BACKGROUND: New information for potential treatments against SARS-CoV-2 is rapidly increasing As a result, countries and organizations have begun to release therapeutic guidelines OBJECTIVE: To provide a synopsis of the recommendations supported in evidence-based guidelines for therapeutic options with potential activity against SARS-CoV-2 METHOD: Rapid systematic review of guidelines and/or protocols that provide interim clinical guidance for COVID-19 disease were extracted from PubMed/Medline, Web of Science, Scopus, Scielo, Google Scholar, and a general Google search Duplicates were removed and a summary of the proposed interventions was included A benefit risk analysis was then conducted RESULTS: Twenty guidelines and/or protocols were selected;the majority of which came from Europe and Latin America Seventeen interventions were identified and classified into 6 pharmacological groups Antimalarials, lopinavir/ritonavir and remdesivir were the only agents recommended and supported by clinical trials The remaining interventions were recommended based on indirect evidence, observational studies, or in vitro studies CONCLUSIONS: Antimalarials have shown results against COVID-19 with surrogate outcomes and the presence of serious adverse events We recommend active monitoring of agents with potential efficacy against SARS-CoV-2 and incorporating the results in national guidelines and protocols Clinical trials should be conducted to show direct benefit with clinically relevant outcomes in various populations © 2020 Comunicaciones Cientificas Mexicanas S A de C V All rights reserved


The main purpose of our research is to examine the role of economies of scale in influencing the United Kingdom domestic production and its exports and imports. Chapter One discusses the role of economies of scale in the theory of- international trade. Chapter Two discusses the various methods of measuring economies of scale, classified according to different types of cost-curves. In Chapter Three I estimate the minimum efficient firm size in U.K. industries, and also "point elasticities" for scale-economy cost-curves for 1963 and 1972. The scale elasticities were estimated at firm and plant levels. Chapter Four uses the point elasticity estimates to analyse the U.S./U.K. relative exports and imports. In addition I also consider two other explanatory variables, namely skill intensities and import tariffs. The tests were carried out for 1963 and 1972 for three different markets, namely the World, OECD, and non-OECD. In general the independent variables performed well and showed the expected signs. Chapter Five examines whether the average size of plants and capital intensity in British and American industries have a significant effect on productivity within the plants. The test makes use of a weighted average size of plants and weighted average productivity. The tests were undertaken separately at the level of the entire industry and for each of two groups, namely the large and small plants. The regression results were significant for tests on both small and large sized level plants. The co-variance technique was used to see whether the relationship between the variables differs. Chapter Six states the implications, that large firms in the U.K. operate at a disadvantage as diseconomies of scale, such as strike activities, bad labour relations and inadequate managerial control, outweigh the advantages which arise from producing on a large scale. Also, the United Kingdom has a disadvantage in skill requirements, more training courses are needed to increase the number of workers with vocational qualifications.


Objective: To investigate some of the demographic, medical, and visual aspects of diabetic retinopathy (DR) and diabetic macula edema (DME) in diabetics attending an urban clinic in Johannesburg, Gauteng. Design: In this cross-sectional study, 202 diabetic patients were recruited. Demographic variables included age, gender, race, age of diagnosis, duration of diabetes mellitus (DM), and social habits. Medical variables included systemic conditions present, blood pressures, body mass indices (BMI), lipid profiles, glycerated haemoglobin (HbA1c), and other biochemical data. Visual variables included distance, pinhole and near visual acuities, contrast visual acuities (CVA), refractive status, colour vision, central visual field evaluation with the Amsler grid, intraocular pressures (IOP), fundus photography and administration of the Impact of Visual Impairment (IVI) questionnaire. All variables were compared between diabetic subjects with and with-out DR and DME in both right and left eyes. Results: Overall prevalence of DR was 22.8% and DME 12.5%. In DR subjects, significant results indicated that Whites were more likely to present with DR (p = 0.002). Subjects with DR had a higher mean duration of DM (p = 0.002) and a higher mean diastolic blood pressure (p = 0.035). Autorefraction suggested that more myopia and less astigmatism might be associated with DR. A higher mean CVA at the 2.5% level in DR was significant in both the right eyes (p = 0.042) and left eyes (p = 0.035). These subjects also reported a higher mean IVI score in the consumer and social interaction domain (p = 0.032). Similarly, DME subjects displayed a higher mean duration of DM (p = 0.042) and a higher mean diastolic blood pressure (p = 0.048). A higher mean CVA was associated at both the 10% level: right eyes (p = 0.021); and left eyes (p = 0.046), and at the 2.5% level: right eyes (p = 0.033) and left eyes (p = 0.045). A higher mean IVI score in leisure and work (p = 0.026), consumer and social interactions (p = 0.01) and emotional re-action to vision loss (p = 0.018) was reported in subjects with DME. Conclusion: This study has identified possible demographic, medical and visual risk factors of DR and DME in South African diabetic patients.


I. Introduction The life of an isolated area, be it island or oasis, has a special interest of its own, and this is no less true of the past than the present. Indeed, in the case of Kharga Oasis, the interest is heightened by the fact that this region is now naturally a desert: where life once flourished there is now no sign of shell or shrub. What kind of fauna and flora lived in the depression in Pleistocene times, whence and by what means did it come, what were its reactions to the existing conditions, and why did it go? The facts that have been accumulated in three seasons' work (1930–1933) will be marshalled in the following paper in an attempt to answer these questions, but a short sketch of the oasis and its later history must first be given to make the faunal discussions intelligible; a fuller account is in my paper in the Geological Magazine for 1932 (vol. lxix, p. 386). Kharga Oasis is an elongated depression some 185 kilometres from north to south by 80 broad, lying between latitudes 24° and 26° north. It is sunk from 300 to 400 metres below the general level of the Libyan plateau, which separates it from the Nile by 140 kilometres of waterless limestone. The eastern and northern boundaries are sharply defined by steep scarps capped by Eocene or Cretaceous limestone. The later fossiliferous deposits occur mainly along the eastern scarp and consist of gravels, silts, and tufas, mostly


The introduction of foam into concrete, made the concrete have a small internal, closed independent uniform bubbles, which can form light weight, good insulation properties of foamed concrete, mainly used for roofing, non-load-bearing walls and thermal insulation layer pipeline. The purpose of this study is to obtain basic data on the properties of the development of lightweight foamed concrete containing a novel and high-efficiency foaming agent for various applications. The results show that this novel complex foaming agent have high foam expansion and stable foam. Lightweight foamed concrete based on LC foaming agent exhibits high compressive strength, low thermal conductivity and low water absorption after 28-day curing. Furthermore, it can be found that micropores is homogenously distributed into the LC foamed concrete with density of 400kg/m3.


Background: Breast carcinoma is the most prevalent malignancy in females globally and also the leading cause of cancer-related mortality. The immunohistochemistry (IHC)-based molecular subtyping has put newer insights into the biological behaviour and clinical management of breast carcinoma. We conducted the present study to correlate the four IHC-based molecular subtypes: Luminal A, Luminal B, Human epidermal growth factor receptor 2 positive, and triple negative breast carcinoma with various clinicopathological parameters amongst the industrial population of Haryana. Method: This cross-sectional study was conducted on 92 cases of invasive breast carcinoma, who underwent modified radical mastectomy over a period of 2.5 years with the prior approval of Institutional Ethical Committee at ESIC Medical College and Hospital, Faridabad. We performed routine histopathological examination along with IHC (Estrogen receptor, Progesterone receptor and Human epidermal growth factor receptor 2) study. The correlation of the four molecular subtypes with various clinicopathological parameters were also studied. We analysed the data using SPSS software. Results: The mean age of the patients in this study was 47 years with a maximum number of cases in the 3rd and 4th decade of their life. The most common subtype was luminal B (40.9%) with the maximum number of cases presenting in stage II (53.26%) and with grade II (51.1%). Triple-negative breast cancer was found to be associated with brisk mitosis, lymphovascular invasion (66.67%), necrosis (77.78%), and ductal carcinoma in situ (66.67%). These findings were clinically significant. (p <0.05) Conclusion: The early age of presentation of breast carcinoma in the industrial population would warrant the need to focus on various molecular subtypes and clinicopathological parameters that may have different prognostic implications in this population.


The COVID-2019 pandemic is the most severe acute public health threat of the twenty-first century. To properly address this crisis with both robust testing and novel treatments, we require a deep understanding of the life cycle of the causative agent, the SARS-CoV-2 coronavirus. Here, we examine the architecture and self-assembly properties of the SARS-CoV-2 nucleocapsid (N) protein, which binds viral RNA and assembles into a filament that is packaged into new virions. We determined a 1.4 Å resolution crystal structure of this protein's N2b domain, revealing a compact, intertwined dimer very similar to that of related coronaviruses SARS-CoV and MERS-CoV. Using size exclusion chromatography and multi-angle light scattering, we find that this domain forms a dimer in solution, and that addition of the C-terminal spacer B/N3 domain mediates tetramer formation. Using hydrogen-deuterium exchange mass spectrometry, we find evidence that at least part of this putatively disordered domain is structured, potentially forming an α-helix that either self-associates or docks against the N2b domain to mediate tetramer formation. Finally, we map the locations of over 4,400 individual amino acid substitutions in the N protein from ~17,000 SARS-CoV-2 genome sequences, and find that they are strongly clustered in the protein's N2a linker domain. The nearly 300 substitutions identified within the N1b and N2b domains cluster away from their functional RNA binding and dimerization interfaces. Overall, this work reveals the architecture and self-assembly properties of a key protein in the SARS-CoV-2 life cycle. As the N protein is a common target of patient antibodies, this work will also benefit ongoing efforts to develop robust and specific serological tests, and could also benefit the analysis of patient-derived antibodies. Significance Statement After infecting a cell, the SARS-CoV-2 coronavirus replicates its genome and packages it into new virus particles. The virus's nucleocapsid (N) protein is critical for this process, binding the genomic RNA and assembling into large filaments before being packaged into new virions. Here, we sought to understand the structure of the SARS-CoV-2 N protein and how it forms large assemblies. We combined x-ray crystallography and two biochemical methods to show that the protein's N2b and N3 domains mediate self-association into dimers and tetramers, respectively. We have therefore outlined the first two steps of a probable three-step self-assembly mechanism of the SARS-CoV-2 nucleocapsid. This work will benefit ongoing efforts to develop robust viral tests and to develop new drugs targeting key steps in the viral life cycle.


The Creative Arts Graduate Placement Scheme (2007-2009) served as a model for the UWE 2010 Graduate Internship Scheme, which sponsored 400 paid internships – the most of any University - through a successful HEFCE (ECIF) bid. By sharing best-practice and intelligence gathered from CA-GPS, the University's Careers Unit was able to respond quickly to funding and graduate demands.

Of these 400 internships, a high percentage (20%+) of these internships are in the creative sector. This case study investigates whether this statistic reflects a direct correlation to close industry links, networks and support of the CA-GPS. The study also compares performance and retention with the CA-GPS, and aims follow up with current and past participants.

[This case study is currently in draft form, and will serve the basis of an ADM-HEA 2011/12 'Graduates with Impact' bid.]


Interleukin 6 (IL-6) is considered a major indicator of the acute-phase inflammatory response. Endometriosis and pelvic inflammation, diseases that manifest elevated levels of IL-6, are commonly associated with higher infertility. However, the mechanistic link between elevated levels of IL-6 and poor oocyte quality is still unclear. In this work, we explored the direct role of this cytokine as a possible mediator for impaired oocyte spindle and chromosomal structure, which is a critical hurdle in the management of infertility. Metaphase-II mouse oocytes were exposed to recombinant mouse IL-6 (50, 100 and 200 ng/mL) for 30 minutes and subjected to indirect immunofluorescent staining to identify alterations in the microtubule and chromosomal alignment compared to untreated controls. The deterioration in microtubule and chromosomal alignment were evaluated utilizing both fluorescence and confocal microscopy, and were quantitated with a previously reported scoring system. Our results showed that IL-6 caused a dose-dependent deterioration in microtubule and chromosomal alignment in the treated oocytes as compared to the untreated group. Indeed, IL-6 at a concentration as low as 50 ng/mL caused deterioration in the spindle structure in 60% of the oocytes, which increased significantly (P<0.0001) as IL-6 concentration was increased. In conclusion, elevated levels of IL-6 associated with endometriosis and pelvic inflammation may reduce the fertilizing capacity of human oocyte through a mechanism that involves impairment of the microtubule and chromosomal structure.


We report on photometric variability studies of a L3.5 brown dwarf 2MASS J00361617+1821104 (2M0036+18) in the field and of four young brown dwarfs in the star-forming region IC 348. From muti-epoch observations, we found significant periodic variability in 2M0036+18 with a period of 2.66 ± 0.55 hours on one occasion while it seemed to be non-variable on three other occasions. An evolving dust cloud might cause such a scenario. Among four young brown dwarfs of IC 348 in the spectral range M7.25 - M8, one brown dwarf 2MASS J03443921+3208138 shows significant variability. The K-band spectra (2.0-2.4 m) of nine very low mass stars (M1 - M9 V) are used to characterize the water band index (H20-K2). We found that it is strongly correlated with the surface temperature of M dwarfs.


BACKGROUND
Giving birth to a child with cleft lip and palate (CLP) can be emotionally traumatic for parents. The facial appearance awakens feelings and reactions in the family and other people. Feeding these children in the neonatal period is known to be difficult. Previous research has mainly dealt with visual defects, feeding and speech problems. There is a lack of studies about parents' experiences of having a child with CLP.

AIMS
This study was performed to investigate parents' experiences of having a child born with a cleft lip or CLP, and how they perceive encouragement and social and mental support from professionals, family and friends.

METHOD
A phenomenographic approach was used. The study was performed at a university hospital in central Sweden. Twenty families (20 mothers and 12 fathers) were interviewed using guided interviews.

FINDINGS
Two categories, consisting of three and two subcategories, emerged. Informants described their experiences of having a child with CLP, how they slowly adapted to this situation, the first meeting with their child, support from professionals, and reactions from family and other people. Parents commented on the craniofacial team with satisfaction. Due to a low level of knowledge, other professionals often had difficulty in handling the situation and a poor quality of advice on feeding was reported. Family and friends commented on the child positively or by being neutral, which was seen as a lack of interest. A visible scar on the face was seen as a problem, especially for girls. Most informants expressed anxiety about possible problems with speech.

CONCLUSIONS
Parents did not look upon their child as handicapped but as having a congenital defect or 'flaw'. The findings of this study could be used in staff education to promote understanding of parents' experiences and how best to help them. They could also be used in the general media to improve public understanding. Future research could explore staff perceptions of this sensitive clinical area.


The 11-member Coupled Ocean–Atmosphere Mesoscale Prediction System-Tropical Cyclones (COAMPS-TC) ensemble has been developed by the Naval Research Laboratory (NRL) to produce probabilistic forecasts of tropical cyclone (TC) track, intensity and structure. All members run with a storm-following inner grid at convection-permitting 4-km horizontal resolution. The COAMPS-TC ensemble is constructed via a combination of perturbations to initial and boundary conditions, the initial vortex, and model physics to account for a variety of different sources of uncertainty that affect track and intensity forecasts. Unlike global model ensembles, which do a reasonable job capturing track uncertainty but not intensity, mesoscale ensembles such as the COAMPS-TC ensemble are necessary to provide a realistic intensity forecast spectrum. The initial and boundary condition perturbations are responsible for generating the majority of track spread at all lead times, as well as the intensity spread from 36 to 120 h. The vortex and physics perturbations are necessary to produce meaningful spread in the intensity prediction from 0 to 36 h. In a large sample of forecasts from 2014 to 2017, the ensemble-mean track and intensity forecast is superior to the unperturbed control forecast at all lead times, demonstrating a clear advantage to running an ensemble versus a deterministic forecast. The spread–skill relationship of the ensemble is also examined, and is found to be very well calibrated for track, but is underdispersive for intensity. Using a mixture of lateral boundary conditions derived from different global models is found to improve upon the spread–skill score for intensity, but it is hypothesized that additional physics perturbations will be necessary to achieve realistic ensemble spread.


Perkinsus species are important marine parasites of molluscs including mussels and oysters with substantial commercial and environmental impact. Perkinsus forms a sister lineage to the apicomplexan parasites (e.g. malaria agent, Plasmodium) and share similar invasion-related structures with these better studied pathogens. However, much less is known of the transmission and invasion biology of Perkinsus spp. We are developing genetic tools to study these parasites, and Perkinsus is emerging as an experimental model for marine parasites. The life cycle of Perkinsus species start with motile zoospores that are ingested by the host via filtration of sea water. After infection of the mollusc, these cells develop into a replicating non-motile vegetative form of the parasite, the trophozoite. Upon host death or morbidity, the parasites are released back into the water column where they differentiate into zoosporangia that release up to 100 motile zoospores. In vitro, Perkinsus species can be maintained as trophozoites in an axenic sea water-based media, and this is the best studied form of the parasite. However, Perkinsus olseni, can be triggered to sporulate in vitro using Ray's fluid thioglycollate media, and we seek to better study this phase of the lifecycle that is essential for disease spread. To do this, we are determining stage-specific gene expression, during the transformation from trophozoites to zoospores, by RNA-Seq. This will both identify genes that are specific to this growth stage, and also identify zoospore-specific promoters that can be used in experimental manipulation and study of this poorly known cell stage.


Nine births affected by Down's disease in young families are reported. The mean age of fathers was 28.5 years and that of mothers 25.2 years. History revealed no parental exposures to occupational or household adverse factors or nutritional contaminants. The parents had normal karyotypes. However, a history of urogenital disease 1-3 years before the affected births was elucidated in all 9 families: three cases of gonorrhea, one case of trichomoniasis and nonspecific inflammation in the rest. After visits to genetic counseling clinics torpid urogenital infections were identified in all 9 couples: nonspecific prostatitis and urethroprostatitis in fathers, hysterosalpingoophoritis and vaginal dysbacteriosis in mothers. Teratozoospermia and oligozoospermia with abnormal sperm cell proportions of 56 to 92% occurred in the fathers. It is suggested that infectious-toxic disorders of chromosomal segregation during the meiosis may be a paternal cause of trisomy 21. The same mechanism is feasible in mothers. After reversal of urogenital infections and normalization of spermograms normal infants were born in 7 of 9 families, the other 2 currently refrain from childbirth.


As a new kind of structures, Multi-ribbed wall structure is now widely used in new-built buildings and old structures needed to be strengthened. In the field of strengthening, Masonry structure with bottom frame is often mentioned for it is vulnerable to earthquake. However, it is still widely applied in China for its agility for arrangement. So how to guarantee the safety of this kind of structure is very important. There are many methods to reinforce this style of structure, but every way has its limitations. Compared with other methods, Multi-ribbed wall structure is more proper, because its stiffness and mass can easily be changed through optimal design of different kinds of materials inside.


Pituitary adenylate cyclase-activating peptide (PACAP) is a stress-related neuropeptide that is produced in several brain areas. It acts by 3 receptors: PACAP type-1 (PAC1), vasoactive intestinal peptide (VIP) -1 and -2 (VPAC1 and 2). Data on polymorphisms in PACAP and PAC1 indicate a relationship of the PACAP system with schizophrenia (SCZ).The prefrontal cortex was chosen to measure PACAP-gene related expression changes, since this is a central structure in the symptoms of schizophrenia (SCZ). We investigated alterations in the expression of the PACAP-related genes by qPCR in the human dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC) of 35 SCZ patients and 34 matched controls in relation to SCZ, suicide, gender and medication.The ACC revealed an upregulation in PACAP, PAC1, VPAC1 and VPAC2 in SCZ suicide (S) completers compared to controls. An increase in PACAP, VPAC1 and VPAC2 expression was also present in the ACC in SCZ-S compared to SCZ patients who died naturally (SCZ-N). In the DLPFC, an increase in PAC1 was found in SCZ-N patients compared to SCZ-S and controls. Moreover, an increase in all PACAP-related genes was present in SCZ-N male patients compared to SCZ-N females. Concluding, expression changes were found in PACAP-related genes in relation to SCZ, suicide and gender. In particular, there was a higher PACAP-related gene expression in SCZ patients in the ACC in relation to suicide and in DLPFC in relation to SCZ.These findings suggest a potential link between PACAP and the pathophysiology of SCZ and suicide. Further research is needed to understand the functional significance and potential clinical applications of these changes.


Background
phacoemulsification combined with limbal relaxing incision (LRI) is reported to be effective for the management of coexisting cataract astigmatism, but the influence of after phacoemulsification with LRI on corneal high-order aberration is still rarely reported.

Objective
This study was to evaluate the effect of cataract surgery with LRI for preoperative astigmatism or on corneal high-order aberration.

Methods
A self-controlled serial cases observational study was designed.A total of 35 cataractous eyes of 35 patients with astigmatism ≥1.0 D before cataract surgery were enrolled in Tianjin Medical University Eye Hospital from August 2014 to April 2015 under the informed consent of patients.LRIs were performed on the eyes during the phacoemulsification and IOL implantation.The uncorrected visual acuity (UCVA), BCVA and optometry were recorded before operation and 1 day, 1 week, 1 month, 3 months after operation.Pentacam was employed to measure the maximal and minimal diopters, astigmatism and high-order aberrations within 3 mm of the anterior corneal surface at above-mentioned time points.All the results were compared among different time points.The optometry outcomes and the anterior corneal surface astigmatism change were analyzed using vector analysis method.

Results
The UCVA was 0.34±0.22, 0.38±0.25, 0.43±0.27, 0.42±0.28 in 1 day, 1 week, 1 month and 3 months after operation, which was significantly higher than 0.08±0.09 before operation; and the BCVA was 0.54±0.27, 0.64±0.29, 0.67±0.29, 0.71±0.32 in 1 day, 1 week, 1 month and 3 months after operation, showing a significant increase in comparison with 0.22±0.51 before operation(F=54.457, P=0.000; F=62.653, P=0.000). The refractive cylindrical error and corneal astigmatism were significantly decreased after operation in comparison with before operation(F=31.061, P=0.000; F=113.043, P=0.000). High order aberrations (HOA) at postoperative 1 day, 1 week, 1 month, 3 months were all higher than those in preoperation (F=11.189, P=0.000) under the 4 mm pupil diameter.Compared with preoperation, the vertical coma, secondary vertical coma and three leaf clover were significantly increased(all at P 0.05) under the 6 mm pupil diameter.

Conclusions
Phacoemulsification combined with LRI can reduce the corneal astigmatism effectively and steadily, and the increase of corneal aberrations does not affect visual acuity.

Key words:
Cataract/surgery; Cataract/complication; Astigmatism/surgery; High order aberration; Limbal relaxing incision


Antiarrhythmic activity of psychotropic agents, such as phenibut, eglonyl, azaphen, grandaxin, fali-lepsin, is demonstrated for the first time ever in patients with paroxysmal supraventricular tachycardia, atrial fibrillation and ventricular extrasystole. It is dependent on the nature of the underlying heart disease, the psychopathologic syndrome and vegetative cardiac rhythm regulation type. Different trends of cardiac and hemodynamic change are produced by different psychopharmacologic agents. Differential long-term intermittent psychopharmacotherapy is proposed for the control of heart rhythm disorders.


In 22 human embryos and fetuses from 6 to 36 weeks of age successive formation of papillary patterns in the distal phalanges of the fingers have been studied. It has been stated that the papillary pattern begins forming with definition of its typical model, that is the central fragment of the pattern appears the first; the delta formation completes the process. The central fragment of the pattern is distinctly seen in the 16-17-week-old, and the delta-in the 22-24-week-old fetuses.


Background: Methotrexate (MTX) and cyclosporine (CYC) may adversely interact with common medications in patients with psoriasis. Objective: Our purpose was to investigate the prevalence and outcomes of MTX/CYC polypharmacy. Methods: We evaluated rates of events that may be associated with drug-related toxicity, health care resource utilization and costs for patients with psoriasis in the Ingenix® Impact National Managed Care Database (1999–2007) who were exposed or not exposed to potential drug-drug interactions. Results: Among 4,583 (57.6%) exposed and 3,372 (42.4%) nonexposed patients, nonsteroidal anti-inflammatory drugs and antibiotics were the most common drugs with potential interactions. The exposed patients had significantly greater risks of developing renal [adjusted odds ratio (OR): 2.58; p = 0.0145], gastrointestinal (OR: 1.36; p = 0.0197) and pulmonary events (OR: 1.20; p = 0.0470), and significantly greater health care resource utilization (e.g. OR for inpatient and emergency department visits: 1.47; p < 0.0001) and costs (adjusted incremental cost: USD 1,722; p < 0.0001). Conclusions: MTX/CYC polypharmacy is prevalent in patients with psoriasis and associated with significant risks.


Background and aims: Financing in the health system will be equitable when the costs of health care for households in based on their ability to pay rather than on the disease risk are were distributed. The aim of this study was to assess equity in the public health care financing based on two main sources of funding include direct payments by households for public health care and public health budget is distributed . Methods: This study was descriptive analytic study, and the registration statistics of the Ministry of Health and Medical Education Statistics Center of Iran in 2013 was used. The main variables studied including direct payments by households for public health care, public health budgets and household income distribution were studied separatelyin the provinces of the country. For data analysis, Excel as calculation software was used. Indicators used in this study to assess equity in health cost financing include the Gini coefficient, concentration index and the Kakwani progressive index. Results: In 2013, the Gini index of income distribution among households and the concentration index of direct payments by households for public health care in the provinces were 0.387 and 0.056, respectively. On this basis, Kakwani progressive index and the concentration index of public health budget in the provinces were obtained -0.331 and -0.05, respectively. Accordingly, Kakwani progressive index, equivalent to -0.337 percent was calculated. Conclusion: The assessment made based on the Gini coefficient, concentration index, and the Kakwani progressive index show that the distribution of the public budget in the provinces of country and direct payments by households for public health care, based on the household income variable, is inequitable.


Investors have increased their investments in sovereign government bonds together with the globalization of economies. The increasing share of government bonds in total debt instruments raised the importance of sovereign credit ratings. Sovereign credit ratings do not affect only government bonds but also have potential to affect ratings of domestic banks or companies, so they may affect financial markets positively or negatively. This study examines the effects of sovereign credit ratings of the Eurozone countries, interest rate decisions of European Central Bank and US dollar/euro exchange rate on the stock markets of Eurozone countries during the recent financial crises from January 2008 to December 2012. Pedroni's cointegration analysis is used to test whether there is long term relationship among variables in the model, DOLS and FMOLS methods are used to estimate final unbiased coefficients of this relationship and test consistency of estimators and then Holtz-Eakin causality test is used to determine the direction of causality among the variables. We find that there was a long term relationship between stock index and sovereign credit ratings, foreign exchange rate and interest rate variables and the direction of causality was unidirectional from sovereign credit ratings andi nterest rate tostockindexandbidirectionalbetweenforeign exchange rate and stock index. On the other hand in the short term changes in sovereign credit ratings and foreign exchange rate had positive effects on stock market index; interest rate had negative effects on stock index.


This paper uses two different techniques to measure efficiency in a panel of two hundred multi-product Kansas farms from the period 1984 to 2004. The non-parametric linear programming technique, Data Envelopment Analysis (DEA); and a parametric stochastic frontier approach, a translog production function, are used to calculate and then compare efficiencies measures including pure efficiency, technical, scale and allocative. Production, financial, and demographic variables are used to identify and quantify the causes of inefficiencies. We expect to find variables such as hours of family labor, owned versus rented farm, intensity of production, farmers´ risk attitudes and farmers´ age, significant in explaining farm inefficiency levels in Kansas farms.


The first enzyme in the oxidative phosphorylation pathway is Complex I (EC 22.214.171.124). Complex I is a large heteromeric enzyme complex with 45 protein subunits that translocates H+ ions across the mitochondrial inner membrane. Among northern and southern populations of the teleost fish Fundulus heteroclitus, Complex I subunits have fixed amino acid substitutions. Additionally, there are differences in oxidative phosphorylation activity among populations of F. heteroclitus. To investigate whether these differences are related to Complex I, enzyme activity was measured in 121 individuals from five populations of F. heteroclitus and its sister species Fundulus grandis acclimated to a constant 20°C temperature. Within each population, Complex I activity is highly variable among individuals of F. heteroclitus (coefficient of variation percentage among individuals has a mean of 90% in the five F. heteroclitus populations), and the mean Complex I activity among populations is significantly different at the latitudinal extremes of the range. Importantly, Complex I activity is more similar between F. heteroclitus from the southernmost population and its sister species F. grandis than to the northern populations of F. heteroclitus, suggesting important evolutionary differences. Unexpectedly, the activity is nearly fourfold higher in southern populations than northern populations. Mitochondrial density appears to compensate partially for decreased activity in northern individuals; activity per wet weight is only twofold higher in southern populations. We suggest that some of the variation in Complex I activity is genetically based and thus is being influenced by directional selection. However, this conclusion presents a conundrum: there should not be so much variation in Complex I activity within a population if this variation is biologically important.


The study deals with the effect of instruction and study abroad (SA) on pragmatic knowledge. More specifically, the focus is on gains in explicit knowledge of request mitigators, and whether learners draw on this knowledge when they perform email requests. Email requests produced by 60 Spanish students staying abroad (30 treatment/30 control group) were analysed as regards the frequency of internal mitigators on four separate occasions. Findings from the present study show that as length of SA increases participants compare explicit knowledge gained from pragmatic instruction with what happens in real email communication. As a result, although individual variation is observed, we notice a general pattern towards a decrease in the use of request mitigators and towards accepted patterns of email interaction in the community in which students find themselves.


The article presents, in a simplifi ed manner, selected theories of population to explain the current trends of population development in Poland and throughout the world. The aim of the article is to present the demographic threats that have emerged in the last eighty years. Prognosticated age structures have also been predicted. Signifi cant diff erences between the structure of the population now and the future have been indicated, particularly regarding the ageing of the population. Against the background of global transformations analyzes of changes in Poland have been conducted. The comparison shows that changes in Poland are highly analogous to transformations around the world, such as declining birth rates and increasing life expectancy. These changes cause ageing of the population, which could result in the collapse of the functioning of the labor market and the pension system as it currently exists.


This study investigated how the participants of an online learning course employed figurative language to express their emotions and feelings during the learning experience. Textual analysis was carried out in the social and metacognitive discussion areas as those related to the expression of the social dimension. Its aim was to analyze the distribution of figurative language across the course, to understand if figurative language elicited the creation of new figurative language, and to classify recurring types of conceptual categories. Results show that figurative language use increased in coincidence with crucial, social events; it did not necessarily encourage the production of further figurative language; and it allowed participants to represent their affective domain and to conceptualize the learning environment in an original manner.


Teleost fishes develop a huge variety of skin ornaments. How these diverse skin structures develop in fishes is unknown. The teleost fish order Tetraodontiformes includes some of the most unusual fishes such as the ocean sunfish, triggerfish and pufferfish, and they all can develop a vast assortment of scale derivatives that cover their bodies. Pufferfish have some of the most extreme scale derivatives, dermal spines, which are erected during their characteristic puffing behavior. Here we show that pufferfish spines develop through conserved gene interactions essential for other vertebrate skin appendage formation, like hair and feathers. However, pufferfish spines form without EDA (ectodysplasin), an essential molecule for the development of most vertebrate skin appendages. Modifying signaling pathways lead to loss or reduction of spine coverage in pufferfish, suggesting a mechanism for skin appendage diversification. We suggest that pufferfish skin spines evolved from a basic teleost scale-type through derived gene network modification in Tetraodontiformes.


We experimentally study the controllable generation of a beating signal using stored light pulses based on electromagnetically induced transparency (EIT) in a solid medium. The beating signal relies on an asymmetric procedure of light storage and retrieval. After storing the probe pulse into the spin coherence under the EIT condition, two-color control fields with opposite detunings instead of the initial control field are used to scatter the stored spin coherence. The controllable beating signal is generated due to alternative constructive and destructive interferences in the retrieved signal intensities. The beating of the two-color control fields is mapped into the beating of weak probe fields by using atomic spin coherence. This beating signal will be important in precise atomic spectroscopy and fast quantum limited measurements.


Despite recent advances in hormonal therapy for breast cancer, tamoxifen remains a major therapeutic option, with indications ranging from primary prevention to metastatic disease. Understanding the variation in response to tamoxifen may significantly improve our ability to personalize cancer care and maximize therapeutic efficacy. One area of particular interest is the impact of cytochrome P450 CYP2D6 genetic polymorphisms on tamoxifen metabolism. Tamoxifen is considered a prodrug, whose efficacy may be dependent on active metabolites, including endoxifen. Patients with reduced CYP2D6 enzymatic activity tend to have lower endoxifen levels, but the clinical relevance of reduced endoxifen levels remains to be determined. Several small to moderate size retrospective studies have suggested an intriguing association between poor metabolizer status and increased disease recurrence. However, these data are limited by sample size and methodologic challenges, including the inability to adjust for major prognostic and confounding factors. More importantly, several subsequent studies have failed to find an association or found improved outcomes among reduced CYP2D6 metabolizers. Therefore, current findings are conflicting and should be considered preliminary. However, the CYP2D6 test is commercially available, making clinical use possible even as evidence in this area is still evolving. More definitive clinical research is needed before routine CYP2D6 testing can be recommended and considered standard of care. Anticipated data from retrospective analysis of large adjuvant randomized trials of tamoxifen should help address the clinical utility of CYP2D6 testing. Understanding the current state of evidence in this area and its limitations is important for the care of patients who require endocrine therapy for breast cancer.


Reaction time is the interval from stimulus onset to movement initiation. It is relatively straightforward to measure stimulus onset to within a few milliseconds. Movement initiation, however, is more difficult to measure. Common strategies to measure movement initiation include mechanical events (e.g. release of a home button), absolute thresholds (e.g. velocity > 50 mm/s), and relative thresholds (e.g. velocity > 5% of peak velocity). We compared these three measures in this methodology-based study. Forty-one participants completed a 2-choice reaction time task where they held down a home button until a short- or long-distance target button illuminated. There was a load cell under the home button and an LED and accelerometer on the participant's finger. Participants were instructed to press the target button as quickly as possible. Reaction time based on button release was 282 ms, [273, 291]. The velocity at button release was 147 mm/s, [129, 165]. It follows that reaction time based on a lower absolute velocity threshold of 50 mm/s was significantly shorter (255 ms, [246, 265]). Reaction time was comparable with a threshold of 5% of peak velocity (253 ms, [245, 261]), likely because 5% of peak velocity was 49 mm/s, [45, 53]. Interestingly, this was the only measure with a significant difference between short- and long-amplitude movements (249 ms [247, 250] vs. 257 ms, [255, 259]), a response complexity effect. Correlations between the measures were all larger than .9, but the significantly largest correlation was between absolute and relative velocity thresholds (.985, [.976, .994]).Acknowledgments: Department of Kinesiology & Sport Management, Texas Tech University


Introduction Sexual coercion by husbands within marriage, 'marital rape', is till date a shadowy subject in India. Studies are limited on forced sex within marriage in Indian context where early marriage is common, sex that may not be perceived as forced but that is unwanted and awareness on sexual and reproductive matters is limited among women, making them increasingly vulnerable to innumerable sexual health problems. The objective of the present study was to find out the extent of forced sex, explore the confounding factors and assess men's attitude towards sex within marriage. Methods A sample of 7812 young married men (15–29 years) from Youth in India: Situation and Needs Study (2006–07) was analysed. Bi-variate and multivariate techniques were applied. Results 15% of married men forced their wives to have sex ever in life and 45% did so in last one year. Around 19% justified wife beating if wife refuses to have sex. The perpetrators mostly belonged to rural areas, lower economic background and were illiterate. Sexual coercion was most prevalent in arranged marriages and among men who were unhappy in marriage. Poor spousal communication, acceptance of husbands' authoritarian role and wife beating norms for denial of sex were significantly associated (p<0.001) with forced sex. Exposure to pornographic materials and regular consumption of alcohol increased the risk of sexual coercion significantly. Men who had witnessed parental violence were 2 times more likely (p<0.001) to use force for sex. Those who had experienced gender biassed socialisation and held non-egalitarian gender role attitude were 1.4 times more likely to justify wife beating if wife denies to have sex. Conclusion Non-equitable gender attitude in men and their belief that a wife has no right to contradict her husband's wish to have sex are the most important risk factors for sexual coercion in marriages in India. Proper orientation on gender issues, sexual


The paper focuses on the multi-level character of existing or currently developed models for polycrystal deformation. A general multilevel frame is presented, which can be applied to models for the simulation of plastic anisotropy to be implemented in FE codes for the simulation of metal forming processes, or to models for the simulation of deformation textures. A short overview is presented of two-level models ranging from the full-constraints Taylor model to the crystalplasticity finite element models, including the description of a few recent and efficient models (GIA and ALAMEL). Validation efforts based on experimental cold rolling textures obtained for steel and aluminium alloys are discussed. Finally a recent three-level model which also takes the microscopic level (dislocation substructure) is discussed.


: The dilatation and evacuation procedure was explored in 1971 as an alternative method of second-trimester abortion. The results in 11,747 cases from 1972 through 1981 are presented. Although complications do occur--most notably hemorrhage, cervical laceration, fever, and perforation--the overall complication rate was lower than that reported for saline or prostaglandin in other large series. Further study and refinement of technique may help bring this shorter, safer, and more convenient procedure within the reach of larger numbers of women seeking second-trimester abortion.


Summary form only given. The amount of diversity and the total number of degrees of freedom are two important resources in a wireless system. Traditionally they have been considered in isolation. We propose the point of view of describing the performance of communication schemes as a tradeoff between the actual utilized amount of these two resources. The optimal tradeoff achievable by any scheme provides a fundamental benchmark with respect to which the actual schemes can be judged. We give several examples on which this framework can be applied: 1) point-to-point MIMO links, 2) multiple access MIMO channels, 3) frequency selective ISI channels, 4) cooperative relaying systems.


Using the literature on both pricing and regret, the authors develop a conceptual model of purchase likelihood and propose a pricing tactic that appears to have marketplace potential. Sellers currently using a hi–lo pricing tactic discount a product for a limited time and then raise the price back to its original level in one step. Here, the authors investigate whether sellers should return prices to their prepromotion levels all at once or in steps. They propose that sellers should consider an alternative tactic, labeled "steadily decreasing discounting" (SDD). This alternative tactic requires that the seller offer one or more additional discounts that are less than the prior discount before returning the product to its original price. Study 1 is a laboratory experiment that tests the proposed underlying mechanisms (future price expectations and anticipated inaction regret) influencing likelihood to buy. In Study 2, an additional laboratory experiment is undertaken to provide further empirical support in favor of the SDD tactic, to address alternative explanations for the findings, and to demonstrate that there are no negative perceptions associated with using SDD. Study 3 is a field experiment that assesses the effectiveness of SDD, and Study 4 examines scanner panel data to evaluate its generalizability.


A new 3×3 edge operator is presented, based on a suitable classification of binary configurations and corresponding decision table. It is shown how, setting the 8 pixels around the central one in a 3×3 block to binary level through comparison-decisions, the resulting 256 configurations are classified in two groups: those corresponding to estimate the central pixel as part of an edge or boundary and the other ones. The fast implementation of the operator through the direct comparison with the reference table for the 256 configurations is described and experimental results obtained by using a microprocessor system are presented.


Heating appliances such as HVAC systems consume around 48% of the energy power spent on household appliances every year. With this in mind, it is relevant to increase the efficiency of those solutions. Moreover, a malfunctioning device can increase this value even further. Thus, there is a need to develop methods that allow the identification of eventual failures before they occur. This is only achievable when services capable of analyzing data, interpret it and obtaining knowledge from it, are created. This paper presents an infrastructure that supports the inspection of failure detection in boilers, making viable to forecast faults and errors. A major part of the work is data analysis and the creation of procedures that can process it. The main goal is creating an efficient system able to identify, predict and notify the occurrence of failure events. Our fundamental contribution is the possibility to scale the system to others datasets, being able to resolve different Big Data issues.


This article presents a case study of small, distributed electrical power generators, representing a potential substitute for large power plants, and raises questions regarding the ability of established manufacturers to manage this kind of technological transition. The analysis demonstrates that the step from experimental R&D to commercial production is particularly difficult for the incumbents. This observation is explained by showing that whereas manufacturing of large power plants rests upon extensive systems integration capabilities, distributed generators are based on a 'plug-and-play' logic. Copyright 2005, Oxford University Press.


: Commercial preparations of vasopressin for the treatment of diabetes insipidus are not available in Mexico. Besides, the hormone is useless in the nephrogenic variety. In the department of Endocrinology at the Hospital Infantil de Mexico, a preparation containing hydrochlorothiazide, aminopyrine and potassium chloride, which reduces urinary volumes in about two thirds, is employed in all varieties of the disease. Growth in stature was investigated in 44 patients under treatment, attending the Endocrine Outpatient Clinic since 1967 for a period of 2 to 12 years. Clinical material included 29 males and 15 females. There were 23 idiopathic, 7 histiocytosis, 5 nephrogenic, 4 craniopharyngiomas, 2 psychogenic polydipsia, 2 traumatic and 1, as a sequel of tuberculous meningoencephalitis. Six idiopathic, 2 nephrogenic, 2 traumatic, 1 histiocytosis, and 1 psychogenic proceeded between percentiles 3 and 97, parallel to the nearest line of reference along the whole period of study. Two nephrogenic, 2 histiocytosis, 1 psychogenic, 1 post-meningoencephalitis and 14 idiopathic, grew below the third percentile, but parallel to it. One nephrogenic, 4 histiocytosis, 4 craniopharyngioma and 3 idiopathic progressively departed from the initial centile. Two of the latter had growth hormone deficiency, and 1 had been very irregularly treated. It is concluded that the therapy employed limits stature impairment but does not produce catch-up growth. Accordingly, it is proposed that the treatment of diabetes insipidus should be started as early as possible, and that if progress in stature is appreciably deteriorated, the presence of additional pathology should be suspected.


AIMS
Enhanced microvascular perfusion of skeletal muscle is important for nutrient exchange and contributes ∼40% insulin-mediated muscle glucose disposal. High fat-fed (36% fat wt./wt.) rats are a commonly used model of insulin-resistance that exhibit impairment of insulin-mediated microvascular recruitment and muscle glucose uptake, which is accompanied by myocyte insulin-resistance. Distinguishing the contribution of impaired microvascular recruitment and impaired insulin action in the myocyte to decreased muscle glucose uptake in these high-fat models is difficult. It is unclear whether microvascular and myocyte insulin-resistance develop simultaneously. To assess this, we used a rat diet model with a moderate increase (two-fold) in dietary fat.

METHODS AND RESULTS
Sprague Dawley rats fed normal (4.8% fat wt./wt., 5FD) or high (9.0% fat wt./wt., 9FD) fat diets for 4 weeks were subject to euglycaemic hyperinsulinemic clamp (10 mU/min/kg insulin or saline) or isolated hindlimb perfusion (1.5 or 15 nM insulin or saline). Body weight, epididymal fat mass, and fasting plasma glucose were unaffected by diet. Fasting plasma insulin and non-esterified fatty acid concentrations were significantly elevated in 9FD. Glucose infusion rate and muscle glucose uptake were significantly impaired during insulin clamps in 9FD. Insulin-stimulated microvascular recruitment was significantly blunted in 9FD. Insulin-mediated muscle glucose uptake between 5FD and 9FD were not different during hindlimb perfusion.

CONCLUSIONS
Impaired insulin-mediated muscle glucose uptake in vivo can be the direct result of reduced microvascular blood flow responses to insulin, and can result from small (two-fold) increases in dietary fat. Thus, microvascular insulin-resistance can occur independently to the development of myocyte insulin-resistance.


According to the structure dynamics and the aerodynamics theories, based on and equations turbulent model, the paper deduced metro train head aerodynamic models. On the basis of three new train heads designed by changing the profile or length of longitudinal projection, the outside flow fields around streamlined B-type metro vehicle were simulated with 3-D incompressible viscous fluid theory based on CFdesign software. This paper analyzed theoretically metro train's physics characteristics in the tunnel, studied its pneumatic idiosyncrasies in running time, calculated its air resistance coefficient, and looked forward to better head sculpt to reduce aerodynamic resistance and filled the metro train heads with beauty and flavor of the times.


Canine Cognitive Dysfunction Syndrome (CCD) is a neurodegenerative disease affecting aging dogs. CCD is an underdiagnosed disease that involves at least 14% of geriatric dogs, but apparently less than 2% of diseased dogs are diagnosed. There are several physiopathological similarities between Alzheimer disease (AD) and CCD, developing amyloid-β deposits in brain parenchyma and blood vessels, brain atrophy and neuronal loss. The clinical signs lead to behavioural changes. They are unspecific and could appear as soon as seven years of age, but are more relevant in senior dogs. The abnormal behaviour could be classified following the acronym DISHA: Disorientation in the immediate environment; altered Interactions with humans and other animals; Sleep-wake cycle disturbances; House-soiling; and changes in Activity levels. There is no specific diagnostic test or biomarker to demonstrate the presence of CCD; therefore, it is often assessed by ruling out other diseases that may cause similar behavioural changes. Veterinarians have to be able to make an accurate account of veterinary history asking for abnormal behaviour that could be misreported by the owners. CCD is a neurodegenerative disorder that cannot be cured. It is possible to delay the progression of the clinical signs and improve the quality of life of patients, but like in AD, the progression of the illness will depend on the individual. There are three treatment pathways, which could be used in combination: drug therapy to improve cognition and reduce anxiety, antioxidant diet and nutraceutical supplements to reduce the progression of the illness, and finally, environmental enrichment to maintain brain activity. The aim of this review article is to contribute to the knowledge of the illness, presenting recent advances in the pathophysiology, diagnosis and treatment of the disease.


A Continuing Investigation into the Stress Field around Two Parallel Edge Cracks in a Finite Body. (December 2004) Justin Patrick Gilman, B.S., Mississippi State University Co-Chairs of Advisory Committee: Dr. Ravinder Chona Dr. Harry Hogan The goal of this research was to extend the investigation into a method to represent and analyze the stress field around two parallel edge cracks in a finite body. The Westergaard-Schwarz method combined with the local collocation method was used to analyze different cases of two parallel edge cracks in a finite body. Using this method a determination of when two parallel edge cracks could be analyzed as isolated single edge cracks was determined Numerical experimentation was conducted using ABAQUS. It was used to obtain the coordinate and stress information required in the local collocation method. The numerical models were created by maintaining one crack at a fixed length while varying the length of the second crack as well as the separation distance of the two cracks. The results obtained through the local collocation method were compared with the finite element obtained J-Integrals to verify the accuracy of the results. The results obtained in the analysis showed that the major factor in determining when the second crack's stress field has to be considered was the crack separation distance. It was found that a reduction in the second crack's length did not have a significant effect on overall stress intensity factors of the fixed crack. A larger change in the opening mode stress intensity factor can be seen by varying the crack separation distance. As well as seeing a steady reduction in shear mode stress intensity factors as the crack separation was increased. The results showed that after a certain crack separation distance the two cracks could be analyzed separately without introducing significant error into the stress field calculations.


Enhanced agricultural productivity has led to intensification of irrigation and increased application of agrochemicals. Further expansion of agriculture will increase environmental risks from application of nutrients and pesticides. Pressures from agrochemicals can act with or separately from habitat modifications of either, or both, terrestrial and aquatic ecosystems. Addressing the impact of pollution requires adaptable management, which necessitates development and implementation of adequate policies that are able to accommodate increasing agricultural production while mitigating associated risks of water pollution. This paper explores the global drivers of and pressures from agricultural expansion. The paper reviews the underlying factors in agriculture that result in combined nutrients and pesticides loads and impact. The paper further discusses the independent effects on nutrients and pesticides in aquatic ecosystems, followed by the potential combined effects of both nutrients and pesticides. The combined effects of nutrients and pesticides are explored based on the concentration addition, independent action and interaction approaches. While management measures incorporating combined nutrients and pesticides are still not well developed, the paper explores key steps towards monitoring measures for combined nutrients and pesticides contamination: detection and identification; and prioritization of measures.


Adenovirus disease was diagnosed in 2 hr by staining exfoliated infected oropharyngeal cells with fluorescein-tagged rabbit antisera to adenovirus types 4 and 7. The method was as sensitive as the standard virus isolation procedures, but serological cross reactions were observed. Viral antigens were detected in both the nucleus and cytoplasm of infected cells. Infection was accompanied by the outpouring of large numbers of polymorphonuclear leukocytes and smaller numbers of mononuclear cells. The method provides a model for the study of the cellular response to viral upper respiratory disease.


Aim: To identify the prevalence of intimate partner violence (IPV) against Japanese women (JW) and non-Japanese women (NJW) in a perinatal setting. Additional purposes were to identify the associated factors of IPV, describe the characteristics of IPV against NJW, and assess the acceptability of the Violence Against Women Screen (VAWS) instrument as a screening tool. Methods: A cross-sectional survey was conducted from September to November 2007 in an urban hospital maternity clinic in Tokyo, Japan. Women who attended the maternity clinic received the VAWS instrument, which was translated into four languages (Japanese with Kanji and Hiragana, English, Chinese, and Tagalog) and was used to identify IPV. Results: A total of 400 women participated in the study: 357 were JW and 43 were NJW. The prevalence rate of IPV among the JW was 31.4% and 21.4% among the NJW. There was no statistical significance between the two groups. A multiple logistic regression with adjusted odds ratio identified two associated factors for IPV: being multipara and previous experience of physical violence from a partner. Conclusion: The prevalence of IPV was not statistically different among JW and NJW. Screening for IPV, early intervention, and support should be expanded in hospitals and maternity clinics in Japan.


We report the current-induced domain-wall (CIDW) motion along the electron flow in the perpendicularly magnetized Co/Ni/Co structure sandwiched between the top and bottom Pt layers, observed by means of the Kerr microscope. As the lower Co thickness increases, the DW velocity for the electron flow is significantly increased, and also its motion becomes more stable irrespective of various current pulses. From the longitudinal field dependence of the DW velocity, it is found that the increase of the lower Co thickness increases a Dyzaloshinskii-Moriya interaction in the bottom Co/Pt interface, which results in the increase of the chiral spin torque, responsible for the increase of the DW velocity along the electron flow.


The present study focuses on the risk perception and risk management strategy used by Pakistani farmers in agriculture sector. Agriculture activities are the basic source of revenue and play an important role in the growth of its GDP. The sector helps to provide the gainful employment to a large percentage of population especially in Pakistan. Farmers are always operating under risky conditions. They have to face many risks and uncertainties arising from natural, economical and social environments. The more the farmers would learn about risk possibilities and risk management tools available to them, the better they will be in a situation to cope with it. The basic purpose of research is to provide the pragmatic insights that how farmers in Pakistan perceive and manage the risk. Farmers in the districts of south Punjab will be targeted through conducting detailed interviews and using questionnaires by asking questions about specific issues. Moreover, literature will be reviewed for its application in risk perception and management by farmers. Research findings can be helpful in developing an integrated risk management strategy framework, which will prove beneficial for agriculture sector in Pakistan.


Of the three legislature's functions, unlike representation and law-making, oversight is particularly related to PACs. As a supposedly strong committee of legislature, PACs can emerge as a potential solution to the need of the State Legislative Assemblies (SLAs) to monitor the financial conducts of the state governments. However, within the Malaysian context, much about the related situations is not known due to limited exploration on the matter at states level. Focus has probably been more directed towards PAC at federal level as issues under purview at that level are more likely to capture public concerns and media interests. Thus, this paper attempts an exploration of states' PAC practices, and associating them with some theoretical concepts in order to illuminate the current state of affairs. It seems that PACs' institutional designs and capacity building are among factors to be improved to promote state PACs' effectiveness. Such information gives this paper a knowledge base to launch further inquiries into future research initiatives regarding the topic.


By synthesizing evolutionary, attachment, and acoustic perspectives, Soltis has provided an innovative model of infant cry acoustics and parental responsiveness. We question some of his hypotheses, however, because of the limited extant data on infant crying among hunter-gatherers. We also question Soltis' distinction between manipulative and honest signaling based upon recent contributions from attachment theory.


Recent progress of wide-band communication systems demands high-frequency circuits. Conventionally, the linearity of the operational transconductance amplifier and capacitor (OTA-C) has been analyzed using Taylor series expansion. Unfortunately, this approach does not predict the frequency-dependent linearity degradation. Thus, to properly design linearized OTAs, the frequency dependence of these coefficients must be determined. In this paper, we present a frequency-dependent harmonic-distortion analytical method applied to a linear-enhanced OTA. This OTA, which is suitable for high-frequency operation, uses three linearization techniques simultaneously: 1) attenuation through floating-gate MOS transistors; 2) source degeneration; and 3) polynomial cancellation techniques. By using the harmonic-distortion analysis, some properties on the performance of OTA are used to improve the performance of OTA-C based circuits at high frequencies. A 0.5-mum CMOS OTA simulation and experimental results are shown to verify the harmonic-distortion analytical method


Dynamic capabilities have been widely discussed in the academic literature for over twenty years. Yet there remains a lack of consensus or conceptual clarity on a common definition. The priority for researchers is therefore to pursue further theoretical development of the concept. In addition, most empirical research to date has been based on quantitative research. Qualitative, granular treatment of the topic has been encouraged (see p.44). Accordingly, in this thesis, the data from the main study was collected from in-depth interviews with change consultants, and the emerging theory was tested in a follow-up study using further interviews with case study participants.

The data from both studies was analysed using a grounded theory approach. The emergent and flexible nature of grounded theory complements the use of semi-structured interview questions, because both grounded theory and semi-structured interviews facilitate the drilling down into, and the microscopic exploration of, those data which are of greatest interest.

I identify a phenomenon in the primary data from the main study, which I call 'orchestrated stakeholder dialogue'– the purposeful orchestration of dialogue amongst the organisation's stakeholders. Some empirical examples of this phenomenon are presented. The follow-up study further examines the phenomenon of orchestrated stakeholder dialogue in order to explore: 1) the relationship of this phenomenon to dynamic capability theory; 2) the context of the phenomenon; 3) how it is deployed; and 4) its potential for securing sustainable competitive advantage. The thesis uses an instrumental reading of stakeholder theory in order better to depict and locate orchestrated stakeholder dialogue in relation to the organisation's traditional boundaries.

I conclude that the phenomenon of orchestrated stakeholder dialogue is a foundational, underlying component of the dynamic capabilities concept, which underpins all dynamic capabilities. The identification of orchestrated stakeholder dialogue represents a significant step in developing a conceptual theory of dynamic capability in which dialogue is a consistent component. Further research could build on this advance in dynamic capabilities theory.

The detailed depiction of orchestrated stakeholder dialogue in the thesis also represents a significant empirical contribution for strategy as practice. The thesis offers two steps towards advancing the practical value of the concept of dynamic capabilities to practitioners: (i) the organisation is encouraged to use dialogue to map more fully the sources of value derived by particular stakeholders from their relationship with the organisation and its capability; and (ii) where possible, organisations must reconceive and reconfigure the relationships with stakeholders in order to accommodate and harness heterogeneous perceptions of value.


Despite the recent success of stereo matching with convolutional neural networks (CNNs), it remains arduous to generalize a pre-trained deep stereo model to a novel domain. A major difficulty is to collect accurate ground-truth disparities for stereo pairs in the target domain. In this work, we propose a self-adaptation approach for CNN training, utilizing both synthetic training data (with ground-truth disparities) and stereo pairs in the new domain (without ground-truths). Our method is driven by two empirical observations. By feeding real stereo pairs of different domains to stereo models pre-trained with synthetic data, we see that: i) a pre-trained model does not generalize well to the new domain, producing artifacts at boundaries and ill-posed regions; however, ii) feeding an up-sampled stereo pair leads to a disparity map with extra details. To avoid i) while exploiting ii), we formulate an iterative optimization problem with graph Laplacian regularization. At each iteration, the CNN adapts itself better to the new domain: we let the CNN learn its own higher-resolution output; at the meanwhile, a graph Laplacian regularization is imposed to discriminatively keep the desired edges while smoothing out the artifacts. We demonstrate the effectiveness of our method in two domains: daily scenes collected by smartphone cameras, and street views captured in a driving car.


This paper presents the design and measurement of a stimulus generator suitable for on-chip RF test aimed at gain, 1-dB compression point (CP), and the blocking profile measurement. Implemented in a 90-nm complementary metal-oxide-semiconductor (CMOS), the generator consists of two low-noise voltage-controlled ring oscillators (VCOs) and an adder. It can generate a single- or two-tone signal in a range of 0.9-5.6 GHz with a tone spacing of 3 MHz to 4.5 GHz and adjustable output power. The VCOs are based on symmetrically loaded double-differential delay line architecture. The measured phase noise is -80 dBc/Hz at an offset frequency of 1 MHz for the oscillation frequency of 2.4 GHz. A single VCO consumes 26 mW at 1 GHz while providing -10-dBm power into a 50-Ω load. The silicon area of the complete test circuit including coupling capacitors is only 0.03 mm2, while a single VCO occupies 0.012 mm2. The measured gain, 1-dB CP, and blocking profile of the wideband receiver using the on-chip stimulus generator are within ±8%, ±10%, and ±18% of their actual values, respectively. These error values are acceptable for making a pass or fail decision during production testing.


As a new bridge system, mechanics behavior study on long-span multi-tower suspension is also very deficiency. The existence of center towers is the origin of performance difference between multi-tower suspension bridge and the traditional one. Based on the Midas/Civil platform, the paper takes a three tower suspension bridge as project reference, establishes finite element models of suspension bridge, which the main span is longer than one kilometer and towers from two to seven. Moreover, the structural property is analyzed separately, which bending moment and displacement effect of girder and tower along with the tower number changes is considered. Natural frequency differences of the model bridges are also paid attention on.


Abstract This paper illustrates the major challenges faced by globally recognised classical art forms through the examination of Kutiyattam, a centuries old renowned theatre form of India, Kutiyattam was declared by the UNESCO in 2001 as an intangible heritage of humankind. During the mid-twentieth century, Kutiyattam performers came out of their traditional performing space in Hindu temples, encouraged by the proactive support of the State. In the wake of the UNESCO recognition for the theatre form, State support measures underwent further strengthening. However, in spite of this, India's Kutiyattam institutions are confronted with a serious economic crisis that threatens their very existence. Based on detailed field studies and stakeholder consultations, the paper analyses the policy roots of the crisis and explores the options for transforming the Kutiyattam institutions into sustainable enterprises. We argue that the lessons offered by this study have implications for similarly situated art forms in India and elsewhere.


Many different approaches for national sustainable development strategies (NSDS) have been proposed since 1992, with some components common to all. A country's national strategy should be designed to help mainstream environmental concerns into policy. More broadly, it should coordinate local policy with global concerns, as well as integrate scientific knowledge into policy and development planning. The peer review mechanism for national strategies was piloted by France, and also involved representatives of countries from the North and the South as well as stakeholders. The peer review process allows countries to share their experience and information, and can assist them in identifying their own path to sustainable development. The business community can also contribute to sustainable development through provision of local and global public goods. Another input to sustainable development could come from the International Organization for Standardization (ISO) and its Guidance Standard on Social Responsibility (ISO 26000), as a coordinating mechanism between voluntary initiatives and binding obligations (such as international conventions). ISO standards and guidelines should therefore be integrated with national sustainable development strategies and local Agenda 21 frameworks.


The ATPase activity of VCP is required for the retrotranslocation of Hh-C across the ER membrane (Chen et al, 2011). Although in this pathway, the VCP hexamer is shown as part of the SEL1:SYVN1:DERL2 retrotranslocon, the details, order of events and even the full complement of protein players in this pro-cess are not known. In yeast, the VCP homologue Cdc48 is associated with two additional proteins Ufd1 and Npl4 -both of which are also conserved in mammals- and this complex interacts with several ER components including derlins and the yeast SYVN1 homologue, Hrd1 (reviewed in Vembar and Brodsky, 2009). Consistent with the yeast data, VCP interacts with DERL2 by co-immunoprecipitation in HEK293 cells (Huang et al, 2013).


In the mid-1960s and early 1970s, experimental and independent cinema received a considerable amount of support from the U.S. federal government through the American Film Institute (AFI), and from private philanthropies and arts institutions such as the Rockefeller Foundation (RF) and the Museum of Modern Art (MoMA). These measures appeared at a moment when the theatrical film industry was reorganising its industrial model and its main trade organisation, the Motion Picture Association of America (MPAA), was revising its moral standards. Only recently scholars have started historiographical research on experimental cinema's connection with arts and academic infrastructures, yet they have not paid similar attention to the FI's support for experimental and independent cinema production. Thus, they have failed to explain experimental and independent cinema's complex relationship with both the theatrical film industry and philanthropic enterprises during that period.
In this project I address these connections through archival research on the FI's experimental and independent film production fund, the Independent Filmmaker Program (IFP), relating this measure to other distribution and exhibition policies. I locate the origins of these policies in pre-WWII federal government's and RF's film education and propaganda programmes. Then I further contextualise the measures within the wider international state of the film industry between 1945 and 1974. Thus I argue that the policies advanced in the 1960s engaged with some of the demands of experimental and independent filmmakers and critics for freer personal expression and more flexible modes of film production. At the same time, these policies contributed to expand non-theatrical film production and update film education in line with the interests of the main theatrical film industry. This study contributes to understand a key moment in American film history considering both the relationship between the U.S. federal government, private philanthropies and the MPAA, and between institutions and filmmakers.


The landscape of the contemporary IoT radio access technologies (RATs) is excessively diverse, especially when it comes to such a complex environment as Smart City. On the one hand, this diversity offers operators sufficient flexibility to select the most appropriate RAT for their target application. On the other hand, it becomes a severe limiting factor leading to high level of uncertainty for the IoT device vendors, who need to decide, which technology to support in their hardware. In this paper, we consider the provisioning of the low-power wide area network (LPWAN) devices supporting multiple RATs. First, we briefly discuss the parameters of several potential radio technologies as well as analyze the pros and cons of combining them in a single device. Next, we prototype a real-life device capable of communicating via two perspective LPWAN technologies, namely, LoRaWAN and NB-IoT, and report on the initial results of its performance evaluation. These confirm the feasibility of instrumenting dual-mode devices as well as reveal several important aspects related to the development of multi-radio IoT equipment and its performance. In our view, due to their higher flexibility, reliability, and dependability, the devices such as the one developed can be beneficial for various Smart City applications, with smart energy grids and road traffic control being only two of many examples.


Background Little information has been published on opioid prescribing practices in the United States as a whole for any year since 2005, despite increased use and increased overdoses. The objective of this study was to describe trends in prescribing rates and prescription sizes for commonly used opioids over the past decade. Methods We used 2 data systems. Vector One: National (VONA; data obtained for the period 2000–2009) is a service that can estimate the number of prescriptions dispensed by retail pharmacies. The Automation of Reports and Consolidated Orders System (ARCOS; data obtained for the period 2000–2010) is a mandatory reporting system that allows the US Drug Enforcement Administration to monitor certain controlled substances from the point of manufacture to the point of sale. ARCOS data represent the amount of controlled substances legitimately distributed at the retail level. We calculated crude prescription rates of various opioids from VONA data, total drug amounts distributed (as milligrams per 100 persons) from ARCOS data and morphine milligram equivalents (MME) per prescription by combining data from these 2 sources. Results The number of opioid prescriptions per 100 persons increased by 35.2%, from 61.9 to 83.7, during the period 2000–2009. The distribution of opioids to US pharmacies, in milligrams per 100 persons, increased by at least 100% for all selected opioids during the period 2000–2010. The average size of an oxycodone prescription increased by 69.7% (from 923 MME to 1566 MME) during the same period, while the average size of a hydrocodone prescription increased by 69.4% (from 170 MME to 288 MME). The increase for fentanyl was smaller (20.9%) (from 4804 MME to 5809 MME). Interpretation The rate of opioid prescribing, the amount of opioids distributed and the average prescription size all increased markedly in the United States over the past decade. Rates of death from opioid overdose also have increased steadily through 2008 and have likely continued to increase in subsequent years. Effective measures to prevent prescription drug overdoses have yet to be identified and employed.


The prefrontal cortex is the anterior part of the frontal lobe, situated before the primary motor cortex and the premotor cortex and plays a role in the regulation of complex cognitive, emotional and behavioral functioning. It includes various Brodmann areas, such as 9, 10, 11, 12, 46, 47. The basic function of this region is guiding thoughts and actions toward one's goals. The goal of the study is using functional near-infrared spectroscopy (fNIRS) to identify the most suitable rehabilitation model in subacute post-ischemic pathologies and impairments involving directly or indirectly the prefrontal cortex. The aim is to measure threshold parameters for neural fatigue through Hb-HbO2 variation. The overall purpose is the ongoing evaluation of Hb-HbO2 variation throughout the entire tailored rehabilitation program with the observation of patient's clinical changes, which represents the heart of the Cerebro rehabilitation model.


Many state-of-the-art wireless systems, such as long distance mesh networks and high bandwidth networks using mm-wave frequencies, require high gain antennas to overcome adverse channel conditions. These networks could be greatly aided by adaptive beamforming antenna arrays, which can significantly simplify the installation and maintenance costs (e.g., by enabling automatic beam alignment). However, building large, low cost beamforming arrays is very complicated. In this paper, we examine the main challenges presented by large arrays, starting from electromagnetic and antenna design and proceeding to the signal processing and algorithms domain. We propose 3-dimensional antenna structures and hybrid RF/digital radio architectures that can significantly reduce the complexity and improve the power efficiency of adaptive array systems. We also present signal processing techniques based on adaptive filtering methods that enhance the robustness of these architectures. Finally, we present computationally efficient vector quantization techniques that significantly improve the interference cancellation capabilities of analog beamforming architectures.


Procedural modelling deals with (semi‐)automatic content generation by means of a program or procedure. Among other advantages, its data compression and the potential to generate a large variety of detailed content with reduced human intervention, have made procedural modelling attractive for creating virtual environments increasingly used in movies, games and simulations. We survey procedural methods that are useful to generate features of virtual worlds, including terrains, vegetation, rivers, roads, buildings and entire cities. In this survey, we focus particularly on the degree of intuitive control and of interactivity offered by each procedural method, because these properties are instrumental for their typical users: designers and artists. We identify the most promising research results that have been recently achieved, but we also realize that there is far from widespread acceptance of procedural methods among non‐technical, creative professionals. We conclude by discussing some of the most important challenges of procedural modelling.


FLASH radiotherapy, or the delivery of a dose at an ultra-high dose rate (>40 Gy/s), has recently emerged as a promising tool to enhance the therapeutic index in cancer treatment. The remarkable sparing of normal tissues and equivalent tumor control by FLASH irradiation compared to conventional dose rate irradiation—the FLASH effect—has already been demonstrated in several preclinical models and even in a first patient with T-cell cutaneous lymphoma. However, the biological mechanisms responsible for the differential effect produced by FLASH irradiation in normal and cancer cells remain to be elucidated. This is of great importance because a good understanding of the underlying radiobiological mechanisms and characterization of the specific beam parameters is required for a successful clinical translation of FLASH radiotherapy. In this review, we summarize the FLASH investigations performed so far and critically evaluate the current hypotheses explaining the FLASH effect, including oxygen depletion, the production of reactive oxygen species, and an altered immune response. We also propose a new theory that assumes an important role of mitochondria in mediating the normal tissue and tumor response to FLASH dose rates.


PurposeThe primary purpose of this paper is to identify the so-called core authors and their publications according to pre-defined criteria and thereby direct the users to the fastest and easiest way to get a picture of the otherwise pervasive field of bankruptcy prediction models. The authors aim to present state-of-the-art bankruptcy prediction models assembled by the field's core authors and critically examine the approaches and methods adopted.Design/methodology/approachThe authors conducted a literature search in November 2022 through scientific databases Scopus, ScienceDirect and the Web of Science, focussing on a publication period from 2010 to 2022. The database search query was formulated as "Bankruptcy Prediction" and "Model or Tool". However, the authors intentionally did not specify any model or tool to make the search non-discriminatory. The authors reviewed over 7,300 articles.FindingsThis paper has addressed the research questions: (1) What are the most important publications of the core authors in terms of the target country, size of the sample, sector of the economy and specialization in SME? (2) What are the most used methods for deriving or adjusting models appearing in the articles of the core authors? (3) To what extent do the core authors include accounting-based variables, non-financial or macroeconomic indicators, in their prediction models? Despite the advantages of new-age methods, based on the information in the articles analyzed, it can be deduced that conventional methods will continue to be beneficial, mainly due to the higher degree of ease of use and the transferability of the derived model.Research limitations/implicationsThe authors identify several gaps in the literature which this research does not address but could be the focus of future research.Practical implicationsThe authors provide practitioners and academics with an extract from a wide range of studies, available in scientific databases, on bankruptcy prediction models or tools, resulting in a large number of records being reviewed. This research will interest shareholders, corporations, and financial institutions interested in models of financial distress prediction or bankruptcy prediction to help identify troubled firms in the early stages of distress.Social implicationsBankruptcy is a major concern for society in general, especially in today's economic environment. Therefore, being able to predict possible business failure at an early stage will give an organization time to address the issue and maybe avoid bankruptcy.Originality/valueTo the authors' knowledge, this is the first paper to identify the core authors in the bankruptcy prediction model and methods field. The primary value of the study is the current overview and analysis of the theoretical and practical development of knowledge in this field in the form of the construction of new models using classical or new-age methods. Also, the paper adds value by critically examining existing models and their modifications, including a discussion of the benefits of non-accounting variables usage.


At a confining pressure of a few kilobars, deformation of many sedimentary rocks, altered mafic rocks, porous volcanic rocks, and sand is ductile, in that instabilities leading to audible elastic shocks are absent. At pressures of 7 to 10 kilobars, however, unstable faulting and stick-slip in certain of these rocks was observed. This high pressure-low temperature instability might be responsible for earthquakes in deeply buried sedimentary or volcanic sequences.


Interior point methods for nonlinear programs (NLPs) are adapted for solution of mathematical programs with complementarity constraints (MPCCs). The constraints of the MPCC are suitably relaxed so as to guarantee a strictly feasible interior for the inequality constraints. The standard primal-dual algorithm has been adapted with a modified step calculation. The algorithm is shown to be superlinearly convergent in the neighborhood of the solution set under assumptions of MPCC-LICQ, strong stationarity and upper level strict complementarity. The modification can be easily accommodated within most nonlinear programming interior point algorithms with identical local behavior. Numerical experience is also presented and holds promise for the proposed method.


Objective: This study describes the distribution of patient-to-registered nurse (RN) ratios, RN intensity of care, total staff intensity of care, RN to total staff skill mix percent, and RN costs per patient day in 65 acute community hospitals and 9 academic medical centers in Massachusetts. Methods: We conducted a retrospective secondary analysis of the Patients First database published by the Massachusetts Hospital Association for planned nurse staffing in 601 inpatient nursing units in the state for 2005 using a multivariate linear statistical model controlling for hospital type and unit type. Nursing unit types were identified as adult and pediatric medical/surgical, step down, critical care, neonatal level II, and neonatal level III/IV nurseries. Results: Medical centers had significantly higher case-mix index (1.72 vs 1.20, P < .001), longer lengths of stay (5.18 vs 4.19, P < .001), more beds (574 vs 147, P < .001), discharges (31,597 vs 7,248, P < .001), and patient days (161,440 vs 31,020, P < .001) compared with to community hospitals. Medical centers had significantly lower patient-to-RN ratios (3.22 vs 4.64, P < .001), higher nursing intensity and total nursing staff intensity (9.62 vs 7.43/11.75 vs 9.87, both P < .001), higher percent of RN to all staff mix (79% vs 71%, P < .001), and higher RN costs per patient day ($385 vs $297, P < .001) compared with to community hospitals. There were significant differences in adult med/surg units between community hospitals and medical centers for patient-to-RN staffing ratios (5.25 vs 4.08), nursing intensity (5.1 vs 6.2 hours daily), skill mix (67% vs 73% RN), and RN costs per patient day ($203 vs $248, all P < .001). There were no significant differences between the adult step-down units. Conclusion: The significant differences between community hospitals and medical centers, unit type, as well as the high degree of variability in patient-to-RN ratios, nursing intensity, skill mix, and RN costs per patient day suggest that nursing resource expenditure at Massachusetts hospitals is complex and affected by case mix, unit size, and complexity of care.


Clevosaurus was a cosmopolitan rhynchocephalian genus, known from the Late Triassic to the Early Jurassic. In South America this genus is represented by C. brasiliensis, an important component of the Linha São Luiz taphocoenosis, on the top of the Norian Santa Maria 2 Sequence of Southern Brazil. The best preserved and most abundant bone elements of C. brasiliensis are dentaries, in which variations of shape and size are observed. The aim of this study is to describe and evaluate the variation, using geometric morphometrics methods. Geometric morphometric analysis of 10 specimens highlights variations in relative size of the dentary. Most of the variation observed for PC1 (83.3%) is likely related to ontogeny, and PC2 (10.0%) is likely related to taphonomic signatures. The development patterns observed, such as the growth of the dentary, consists of differential growth in length between the posterior portion of the dentary, that grows at a higher rate, regarding the anterior portion of the element. This allometric growth is similar to what is observed in other rhynchocephalians and is accompanied by the allometric skull growth, similar to the trend exhibited by clevosaurs. The taphocoenosis is bimodal (juveniles and adults) with a bias towards adult preservation. Some diagenetic influence is reflected in deformed skulls and this is observed in the tangent-plot. Finally, a strong correlation was detected between the taphonomic signatures and the PC2, regarding specially disarticulation and degree of fragmentation.


Variation or periodization of training is an important concept in designing weight-training programs. To date, the majority of studies examining periodization of weight training have used a traditional strength/power training model of decreasing training volume and increasing training intensity as the program progresses. The majority of these studies have used males as subjects and do support the contention that periodized programs can result in greater changes in strength, motor performance, total body weight, lean body mass, and percent body fat than nonperiodized programs. However, studies are needed examining why periodized training is more beneficial than nonperiodized training. Studies are also needed examining the response of females, children, and seniors to periodized weight-training programs and the response to periodized models other than the traditional strength/power training model.


Since the beginning of the HIV epidemic, intravenous drug use has been directly and indirectly accountable for more than 1/3 of all cases. It has been shown that syringe exchange programs (SEPs) prevent and reduce incidence of HIV and other blood borne pathogens among IDUs. Approximately 203 SEPs are operating in 34 different states, but less than 10% of IDUs can access their services. This is of strategic public health significance due to the recent federal ban on funding for SEPs in January 2012. One response to this, in an effort to increase coverage and reduce incidence of blood borne pathogens, IDUs have spontaneously emerged as "secondary syringe exchangers" (SSEs) to disseminate sterile injection equipment in the community. Although secondary exchangers exist, minimal data exists on their effectiveness and risk for HIV and other blood borne pathogens. A critical literature review included peer-reviewed studies on SSEs anywhere in the United States. Relevant research with regard to SSEs was accessed primarily through medical, public health, and social science databases. In order to ensure that relevant studies were included, the search terms used employed multiple synonyms for SEPs and SSEs, with no publication date restrictions. The studies included in the review were concentrated in two states and were subject to several different types of bias including: recall, response, interviewer, and sampling. The majority of studies found that SSEs were likely to be African American, male, unemployed, and had more extensive social interactions with other IDUs and larger networks. HIV risk-related behaviors were higher among receptive secondary exchangers versus distributive exchangers; however, both were more likely to be protected against HIV versus non-exchangers. Although the majority of studies show that SEPs reduce HIV risk-related behaviors for IDUs, they do not eliminate the risk entirely. SSE extends the benefits of needle exchange to people at times beyond the capability of SEPs. A major strategy that should be employed is peer-based education about prevention and risk reduction for those participating in SSE.


We show that all algorithms that search for an extremum of a cost function perform exactly the same, according to any performance measure , when averaged over all possible cost functions. In particular, if algorithm A outperforms algorithm B on some cost functions, then loosely speaking there must exist exactly as many other functions where B out-performs A. Starting from this we analyze a number of the other a priori characteristics of the search problem, like its geometry and its information-theoretic aspects. This analysis allows us to derive mathematical benchmarks for assessing a particular search algorithm's performance. We also investigate minimax aspects of the search problem, the validity of using characteristics of a partial search over a cost function to predict future behavior of the search algorithm on that cost function, and time-varying cost functions. We conclude with some discussion of the justiiability of biologically-inspired search methods.