A review of literature during calendar year 2013 focused on environmental policies and sustainable development, and economic policies. This review is divided into these sections: sustainable development, irrigation, ecosystems and watershed management, climate change and disaster risk management, environmental policies management, economic growth, water supply policies, water consumption, water price regulation, and valuation.


Purpose: N3 gastric cancer (GC) is characterized by a heavy burden of lymph node metastasis and a high postoperative recurrence rate. The role of radiotherapy in this group of patients remains undetermined. The purpose of this study was to compare the effectiveness of adjuvant chemoradiotherapy (CRT) and adjuvant chemotherapy (ChT) for N3 GC after D2/R0 resection. Patients and methods: From January 2004 to December 2015, patients with N3 GC in the database of Fudan University Shanghai Cancer Center were retrospectively reviewed. The eligible patients were enrolled in an adjuvant CRT group and an adjuvant ChT group. Four different methods based on a propensity score model were used to balance the baseline characteristics. Then, survival analyses between the two groups were performed in addition to patterns of recurrence and subgroup analyses. Results: In total, 175 and 365 eligible patients were enrolled into the CRT and ChT groups, respectively. After balancing, the disease-free survival (DFS) of patients in the CRT group was significantly better than that of patients in the ChT group (p=0.021). Subgroup analyses showed that patients with N3a GC benefitted from adjuvant CRT. Conclusion: Compared with adjuvant ChT, adjuvant CRT can further improve the DFS of patients with N3 GC after D2/R0 resection. Patients with lymph node metastases should be further stratified when selecting patients for adjuvant CRT.


The mammalian chromosome is longitudinally heterogeneous in structure and function and this is the basis for the specific banding patterns produced by various chromosome staining techniques. The two most frequently used techniques are G, or Giemsa banding and R, or reverse banding. Each type of stained band is characterised by variations in gene density, time of replication, base composition, density of repeat sequences, and chromatin packaging. It is increasingly apparent that R and G bands, which are complementary to each other, represent separate compartments of the euchromatic human genome, with R bands containing the vast majority of genes. R bands are also more GC-rich, contain a higher density of Alu repeats, and replicate earlier in S phase, than G bands. These properties may be interdependent and may have coevolved.


Studies report substantial sexual behaviour change in Africa in response to HIV/AIDS. Generally there seems to be an increase in condom use and a reduction in partners, with men reporting more change than women. However, it is not only important to know whether people are changing their sexual behaviour but also their reasons for changing and the consistency and extent of change. Between 1996 and 2000 a study involving 196 respondents was carried out in rural southwest Uganda to investigate the exact nature of behaviour change and the reasons for change or lack of change since people became aware of HIV/AIDS. Data were collected from three rounds of questionnaire surveys, four rounds of open in-depth interviews, six rounds of semi-structured interviews and from informal conversations and participant observation. In order to obtain a comprehensive assessment of behaviour change the data for each participant from all sources were compared and discrepancies were then followed up by re-interviewing participants. After triangulation between all sources of data, 48% of respondents had ever used a condom. Condom use in 76% of all cases was at least partly AIDS related, while 19% was exclusively for protection against HIV. Condom use tended to be sporadic: only 13% of condom users currently used a condom regularly and most of this use was for family planning. After triangulation, 45% had reduced the number of sexual partners. Of all partner reductions, 93% was at least partly AIDS related; 29% was exclusively to avoid HIV. Half of those who had reduced the number of partners either stuck to one partner or abstained. Men reported more change than women. Of those who reported no partner reduction, 89% could not reduce the number of partners because they already had only few or a single partner or abstained; most of these were women. Most of those who could change their sexual behaviour had already changed, though the degree of change (particularly condom use) was often minimal. Not only behaviour change, but also the maintenance of safe behaviour is important. Also, understanding reasons for change and extent and consistency of change are important when planning and evaluating interventions.


To the Editor .—Nasal polyps were first described more than 3000 years ago and comprise the most common group of mass lesions encountered in the nose. Despite this long history and frequent occurrence, a great many questions still exist with regard to pathogenicity. Heading the list of possible mechanisms is allergy. The major features pointing to allergy as a cause of nasal polyps are rhinorrhea, sneezing and itching, elevated histamine and IgE concentration in extracellular polyp fluid, degranulated mast cells in polyps, marked tissue eosinophilia, and association with late-onset asthma. The assumption that allergy does play an important role in the pathogenesis of nasal polyps is certainly evident in clinical practice. The experience of allergists is that many patients with nasal polyps are referred by otolaryngologists for allergy evaluation. It is my impression based on a nonscientific "straw poll" that the majority of otolaryngologists do believe that allergy and nasal


The biolinguistic perspective regards the language faculty as an organ of the body, along with other cognitive systems. Adopting it, we expect to find three factors that interact to determine (I-) languages attained: genetic endowment (the topic of Universal Grammar), experience, and principles that are language- or even organism-independent. Research has naturally focused on I-languages and UG, the problems of descriptive and explanatory adequacy. The Principles-and-Parameters approach opened the possibility for serious investigation of the third factor, and the attempt to account for properties of language in terms of general considerations of computational efficiency, eliminating some of the technology postulated as specific to language and providing more principled explanation of linguistic phenomena


The arenavirus Lassa is found in West Africa, where it sometimes causes a severe illness called Lassa fever. Lassa fever has been seldom investigated outside of a few hyperendemic regions, where the described epidemiology may differ from that in areas of low or moderate incidence of disease. Through a prospective cohort study, we investigated the epidemiology and clinical presentation of Lassa fever in Guinea, where the disease has been infrequently recognized. A surveillance system was established, and suspected cases were enrolled at five Guinean hospitals. Clinical observations were made, and blood was taken for enzyme-linked immunosorbent assay testing and isolation of Lassa virus. Lassa fever was confirmed in 22 (7%) of 311 suspected cases. Another 43 (14%) had Lassa IgG antibodies, indicating past exposure. Both sexes and a wide variety of age and ethnic groups were affected. The disease was more frequently found, and the IgG seroprevalence generally higher, in the southeastern forest region. In some areas, there were significant discrepancies between the incidence of Lassa fever and the prevalence of antibody. Clinical presentations between those with Lassa fever and other febrile illnesses were essentially indistinguishable. Clinical predictors of a poor outcome were noted, but again were not specific for Lassa fever. Case-fatality rates for those with Lassa fever and non-Lassa febrile illnesses were 18% and 15%, respectively. Seasonal fluctuation in the incidence of Lassa fever was noted, but occurred similarly with non-Lassa febrile illnesses. Our results, perhaps typical of the scenario throughout much of West Africa, indicate Lassa virus infection to be widespread in certain areas of Guinea, but difficult to distinguish clinically.


In model-based reinforcement learning, planning with an imperfect model of the environment has the potential to harm learning progress. But even when a model is imperfect, it may still contain information that is useful for planning. In this paper, we investigate the idea of using an imperfect model selectively. The agent should plan in parts of the state space where the model would be helpful but refrain from using the model where it would be harmful. An effective selective planning mechanism requires estimating predictive uncertainty, which arises out of aleatoric uncertainty, parameter uncertainty, and model inadequacy, among other sources. Prior work has focused on parameter uncertainty for selective planning. In this work, we emphasize the importance of model inadequacy. We show that heteroscedastic regression can signal predictive uncertainty arising from model inadequacy that is complementary to that which is detected by methods designed for parameter uncertainty, indicating that considering both parameter uncertainty and model inadequacy may be a more promising direction for effective selective planning than either in isolation.


The small genus Snellenius Westwood, 1882 is newly recorded for Vietnam and two new species are described and illustrated, viz. Snellenius nigellus Long & van Achterberg sp. n. and S. similis Long & van Achterberg sp. n.; one new status is Snellenius theretrae (Watanabe, 1937) stat. n.; two newly recorded species for Vietnam's fauna are Snellenius philippinensis (Ashmead, 1904) and S. maculipennis (Szépligeti, 1900). The checklist and distribution of seventeen extant species and one fossil species, Snellenius succinalis Brues, 1933, are given, of those four species are described from the Neotropical region and the remaining species are described from Oriental region. A key to the species of the genus Snellenius from Vietnam is provided.


Hydrogels are perfectly suited to support cell and tissue growth in advanced tissue engineering applications as well as classical wound treatment scenarios. Ideal hydrogel materials for these applications should be easy to produce, biocompatible, resorbable and antimicrobial. Here we report the fabrication of degradable covalent antimicrobial lysine and tryptophan containing copolypeptide hydrogels, whereby the hydrogel properties can be independently modulated by the copolypeptide monomer ratio and chiral composition. Well-defined statistical copolypeptides comprising different overall molecular weights as well as ratios of l- and d-lysine and tryptophan at ratios of 35 : 15, 70 : 30 and 80 : 20 were obtained by N-carboxyanhydride (NCA) polymerisation and subsequently crosslinked by the selective reaction of bifunctional triazolinedione (TAD) with tryptophan. Real-time rheology was used to monitor the crosslinking reaction recording the fastest increase and overall modulus for copolypeptides with the higher tryptophan ratio. Water uptake of cylindrical hydrogel samples was dependent on crosslinking ratio but found independent of chiral composition, while enzymatic degradation proceeded significantly faster for samples containing more l-amino acids. Antimicrobial activity on a range of hydrogels containing different polypeptide chain lengths, lysine/tryptophan composition and l/d enantiomers was tested against reference laboratory strains of Gram-negative Escherichia coli (E. coli; ATCC25922) and Gram-positive, Staphylococcus aureus (S. aureus; ATCC25923). log reductions of 2.8-3.4 were recorded for the most potent hydrogels. In vitro leachable cytotoxicity tests confirmed non-cytotoxicity as per ISO guidelines.


1. Intravenous administration of 1.0 mg/kg of morphine produces inhibition of the nociceptive tail-flick (TF) reflex, hypotension, and bradycardia in the pentobarbital-anesthetized rat. The present experiments examined peripheral, spinal, and supraspinal relays for inhibition of the TF reflex and cardiovascular responses produced by morphine (1.0 mg/kg iv) in the pentobarbital-anesthetized rat using 1) bilateral cervical vagotomy, 2) spinal cold block or mechanical lesions of the dorsolateral funiculi (DLFs), or 3) nonselective local anesthesia or soma-selective lesions of specific CNS regions. Intravenous morphine-induced inhibition of responses of unidentified, ascending, and spinothalamic tract (STT) lumbosacral spinal dorsal horn neurons to noxious heating of the hindpaw were also examined in intact and bilateral cervical vagotomized rats. 2. Bilateral cervical vagotomy significantly attenuated inhibition of the TF reflex and bradycardia produced by intravenous administration of morphine. Bilateral cervical vagogtomy changed the normal depressor response produced by morphine into a sustained pressor response. Inhibition of the TF reflex in intact rats was not due to changes in tail temperature. 3. Spinal cold block significantly attenuated inhibition of the TF reflex, the depressor response, and the bradycardia produced by intravenous administration of morphine. However, bilateral mechanical transections of the DLFs failed to significantly affect either inhibition of the TF reflex or cardiovascular responses produced by this dose of intravenous morphine. 4. Microinjection of either lidocaine or ibotenic acid into the nuclei tracti solitarii (NTS), rostromedial medulla (RMM), or ventrolateral pontine tegmentum (VLPT) attenuated morphine-induced inhibition of the TF reflex. Similar microinjections into either the periaqueductal gray (PAG) or the dorsolateral pons (DLP) failed to affect morphine-induced inhibition of the TF reflex. 5. Microinjection of either lidocaine or ibotenic acid into the NTS, RMM, VLPT, DLP, or rostral ventrolateral medulla (RVLM) attenuated the depressor response produced by morphine, although baseline arterial blood pressure (ABP) was affected by ibotenic acid microinjections in the DLP. In all these cases, the microinjections failed to reveal a sustained pressor response as was observed with bilateral cervical vagotomy. Similar microinjections into the PAG failed to affect the depressor response produced by morphine. 6. The lidocaine and ibotenic acid microinjection treatments also showed that the bradycardic response produced by morphine depends on the integrity of the NTS, RMM, RVLM, and possibly the DLP, but not the PAG or VLPT.(ABSTRACT TRUNCATED AT 400 WORDS)


DNA vaccination has been extensively studied as a promising strategy for tumor treatment. Despite the efforts, the therapeutic efficacy of DNA vaccines has been limited by their intrinsic poor cellular internalization. Electroporation, which is based on the application of a controlled electric field to enhance DNA penetration into cells, has been the method of choice to produce acceptable levels of gene transfer in vivo. However, this method may cause cell damage or rupture, non-specific targeting, and even degradation of pDNA. Skin irritation, muscle contractions, pain, alterations in skin structure, and irreversible cell damage have been frequently reported. To overcome these limitations, in this work, we use a microfluidic platform to generate DNA-loaded lipid nanoparticles (LNPs) which are then characterized by a combination of dynamic light scattering (DLS), synchrotron small-angle X-ray scattering (SAXS), and transmission electron microscopy (TEM). Despite the clinical successes obtained by LNPs for mRNA and siRNA delivery, little is known about LNPs encapsulating bulkier DNA molecules, the clinical application of which remains challenging. For in vitro screening, LNPs were administered to human embryonic kidney 293 (HEK-293) and Chinese hamster ovary (CHO) cell lines and ranked for their transfection efficiency (TE) and cytotoxicity. The LNP formulation exhibiting the highest TE and the lowest cytotoxicity was then tested for the delivery of the DNA vaccine pVAX-hECTM targeting the human neoantigen HER2, an oncoprotein overexpressed in several cancer types. Using fluorescence-activated cell sorting (FACS), immunofluorescence assays and fluorescence confocal microscopy (FCS), we proved that pVAX-hECTM-loaded LNPs produce massive expression of the HER2 antigen on the cell membrane of HEK-293 cells. Our results provide new insights into the structure–activity relationship of DNA-loaded LNPs and pave the way for the access of this gene delivery technology to preclinical studies.


After infection, a plant develops symptoms that appear in different parts of plants; however, at moment in which these symptoms are visible, the plant can already be affected negatively. In addition, plants that remain asymptomatic are pathogens reservoirs, since they can remain infected for most of their development cycle, becoming a source of contamination for entire crop. After the symptoms onset, disease is verified using detection techniques, such as ELISA, Polymerase Chain Reaction, Immunofluorescence, Flow Cytometry, Fluorescence in situ and, Gaseous Metabolite Profiles, among others. However, despite the availability of these techniques, a diseases early detection system based on spectrometry techniques can help to reduce losses caused in crops and prevent a greater spread of disease, with more speed, sensitivity, selectivity and without requiring the samples destruction required for analysis. The aim of this study is to evaluate early detection of plants diseases caused by fungal infections using in situ reflectance spectroscopy. To achieve this, reflectance spectra were measured from leaves of S. lycopersicum infected with a fungus pathogenic strains at various times of pathogenesis before the symptoms of the disease were visible. Additionally, physiological analyzes were performed and were related to reflectance spectra of the infected and healthy plants in different infection periods; also, were developed disease prediction models based on Vis/NIR reflectance data before the visual expression of the symptoms using different multivariate statistical tools. In this study it was possible to characterize the spectral variation in leaves of S. lycopersicum L. infected with F. oxysporum during the incubation period. It was also possible to identify the relevant specific wavelengths in the range of 380-1000 nm that can be used as spectral signatures for the detection and discrimination of vascular wilt in S. lycopersicum. We watch that inoculated tomato plants increased their reflectance in the visible range (Vis) and decreased slowly in the near infrared range (NIRs) measured during incubation, showing marked differences with plants subjected to water stress in the VIS/NIR. Additionally, three ranges were found in the spectrum related to infection by F. oxysporum (510nm-520nm, 650nm-670nm and 700-750nm). Linear discriminant models on spectral reflectance data were able to differentiate between tomatos varieties inoculated with F. oxysporum from healthy ones with accuracies higher than 70% 9 days after inoculation (only with three explanatory variables). Additionally, it was possible to characterize and relate the spectral variance in leaves of S. lycopersicum infected with F. oxysporum with the physiological variation and pathogen concentration in tomato plants during the asymptomatic period of vascular wilt. Photosynthetic parameters derived from gaseous exchange analyzes in the tomato leaves correlated related with four bands in the visible range (Vis). Additionally, five specific bands also correlated highly correlated with the increase of F. oxysporum conidia concentration measured at root: 448-523nm, 624-696nm, 740-960nm, 973-976nm and 992-995nm. These wavelengths allowed classifying correctly 100% the plants inoculated with F. oxysporum of plants subjected to hydric stress and controls in the disease asymptomatic period. Finally, it was possible to develop logistic regression models to predict infection by F. oxysporum in plants, obtaining accuracies and areas under the curve greater than 0.9 for one of the tomato varieties evaluated. The results of this study will contribute to a better understanding of the optical properties of the plant during the development of fungal diseases. These methods will be applicable in development of precision crops, specifically in crop protection, differentiation, quantification, and disease early detection of plant; in addition to, the developed models which can be used as a basic input in the design of technological tools that allow the plant disease detection in real time


XML – the extensible markup language – is a versatile platform for representation of information. Using the type mechanisms available within XML, we have proposed OOXML, an object-oriented dialect for XML. XML elements can be realized as objects by enhancing them to support object-identities, object hierarchy, and references. As OOXML documents are legal XML documents, they are amenable for use in XML processing technologies such as XQuery, XSLT, DOM/API, etc. In addition to the usual syntax the users can benefit from dotted expressions of object-oriented systems to access properties of super and referenced objects, we have implemented a preprocessor for OOXQuery – a dialect of XQuery – that translates an OOXQuery query into XQuery query. Although the translated query is cryptic for users, it can be processed in an XQuery engine. In this paper we consider benchmarking XQuery and OOXQuery for ease of use and runtime performance. Due to dotted expressions, OOXQuery is generally more natural than XQuery. For many types of queries, the performance of OOXQuery seems better. Therefore, we find that OOXQuery is an interesting alternative to XQuery. The object hierarchy is available in two flavors: hierarchy by reference and hierarchy by value for which we informally use suffixes "-R" and "-V", respectively, when necessary. Within the two options for hierarchy, OOXQuery-R seems more natural than OOXQuery-V and the performance results are mixed.


HSA structure was studied in healthy subjects and cancer patients using infrared spectroscopy. No significant differences were observed although the intensity of valent C-H fluctuation lines in alkyl groups of HSA was slightly increased in cancer patients. Gas-liquid chromatography established changes in the profile of polyunsaturated fatty acids binding to HSA in cancer patients. The data obtained suggest inhibition of omega-6 pathway of fatty acid metabolism and activation of omega-3 pathway. Marked binding of POL products to serum albumin was found nonspecific and was considered evidence of protective function of that protein.


Background: Peripheral edema is one of the common causes of visit to medical outpatient department. After history taking and investigations few patients are left without diagnosis. This study was designed to find if there is any association between pedal edema and subclinical hypothyroidism when there is no other systemic disease is found.Materials and Methods: This is a cross-sectional observational hospital based study done in one of Medical colleges in Kathmandu for a period of 2 years .All patient coming to medical OPD for the first time with bilateral painless limb swelling were evaluated data were tabulated and analyzed using Ms Excel.Results: Out of 300 patients, 146 patients were exclude from history and clinical evaluation, 154 patients underwent laboratory evaluation. After investigations 46 patients were left without any other systemic disease. Out of them only 3 were male. About 40% of them are overweight or obese. 57% of them had high TSH level, which was significantly associated with limb swelling (t=0.012)Conclusion: Subclinical hypothyroidism is significantly associated with painless bilateral limb swelling when there is no other systemic cause. It is logical to investigate a limb swelling with thyroid function test however there needs to be a larger interventional study to exactly point out the cause in these patients.


We conducted secondary data analyses on two experiments examining reactions to attorney anger expressing in court. In two experiments, participants viewed a video of a closing statement. The closing statement was delivered by either a male or a female trial attorney in a calm or angry tone. Participants completed measures of perceptions of how effective the attorney was, and several individual difference factors that might predict greater bias against angry female attorneys (i.e ambivalent sexism scale, political conservatism, age). Across two experiments we found that individual difference measures that were theorized to be related to participants' endorsement of traditional gender roles determined the level of bias against angry female attorneys. Angry (versus calm) female attorneys were penalized more and angry (versus calm) male attorneys were rewarded more as individual difference proxies for endorsing traditional gender roles increased (i.e., benevolent sexism, political conservatism, and age). Thus, the gender bias we demonstrated is likely to be due, in part, to the fact that angry women are being penalized for violating traditional gender roles by expressing anger, while angry men are being rewarded for conforming to traditional gender roles by expressing anger—despite the fact that the attorneys were all delivering the same exact arguments and similar displays of anger.


Logical AI involves representing knowledge of an agent's world, its goals and the current situation by sentences in logic. The agent decides what to do by inferring that a certain action or course of action is appropriate to achieve the goals. We characterize briefly a large number of concepts that have arisen in research in logical AI. Reaching human-level AI requires programs that deal with the common sense informatic situation. Human-level logical AI requires extensions to the way logic is used in formalizing branches of mathematics and physical science. It also seems to require extensions to the logics themselves, both in the formalism for expressing knowledge and the reasoning used to reach conclusions. A large number of concepts need to be studied to achieve logical AI of human level. This article presents candidates. The references, though numerous, to articles concerning these concepts are still insufficient, and I'll be grateful for more, especially for papers available on the web. This article is available in several forms via http://www-formal.stanford.edu/jmc/conceptsai.html.


GaP terahertz (THz) two-dimensional (2D) photonic crystal (PC) waveguides with line defects were fabricated using inductively-coupled plasma reactive-ion etching (ICP-RIE) in Ar/Cl2 gas chemistries. THz-wave generation from the fabricated PC waveguides was demonstrated under collinear phase-matched difference-frequency generation (DFG), using Cr:Forsterite (Cr:F) lasers as the incident source. We compared the THz-wave output characteristics of the PC waveguides with that of GaP planar waveguides. The collinear phase-matching conditions in the DFG process were satisfied for 300- and 500-μm-wide PC waveguide structures at 0.7 and 0.6 THz, respectively. The additional output peaks that appeared near the edge of the photonic band gap, around 0.5 THz, were attributed to the guiding modes in the PC waveguide; no such peaks appeared in the non-patterned ridge waveguides. These experimental results suggest that the phonon-polariton confinement in THz-PC waveguides based on the GaP crystal could be used to enhance the nonlinear optical effect for THz-wave generation.


We present results from density functional theory and computer simulations that unambiguously predict the occurrence of first-order freezing transitions for a large class of ultrasoft model systems into cluster crystals. The clusters consist of fully overlapping particles and arise without the existence of attractive forces. The number of particles participating in a cluster scales linearly with density, therefore the crystals feature density-independent lattice constants. Clustering is accompanied by polymorphic bcc-fcc transitions, with fcc being the stable phase at high densities.


We report on a one-pot, facile approach for the encapsulation of the liquid hexamethylene diisocyanate isocyanurate trimer in polyurea microcapsules formed via the oil-in-water interfacial reaction of an uretonimine-modified diphenyl methane diisocyanate trimer with triaminopyrimidine, with in situ shell functionalization/modification using different types of hydrophobic agents. Remarkably, the use of hexamethylenedisilazane resulted in microcapsules of about 70 μm in diameter, with a smooth outer surface and a high isocyanate core content up to 85 wt% as determined by quantitative online FT-IR analysis of the extracted core. On the other hand, the use of an alkylamine, fluorinated aromatic amine and/or perfluoride amine provided microcapsules of approximately 100 to 150 μm in diameter containing around 65–75 wt% of the isocyanate core content, with the outer shell surface bearing pendant hydrophobic groups as confirmed by SEM-EDX. The effects of the functionalizing compound on the microcapsule properties such as shell morphology, size distribution and stability were assessed. After one day immersion in water, the initial isocyanate content of the microcapsules with a non-functionalized shell dropped rapidly from 49 to 15 wt%, whereas the ones with the modified shell structure maintained their core content, suggesting a significantly enhanced microcapsule stability.


Three-dimensional scaffolds decellularized from native organs are a promising technique to establish engineered liver grafts and overcome the current shortage of donor organs. However, limited sources of bile duct cells and inappropriate cell distribution in bioengineered liver grafts have hindered their practical application. Organoid technology is anticipated to be an excellent tool for the advancement of regenerative medicine. In the present study, we reconstructed intrahepatic bile ducts in a rat decellularized liver graft by recellularization with liver ductal organoids. Using an ex vivo perfusion culture system, we demonstrated the biliary characteristics of repopulated mouse liver organoids, which maintained bile duct markers and reconstructed biliary tree-like networks with luminal structures. We also established a method for the co-recellularization with engineered bile ducts and primary hepatocytes, revealing the appropriate cell distribution to mimic the native liver. We then utilized this model in human organoids to demonstrate the reconstructed bile ducts. Our results show that liver ductal organoids are a potential cell source for bile ducts from bioengineered liver grafts using three-dimensional scaffolds.


OBJECTIVE
The purpose of this study was to summarize our clinical results with distraction osteogenesis for the treatment of infected tibial nonunion around the ankle joint.

METHODS
Between 1994 and 2009, 13 patients with a mean age of 50 years (range: 27-79 years) underwent tibial reconstruction for the treatment of infected nonunion of the distal tibia, with a mean bone loss of 4.8 cm (range: 1-7 cm). Lengthening over an intramedullary nail as a second procedure was used in 2 patients, bifocal compression and distraction technique in 5 cases, compression with Ilizarov external fixator in 5 cases, and Taylor Spatial Frame (TSF, Smith Nephew, Memphis, TN, USA) in 1 case. At final follow-up, functional and radiographic results were evaluated according to Paley's bone and functional healing criteria.

RESULTS
Mean duration of follow-up was 36 months. Mean external fixation time was 198 days, and mean external fixation index was 29 days/cm. According to Paley's bone healing criteria, there were 10 excellent, 2 good, and 1 poor result(s); additionally, according to Paley's functional healing criteria, there were 5 excellent, 6 good, and 2 fair results. There were 11 problems, 5 obstacles, and 1 sequel according to Paley's classification of complications. There was 1 persisting nonunion, which underwent revision with a retrograde intramedullary nail.

CONCLUSION
External fixator and/or combined treatment are effective and reliable methods to treat infected nonunion of the distal tibia. Every patient should be evaluated according to their infection level and bony defects for reconstruction.


Today humankind is facing numerous sustainability challenges that require us to question CO2 intensive practices like those present in the transport and energy sector. To meet those challenges, many countries have adopted ambitious climate targets. Achieving such targets requires an understanding of the wider socio-technical context of transitions. The aim of this licentiate thesis is therefore to analyse such socio-technical transitions towards low-emission futures enabled by the electrification of passenger cars and high voltage grid development.A combination of different transitions theories (for ex. Multi-level perspective and Technological innovation systems) and institutional theory has been used. To reach the aim paper I analyses the climate impacts of electric vehicles (EVs) and policy measures to achieve a breakthrough scenario for EVs. The results show that a mixture of short and long term policies are needed that take into account the technology development stage and behavioural aspects of EV adopters. Paper II addresses the need to include the high voltage transmission grid and its planning procedures as a central part of debates on transitions. Therefore the opportunities, challenges and reasons for conflict in the established regime are studied. The results show that in order to achieve a sustainable grid development regime, it is necessary to spend time on achieving legitimacy and social sustainability. The third paper uses semi-structured expert interviews and focuses on innovation dynamics for EV adoption. By focusing on dynamics instead of single policy measures, it is possible to grasp interactions within a niche, but also in between a niche, regime and landscape. The results show that strong initial technology legitimacy was needed to start substantial innovation dynamics. This could be further strengthened with a strong and broad coalition of actors. Both those factors led, if present, to an improved variety and match of policy instruments.As such this thesis has shown that transitions are not just about technology or policy instruments as such but about the dynamics and processes needed to enable them. This can be relevant in other transitions that otherwise may underestimate the importance of these components.


Abstract Background/Objectives: To assess patient and provider behaviors regarding influenza vaccination, diagnosis, and testing strategies and the availability of influenza vaccine during the 2004-2005 nationwide influenza vaccine shortage. Design/Methods: Multisite, anonymous, cross-sectional surveys of patients and providers and qualitative interviews after the 2004-2005 influenza season. Setting: Department of Veterans Affairs (VA) health care facilities with spinal cord injury centers or clinics. Participants: Stratified random sample of 3,958 veterans with spinal cord injuries and disorders (SCI&D; 31% response rate), 177 providers who treat persons with SCI&D, and 17 key informants. Results: Most patient respondents (96.1%) reported awareness of a vaccine shortage (n = 938). When asked whether the shortage affected their ability to get the vaccine, 64.8% said they had no problem, whereas 12.1% reported an inability to get the vaccine. The vaccination rate was 71.8%; most veterans received the vaccine early (October-November) at the VA, and vaccination rates increased with age (P < 0.0001). Although vaccine shortages were reported by 47.5% of provider survey respondents (n = 177), most reported that the vaccine shortage did not affect availability of vaccine for patients with SCI&D. Few clinicians conducted diagnostic tests for influenza more often than in past years (4.9%). Although providers reported shortages at 12 centers (n = 23), patients with SCI&D had priority at 11 of 12 centers. Conclusions: Most patients were aware of the vaccine shortage, and the vaccination rate remained high and comparable with previous years. VA providers and facilities targeted SCI&D as a high-risk group and prioritized use of the limited vaccine supply for them.


The aim of this paper is to understand which attributes Slovak marketers consider to be the most important and consequently which media they perceive to meet those requirements best. The first part of the analysis represents the answer to the supporting research question: What do Slovak marketers consider to be the most important attributes of the advertising medium in delivering a brand building campaign. The relative importance of attributes was evaluated using MaxDiff analysis where respondents were asked to trade off the most and least important attributes in 9 different combinations of 4 attributes at the time. The responses were analysed using a simple count-based approach, which is concerned with an overall number of -term brand building when the respondent was forced to make a choice between attributes. The purpose of this article is to help Slovak marketers become aware of their current perception of advertising media and whether this perception needs to be re-evaluated in order to prevent potential negative long-term consequences of incorrect media decisions as experienced in other countries. Therefore, this paper aims to assess the current state of the Slovak advertising industry in terms of ability to evaluate the effectiveness of advertising media to grow brand in a long-term by identifying the most important attributes Slovak marketers consider when choosing media for a brand campaign.


This study, based on the current sports risk management in primary and middle schools, performs corresponding analysis on the current sports risk management pattern in primary and middle schools. It is concluded that, for primary and middle schools especially those in Xinjiang, the primary measures for risk management is to identify the risk factors, including personnel factor, space and equipment factors, and the characteristics of sports activities in the province. Then, in accordance with the risk factors existing in the sports activities in middle and primary schools, this study performs risk assessment and evaluation on various risk factors in sports activities in Xinjiang middle and primary schools. And, according to the types, characteristics and natures of risks, proposes a series of effective solution strategies to shift risk, retain risk, reduce risk, avoid risk. It aims to prevent students from harm or reduce the damage as far as possible, to improve the risk management pattern in sports activities in the middle and primary schools, and ensure safe and effective sports activities in middle and primary schools in our country.


We outline possible actions to be adopted by the European Union to ensure a better share of total coffee revenues to producers in developing countries. The way to this translates, ultimately, in producers receiving a fair price for the commodity they supply, i.e., a market price that results from fair market conditions in the whole coffee producing chain. We plead for proposals to take place in the consuming countries, as market conditions in the consuming-countries side of the coffee producing chain are not fair; market failures and ingenious distortions are responsible for the enormous asymmetry of gains in the two sides. The first of three proposals for consumer government supported actions is to help in the creation of domestic trading companies for achieving higher export volumes. These tradings would be associated to roasters that, depending on the final product envisaged, could perform the roasting in the country and export the roasted – and sometimes ground – coffee, breaking the increasing importers-exporters verticalisation. Another measure would be the systematic provision of basic intelligence on the consuming markets. Statistics of the quantities sold according to mode of consumption, by broad 'categories of coffee' and point of sale, could be produced for each country. They should be matched to the exports/imports data and complemented by (aggregate) country statistics on the roasting sector. This would extremely help producing countries design their own market and producing strategies. Finally, a fund, backed by a common EU tax on roasted coffee – created within the single market tax harmonisation programme, is suggested. This European Coffee Fund would have two main projects. Together with the ICO, it would launch an advertising campaign on coffee in general, aimed at counterbalancing the increasing 'brandification' of coffee. Basic information on the characteristics of the plant and the drink would be passed, and the effort could be extended to the future Eastern European members of the Union, as a further assurance that EU processors would not have a too privileged access to these new markets. A quality label for every coffee sold in the Union could complement this initiative, helping to create a level playing field for products from outside the EU. A second project would consist in a careful diversification effort, to take place in selected producing countries.


The hydraulic characteristics of constructed wetland are vital to its performance for pollutant removal. Hydraulic characteristics of a pilot scale vertical flow constructed wetland were studied by tracer experiments with the method of moments (MoM) analyzing. From the residence-time distribution (RTD) of tracer during the experiment, the mean detention time, average water velocity and dispersion coefficients were obtained for the constructed wetland. The results showed that the mean residence time was approximately 15% shorter than nominal residence time indicating 85% of total available pore volume was active in pollutant removal processes. The two peaks observed on the RTD curves suggested short-circuiting flows or dead zones exist in the constructed wetland. The relatively large Peclet number of 11.8 suggested that dispersive processes dominated in the tracer movement. Comparison of tracer profiles at different sampling locations indicated that large amount of tracer transported through the upper portion of the constructed wetland.


Different climate bring about different buildings, Climate has very close relation with architecture. Building climatic classification has important direction mean for architecture design, building energy efficiency and building energy simulation. Ago, China classified building climate using temperature, relative humidity, etc.. Degree, relative humidity and clearness index were regarded as classification factors. Meteorological data of 165 stations from 1970 to 2000 is used to reclassify building climate in China. Six types of building climates which respectively is Warm, Warm & humid, Weak solar radiation & humid, Cold & dry, Cold and Sever Cold & dry was obtained, character of every climate zone was summarized.


In the fire ant Solenopsis invicta, a supergene composed of ~600 genes and having two variants, SB and Sb, regulates colony social form. In single queen colonies, all individuals carry only the SB allele, while in multiple queen colonies, some individuals carry the Sb allele. In this study, we characterized genes with copy number variation between SB and Sb‐carrying individuals. We showed extensive acquisition of gene duplicates in the Sb genome, with some likely involved in polygyne‐related phenotypes. We found 260 genes with copy number differences between SB and Sb, of which 239 have greater copy number in Sb. We observed transposable element (TE) accumulation on Sb, likely due to the accumulation of repetitive elements on the nonrecombining chromosome. We found a weak correlation between TE copy number and differential expression, suggesting some TEs may still be proliferating in Sb while many of the duplicated TEs have presumably been silenced. Among the 115 non‐TE genes with higher copy in Sb, enzymes responsible for cuticular hydrocarbon synthesis were highly represented. These include a desaturase and an elongase, both potentially responsible for differential queen odour and likely beneficial for polygyne ants. These genes seem to have translocated into the supergene from other chromosomes and proliferated by multiple duplication events. While the presence of TEs in supergenes is well documented, little is known about duplication of non‐TE genes and their possible adaptive role. Overall, our results suggest that gene duplications may be an important factor leading to monogyne and polygyne ant societies.


This paper examines the protection of labour rights in the context of civil and political rights documents and explores the compatibility of closed shop arrangements with human rights law. It contributes to the relevant debates in two ways. First, it seeks to examine how the "integrated approach" to interpretation, a method increasingly preferred by the European Court of Human Rights when examining work-related complaints, affects the regulation of closed shops. Second, it attempts to resolve the apparent tension between individual rights and the collective interests of labour that is commonly articulated in both the case law and the academic literature. The paper suggests that, contrary to a widely held understanding, civil and labour rights share common values. Through the example of closed shops it is argued that the rights of workers and their unions can be enhanced rather than harmed by an effective and principled human rights regime.


Research evaluation recently became a widely disseminated exercise aimed in the end of the day at improving the cost efficiency of public funding of national R&D sectors. In November 2013, the Government of the Russian Federation initiated a national evaluation exercise of public research organizations (PROs) to provide information basis for development of S&T policies aimed at increasing effectiveness and strengthening the role of R&D performing institutions in economic and social development. The aim of this paper is that of providing an approach for multidimensional assessment of R&D performance based on quantitative data derived from the national evaluation exercise, specifically looking at its applicability and limitations for further analysis and preliminary differentiation of PROs as well as for use in policymaking.


A novel pyrrolophthalazine dione (PPD) acceptor was sophisticatedly designed and synthesized via an inverse electron demand Diels–Alder reaction, followed by aromatization with N-bromosuccinimide. The PPD moiety was incorporated into donor–acceptor type conjugated polymers through Stille coupling polymerization to yield a series of polymers P1–P3 with different linking groups, namely, thiophene, thieno[3,2-b]thiophene, and bithiophene. The polymers reveal excellent solubility in common organic solvents. Due to their low bandgaps of around 1.72–1.78 eV, the polymers show broad absorption that covers most of the visible region. All the polymers reveal electrochromism, switching between dark blue and transmissive sky blue states. In particular, P2 exhibits exceptional electrochromic properties with high optical contrasts of up to 34 and 71% in the visible and NIR regions, high coloration efficiencies of 471 and 651 cm2 C−1 respectively, as well as reasonable switching speeds and good long-term stability.


Coconut milk is a food ingredient that is used to increase the taste of food and drinks. Coconut milk has processed products in the form of traditional drinks such as ice dawet and cendol ice. According to the Indonesian National Standard in 2009 about Maximum Microbial Contamination in Food in liquid coconut milk must be in accordance with the requirements of TPC parameters, MPN Coliform, Salmonella sp., and Staphylococcus aureus. This study aims to determine the description of Staphylococcus aureus contamination in traditional coconut milk in the Banjarbaru region. This type of research is a descriptive survey. The samples in this study were traditional drinks (es dawet and es cendol) that used coconut milk by using Purposive sampling techniques as many as 6 sellers who made 2 times taking, namely taking 1 hour (testing I) after processing and 2 hours after the first take (testing II) . From the research that has been done, it is found that there are 4 samples of Staphylococcus aureus contamination in 4 samples, namely 3 samples fulfilling the requirements of the Indonesian National Standard and 1 sample that does not meet the requirements of the Indonesian National Standard. It is expected for the seller to always maintain personal hygiene, pay attention to the cleanliness of drinks sold either during processing or serving, noting the cleanliness of the appliance and storing the ingredients of the drinks sold.


Asphyxiating thoracic dysplasia (ATD) represents a heterogeneous group of skeletal dysplasias with short ribs, narrow chest and reduced thoracic capacity. Mutations in several genes including IFT80, DYNC2H1, TTC21B and WDR19 have been found in patients with ATD. Both severe and milder course of the disease were described in correlation with secondary involvement of lung's function. Two children with attenuated form of ATD are described. Their anthropometric parameters for birth weight, length and head circumference were normal but narrow thorax was observed in both of them in early infancy with chest circumference < -3 SD (standard deviation) in comparison to age related controls. The postnatal adaptation and development of both children was uneventful except for mild tachypnoea in one of them which persisted till the age of 6 months. In both children, radiographs revealed narrow upper half of the chest with shorter ribs and atypical configuration of pelvis with horizontally running acetabula and coarse internal edges typical for ATD. Molecular analyses using whole exome sequencing in one family revealed that the patient is compound heterozygote in DYNC2H1 gene for a frame-shift mutation c.4458delT resulting in premature stop-codon p.Phe1486Leufs*11 and a missense mutation c.9044A>G (p.Asp3015Gly). The second family refused the DNA analysis. Regular monitoring of anthropometric parameters during childhood is of big importance both in health and disease. In addition, measurement of the chest circumference should be included, at least at birth and during infancy.


This paper describes a novel bonding technique using reactive multilayer Ni/Al foils as local heat sources to bond Parylene-C layers to another Parylene-C coating on a silicon wafer. Exothermic reactions in Ni/Al reactive multilayer foils were investigated by x-ray diffraction (XRD) and differential scanning calorimetry. XRD measurements showed that the dominant product after exothermic reaction was ordered B2 AlNi compound. The heat of reaction was calculated to be −57.9 kJ mol−1. A numerical model was developed to predict the temperature evolution in the parylene layers and silicon wafers during the bonding process. The simulation results revealed that localized heating occurred during the reactive foil joining process. Our experimental observation showed that the parylene layer was torn when the bond was forcefully broken, indicating a strong bond was achieved. Moreover, leakage test in isopropanol alcohol showed that reactive foil bonds can withstand liquid exposure. This study demonstrated the feasibility of reactive foil joining for broad applications in bio-microelectromechanical systems and microfluidic systems.


We propose the so-called domestic "embodied unit labor costs" (EULC) at the country-sector level as a new cost-related basis for measures of international competitiveness. EULC take into account that a sector's labor costs constitute only a small share of its total cost which to a large extent consist of expenses for intermediate goods from other sectors. In line with a simple Leontief-type model, the proposed measure is constructed as a weighted average of unit labor costs of all domestic sectors contributing to the final goods of a specific sector. The contribution is expressed in value-added terms and takes global supply chains into account. We also show how EULC can be consistently calculated for sectoral aggregates such as the tradable goods sector. Based on EULC we propose the "embodied real effective exchange rate" (EREER) at the country-sector level as a new competitiveness indicator where the relevance of trading partners is quantified by an appropriate value-added measure. The chosen value-added concept replaces gross exports traditionally used as the weight basis in effective exchange rates. Using the World Input-Output Database (WIOD) we employ the proposed indicators to shed new light on changes in cost competitiveness at the sectoral level for Germany, and compare the empirical evidence with selected other euro area countries.


This thesis focuses on the roles of memory and identity in Octavia E. Butler's novels: Kindred, Lilith's Brood, Parable of the Sower, Parable of the Talents, and Fledgling. By using material from such diverse disciplines as philosophy, psychology, neuroscience, and sociology, I have treated the characters in Butler's novels as individual selves; selves narrated by a living Butler. In current identity studies, the thought is that the self is constructed through narrative; therefore, what better way to analyze individual characters and communities than through the narrative provided by Butler. These selves are, of course, fictional, but how often are the selves we present, even temporarily, to the world in a given situation a fictional construction.
We use many different critical tools to interpret and understand the world around us. While it is important to acknowledge the insightful implications of Butler's work in regard to African American, gender, and feminist studies, there are unexplored approaches to her writing that can contribute to understanding the intricacies of Butler's writing. This look at Butler's texts shows that by opening up the ways we traditionally look at certain texts we can gain a more multi-faceted view of those texts, which are sometimes viewed through a type of tunnel vision.
My discussion begins with a look at the theories used in the analyses of Butler's novels. First, I look at Kindred and a discussion of individual identities and how they are deeply connected to group affiliations, as well as history. Then I move on to how group identities are created and influenced by collective memories in Lilith's Brood. The Parable novels are the focus of my discussion on the construction of self through narrative. I end my analyses with a look at neuroscience and memory pathology through the amnestic protagonist of Fledgling.


To represent the relation between force and cutting parameters in milling T10 hardened steel, single factor milling experiments with different cutting parameters were done. The experimental result showed that there exited maximum inflection point in force curve under different speeds, and the relation between force and cutting parameters could not be represented with an uniform mathmatical equation. Respective prediction modal of milling force in low speed and high speed were set up using least-square method, which was significant at level of α=0.0005, and its result of R- test was higher than 0.98. This study indicates that the applicable prediction modals in milling T10 steel with low and high speed are different, predict modals being set up can be used to estimate milling force.


ABSTRACT The emergence of 'post-truth' is often associated with the rise of conspiracy theories and the lack of trust in scientific knowledge. This article attempts to theorise the complex division of labour in this regime of 'post-truth', with reference to the COVID-19 pandemic/infodemic. First, we argue that the 'post-truth' condition mirrors what Foucault called the 'will to truth', and that this challenges the procedures and systems by which truth and knowledge are ordered. Second, through Basil Bernstein's extension of Foucault's work, we argue that the era of post-truth has two features regarding the condition of knowledge: (1) that conflicts in the field of knowledge recontextualisation, that is, the pedagogisation of knowledge, are becoming more intense and visible, and (2) that greater exposure to high-stakes, uncertain scientific knowledge, which grows at exponential rate, increases social anxieties and leads to biopoliticisation of neoliberal responsibilisation.


Background: Levothyroxine is commonly used in the treatment of patients with hypothyroidism. Levothyroxine is often administered in the morning, on an empty stomach, to increase its absorption. However, many patients have trouble for taking levothyroxine in the morning. The aim of this study was to evaluate the effect of changing administration time of levothyroxine from before breakfast to before dinner on serum levels of TSH and T4. Methods: Fifty hypothyroidism patients aged 18-75 years old were included in the study and randomly divided into two groups. Each group received two tablets per day blindly (one levothyroxine tablet and one placebo tablet) before breakfast and before dinner. After two months, the administration time for the tablets was changed for each group, and the new schedule was continued for a further two-month period. The serum TSH and T4 levels were measured before and after treatment in each group. Results: Changing the levothyroxine administration time, resulted in 1.47±0.51 µIU/mL increase in TSH level (P=0.001) and 0.35±1.05µg/dL decrease in T4 level (P=0.3). Conclusion: Changing the levothyroxine administration time from before breakfast to before dinner minimally reduced the therapeutic efficacy of levothyroxine.


High resolution HLA genotyping of donors and recipients is a crucially important prerequisite for haematopoetic stem-cell transplantation and relies heavily on the quality and completeness of immunogenetic reference sequence databases of allelic variation. Here, we report on DR2S, an R package that leverages the strengths of two sequencing technologies—the accuracy of next-generation sequencing with the read length of third-generation sequencing technologies like PacBio's SMRT sequencing or ONT's nanopore sequencing—to reconstruct fully-phased high-quality full-length haplotype sequences. Although optimised for HLA and KIR genes, DR2S is applicable to all loci with known reference sequences provided that full-length sequencing data is available for analysis. In addition, DR2S integrates supporting tools for easy visualisation and quality control of the reconstructed haplotype to ensure suitability for submission to public allele databases. DR2S is a largely automated workflow designed to create high-quality fully-phased reference allele sequences for highly polymorphic gene regions such as HLA or KIR. It has been used by biologists to successfully characterise and submit more than 500 HLA alleles and more than 500 KIR alleles to the IPD-IMGT/HLA and IPD-KIR databases.


In this study, high temperature (T>500oC) oxidation behavior of two commercial Ni-base alloys and two experimental alloys, all containing more than 10% Molybdenum, is investigated. Experimental alloys were prepared from high purity materials using an arc-melting furnace under a protective environment. During tests, samples were exposed to the stagnant air environment of a high temperature furnace for predetermined times. Extent of oxidation was determined from sample mass change measurements as well as morphological and chemical analyses of the oxidation products. For analyses, a scanning electron microscope (SEM) equipped with backscattered electron (BE) and energy dispersive spectroscopic (EDS) detectors was used. Crystalline phases formed in the product scales over the alloy samples were identified by an x-ray diffractometer (XRD). Preliminary results indicate that although Mo in the alloy prevents the development of a protective oxide scale at the alloy surface, presence of alloying elements such as Cr or Al can decrease this negative effect of Mo on oxide scale formation.


Importance: Heterogeneity in transmission of COVID-19 is a significant multiscale phenomenon. However, the role of this heterogeneity in shaping the overall dynamics of disease transmission is not well understood. Objective: To investigate the role of heterogeneous transmission among different towns in Massachusetts in shaping the dynamics of COVID-19 transmission, especially the recent decline during winter of 2020/2021. Design, Setting, Participants: Analysis of COVID-19 data collected and archived by the Massachusetts Department of Public Health. Exposures: The entire population of the state of Massachusetts is exposed to the virus responsible for COVID-19, to varying degrees. This study quantifies this variation. Main outcome measures: Weekly observations, by town, on confirmed COVID-19 cases in Massachusetts, during the period (April 15th, 2020 to February 9th 2021). Results: The relative decline in COVID-19 cases, during January 12th, 2021 to February 9th, 2021, in the group of towns with higher total accumulated cases in the period before January 12th, 2021 is significantly larger than the corresponding relative decline in the group of towns with lower accumulated cases during the same period. Conclusions and Relevance: Heterogeneous nature of transmission is playing a significant role in shaping the rapid recent decline (January 12th to February 9th, 2021) in reported cases in Massachusetts, and probably around the country. These findings are relevant to how we estimate the threshold defining herd immunity, suggesting that we should account for effects due to heterogeneity.


Early prognostic information in cases of severe spinal cord injury can aid treatment planning and stratification for clinical trials. Analysis of intraparenchymal signal change on MRI has been suggested to inform outcome prediction in traumatic spinal cord injury. We hypothesized that intraparenchymal T2-weighted hypointensity would be associated with a lower potential for functional recovery and a higher risk of progressive neurological deterioration in dogs with acute, severe, naturally occurring spinal cord injury. Our objectives were: 1) to demonstrate capacity for machine-learning criteria to identify clinically relevant regions of hypointensity; and, 2) to compare clinical outcomes for cases with and without such regions. A total of 95 dogs with complete spinal cord injury was evaluated. An image classification system based on Speeded-Up Robust Features (SURF) was trained to recognize individual axial T2-weighted slices that contained hypointensity. The presence of such slices in a given transverse series was correlated with a lower chance of functional recovery (OR 0.08 (CI 0.02-0.38); p < 10-3) and with a higher risk of neurological deterioration (OR 0.14 (CI 0.05-0.42); p < 10-3). Identification of intraparenchymal T2W hypointensity in severe, naturally -occurring spinal cord injury may be assisted by an image classification tool and is correlated with functional recovery.


Natural images are known to have scale invariant statistics. While some eariler studies have reported the kurtosis of marginal bandpass filter response distributions to be constant throughout scales, other studies have reported that the kurtosis values are lower for high frequency filters than for lower frequency ones. In this work we propose a resolution for this discrepancy and suggest that this change in kurtosis values is due to noise present in the image. We suggest that this effect is consistent with a clean, natural image corrupted by white noise. We propose a model for this effect, and use it to estimate noise standard deviation in corrupted natural images. In particular, our results suggest that classical benchmark images used in low-level vision are actually noisy and can be cleaned up. Our results on noise estimation on two sets of 50 and a 100 natural images are significantly better than the state-of-the-art.


Multiplication is frequently the speed-limiting function in digital signal processing systems. High-speed hardware multiplier ICs can therefore greatly enhance the throughput and bandwidth of many digital systems. In this paper, the design, fabrication, and performance of GaAs parallel multipliers are discussed. The largest of these circuits, an 8/spl times/8 bit multiplier, has 1008 gates, and is by far the most complex GaAs IC demonstrated today. This multiplier forms the 16 bit product of two 8 bit input numbers in 5.25 ns. This corresponds to an equivalent gate propagation delay of 150 ps/gate. The power dissipation ranges between 0.6-2 mW/gate.


In 2017, Google announced Kotlin as one of the officially supported languages for Android development. Among the reasons for choosing Kotlin, Google mentioned it is "concise, expressive, and designed to be type and null-safe". Another important reason is that Kotlin is a language fully interoperable with Java and runs on the JVM. Despite Kotlin's rapid rise in the industry, very little has been done in academia to understand how developers are dealing with the adoption of Kotlin. The goal of this study is to understand how developers are dealing with the recent adoption of Kotlin as an official language for Android development, their perception about the advantages and disadvantages related to its usage, and the most common problems faced by them. This research was conducted using the concurrent triangulation strategy, which is a mixed-method approach. We performed a thorough analysis of 9,405 questions related to Kotlin development for the Android platform on Stack Overflow. Concurrently, we also conducted a basic qualitative research interviewing seven Android developers that use Kotlin to confirm and cross-validate our findings. Our study reveals that developers do seem to find the language easy to understand and to adopt it. This perception begins to change when the functional paradigm becomes more evident. Accordingly to the developers, the readability and legibility are compromised if developers overuse the functional flexibility that the language provides. The developers also consider that Kotlin increases the quality of the produced code mainly due to its null-safety guarantees, but it can also become a challenge when interoperating with Java, despite the interoperability being considered as an advantage. While adopting Kotlin requires some care from developers, its benefits seem to bring many advantages to the platform according to the developers, especially in the aspect of adopting a more modern language while maintaining the consolidated Java-based development environment.


HANEDA, K., TOGO, T., TABAYASHI, K., TSURU, Y. and MOHRI, H. Long-Term Results after Repair of Tetralogy of Fallot. Tohoku J. Exp. Med., 1990, 161(4), 319-327 One hundred sixty-six patients with tetralogy of Fallot including 15 pulmonary atresia repaired since 1971 were analyzed with respect to their physical activities, school or social life, hemodynamics, ECG, reoperation and late mortality. Follow-up period ranged from 1 to 19 years with an average of 9.1. There were 9 late deaths including 4 sudden deaths. Actuarial survival rates at 5 and 13 years were 96.4% and 90.5%, respectively. Eighty-five patients (72.0%) of 118 replied were in NYHA functional class I, 31(26.3%) in class II and 2 (1.7%) in class III. Thirteen patients (7.8%) demonstrated right ventricular/left ventricular systolic pressure ratio over 0.80 because of inadequate relief of the pulmonary stenosis or obstruction, hypoplasia of the pulmonary artery or external conduit stenosis. Although the left ventricular ejection fraction was maintained at the normal range (0.65 + 0.09), that of the right ventricle was below the normal level (0.52+0.09). Two patients developed complete heart block postoperatively and underwent pacemaker implantations. Complete right bundle branch block was observed in 85 patients including 6 with left axis deviation. Most of the patients after correction of tetralogy of Fallot are in satisfactory conditions. However, some patients have limitations in school or social life because of residual lesions or postoperative complications. It is important to consider the proper operative procedures to avoid these problems. tetralogy of Fallot ; right ventricular outflow tract obstruction ; late results


The study was conducted in the period 2015-2017 in the experimental field of IRGR "K. Malkov" Sadovo. The elements of productivity of 24 varieties and lines of triticale (X. Triticosecale Wittmacks) were studied. The degree of variation of each of the indicators of productivity is determined by calculating a coefficient of variation. The results obtained show that the most variable indicator is the weight of grains in the central spike whereas the slightest variation is observed in the parameters of test weight and 1000 grains weight. Hierarchical cluster analysis and analysis of the main components (PC-analysis) are applied to assess the genetic similarity and distance between the different varieties. As a result of the clustering the studied samples were divided into six groups. The varieties Trit 32/6 and KS 60 are characterized with the greatest genetic proximity, followed by line BGR 30071 with the Bulgarian variety Rozhen. The largest genetic difference was reported between line BGR 30816 and variety KT 81. The applied analysis of the main components shows that the components PC 1, PC 2 and PC 3 explain 70.6% of the total variation of all traits by genotypes. The largest numbers of samples (9) belong to component 3, as four of them are located in the negative values of PC 3, and the other five genotypes are in the positive values of PC 3. Component 1 is represented by eight samples, and component 2 includes seven triticale genotypes.


Soft law provides a substantive norm from a professional organisation with some specific expertise in an administrative law procedure. In this paper I explore the many functions soft law has in the continental legal systems. The question that is addressed in this paper is: what are the consequences of soft law for administrative decision-making in the Netherlands and in other continental European systems? Though the Dutch legal system stands in the tradition of continental legal systems like the German administrative law, there are some differences. In this paper I reflect on the function of soft law from a continental European point of view and focus especially on the situation in the Netherlands.First I provide an overview of the many functions of soft law from a continental European perspective (par 2). From these many functions I then derive some general characteristics of soft law that are applicable in any legal system and that play a role in the codification of soft law in the Dutch legal system (par 3). Since soft law almost by definition exists on the linkage between the law in the books and the law in action, I then focus on the application of soft law and highlight some relevant characteristics of that aspect as well, again first from a more general continental point of view and then the way the Dutch system handles the application of soft law (par 4). The last section (par 5) contains some concluding remarks with regard to the added value of soft law in administrative decision-making.


Random amplified polymorphic DNA (RAPD) analysis was applied to pearl millet genotypes in order to assess the degree of polymorphisms within and among genotypes and to investigate if this approach was suitable for genetic studies of pearl millet. 20 genotypes were evaluated using 30 different 10-mer primers of arbitrary sequence. Most of the primers did not reveal any polymorphism; however 12 primers revealed scorable polymorphism between genotypes of pearl millet and these can be further evaluated for use in genetic mapping. Pair-wise comparisons of unique and shared polymorphic amplification products were generated by Jaccard's similarity co-efficient. These similarity co-efficients were employed to construct a dendrogram showing phylogenetic relationships using unweighted paired group method with arithmetic averages (UPGMA). The UPGMA analysis indicated a higher similarity between genotype PT 2835/1 and PT 5552 and lowest similarity index was observed between PT 5554 and PT 2835/1. Analysis of RAPD data appears to be helpful in determining the genetic relationship among 20 pearl millet genotypes. The associations among the 20 genotypes were also examined with Principle components analysis (PCA) from Jaccard's similarity co-efficient and it is more informative to analyze the extreme genotypes.


ABSTRACT We present a hierarchical decomposition scheme for computing the n-dimensional integral of multivariate normal probabilities that appear frequently in statistics. The scheme exploits the fact that the formally dense covariance matrix can be approximated by a matrix with a hierarchical low-rank structure. It allows the reduction of the computational complexity per Monte Carlo sample from to , where k is the numerical rank of off-diagonal matrix blocks and m is the size of small diagonal blocks in the matrix that are not well-approximated by low-rank factorizations and treated as dense submatrices. This hierarchical decomposition leads to substantial efficiencies in multivariate normal probability computations and allows integrations in thousands of dimensions to be practical on modern workstations. Supplementary material for this article is available online.


Migration (especially internal) changes sex-age structures substantially both in donor and host areas. As long as migration involves mainly young people, their relocation to the big cities (mainly regional centers) accelerates population ageing in peripheral areas and thus depopulation. Ageing is particularly fast in the Russian hinterland. Here you can find areas with the median age of population reaching the edge of 50 years. The cohort research on youth's migration to the centers on the last two Russian census data shows that up to 70% of school graduates leave the regional periphery for good. At the end of the article there is an author's method which presents the attempt to estimate the trend in regional center's migration attractiveness for the youths. DOI: 10.5901/mjss.2013.v4n10p358


Abstract The role of oxidative stress, as well as inflammation in the pathogenesis of methotrexate (MTX)-induced oral mucositis, is a known fact. The anti-inflammatory, antitumor, antimicrobial, and antioxidant properties of taxifolin—the effect we tested against MTX-induced oral mucosal damage—are well known. Objective Evaluating biochemically and histopathologically the effects of taxifolin on methotrexate-induced oral mucosal damage in rats. Methodology In the taxifolin+MTX (TMTX) group, 50 mg/kg taxifolin was orally administered to rats by gavage. In the MTX and healthy (HG) groups, normal saline was applied to rats as solvent by the same method. One hour after administration of taxifolin and solvent, 5 mg/kg MTX was orally administered to rats in the MTX and TMTX groups. Taxifolin and methotrexate were administered once a day for 30 days. Macroscopic, biochemical, and histopathological evaluations were performed on the inner cheek and tongue tissues of rats. These parts were removed after rats were killed with a high-dose anesthesia. Results Taxifolin with MTX prevented the increase in oxidant and pro-inflammatory parameters, such as malondialdehyde (MDA), tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1β), interleukin 6 (IL-6), on the inner cheek and tongue tissues of rats. Moreover, taxifolin antagonized the decrease in total glutathione (tGSH). Taxifolin decreased MTX-induced histopathological damage. Conclusion These findings suggest that taxifolin may be useful to treat MTX-associated oral mucositis.


Introduction
The importance of Bonwill's triangle can be appreciated in the following situations: construction of articulators; laying down foundation of most occlusion theories; determination of inclination of teeth to the occlusal plane and mounting of models on articulators.  Consequently, the objectives of this study were to determine the average size of Bonwill triangle among Nigerians with a view to confirming or refuting Bonwill's claim and to compare the results of this study with other international studies.
Methodology
This study was a descriptive cross-sectional study with data from patients who attended a tertiary dental centre in Lagos, Nigeria. Forty-eight patients consisting of 24 males and 24 females, with age range of 18-55 years, participated in this study. Two investigators were involved in carrying out measurements.
Results
Forty-eight patients, consisting of 24 males and 24 females, with age range of between 18-55 years, participated in this study. The age range for males was between 21- 55years and females between 18 - 54 years. Males had a significantly higher mean age compared to females (P-value=0.019). The mean age for both male and female in groups 18-25 years, 26-35years and 36 years > were 29.2years, 47.9 years and 22.9 years respectively while the combined mean age of all the 48 participants was 31.31± 9.31 years. There was no significant statistical association between gender and age group (p=0.072).

Conclusion
Mean value articulator in the construction of dentures for Nigerians can accommodate the range of values as well as mean values obtained in this study.


We present a method for accelerating GW quasi‐particle (QP) calculations. This is achieved through the introduction of optimal basis sets for representing polarizability matrices. First the real‐space products of Wannier like orbitals are constructed and then optimal basis sets are obtained through singular value decomposition. Our method is validated by calculating the vertical ionization energies of the benzene molecule and the band structure of crystalline silicon. Its potentialities are illustrated by calculating the QP spectrum of a model structure of vitreous silica. Finally, we apply our method for studying the electronic structure properties of a model of quasi‐stoichiometric amorphous silicon nitride and of its point defects.


Litter decomposition is an important process in the global carbon cycle. It accounts for most of the heterotrophic soil respiration and results in formation of more stable soil organic carbon (SOC) which is the largest terrestrial carbon stock. Litter decomposition may induce remarkable feedbacks to climate change because it is a climate-dependent process. To investigate the global patterns of litter decomposition, we developed a description of this process and tested the validity of this description using a large set of foliar litter mass loss measurements (nearly 10,000 data points derived from approximately 70,000 litter bags). We applied the Markov chain Monte Carlo method to estimate uncertainty in the parameter values and results of our model called Yasso07. The model appeared globally applicable. It estimated the effects of litter type (plant species) and climate on mass loss with little systematic error over the first 10 decomposition years, using only initial litter chemistry, air temperature and precipitation as input variables. Illustrative of the global variability in litter mass loss rates, our example calculations showed that a typical conifer litter had 68% of its initial mass still remaining after 2 decomposition years in tundra while a deciduous litter had only 15% remaining in the tropics. Uncertainty in these estimates, a direct result of the uncertainty of the parameter values of the model, varied according to the distribution of the litter bag data among climate conditions and ranged from 2% in tundra to 4% in the tropics. This reliability was adequate to use the model and distinguish the effects of even small differences in litter quality or climate posi


This paper contains a theoretical analysis of the data association problem of a common type of surveillance system. By a method of inverse probability, the optimal data processor is obtained which permits maximum likelihood estimates to be made of the true data-surveillance object association. The maximum likelihood estimator is given in a form that lends itself to sequential computations performed in real time as the data arrives. Examples of the use of this estimator make clear the precise mathematical meaning of such terms as tentative, confirmed, and established data tracks, and the concept of search areas. The analytical technique is of general use in a variety of surveillance situations. Computer implementations are possible.


The research goal is to work out criteria for the evaluation of medical care quality. Materials included 386 medical cards of daily in-patients, 216 medical cards of in-patients; 602 cards of analysis of case histories; 4 computer data bases. Methods of mathematical statistics were successfully used in the study. The comparative method of data analysis was applied to the research work. Intensity of medical care in values from 0,1 to 0,5 conditional units corresponded to requirements of criterion of estimation of medical care quality. Parameters of medicinal treatment were close to the standards of treatment in interval from 44,4 to 100%, as criterion of quality of medical care. Specific weight of apparatus and instrumental researches constituted an interval from 7, 4% to 22, 6%, forming corresponding criterion. Interval of effectiveness according to standards of consultations is from 0, 26 to 1, 04 conditional units. In conclusion the article stated that the characteristics for criteria to evaluate medical care in daily in-patient departments were worked out on the basis of indices obtained during the research work


PURPOSE
The purpose of this study was to identify subgroups of the physical and behavioral risk profiles for cardiovascular disease among industrial workers, and to examine predicting factors for the subgroups.

SAMPLE AND METHOD
Health records of 2,616 male and female workers aged 19-56 years who were employed in an airplane manufacturing industry were analyzed. Data were analyzed using the Latent class cluster analysis.

RESULTS
Four different clusters (two high-risk groups, one low-risk group, and one normal group) were found and these clusters were significantly different by age, gender, and work type (p<.05). The two high-risk groups had higher chances of drinking alcohol, elevated BMI, FBS, total cholesterol, having hypertension, and were significantly older, and had relatively high chances of being day workers rather than other groups. The low-risk group had higher chances of drinking alcohol, higher BMI and total cholesterols compared to normal group, and highest portions of current smokers and shift workers in the four clusters and their mean BP was within prehypertension criteria.

CONCLUSION
Industrial nurses should guide the lifestyle behaviors and risk factors of the high risk groups for CVD and need to intervene early for behavioral change for the low-risk group who are young and shift workers. Age, and work environment should be considered in planning for targeted preventive interventions for industrial workers.


With the increasing competition in the market today,
the customers have a variety of options to choose from. The
biggest challenge faced today by any business is to understand
and deliver the exact requirements of the customers to retain the
existing customer base and acquire new customers. The key to
this is meeting and surpassing customer expectations leading to
the goal of customer satisfaction through enhanced customer
experiences. Upcoming technologies like Artificial Intelligence
provide widespread opportunities to understand dynamic
customer behavior and trends. However, not much exploration is
done in academic research as to what factors primarily impact
customer experience and the emerging significance of AI in this
domain. Hence, the objective of this study is to understand the
impact of artificial intelligence on customer experience. The
paper adopts a quantitative approach wherein a survey was
conducted across 207 participants to understand the impact of
AI-enabled chatbots to deliver better personalization, quality of
service, and hassle-free service to achieve better customer
experience. The study provides implications to academicians as it
contributes to the literature on the impact of AI on customer
experience, helps practitioners in exploring and analyzing the
various useful aspects of such emerging technologies in
reshaping market trends, the companies and the society at large
by providing a better experience to the customers, thus enabling a
healthier customer relationship.


I was the senior programmer responsible for the development of BOSS (Bug Oriented Surveillance System, Ardmore, Pennsylvania) software, the nosocomial infection control program based on Dr. Maryanne McGuckin's renowned system. Your recent reviews of infection control software are invaluable resources for your readers, and I wanted to comment on the features provided by BOSS. We developed the program with the mandate to create a software package that stressed the ease of use for which Dr. McGuckin's system has become known. The system requires a minimal amount of user entry and data collection. While it appears rather spartan when compared to other systems, it is only because of the power of simplicity. The BOSS program was written to be used with minimal hardware so it would fit into the most restrictive budget. It can run on a personal computer (PC) system with a single floppy disk and only 256K of memory. Reports are predefined, but provide for user selection of data ranges, and the data can be exported in several formats for use with data base and statistical packages. Data are stored in flat files using a multi-level index. The key to the BOSS system is its ease of use. One reading of the manual is sufficient; the menu structure is concise, and help information is displayed on-screen at all times. We created a program that does the important tasks as quickly and as easily as possible, leaving out the frills that complicate data entry and learning. The reality of the institutional environment means that one person will have very little time to enter data and prepare reports. BOSS was created for that reality.


Remote work provides an alternative method of working for organisations, which in turn became a norm during the Covid-19 pandemic. In this, paper, we study adaptation practices introduced by both individuals and organisations as a way for managing the enforced remote work. The study draws upon 33 interviews collected over a year during different phases of the Covid 19 pandemic. We apply adaptation theory lenses to examine the adaptation process over time and new digital working practices. In our study, we extend technological practices by including organisational and behavioral practices. We approach adaptation as a way of coping with a radical change or dynamic situation and building resilience. Based on the data analysis, we expend the adaptation theory in relation to different forms of adaptation to new remote work practices (e.g. at technological, organisational, and behavioural level).


A superbase ionic liquid (IL), trihexyltetradecylphosphonium benzimidazolide ([P66614][Benzim]), is investigated for the capture of CO2 in the presence of NO2 impurities. The effect of the waste gas stream contaminant on the ability of the IL to absorb simultaneously CO2 is demonstrated using novel measurement techniques, including a mass spectrometry breakthrough method and in situ infrared spectroscopy. The findings show that the presence of an industrially relevant concentration of NO2 in a combined feed with CO2 has the effect of reducing the capacity of the IL to absorb CO2 efficiently by ∼60% after 10 absorption–desorption cycles. This finding is supported by physical property analysis (viscosity, 1H and 13C NMR, and X-ray photoelectron spectroscopy) and spectroscopic infrared characterization, in addition to density functional theory (DFT) calculations, to determine the structure of the IL-NO2 complex. The results are presented in comparison with another flue gas component, NO, demonstrating that the absorption of NO2 is more favorable, thereby hindering the ability of the IL to absorb CO2. Significantly, this work aids understanding of the effects that individual components of flue gas have on CO2 capture sorbents, through studying a contaminant that has received limited interest previously.


In thinking about Asian economic integration, it is noteworthy that most attempts at regional economic integration have been failures. Beside the European Union (EU), the only other case that has been meaningful enough and durable enough is the North American Free Trade Area (NAFTA). Unlike the EU, NAFTA allows only limited labor mobility across countries; has no plans to coordinate exchange rate policies; and does not envisage an eventual political union. Our conclusion is that the feasible architecture for an Asian Economic Union would be a free trade and open investment area that has a regional financial facility. For the medium run, an Asian Financial Facility (AFF) would operationally be a large Asian swap facility that has its own surveillance mechanism to pre-qualify members for emergency loans. The primary mission of AFF is to reduce the cost of bad luck and not the cost of bad policies. AFF would evolve according to the progress of reforming the IMF, and to the needs created by an increasingly integrated Asia. Given the large size of East Asian foreign reserves, the AFF should take on the additional task of designing a pooling scheme where part of the East Asian reserves could be safely used to finance sound infrastructure projects in the poorest Asian countries. It is important that the AFF does not suffer from the institutional inertia that is characteristic of the present global organizations like the Security Council of the United Nations, the World Bank and the International Monetary Fund. The leadership structure of the AFF should be designed to avoid simply locking in the balance of economic power that existed at the time of its founding. Given the great disparity in the present and future distribution of economic power in East Asia, and the greater restrictions on labor mobility within the (commonly proposed) Asian Economic Union, a NAFTA-type of Asian Economic Union would be preferable to an EU-type of Asian Economic Union. Exchange rate coordination might occur sporadically but it is unlikely to be the norm in the medium term, and most possibly even in the long term. East Asia should therefore be focusing its energy on creating as wide a free trade area as possible (i.e. be geographically unrestricted), and forgo the unrealistic goal of a common Asian currency. However, if an Asian common currency is still adopted, then the lesson from the Greek crisis in early 2010 is that it is necessary for the Asian Financial Facility to become the Asian Monetary Fund.


The Crab Nebula is the most studied object in the gamma-ray sky. Yet there are many important unanswered questions on the interrelation between the gamma-ray emission from the Pulsar and the Nebula. We present the results of 112 hours of observations conducted with the MAGIC Telescopes by using the stereoscopic Sum-Trigger-II, a novel trigger system essentially halving the lower energy threshold of the telescopes. In order to process the data, a dedicated analysis aiming for the lowest energies is applied. From these observations, we detect pulsed gamma-ray emission down to 27 GeV, which allows us to perform a detailed spectral study. Due to the sound statistical basis, we perform short-time variability studies of the Pulsar and test possible correlations with the nebular flares detected by Fermi-LAT.


Hydrodynamical simulations of galaxy formation have now reached sufficient volume to make precision predictions for clustering on cosmologically relevant scales. Here we use our new IllustrisTNG simulations to study the non-linear correlation functions and power spectra of baryons, dark matter, galaxies and haloes over an exceptionally large range of scales. We find that baryonic effects increase the clustering of dark matter on small scales and damp the total matter power spectrum on scales up to k ~ 10 h/Mpc by 20%. The non-linear two-point correlation function of the stellar mass is close to a power-law over a wide range of scales and approximately invariant in time from very high redshift to the present. The two-point correlation function of the simulated galaxies agrees well with SDSS at its mean redshift z ~ 0.1, both as a function of stellar mass and when split according to galaxy colour, apart from a mild excess in the clustering of red galaxies in the stellar mass range 10^9-10^10 Msun/h^2. Given this agreement, the TNG simulations can make valuable theoretical predictions for the clustering bias of different galaxy samples. We find that the clustering length of the galaxy auto-correlation function depends strongly on stellar mass and redshift. Its power-law slope gamma is nearly invariant with stellar mass, but declines from gamma ~ 1.8 at redshift z=0 to gamma ~ 1.6 at redshift z ~ 1, beyond which the slope steepens again. We detect significant scale-dependencies in the bias of different observational tracers of large-scale structure, extending well into the range of the baryonic acoustic oscillations and causing nominal (yet fortunately correctable) shifts of the acoustic peaks of around ~5%.


The noncoding SNP rs7205289, located in the microRNA‐140 gene has been associated with cleft palate risk. MiR‐140 was found to regulate zebrafish palatal development in vivo and its expression level be reduced by environmental smoke exposure in vitro. Therefore, we sought to investigate whether the A allele of rs7205289 and maternal smoke exposure during the first trimester might contribute to cleft palate risk by regulating microRNA‐140. We used in situ hybridization to explore the microRNA‐140 expression pattern. A luciferase reporting system and Western blot were used to validate the target of microRNA‐140. Mouse palatal mesenchymal cells (MPMC) were transfected with microRNA‐140 expression vectors, or treated with cigarette smoke extract. In addition, we performed a hospital‐based case–control study in 169 patients with nonsyndromic cleft palate and 306 unaffected controls. We demonstrated microRNA‐140 expression in mouse palatal shelves from embryonic days 12 to 15. Pdgfrα was the target of microRNA‐140 in MPMC. When these cells were transfected with the minor allele vector or exposed to cigarette smoke extract, they showed a decrease in microRNA‐140 expression. Epidemiological analyses showed that infants with CA/AA genotypes and exposed to maternal passive smoking during pregnancy had evidence of synergistic interaction in contributing to cleft palate risk. We concluded that infants with CA/AA genotypes at rs7205289 and maternal passive smoking during the first trimester may synergistically contribute to cleft palate risk by decreasing microRNA‐140 during palatal development. © 2011 Wiley Periodicals, Inc.


The recent expansion of health-plan choice has been touted as increasing competition and enabling people to choose plans that fit their needs. This study provides new evidence challenging these proposed benefits of expanded health-insurance choice. We examine health-insurance decisions of employees at a large U.S. firm where a new plan menu included a large share of financially dominated options. This menu offers a unique litmus test for evaluating choice quality since standard risk preferences and beliefs about one's health cannot rationalize enrollment into the dominated plans. We find that a majority of employees – and in particular, older workers, women, and low earners – chose dominated options, resulting in substantial excess spending. Most employees would have fared better had they instead been enrolled in the single actuarially-best plan. In follow-up hypothetical-choice experiments, we observe similar choices despite far simpler menus. We find these choices reflect a severe deficit in health insurance literacy and naive considerations of health risk and price, rather than a sensible comparison of plan value. Our results challenge the standard practice of inferring risk attitudes and assessing welfare from insurance choices, and raise doubts whether recent health reforms will deliver their promised benefits.


American writer Rebecca Solnit has published 17 books since 1990, ranging from biography to cultural histories and art criticism to personal essays. Because her work is not easily classified and because she sits at the intersection of a number of different fields, her work provides a particularly interesting case study of hybrid practices in contemporary non-fiction. This article argues that her work is a form of literary journalism: polyphonic open journalism. Solnit's work demonstrates traces and practices arising from her training as a journalist that she has combined them with writerly and activist practices that produce a distinctive open form of literary journalism. This article develops a detailed case study of Solnit's Savage Dreams, her book-length investigation of the Nevada Test Site and Yosemite National Park, in order to show how her writing pursues a range of open-ended, associative strategies that create a choral effect: she moves from evocative to proclamatory to exegetical modes of writing as part of this multivoiced strategy.