, we first collected an appropriate database containing image-pairs of individuals with and without facial tattoos or paintings. The assembled database was used to evaluate how facial tattoos and paintings affect the detection, quality estimation, as well as the feature extraction and comparison modules of a face recognition system. The impact on these modules was evaluated using state-of-the-art open-source and commercial systems. The obtained results show that facial tattoos and paintings affect all the tested modules, especially for images where a large area of the face is covered with tattoos or paintings. Our work is an initial case-study and indicates a need to design algorithms which are robust to the visual changes caused by facial tattoos and paintings.


Every day, we are exposed to multiple chemicals by several routes of exposure: diet, inhalation and dermal contact. Until recently, risk assessment is mostly performed separately for each chemical, considering only a single route of exposure. However, this simplified risk assessment does not take into account the effect that chemicals may have on each other and their effect on the same target organ. According to EU Regulation, EFSA is responsible to establish the methodology for combined exposure to multiple pesticides. Recently, EFSA has published the outline of the methodology on the EFSA website, including four EFSA opinions on how based on their toxicological profile and EFSA guidance on how to perform the exposure assessment. EFSA started grouping pesticides into cumulative assessment groups based on their toxicological profile for all pesticides affecting the nervous system and all pesticides affecting the thyroid gland. EFSA noticed that relevant information on the toxicity of the chemical is not always available. Consequently, EFSA applied a precautionary principle in their grouping and it was noticed that refinements are possible when data on toxicity becomes available. To this end, the new European funded project EuroMix will apply several in-silico and in-vitro tools to mixtures of chemicals that can affect the liver, the endocrine system, and the development stage. A number of test systems, including omics technology and classic toxicological testing, will be explored. The most promising tests for mixtures will be verified against results from animal studies. Once validated, the tests will be used to collect information needed to refine the risk assessment. Data and models will become available in a web-based platform for all European countries and stakeholders.


PURPOSE
To validate the instrument Body Image Relationship Scale (BIRS) for Brazilian women with breast cancer.

METHODS
The instrument was administered by trained interviewers to 139 women who used the Brazilian Unified Health System (SUS). All of them had been submitted to cancer treatments between 2006 and 2010. The instrument was validated considering internal consistency and reliability. In order to compare the techniques, the same factorial analysis as used in the original paper was carried out.

RESULTS
The Spearman-Brown correlation value was 0.8, indicating high internal reliability. The Cronbach's alpha found was 0.9, indicating a high level of internal consistency. Factorial analysis showed that four items had low factorial load and no discriminatory power, and another five items were relocated to other factors. When the instrument was applied, it showed variability to that of the original instrument.

CONCLUSION
The Brazilian version of the Body Image Relationship Scale (BIRS), named Escala de Relacionamento e Imagem Corporal (ERIC), showed evidence of adequate reliability and internal consistency, making this instrument suitable to be recommended for application to Brazilian women with breast cancer, despite some limitations.


Over the past few years, many applications of satellite navigation systems have been developed. Among the wide range of applications of such systems, transportation in urban environment seems to be one of the most prominent. Hence it is important to fully and accurately characterize the receiver performance for this application.The urban environment is characterized by high masking angles and the presence of a great number of obstacles which produce multipath. Investigating the receiver performance in this medium requires a model of the wave propagation. In this paper, a ray launching simulation tool is used to characterize different environments and the receiver errors due to multipath and the receiver performance with and without augmentation are evaluated.


In the past decade, as inspired by the discovery of graphene, two-dimensional (2D) materials which possess a periodic network structure and with a topographical thickness of atomic/molecular level, have emerged as the new paradigm of materials with enormous potentials, ranging from electronics and optoelectronics to energy technology, membrane, sensing and biomedical applications. Various fabrication strategies have been developed to attain high quality 2D materials. Among of them, mechanical exfoliation remains the most popular protocol to isolate single-layer high quality 2D materials for fundamental physical studies. In contrast to the tremendous exploration of graphene and 2D inorganic materials such as metal dichalcogenides, boron nitride, black phosphorus, metal oxides and nitrides, the study on 2D soft material systems including the bottom-up organic synthesis of graphene, 2D metalorganic frameworks, 2D polymers/supramolecular polymers as well as supramolecular approach to 2D organic nanostructures remains under development.


The revised version of the practice guideline 'The red eye' of the Dutch College ofGeneral Practitioners gives the general practitioner useful information on new insights into diagnosis and therapy for a red eye. An important therapeutic advice is prescribing chloramphenicol ointment instead of fusidic acid ointment in the case of bacterial conjunctivitis after one-week treatment without positive results, since 80% of the conjunctivitis causing bacteria does not react to fusidic acid. A slit lamp is helpful in the diagnosis of a case of red eye, but is not present in every general practitioner's office. Joint efforts of a group of general practitioners in obtaining such a slit lamp may reinforce the diagnosis in general practice.


Background: Intake of dairy-related nutrients of South Africans is low. Nutrition professionals may influence dietary behaviour. Their own disposition related to dairy is unknown, yet important in promoting the "have milk, maas or yoghurt every day" guideline. Aim: Guided by the Theory of Planned Behaviour (TPB), this study aimed to describe determinants of target behaviour of consumption of 2–3 servings of dairy daily among nutrition professionals. Methods: An electronic survey (Qualtrics Online Survey Software) of conveniently sampled Association for Dietetics in South Africa (ADSA) and Nutrition Society of South Africa (NSSA) members determined their dairy-related behaviour, intentions, attitudes, subjective norms and perceived behavioural control regarding dairy in general, and of milk, maas, yoghurt and cheese. Results: Three hundred and six (306) responses (aged 36.4 ± 10.5 years) were received. A third of nutrition professionals reported that their daily dairy intake was 2–3 servings 4–6 times per week, yet over 40% met the target once per week or less often. Intake differed across products. Intention to consume the target was high (5.2 ± 0.12; scale 1–7). Attitudinal evaluations revealed highest belief scores related to nutritional quality and bone health. Associations with cancer development, diabetes and the environment were believed to be least likely. Professional training and scientific evidence emerged as the strongest subjective norms. Nutrition professionals perceived themselves to be in control of the target behaviour, yet their clients significantly less so (p < 0.0001). Conclusion: Nutrition professionals' attitudes, subjective norms and behavioural control can aid responsive empowerment to support dairy-related nutrition education of South Africans.


This paper broadens the scope of traditional stock-flow experiments because for the first time the focus is both on product (task solutions) and process (reasoning process). By using a think aloud protocol, insight is gained in the reasoning processes of 8 participants in the female professors systems thinking inventory task. This knowledge is used to identify patterns and deficiencies in decision-makers' ability to manage simple stock-flow problems and to propose measures to improve this. Furthermore, the effects of elaborate oral feedback on the quality of participants' reasoning and ability to solve the task are assessed. The experiment shows that the most important reason for failure in managing stock-flow problems is decision-makers' lack of familiarity with the concept of average delay time for determining the outflow of a stock. Furthermore, the oral feedback is found to be effective for creating insight in simple stock-flow problems, although use of supporting tools like a spreadsheet is essential for gaining full insight and for successful management of simple stock-flow problems.


The economic theory of regulation is an application of the neo-classical theory, based on the paradigm of perfect competition and on the theoretical category of market failure. On the contrary, the normative theory of regulation assumes a more realistic interpretation of regulatory processes, strongly conditioned by interest groups and political factors. Furthermore, more recent economic literature, particularly Austrian School, has underlined the abstract nature of the theory of perfect competition and the uselessness of the category of market failure, which hasn't effective capacity to select the situations that require regulatory interventions. In fact, the characters of market failure situations are ubiquitous in economic processes because of the irrepressible factors of ignorance and time. For these reasons, the Regulatory Impact Analysis (RIA) can't be used to found on solid scientific basis the regulation of economic activities. The goals of RIA are less ambitious: not to improve the economically perfect regulation, but to recognise the main mistakes of regulator. The RIA processes have been to be built, coherently with these assumptions, as instrument to reduce the informational deficit that afflicts the regulators and the politicians and to sustain the deregulatory and reregulatory process.


BACKGROUND
Sildenafil (Viagra), a new oral drug for the treatment of erectile dysfunction, was licensed for use across Europe in 1998.

AIM
To examine the effectiveness and safety of sildenafil as an oral treatment for erectile dysfunction.

DESIGN OF STUDY
Systematic review and meta-analysis.

SETTING
All published or unpublished randomised controlled trials comparing sildenafil with a placebo or alternative therapies.

METHOD
Published studies were sought by computerised searches of electronic databases using the keywords 'sildenafil' and 'Viagra'. A hand search was also done of the British Medical Journal, Lancet, Journal of the American Medical Association, New England Journal of Medicine, British journal of General Practice, Drug, Inpharma and Scrip. An assessment of quality of all identified studies and data extraction was undertaken independently by two researchers. Results were combined in a meta-analysis where appropriate, using RevMan version 3.

RESULTS
Twenty-one trials were identified. All trials showed a statistically significant improvement in erectile or sexual function in patients using sildenafil compared with a placebo. A meta-analysis of 16 trials reporting a global efficacy response showed that men were 3.57 (95% CI = 2.93-4.43) times as likely to have improved erections on sildenafil compared with those on a placebo. The number needed to treat to have one man with improved erections was two. The drug has a relatively safe side-effect profile.

CONCLUSIONS
Available research shows that sildenafil is an effective treatment for male erectile dysfunction. Many trial participants had some baseline erectile function and it is probable that in clinical practice, where the erectile function tends to be more impaired, the number needed to treat may be higher.


In this article, the professionalization of landscape architecture is placed into a chronological framework and analyzed within the context of the literature on professions, professionalization, and occupational history. It is thus determined that the professionalization of landscape architecture began with the founding of the professional society (the American Society of Landscape Architects) in 1899, and closed with the publication of a written code of ethics in 1927. By means of the code of ethics and the statement of professional practice, landscape architects in the United States defined their professional role for their colleagues and the public. In choosing to become professionals, early landscape architects sacrificed the income from "speculative profit" (for example, from the sale of nursery stock) in order to serve the public and, with architects and engineers, to share in the social status once reserved for lawyers, physicians, and the clergy. Although the scope and membership of the profession have broadened over the years, much of what early practitioners once struggled to define in the "Code" and the "Standards" remains as the traditional core of professional practice today.


As a form of investment, the importance of capital reallocation between firms has been increasing over time, with the purchase of used capital accounting for 25% to 40% of firms total investment nowadays. Cross- firm reallocation of used capital also exhibits intriguing business-cycle properties, such as (i) the illiquidity of used capital is countercyclical (or the quantity of used capital reallocation across rms is procyclical), (ii) the prices of used capital are procyclical and more so than those of new capital goods, and (iii) the dispersion of firms' TFP or MPK (or the bene t of capital reallocation) is countercyclical. We build a search-based neoclassical model to qualitatively and quantitatively explain these stylized facts. We show that search frictions in the capital market are essential for our empirical success but not sufficient---fi nancial frictions and endogenous movements in the distribution of rm-level TFP (or MPK) and interactions between used-capital investment and new investment are also required to simultaneously explain these stylized facts, especially that prices of used capital are more volatile than that of new investment and the dispersion of firm TFP is countercyclical.


Ladle is an important apparatus in metallurgical industry and takes charge of transferring molten steel from a converter to procedure of continuous casting or ingot casting. It not only improves production efficiency, product quality and production flexibility massively, but also decreases energy and material consumption. The ladle lifetime influences economic benefit of iron and steel enter- prises directly. Distribution of its temperature field and stress field has a vital effect on the lifetime. Thermal expansion stress is one of important reasons for damage as ladles operate under the condition of high temperature and overload. Under high temperature, thermal expansion is generated in the ladle lining and shell. Thermal expansion stress is introduced when lining and shell deformation arising from thermal expansion is subjected to mutual constraint from the counterpart due to various thermal expansion coefficient. The finite element software is used to establish the ladle model and influence of working lining material thermal conductivity; thermal expansion coefficient, Young's modulus and its thickness on the ladle temperature and stress field are studied. The calculation result indicated the equivalent stress in the ladle enlarged as the thermal conductivity, thermal expansion coefficient, Young's modulus of working-lining material increased and the thickness decreased. Research in this paper plays a referring role in comprehending distribution of temper- ature field and stress field of the ladle and selecting appropriately physical parameters of lining. The actual operation result indicates that the research increases the ladle lifetime effectively and shows its wide popularization value.


Introduction The aim of this in vitro study was to compare polymicrobial microleakage of calcium enriched mixture (CEM) cement, mineral trioxide aggregate (MTA), amalgam, and composite resin as intra-orifice sealing materials. Materials and Methods Seventy single-rooted mandibular premolars were instrumented and obturated by cold lateral compaction technique. The teeth were randomly divided into four experimental groups according to used material: CEM, MTA, amalgam and composite resin (n=15) and two control groups (n=5). In experimental groups, 2 mm of coronal gutta-percha was removed and replaced with the study material. All the teeth were mounted in a two-chamber apparatus and the coronal portion was exposed to human saliva. The day the turbidity occurred was recorded for each sample. Data were analyzed using one-way ANOVA. Results The negative control group showed no leakage while the average microleakage time in the positive control group was 3.5 days. The average bacterial leakage times for amalgam, composite resin, MTA, and CEM groups were 27.42±3.6, 29.35±3.15, 52.57±2.87, and 50.42±2.73 days, respectively. There was no significant difference between CEM and MTA groups (P=0.27) and also between amalgam and composite resin groups (P=0.36). However, in term of average leakage time, MTA and CEM groups exhibited significant differences with amalgam and composite resin groups (P<0.001). Conclusion According to the results of the present in vitro study, in terms of coronal sealing in endodontically treated teeth, CEM and MTA are more effective than amalgam and composite resin.


Background A high level of user involvement is one way of assuring campaigns to be relevant to people with RMD's. This is true for all projects within the PARE organisations. The Danish Rheumatism Association would like to strengthen our political campaigning and we found this goal could be reached by establishing a representative digital user panel. A representative digital user panel would give us quicker, more relevant and high quality information about the opinion of the users and their experience within many different aspects of living with RMD's in Denmark. Objectives The Danish Rheumatism Association wanted to strengthen the impact of our political campaigning. We wanted to establish a representative user panel consisting of 1500 Danes with RMD's. A digital user panel was found to be a quick and efficient tool to secure real life experiences and knowledge from the users. The user panel would make us interact with our users in even better ways and through that we were able to strengthen our political campaigning. Methods In 2016 we tried to recruit participants among our members to assure that the panel was representative, but that was more difficult than we expected and we had to use other channels to recruit too. We wanted to ask the user panel about different themes 6–8 times each year. We investigated the collected data and used them directly in our political campaigning and communicative work – without the time waster of making fancy reports. Results It turned out to be more difficult to establish a representative user panel than we thought. The barriers were various, but we succeeded in the end. The knowledge gained from the user panel has focused and strengthened our political work. This obtained influence would have been very difficult or even impossible to achieve without the experiences of the users. In our presentation we will go into details about the barriers of the establishing phase, share how we use the panel, give examples of how the answers are an added value and show how it helped us gain more political impact. Conclusions After overcoming several barriers it will possible to establish a digital user panel which can help organisations to improve their political campaigning. Disclosure of Interest None declared


We discuss the spatial and spectral intensity distribution of emission in optical gain media under stripe excitation in the case where the intensity reaches saturation level. It is found that modes propagating along the stripe in different directions are spatially separated if they affect each other due to saturation. The investigation includes the effects of wavelength-dependent inhomogenities, such as localized losses and reflective perturbations. Even relatively small distortions of this kind are found to cause considerable spatial and spectral redistribution of the intensity compared to an ideal disorder-free medium. Our results indicate that a simple ansatz may describe some mechanisms that lead to the formation of random laser action that is commonly observed in high gain media, such as organic semiconductors. Furthermore, consequential difficulties of gain measurements in such media using stripe excitation experiments are highlighted.


Background: Informal caregivers are a particularly vulnerable population at risk for adverse health outcomes. Likewise, there are many scales available assessing individual caregiver burden and stress. Recently, resilience in caregivers gained increasing interest and scales started to assess resilience factors as well. Drawing on a homeostatic model, we developed a scale assessing both caregivers' stress and resilience factors. We propose four scales, two covering stress and two covering resilience factors, in addition to a sociodemographic basic scale. Based on the stress:resilience ratio, the individual risk of adverse health outcomes and suggestions for interventions can be derived. Methods: A total of 291 informal caregivers filled in the ResQ-Care as part of a survey study conducted during the second wave of the COVID-19 pandemic in Germany. Exploratory factor analysis was performed. Validity analyses were examined by correlations with the Brief Resilience Scale (BRS), the Perceived Stress Scale (PSS-4) and the Geriatric Depression Scale (GDS-15). Results: The data fitted our proposed four-factor solution well, explaining 43.3% of the variance. Reliability of each scale was at least acceptable with Cronbach's α ≥0.67 and MacDonald's ω ≥0.68 for all scales. The two strain scales weighed more than the resilience scales and explained 65.6% of the variance. Convergent and discriminant validity was confirmed for the BRS and PSS-4, whereas the GDS-15 correlation pattern was counterintuitive. Conclusion: The factor structure of the ResQ-Care scale was confirmed, with good indications of reliability and validity. Inconsistent correlations of the scales with the GDS-15 might be due to a reduced validity of GDS-15 assessment during the COVID-19 lockdown.


In the reliability analysis community Bayesian Networks have gained increasedinterest and is a eld of research also in the automotive industry company ScaniaCV AB. At Scania, testing of requirements is widely used to ensure functionalityand safety for vehicles. Sometimes testing of a requirement does not exploreall of its possible behaviours and at Scania it is desired to guarantee that allrequired behaviors hold. To estimate the quotient of required behaviours thathold based on testing, a method using Bayesian Networks is proposed in thisthesis to estimate this quotient. It provides a novel framework for modellingrequirements in a hierarchical structure that calculates an estimate of the quotientof required behaviors that hold. Graphs created with the method visualizeswhich requirements that aects the quotient the most.1


A sensitive, precise microbiological assay has been developed for the determination of tissue distribution of 5-diazouracil, a potential antitumor and antimicrobial agent.


Conflict decision is a continuous decision process in a dynamic conflict environment. The evaluation of the dynamic conflict situation is the basis of making proper decisions at different stages of the conflict process. Traditional evaluation approaches are static and do not consider enough impact factors in real conflict environment, so cannot reflect the real conflict situation and its evolution. This paper presents a dynamic evaluation framework for supporting continuous decisions in dynamic conflict environments. The framework includes the timed evaluation models for conflict force, conflict situation, and psychological pressure, as well as a graphical trend analysis approach. The framework has been applied to a virtual military conflict decision training system. A set of dynamic curves is used to intuitively reflect the dynamic evaluation result. Decision makers can know the current conflict situation and its evolution process through these dynamic curves at any stage of the conflict process so can make more evidential decisions.


With the recent approval of sipuleucel-T for metastatic castration-resistant prostate cancer and ipilimumab for metastatic melanoma, there is increasing excitement in the field of cancer immunotherapy. A large number of clinical trials are currently testing various vaccine vectors in a diverse array of cancer types. Which of these strategies will ultimately prove successful has yet to be determined. However, a better understanding of the complex interplay of tumor-specific T cells and the challenges faced at the tumor microenvironment, advances in biotechnology, and lessons learned from prior successes and failures will likely lead to approvals of other therapeutic cancer vaccines.