This volume of "International Perspectives on Education and Society" investigates the often controversial relationship between gender, equality and education from international and comparative perspectives. Much has been written recently about the global progress made toward gender parity in enrolment and curriculum in nations around the world. And there is much to tout in these areas. Although gender parity is not yet the global norm, the expectation of gender equality increasingly is. Some have gone so far as to say that the global expansion of modern mass schooling has created a world culture of gender equality in education. Yet, while there have been many positive advances regarding girls' and women's education around the world, there are still significant differences that are institutionalized in the policies and administrative structures of national education systems. For example, some of the strongest evidence of gendered inequality in schooling is the fact that in many developing countries there are large proportions of school-age children who are not in school - many if not most of whom are girls. The question this volume investigates is whether gender equality in education is really being achieved in schools around the world or not.


One of the most important problem areas associated with the solid oxide fuel cells is selection of a cost effective material for use as the interconnect component of the cell. Metals are now being considered as materials for this component, with ferritic stainless steels being the leading candidate. This work evaluates methods to combat the problem areas, namely rapid growth rate and vaporization of the oxide scale, that hinder the use of these materials. Oxidation experiments have been performed in dry and wet single atmosphere exposures as well as a dual environment exposure to simulate the conditions in a working SOFC. Measurements of the electrical properties of the oxides that formed were also performed. Commercial alloys, E-Brite and Crofer 22APU, were tested to form a baseline and resultant oxidation and electrical behaviors match those found in the literature. Isothermal oxidation tests for short exposure times have also led to a possible mechanism for the formation of the MnCr2O4 layer on Crofer. All of these tests were then replicated on a series of experimental Fe-22Cr-XTi (X=0-4) alloys. These alloys are shown to form a rutile layer analogous to the MnCr2O4 layer on Crofer. While this layer does prevent some chromia vaporization, the consequences due to the presence of Ti in the chromia include increased growth rate, decreased resistivity, extensive internal oxidation and nitridation of Ti, and a change of the growth direction of the chromia. The alloys containing ~2 – 3 wt%Ti appear to offer the best combination of oxidation, electrical, and mechanical properties. Coatings of lanthanum chromites and ferrites were also tested and shown to be very sensitive to exposure condition, resulting in the formation of pores, and to coating thickness, where thicker coatings are subject to cracking. Finally, reactive element oxide doping was attempted to slow the oxide growth rate for E-Brite (CeO2 doping) and for the Fe-Cr-Ti alloys (CeO2 and La2O3 doping). A significant effect was observed for E-Brite, while both dopants produced little change in the amount of oxide formed on the Ti bearing alloys.


This study was conducted to evaluate the genetic diversity of sugar beet half sib inbred lines ( lines and one control cultivar) under water stress ( mm of class A evaporation pan) in field conditions in a randomized complete block design with three replicates in Khorasan Razavi Agricultural and Natural Resources Research and Education Center in . In this research, traits such as root yield, raw sugar yield, sugar content of root, leaf number, index of difference between the temperature of environment and leaf, succulence index, leaf relative water content, specific leaf weight, leaf color score, leaf growth score, leaf architecture, root growth score and ratio of length to width of root were measured. Results showed that there were significant differences (p≤ . ) between studied genotypes for all traits. Results showed that, there were significant positive correlations between root yield and sugar yield, leaf color score and root growth score, while, significant and negative correlations were observed between root yield, leaf number and ratio of length to width of root. The dendrogram generated from the cluster analysis for sugar yield classified genotypes into four main groups. Factor analysis led to introduction of four main factors which explained . percent of total variation. Hf s genotype showed superiority for root yield, sugar yield and leaf color score than other studied genotypes, indicating that, this genotype has a high potential for drought tolerance.


Magnetic resonance imaging (MRI) is widely used in clinical practice, but it has been traditionally limited by its slow data acquisition. Recent advances in compressed sensing (CS) techniques for MRI reduce acquisition time while maintaining high image quality. Whereas classical CS assumes the images are sparse in known analytical dictionaries or transform domains, methods using learned image models for reconstruction have become popular. The model could be prelearned from data sets or learned simultaneously with the reconstruction, i.e., blind CS (BCS). Besides the well-known synthesis dictionary model, recent advances in transform learning (TL) provide an efficient alternative framework for sparse modeling in MRI. TL-based methods enjoy numerous advantages, including exact sparse-coding, transform-update, and clustering solutions; cheap computation; and convergence guarantees; and they provide high-quality results in MRI compared to popular competing methods. This article reviews some recent works in MRI reconstruction from limited data, with a focus on the recent TL-based methods. We present a unified framework for incorporating various TL-based models and discuss the connections between TL and convolutional or filter-bank models and corresponding multilayer extensions, with connections to deep learning. Finally, we discuss recent trends in MRI, open problems, and future directions for the field.


BACKGROUND
Human calcium oxalate (CaOx) nephrolithiasis may occur if urine is supersaturated with respect to the solid-phase CaOx. In these patients, dietary oxalate is often restricted to reduce its absorption and subsequent excretion in an effort to lower supersaturation and to decrease stone formation. However, dietary oxalate also binds intestinal calcium which lowers calcium absorption and excretion. The effect of increasing dietary oxalate on urinary CaOx supersaturation is difficult to predict.

METHODS
To determine the effect of dietary oxalate intake on urinary supersaturation with respect to CaOx and brushite (CaHPO4), we fed 36th and 37th generation genetic hypercalciuric rats a normal Ca diet (1.2% Ca) alone or with sodium oxalate added at 0.5%, 1.0%, or 2.0% for a total of 18 weeks. We measured urinary ion excretion and calculated supersaturation with respect to the CaOx and CaHPO4 solid phases and determined the type of stones formed.

RESULTS
Increasing dietary oxalate from 0% to 2.0% significantly increased urinary oxalate and decreased urinary calcium excretion, the latter presumably due to increased dietary oxalate-binding intestinal calcium. Increasing dietary oxalate from 0% to 2.0% decreased CaOx supersaturation due to the decrease in urinary calcium offsetting the increase in urinary oxalate and the decreased CaHPO4 supersaturation. Each rat in each group formed stones. Scanning electron microscopy revealed discrete stones and not nephrocalcinosis. X-ray and electron diffraction and x-ray microanalysis revealed that the stones were composed of calcium and phosphate; there were no CaOx stones.

CONCLUSION
Thus, increasing dietary oxalate led to a decrease in CaOx and CaHPO4 supersaturation and did not alter the universal stone formation found in these rats, nor the type of stones formed. These results suggest the necessity for human studies aimed at determining the role, if any, of limiting oxalate intake to prevent recurrence of CaOx nephrolithiasis.


In recent decades the world has increasingly become aware of our role in the continual degradation of our planet's natural environment. One of the most influential and controversial issues of the Twenty First Century is climate change and a subsequent rise in global sea-levels. The implications of the most recent scientific predictions will play out over the following century and beyond, significantly affecting millions of people and thousands of coastal cities around the world. Accelerated sea-level rise globally will demand urban, landscape and architectural solutions for low-lying regions to respond over the coming decades to the extensive changes that will occur.  New Zealand has a vast coastline and therefore will be particularly vulnerable to the predicted one-half, to two meter rise in sea-level during the following century (Evans, Milfont, and Lawrence 3). As occupants of an island nation, New Zealanders' share a strong affinity to water. The earliest Maori settlements to the most recent developments in New Zealand have occurred predominantly in coastal regions, taking advantage of both land and marine resources. In order to envision a vital future for New Zealand's coastal cities, the temporality of the relationship between these urban centres and the sea forces us to confront the transitory quality of our place within it. Simultaneously, the design proposal presented in this thesis recognises that Wellington has historically reclaimed large areas of land to form the majority of the central city seen today, and that in order to flourish in the coming century of climate change will require urban design more responsive than we know today.  The imminent threat of the encroaching ocean within the high value precinct of Wellington's central business district provides an opportunity to engage with the dynamic transition from land based activities to those functions that engage with incremental flooding. Using a critical transect of Wellington's central city this thesis proposes a system of intervention to modify a section of the existing urban fabric to accommodate, prepare and adapt for flooding. The aim of this design investigation will be to place the programme as a hinge between land and sea.


Motor learning must be capable of increasing or decreasing the amplitude of movements to meet the demands of the environment. One way to implement such opposite learned changes would be to store them with bidirectional plasticity mechanisms (i.e., long-term potentiation and depression at the same synapses). At the behavioral level, this scheme should result in similar patterns of stimulus generalization of increases and decreases in movement amplitude because the same synapses would be modified but in opposite directions. To test this idea, we quantitatively compared the stimulus generalization of learned increases and decreases in the gain (amplitude) of the vestibuloocular reflex (VOR) in mice and in monkeys. When examined across different sinusoidal frequencies of head rotation, decreases in VOR gain generalized more than increases in gain. This difference was apparent not only in the gain, but also the phase (timing) of the VOR. Furthermore, this difference held when animals were trained with high-frequency rotational stimuli, a manipulation that enhances frequency generalization. Our results suggest that increases and decreases in VOR gain are not exact inverses at the circuit level. At one or more sites, the plasticity mechanisms supporting decreases in VOR gain must be less synapse-specific, or affect neurons more broadly tuned for head rotation frequency, than the mechanisms supporting increases in gain.


We report on a simple, fluorescence-based method for the investigation of the binding kinetics of polystyrene ligands, dispersed in an organic solvent, to substrate supported gold nanoparticles. For this purpose, we develop a protocol for the immobilization of gold nanoparticles on glass substrates, that yields sub-monolayers of randomly distributed particles with excellent homogeneity and reproducibility. Using fluorescently labeled polystyrene, we monitor the ligand concentration in bulk dispersion in real time and follow the binding to the particle-decorated substrates. The influence of the ligand molecular weight on the binding kinetics is investigated. We correlate the reaction rates with the diffusion coefficients of the different ligands and are able to describe the molecular weight dependency with a simple kinetic model. Both the diffusion and the activation step appear to contribute to the effective reaction rates.


Creative works, whether paintings or memes, follow unique journeys that result in their final form. Understanding these journeys, a process known as "provenance analysis," provides rich insights into the use, motivation, and authenticity underlying any given work. The application of this type of study to the expanse of unregulated content on the Internet is what we consider in this paper. Provenance analysis provides a snapshot of the chronology and validity of content as it is uploaded, re-uploaded, and modified over time. Although still in its infancy, automated provenance analysis for online multimedia is already being applied to different types of content. Most current works seek to build provenance graphs based on the shared content between images or videos. This can be a computationally expensive task, especially when considering the vast influx of content that the Internet sees every day. Utilizing non-content-based information, such as timestamps, geotags, and camera IDs can help provide important insights into the path a particular image or video has traveled during its time on the Internet without large computational overhead. This paper tests the scope and applicability of metadata-based inferences for provenance graph construction in two different scenarios: digital image forensics and cultural analytics.


In the wake of yet another failed effort to enact campaign finance reform during the 1998 legislative session, the new Congress will once again wrestle with an issue that the public continues to rank as a high priority. This volume will provide journalists, policymakers, and other citizens concerned about the issue with the most up to date and essential facts about campaign finance reform, as well as clear explanations of key concepts and areas of dispute, just as the next installment of the seemingly perpetual debate is unfolding. In addition to presenting the latest figures from the 1998 elections, the volume, which is part of The Century Foundation's Beyond the Basics series, will analyze such important issues as: the costs of campaigning, sources of funding, party financing and "soft money," issue advocacy, the public financing system for presidential campaigns, and options for reform. In addition, the volume includes an explanation of the Buckley v. Valeo Supreme Court decision and its impact on efforts to change campaign finance laws.


Abstract Since World War II, barriers to international trade in industrial commodities have been reduced, while barriers to agricultural commodity trade have become more severe. During the last several decades the world has experienced cycles of 'food pessimism' and 'food optimism'. Nevertheless, as a result of technical change, the terms at which the world's consumers can expect to have access to food appear to be more favourable in the future than in the past. If consumers are to have access to the greater abundance that can be made available, it will be necessary for developed market economies to reduce the distortions resulting from agricultural commodity and trade policies. It is in the interest of both producers and consumers, in developed and developing countries, that the world move toward an international trading regime in which agricultural commodities move across national borders at least as freely as financial resources.


Prevalence and risk factors for hypertension among Bulawayo City Council employees

Introduction: An increase in the number of employees with raised blood pressure during routine medical examinations from less than two in every ten to four in every ten during the third quarter compared to the first and second quarters of 2009 prompted an investigation on the prevalence of hypertension and risk factors among Bulawayo City Council employees.

Methods and Materials: Analytical cross-sectional study was carried out. Three hundred and two participants were selected by systematic random sampling from employee registers. Questionnaire adapted from World Health Organization STEPwise approach to Surveillance non communicable disease instrument was used to collect data on risk factors. Blood pressure and anthropometric measurements were taken as per World Health Organization STEP guidelines. Hypertension was defined as systolic blood pressure of ≥140mmHg and/or diastolic blood pressure of ≥90mmHg.

Results: Mean systolic BP was 134.1±18.6mmHg and mean diastolic BP was 83.3±19mmHg. Prevalence of hypertension was 38.4% (116). The prevalence of hypertension was higher in females than males. Prevalence of undiagnosed hypertension was 14.2% (43). Seventy three (80%) of hypertensive participants were on treatment but only 21 (39%) of them had well controlled BP. Independent risk factors for hypertension were being aged 40 years or older (AOR 5.95, 95% CI 3.29; 10.77), being obese (AOR 3.66, 95% CI 1.89; 7.06), current tobacco smoking (AOR 3.26, 95% CI 1.05; 10.10), family history of hypertension (AOR 2.87, 95% CI 1.56; 5.28) and being married (AOR 1.95, 95% CI 1.03; 3.67).

Conclusion: There was a high prevalence of both diagnosed and undiagnosed hypertension. Despite high percentage of treatment among hypertensive participants, majority were at risk of developing complications because of poor control. Health education on hypertension and setting up of a surveillance system for hypertension and its risk factors are necessary to reduce the burden of hypertension and related illnesses. Further studies on factors associated with obesity and poor control of blood pressure among hypertensive people on treatment are needed.

Key words: Prevalence, hypertension, risk factors, Bulawayo City employees, Zimbabwe


Sustaining a competitive edge in today's business world requires innovative approaches to product, service, and management systems design and performance. Advances in computing technologies have presented managers with additional challenges as well as further opportunities to enhance their business models Business Transformation and Sustainability through Cloud System Implementation presents novel computing technologies designed for use in business and corporate environments, enabling managers and associates to make the most of the technologies at their disposal. This premier reference work seeks to alert firm management professionals and researchers to the potential risks and benefits associated with emerging technologies and guide firms on the proper selection, maintenance, and use of Web-based computing systems.


The potential for bias embedded in data to lead to the perpetuation of social injustice though Artificial Intelligence (AI) necessitates an urgent reform of data curation practices for AI systems, especially those based on machine learning. Without appropriate ethical and regulatory frameworks there is a risk that decades of advances in human rights and civil liberties may be undermined. This paper proposes an approach to data curation for AI, grounded in feminist epistemology and informed by critical theories of race and feminist principles. The objective of this approach is to support critical evaluation of the social dynamics of power embedded in data for AI systems. We propose a set of fundamental guiding principles for ethical data curation that address the social construction of knowledge, call for inclusion of subjugated and new forms of knowledge, support critical evaluation of theoretical concepts within data and recognise the reflexive nature of knowledge. In developing this ethical framework for data curation, we aim to contribute to a virtue ethics for AI and ensure protection of fundamental and human rights.


In a study on living conditions among children, 13–18 years old (n = 272) in on-going foster and residential care, concepts from welfare theory and empirical research are applied. We argue that using a welfare perspective and the concept of level of living when assessing looked after children's situation provides several advantages. From this perspective, children are agents for whom access to resources will influence their discretion and possibility to act. By using concepts from welfare research and replicated national surveys of living conditions on a population of placed children, we can assess the extent to which these children enjoy such a standard while in care. In other words, it is possible to assess the compensatory capacity of state care for a population of children that has been recognized as deprived in terms of welfare resources in their birth families. The overall conclusion concerning the welfare dimensions studied is that children in care in general have less access to resources than their peers in the normal population. This holds particularly true for children in residential care, where the differences are substantial. In other words, the care context tends to differentiate the extent to which society acts to compensate for the initial disadvantaged position from which children in care often originate


This paper uses historic data from Cundinamarca, Colombia to empirically assess the impact of land inequality persistence, inherited from the colonial rule, on economic development in the long run. Based on the Engerman & Sokoloff hypothesis and the use of GIS, I use plausible exogenous variation in land endowments to design an instrumental variable strategy. In contrast to recent studies, I find that more unequal municipalities in the XIX and XX century are associated with better growth, human capital and public goods provision measures today. Political economy channels instead of agricultural productivity gains can explain these results. In municipalities where land was historically more concentrated, powerful landowners were more successful in solving their collective action problem of accessing political power to influence the allocation economic resources in their interests.


Classication problems with a very large or unbounded set of output categories are common in many areas such as natural language and image processing. In order to improve accuracy on these tasks, it is natural for a decision-maker to combine predictions from various sources. However, supervised data needed to t an aggregation model is often dicult to obtain, especially if needed for multiple domains. Therefore, we propose a generative model for unsupervised aggregation which exploits the agreement signal to estimate the expertise of individual judges. Due to the large output space size, this aggregation model cannot encode expertise of constituent judges with respect to every category for all problems. Consequently, we extend it by incorporating the notion of category types to account for variability of the judge expertise depending on the type. The viability of our approach is demonstrated both on synthetic experiments and on a practical task of syntactic parser aggregation.


There is a need of reliable, rapid, and cost-effective analysis technique to evaluate food and crop compositions, which are important to improve their qualities and quantities. Prior to fast GC-FID development, metabolic fingerprints, and predictive models obtained from a conventional GC-FID were evaluated by comparison to those derived from GC-TOF-MS. A similar chromatographic pattern with higher sensitivity of polyphenol compounds including epicatechin gallate (ECg) and epigallocatechin gallate (EGCg) had been achieved by using conventional GC-FID. Fast gas chromatograph coupled with flame ionization detector (GC-FID) has been carried out with 10 m x 0.18 mm id x 0.20 microm df capillary column. The analysis time per sample was reduced to less than 14 min compared to those of a conventional GC-FID (38 min) and GC-TOF-MS (28 min). The fast GC-FID also offered reliable retention time reproducibility without significant loss of peak resolution. Projections to latent structures by means of partial least squares (PLS) with orthogonal signal correction filtering (OSC) was applied to the fast GC-FID data. The predictive model showed good model fit and predictability with RMSEP of 3.464, suggesting that fast GC-FID based metabolic fingerprinting could be an alternative method for the prediction of Japanese green tea quality.


Pittsburgh, Pennsylvania, among other major American cities, is seeing a sharp rise in Hepatitis A cases. Although it is vaccine preventable, hepatitis A is also a highly contagious disease that can be debilitating to an individual since it has no treatment. High-risk populations that face a greater risk to being exposed to the virus include people that are homeless, have a history of drug use, have a history of incarceration, and men that have sex with men. Targeting these communities where hepatitis A already has high prevalence rates should be a priority when considering vaccination interventions that are created to reduce incidence rates. Past community and clinic interventions for hepatitis A and B have shown that there are numerous barriers to the vaccination of homeless populations. Both access to the vaccine and individual factors can greatly influence whether a person chooses to complete a vaccination series or not. While vaccine access can be addressed simply by the availability of serum and implementation of vaccination programs in areas that are easily reachable, there are more significant individual predictors such as ethnicity, level of social support, and knowledge about hepatitis A disease. Providing resources that offer greater social support can increase one's desire to get vaccinated, in addition to implementing educational programs that teach the public about the dangers of hepatitis A disease, the best prevention methods, and the importance of vaccination. Furthermore, re-educating healthcare providers can increase medical and legislative support for these interventions, aiding influential policy and funding as well. It is important to examine all of these varying predictors to vaccination compliance, present on both systemic and individual levels, in order to inform future vaccination strategies on how to address these different types of barriers. Creating effective vaccination programs for homeless communities in areas in which hepatitis A is highly prevalent is crucial in stemming an epidemic before it reaches dangerous proportions. These methods should be applied to future community efforts to address the new hepatitis A outbreak in Pittsburgh, ensuring a significant decrease in the spread of the disease within vulnerable populations and alleviating this public health issue.


In this demo paper, we introduce the DARPA D3M program for automatic machine learning (ML) and JPL's MARVIN tool that provides an environment to locate, annotate, and execute machine learning primitives for use in ML pipelines. MARVIN is a web-based application and associated back-end interface written in Python that enables composition of ML pipelines from hundreds of primitives from the world of Scikit-Learn, Keras, DL4J and other widely used libraries. MARVIN allows for the creation of Docker containers that run on Kubernetes clusters within DARPA to provide an execution environment for automated machine learning. MARVIN currently contains over 400 datasets and challenge problems from a wide array of ML domains including routine classification and regression to advanced video/image classification and remote sensing.


Most of today's oscilloscopes are digital, which enables more detailed accurate signal measurements and fast calculations, data storage capabilities and automated analysis. Handheld digital oscilloscopes such as the Fluke ScopeMeter® Test Tools offer several advantages over benchtop models: They are battery operated, use electrically isolated floating inputs and also offer the advantage of embedded features that make oscilloscope usage easier and more accessible to a variety of workers.


ABSTRACT Sandstones of the Tunnel City Group, Cambrian, cropping out in Western Wisconsin, contain beds rich in grains of feldspar of generally euhedral outline. Each grain consists of a rounded core. regarded as a detrital fragment from a crystalline provenance, surrounded by a neoformed part of up to 15 % of the grain volume. Analyses of the cores show them to be unzoned, non-perthitic, maximum microclines of remarkably uniform composition averaging Or93Ab6Cn1. Such a composition of low sodium in the cores, as well as in the associated minerals, suggest alteration of feldspars to have occurred before final deposition and certainly preceding crystallization of overgrowths. Overgrowths virtually are endmember potassium feldspar structurally intermediate between adularia and orthoclase. Their habit is similar to that of orthoclase except that {100} pinacoids are developed rather than the common {110} prisms. Various ridges of wedge-like cross section cover the surfaces, and characterize {101}. Such ridges are interpreted as growth interference of new {100} and {001} faces when normal development of {101} was terminated by some unknown event. Physical conditions at the time of authigenesis are regarded as being near 25°C, and pore pressures considerably lower than 100 atm. Overgrowths on feldspars preceded dolomite cementation and are believed to have crystallized from pore waters which initially were of seawater composition. Later these solutions were enriched in alumina, potassium and silica by a process suggested as partial dissolution of unstable detrital feldspars. The concentration increased until supersaturation with respect to microcline prevailed. From this solution a potassium feldspar structurally intermediate between adularia and orthoclase was crystallized on the nuclei of microcline grains.


The development of personalized medicine is tightly linked with the correct exploitation of molecular data, especially those associated with the genome sequence along with these use of genomic data there is an increasing demand to share these data for research purposes. Transition of clinical data to research is based in the anonymization of these data so the patient cannot be identified, the use of genomic data poses a great challenge because its nature of identifying data. In this work we have analyzed current methods for genome anonymization and propose a one way encryption method that may enable the process of genomic data sharing accessing only to certain regions of genomes for research purposes.


Objectives
To examine risk factors for bone mineral density (BMD) and osteoporosis at the femoral neck (FN) and lumbar spine (LS) in a cross-sectional study among Puerto Rican adults, 47- 77 y.

Methods
The Boston Puerto Rican Osteoporosis Study (BPROS) is an ancillary study to the Boston Puerto Rican Health Study, a cohort of 1504 Puerto Rican adults from the Greater Boston area. A total of 973 participants participated in the BPROS, where data on sociodemographics, health and health behaviors, and medication use were collected through questionnaire, and anthropometrics measured. Dietary intake and supplement use were assessed using a food frequency questionnaire. Fasting blood samples were collected for biochemical analysis. BMD (g/cm2) at the FN and LS (L2-L4) was measured using dual-energy X-ray absorptiometry. Linear regression models estimated associations between risk factors and FN and LS BMD and logistic regression for osteoporosis (T-score ≤ -2.5 g/cm2) at the FN and/or LS. A total of 680 participants had complete data on risk factors and bone measures.

Results
Average age of participants was 59.9 y ± 7.6 y and 71.3% were women. The prevalence of osteoporosis was 10.6%. Age was inversely associated with FN BMD (Table 1). BMI and height were positively associated with BMD. Neither calcium intake from food sources nor plasma 25-OH vitamin D were associated with BMD (P > 0.36). Bone medication and calcium supplement use were inversely associated with BMD, likely due to reverse causation. Magnesium intake from supplements was positively associated with LS and FN BMD (β = 0.07, P = 0.006 and β = 0.05, P = 0.008). Moderate alcohol consumption was associated with lower odds of osteoporosis, compared to no intake (OR: 0.40, P = 0.02; Table 2). Current smoking (vs. never smokers) was associated with increased odds of osteoporosis (OR: 2.5, P = 0.02). Magnesium from supplements was associated with lower odds of osteoporosis (OR: 0.41, P = 0.04).

Conclusions
In contrast to expectation, dietary calcium and plasma 25-OH vitamin D were not associated with bone. Interestingly, magnesium intake from supplements was associated with higher BMD and lower odds of osteoporosis. This requires further investigation, as this may serve as a feasible intervention to improve BMD and decrease risk of osteoporosis in this high-risk population.

Funding Sources
NIH/NIAMS K01 AR067894, NIH P50 HL105185, P01 AG023394, and R01 AG027087.

Supporting Tables Images and/or Graphs


A cell‐free system for replication of SV40 DNA was used to assess the effect of mutations altering either the SV40 origin of DNA replication or the virus‐encoded large tumor (T) antigen. Plasmid DNAs containing various portions of the SV40 genome that surround the origin of DNA replication support efficient DNA synthesis in vitro and in vivo. Deletion of DNA sequences adjacent to the binding sites for T antigen either reduce or prevent DNA synthesis. This analysis shows that sequences that had been previously defined by studies in vivo to constitute the minimal core origin sequences are also necessary for DNA synthesis in vitro. Five mutant T antigens containing amino acid substitutions that affect SV40 replication have been purified and their in vitro properties compared with the purified wild‐type protein. One protein is completely defective in the ATPase activity of T antigen, but still binds to the origin sequences. Three altered proteins are defective in their ability to bind to origin DNA, but retain ATPase activity. Finally, one of the altered T antigens binds to origin sequences and contains ATPase activity and thus appears like wild‐type for these functions. All five proteins fail to support SV40 DNA replication in vitro. Interestingly, in mixing experiments, all five proteins efficiently compete with the wild‐type protein and reduce the amount of DNA replication. These data suggest that an additional function of T antigen other than origin binding or ATPase activity, is required for initiation of DNA replication.


Honduras, one of five original Central American states, became a separate republic in 1839 following independence in 1821. It is perhaps least-known of the five. Located centrally in the isthmian area, pre-historic Honduras was the site of a swirling encounter of major cultures-Nahua, Maya, Chibcha. A similar maelstrom has been the bloody internecine warfare of the past century and a half. Mountainous, long inaccessible, exploited rather than developed, Honduras nevertheless possesses a remarkable cultural history, and its share of distinguished leaders such as Francisco Morazan, often compared to George Washington and Simon Bolivar. Honduras has a wealth of natural resources, from minerals amd timber to agriculture and fisheries. Literally devoted to banana culture, its political and military patterns have earned the term "banana republic"; its poverty is second only to that of Haiti in the Western hemisphere. Events of the 1980's decade brought Honduras to the fore-front of world attention because of the Contra-Sandinista border encounters and the extensive United States military build up, economic power, and political influence.


In western cultures, invested in a discourse of heteronormativity, biological fathers are the 'breadwinners' of families, and mothers, the 'caregivers'. In societies with this dominant discourse, the traditional family structures discourage fathers from being involved parents. However, criminological and psychological fields acknowledge that incarcerating biological fathers distresses families, especially children. Research on incarcerated fathers consistently demonstrates the harmful effects of incarceration on children across many developmental outcomes. This paper explores the damage of paternal incarceration and its effect on adolescent children. Attachment Theory is the primary theoretical framework applied, with a qualitative research approach, and a purposive sampling method. Fourteen biological fathers, incarcerated for various offences, were interviewed in Cape Town, South Africa. In addition, five of the incarcerated fathers' adolescent children participated in the study. In-depth interviews were conducted with the fathers and focus groups undertaken with the adolescents. The findings indicated intersections with adolescent deviant behaviours, parental incarceration, and the absence of paternal parenting roles/responsibilities. Additionally, the fathers struggled to maintain their role as 'fathers', after incarceration, as they were excluded from family decisionmaking, and their children's development. The adolescent children were also emotionally affected by the stigma of an imprisoned father. They experienced feelings of abandonment and yearned for the father-child relationship during adolescence. In addition, the incarcerated fathers faced challenges with the demands of survival in prison, and elected to adopt a 'criminal mind-set', to blend in. Penitentiary conditions, and 'criminal' activities, often superseded any family obligations, where support, contributions, or participation in decision-making was required. Ultimately, the importance of joint decision-making, caregiving and parenting, for the children's optimum development, was revealed, with suggestions for interventions. Incarceration of biological fathers has specific consequences for the whole family, especially adolescent children. The social patterning of repression, negatively affects the incarcerated and their families, who are mere bystanders. Introduction Warner (1993: xxii) asserts that "heteronormativity" refers to the process by which heterosexuality presents itself as "society". The heteronormative, nuclear family has always


Introduction Management has been identified as a critical component of organisational resilience when responding to adverse events and crises, as managers must ensure an effective operational response and provide direction and guidance to teams. While there are many management approaches, strategies and interventions that have been applied and studied in healthcare, the impact of them in relation to resilience in healthcare has not been explored, particularly at the organisational level. Understanding the impact of management approaches, strategies and interventions on resilience has the potential to inform healthcare organisations on how to better use management to prepare and respond to organisational adverse events. The objective of this mixed-methods systematic review is to understand the relationship between management and organisational resilience in healthcare, including management approaches and strategies that promote resilience in healthcare. Methods and analysis A search through MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PubMed and EMBASE will be conducted between 1 August 2021 and 31 December 21. This review will consider empirical quantitative, qualitative and mixed-methods studies published in English from 2010 to the present that meet the inclusion and exclusion criteria. Selected studies will be assessed in detail and extracted data will be reviewed by two independent reviewers. Results of the search will be reported in full in the final systematic review and presented in a Preferred Reporting Items for Systematic Reviews and Meta-Analysis flow diagram. This review will follow a convergent integrated approach to data synthesis and integration. Ethics and dissemination This systematic literature review includes no collection of primary data; hence ethical approval will not be sought. The outcomes from this review will be disseminated in a peer-reviewed journal, as conference presentation, and as condensed summary for managers in healthcare and policy-makers. PROSPERO registration number CRD42020223362.


Motivation Identification of biochemical processes that drive the transformation of a totipotent cell into various cell types is essential to our understanding of living systems. This complex machinery determines how tissues differ in terms of their anatomy, physiology, morphology, and, more importantly, how various cellular control mechanisms contribute to the observed similarities/ differences. Tissue-selective genes orchestrate various aspects of cellular machinery in different tissues, and are known to be implicated in a number of tissue-specific pathologies. Results We propose a novel statistical approach that identifies and removes the effect of universally expressed genes in groups of tissues. This allows us to better characterize tissue similarities, as well as to identify tissue-selective genes. We use our method to construct a reliable hierarchy of tissue similarities. The groupings of tissues in this hierarchy are used to specify successively refined priors for identifying tissue-selective functions and their corresponding genes in the reduced subspace. We show that our refinement process enhances the signal-to-noise ratio in the identification of markers. Using case studies of immune cells and brain tissues, we show that our approach significantly outperforms the state-of-the-art methods, both in terms of coverage and reliability of the predicted tissue-selective genes. Conclusions Our statistical approach provides a general framework for enhancing the sensitivity of marker detection methods, which can be used in conjunction with other techniques. Even in cases where the number of available expression datasets is limited, we show that our marker detection method outperforms existing techniques. We present detailed validation on immune cells and brain tissues in this paper. Our approach can be applied to construct similar datasets of other human tissues as well, for identifying tissue-specific genes. We demonstrate how these tissue-selective genes enhance our understanding of differentiating biochemical features of brain tissues, shed light on how tissue-selective pathologies progress, and help us identify specific biomarkers and targets for future interventions.


To evaluate the in vitro αglucosidase inhibitory activities of ethanolic extract from aerial part of Oldenlandia corymbosa. Postprandial hyperglycemia which was focused in the therapy for diabetes was the prime characteristic of diabetes mellitus. Pancreatic αglucosidase inhibitors techniques lower the levels of postprandial blood glucose levels by controlling carbohydrate metabolism and they are the most effective. The therapeutic methodologies includes diminishing hyperglycemia goes for inhibiting the enzyme αglucosidase. Herbal remedies are well known for their establised ability and acceptability together with lower expenditure and lesser side effects for which they were considered more aporopriate for our study. The ethanolic extract obtained was subjected to in vitro alpha glycosidase inhibitory assay for which starch azure was used as the substrate and porcine pancreatic amylase as the enzyme . Enzyme solution was premixed with the extract at various concentrations (20, 40, 60, 80 and 100 mg/ml).Colorimetric reagents and Substrate solutions were added to the reaction. Spectrophotometric method was used to measure the release of glucose. The positive control used was acarbose. The extract (20 to 100 mg/ ml) was found to inhibit αglucosidase activities. The extract has shown higher reduction of α-glucosidase. Inhibition at various concentrations were significantly different (p<0.05).The results shows 90% reduction in αglucosidase activity. This finding tells the utilization of ethanolic extract of aerial plant of Oldenlandia corymbosa is effective in inhibiting α-glucosidase thereby proving to be potential anti-diabeteic agent.


Presented are exact-form expressions for the average error performance of various coherent, differentially coherent, and noncoherent modulation schemes in Nakagami-q (Hoyt) fading channels. The expressions are given in terms of the Lauricella hypergeometric function, FD (n); for nges1, which can be evaluated numerically using its integral or converging series representation. It is shown that the derived expressions reduce to some existing results for Rayleigh fading as special cases


An education alternative proposed to generate well qualified human resources is boarding type school which is located in Islamic boarding school. Boarding school students are faced with very different situation than home. Dense activities make the students should be capable of dividing time for school, boarding house and other activities. Overcapacity in the boarding house makes it possible to evoke low supervision situation. That condition enables students susceptible with procrastinate behavior, particularly in academic field. Academic procrastination is a habit which can causes various negative consequences, like time wasting and school tasks abandoning. This research is purposed to study the relation of self-adjustment with academic procrastination to the students of SMP N 3 Jombang. This research used cluster random sampling technique. Researched subjects were 97 students. Researched measuring instrument used self-adjustment scale with 26 items (α = 0,877) and academic procrastination scale with 27 items (α = 0,898). Both scales are arranged with Likert mode scaling and its analysis statistic is used computer program SPSS version 16.0. Simple regression analysis resulted rxy = -0.463, with p = 0,000 (p<0,05). The result shows that there is a negative relation between self-adjustment with academic procrastination. The higher the student self adjustment, the lower the academic procrastination. Determination coefficient is 0,214, means that self adjustment gives effective contribution of 21,4% to academic procrastination. The remainder of 78,6% is determined by other factors which are not revealed in this research. Keywords : Self-Adjustment, Academic Procrastination, Boarding School Permalink :


Information literacy is an art of learning skills in identifying defining and the information and its needs, approaches to locate the information and the behavior in accessing and evaluating the information in order to make use of the information for the perceived need. Hence, the study aims at covering the various types of information required by the women teaching faculty members particularly, in academic and research environment, the awareness on information access techniques and tools, behavior of scientists in access and use of information-resources, the techniques need to be imparted, the impact of information literacy on improving the productivity of women faculties/scientists were studied in detail. The study is limited to women teaching faculty working in the colleges, universities, and research institutions situated in Coimbatore, Erode, Tripur and Nilgiries. The respondent was selected by 'simple random sampling techniques' Data were collected from 440 respondents out of the total population of 2800 from the surveyed institution in the study area.600 copies of the questionnaire were distributed to the identified respondents and 450 filled in questionnaires were received among them 10 questionnaires were incomplete hence; the response of the sample size is 73 percent.


Bulk and nanoconfined liquids have very different physics; for instance, nanoconfined liquids show stratification and position-dependent relaxation processes. A number of similarities between bulk and nanoconfined liquids have nevertheless been reported in computer simulations during the last decade. Inspired by these observations, we present results from molecular dynamics computer simulations of four nanoconfined liquids (the single-component Lennard-Jones liquid, the Kob-Andersen binary Lennard-Jones mixture, an asymmetric dumbbell model, and the Dzugutov liquid) demonstrating also a microscopic similarity between bulk and nanoconfined liquids. The results show that the interaction range for the wall-liquid and liquid-liquid interactions of the nanoconfined liquid is identical to that of the bulk liquid if the liquid is "Roskilde simple" in bulk as well as nanoconfinement, i.e., exhibits strong correlations between virial and potential-energy equilibrium fluctuations in the NVT ensemble. Under this condition, interactions beyond the first coordination shell may be ignored, in particular for the wall-liquid interactions. This is shown not to be the case for non-Roskilde-simple liquids.


As an answer of unsuccessful dye formation by reaction of paminobenzylidene- o-hydroxyaniline (I) with diazotied sulphanilic acid mixture, the tautomerism reactions in such molecule were found to be the correct reason.Moleule I was prepared by a standard method, its structure was confirmed by the measurements of melting point, beside UV and IR spectra. Themain aimof this investigation was dealwith tautomerismstudy in I by the aid of U.V spectrum. Some factors affecting on equilibrium constants K1 and K2 of tautomerism reactions happen in I were discussed. These included influence of different buffers in the range of pH4-10 and different temperatures were studied. Finally, the thermodynamic parameters of tautomerismreactionsAGo, AHo and ASo were calculated and discussed.


In recent years, with parameter self-tuning of the drive is concerned by national experts and scholars, which has become the focus of research. Because the induction motor has a strong coupling, nonlinear, operating parameters and other significant characteristics change, many scholars do a lot of research on the induction motor parameters identification, the parameters identification theory, many of the results of modern control theory are applied directly to vector control systems to develop into a high-precision vector converter. This article describes an experiment based on single-phase improved methods, the least square off-line identification, only one experiment can measure the motor parameters. According to the simulation results, we obtain a satisfactory result.


OBJECTIVE
Passive smoking is the involuntary inhalation of cigarette smoke (CS) and has an adverse impact on oral health. We examined the effect of CS exposure on saliva and salivary glands (SGs).

METHODS
Cigarette smoke-exposed rats were intermittently housed in an animal chamber with whole-body exposure to CS until killed. Whole saliva was collected before CS exposure (0 day), and 15 and 30 days after the start of CS exposure. Saliva secretion was stimulated by administration of isoproterenol and pilocarpine after anesthesia. SGs were collected on 31 days.

RESULTS
The increase in body weight of the CS-exposed rats was less than that of the control rats. Salivary flow rates did not differ at 0, 15 or 30 days after the start of CS exposure. However, the amylase and peroxidase activities and total protein content in the saliva were significantly lower in 15-day CS-exposed rats than in 15-day control rats. Histological examination of the SGs of CS-exposed rats showed vacuolar degeneration, vasodilation and hyperemia.

CONCLUSION
These results suggest that CS exposure has adverse impacts on salivary composition and SGs, which could aggravate the oral environment.


The benzene metabolite, trans,trans-muconic acid (MA), has been shown to be a sensitive and specific biomarker for ambient benzene exposure levels as low as approximately 0.5 ppm. However, at lower exposure levels, the use of MA as a benzene biomarker is complicated by the fact that it is also a metabolite of the food preservative, sorbic acid. To better assess the extent of this interference, MA was measured in sequential spot urine samples over a 2-day study period from eight volunteers (four adults and two parent-children pairs) who consumed two sorbic acid-preserved foods. Large increases in MA concentration were seen after ingestion of both foods. Individual peaks ranged as high as 1673.7 ng/ml (705.3 ng/mg creatinine) in adults and 1752.1 ng/mg creatinine (1221.3 ng/ml) in children. Ratios of peak to baseline values varied from 2.5 to 60. The average peak in the seven subjects who showed an increase in MA after ingestion of the first sorbic acid-containing food was 531.1 ng/ml (693.2 ng/mg creatinine). The average in the seven participants who ingested the second food was 1102.1 ng/ml (795.3 ng/mg creatinine). Twenty-four-hour personal air benzene levels were all low (< or = 5.6 ppb). Substantial variation in MA results were seen in some males related to creatinine adjustment. These data indicate that sorbic acid-preserved foods have the potential to cause substantial interference with MA as a biomarker for both occupational and environmental benzene exposure in populations, such as in the United States, where consumption of preserved foods is common. Development of methods to minimize and/or assess sorbic acid interference will improve MA specificity in such populations.


The climate change due to global warming is one of the greatest environmental issues we face now. The green house gases including CO2 are released during cement and steel manufacturing process. In order to reduce the amount of green house gases, an attempt has been made to reuse the waste materials along with concrete in construction industries. In recent years, attempts have been made to increase the utilization of fly ash, quarry dust, granite and construction and demolition debris to partially replace the use of fine aggregate and coarse aggregate in concrete are gathering momentum. This paper presents information on fly ash, granite and quarry dust based concrete, material and the mixture proportions, the manufacturing process, and the influence of various parameters on the properties of fresh and hardened concrete with plain concrete and partial replacement of fine aggregate by flyash and quarry dust and coarse aggregate by granite and C & D debris concrete. The column specimens were tested under axial compression to investigate the effects of waste materials. Since the materials used were locally available waste materials, a detailed characterization was planned. In this paper, an attempt was made to utilize the waste materials by effectively recycling and filling in steel tubular circular columns with recycled aggregate concrete instead of conventional concrete. An empirical equation for calculating the design load carrying capacity of the composite column was developed using the experimental results. The test results were compared with the international codes and new theoretical models were suggested for the design. In this paper, experimental and analytical investigations were carried out to study the strength and behaviour of CFST columns over the entire range of loading. The ultimate loads and behaviour of CFST were compared with those of the hollow steel tube columns. From these elaborative experimental and analytical investigations that were done, it is concluded that out of all the waste materials used, the contribution of C & D debris and quarry dust are significant. The remaining materials that include fly-ash and granite are reasonably contributed in the performance enhancement under axial loading conditions. Finally, it is concluded that materials recovered from various waste stream are suitable to be used as secondary aggregates in concrete. The advantage of using such waste materials provides generally a low cost construction than using virgin aggregates and the elimination of the need for waste disposal in landfills. Utilization of these waste materials in concrete leads to an effective solid waste management technique and will also be cost effective. The exploitation of available natural resources and raw materials required for the construction industries can also be reduced which in turn reduces the


BACKGROUND
Ghrelin levels are decreased upon food intake, but the impact of specific diet-derived macronutrients on its regulation remains unclear. In addition, because of ghrelin's association with body weight regulation, it is important to understand the mechanisms regulating its levels in obese individuals.

OBJECTIVE
To examine the effect of specific macronutrients on ghrelin levels in overweight and obese postmenopausal women.

METHODS
Thirty-five subjects underwent a euglycemic/hyperinsulinemic clamp (EHC) to examine glucose disposal and total ghrelin (TotG) and acylated ghrelin (AG) levels. Macronutrient intake was evaluated with a 3-day food questionnaire.

RESULTS
Under fasting conditions, positive associations were observed between fiber intake and TotG and AG levels. Fasting AG also correlated positively with the intake of total energy, as well as monounsaturated and polyunsaturated lipids. Importantly, fiber consumption explained up to 26 and 23% of the variation in TotG and AG respectively. During the EHC, TotG levels were significantly reduced at all times, while AG was decreased at 60 min only. TotG area under the curve (AUC) values were positively associated with fiber and polyunsaturated lipid intake, while AG AUC values correlated positively with fiber, total energy, carbohydrate, and lipid intake. Interestingly, fiber intake explained up to 21% of the variation in TotG AUC, while total energy intake predicted up to 21% of the variation in the AG AUC.

CONCLUSION
The present study suggests that fiber intake is an important regulator of ghrelin levels both in fasting and in hyperinsulinemic conditions. Overall, these results reinforce the importance of the intimate association between eating habits and gastrointestinal hormonal regulation.


Red mud is an inorganic by-product produced from the mineral processing of alumina from Bauxite ores. The development of alkali-activated slag-red mud cement can be a representative study aimed at recycling the strong alkali of the red mud as a construction material. This study is to investigate the optimum water content, compressive strength, water absorption and efflorescence of alkali-activated slag-red mud soil pavement according to binder type. The results showed that the optimum water content, moisture absorption coefficient and efflorescence area of alkali-activated slag-red mud soil pavement increased but the compressive strength of that decreased as the redmud content increased.


CHS 828 is a cyanoguanidine, which has demonstrated potent antitumor activity in preclinical tumor models. The activity of CHS 828 in vitro showed only low to moderate correlation to other antineoplastic agents suggesting a unique mechanism of action. Ten females and 6 males (median age 58 years) with solid tumors refractory to standard therapy were included in this Phase I study. The study drug was administered to fasting patients as a single oral dose on days 1-5 of each treatment cycle. Patients received one to six cycles of treatment. The doses ranged from 30 mg to 200 mg (total dose within a cycle). Hematological toxicity was generally mild and dominated by transient thrombocytopenia and lymphocytopenia. Nonhematological toxicity most frequently consisted of nausea, vomiting, diarrhea, fatigue, and localized genital mucositis. The dose-limiting toxicities were thrombocytopenia, thrombosis, esophagitis, diarrhea, and constipation. The recommended Phase II dose of CHS 828 was 20 mg once daily for 5 days in cycles of 28 days duration. The extent of systemic exposure of CHS 828 across patients was approximately dose proportional. The time at which the highest drug concentration occurs was 2.2 +/- 1.3 h and half-life was 2.1 +/- 0.52 h (mean +/- SD). Large intra- and interindividual variation in dose level-adjusted maximum plasma concentration and the area under the curve from time 0 h to infinity were observed. There was an apparent inverse relationship between systemic exposure of CHS 828, and thrombocyte and lymphocyte nadir levels. No objective tumor responses were observed, and 7 patients showed stable disease after two courses of therapy.


This study was designed to analyze the influence of polymorphisms in CYP2C9, VKORC1, CYP4F2, GGCX, and EPHX1 genes on the optimal warfarin dosage in patients who have undergone artificial heart valve replacement and establish an algorithm for use by physicians in Southeast China to predict each patient's optimal steady-state warfarin dose. One-hundred and ninety-six patients scheduled for heart valve replacement in Southeast China were enrolled in this study. Five genotypes, CYP2C9, VKORC1, CYP4F2, GGCX and EPHX1, were detected using time-of-flight mass spectrometry. Correlations of clinical and genetic factors with optimal steady-state dose of warfarin were analyzed. There were significant correlations between the genotypes of CY2C9, VKORC1, CYP4F2 and the warfarin dosage (P = 0.000, 0.000 and 0.015). Multiple stepwise regression analysis was performed to obtain the following algorithm: [Dose (mg/day) = EXP(0.540 + 0.544 × VKORC1 - 0.392 × CYP2C9 + 0.342 × CYP4F2 + 0.474 × BSA - 0.005 × Age)]. This algorithm could predict 49.2% of the observed differences in optimal warfarin dosage among the enrolled patients. A retrospective validation study comparing this algorithm with the published algorithms used in patient populations of other races revealed that the obtained algorithm had the best accuracy (The smallest MRE: 21.11 ± 19.08 mg/day) and applicability (the largest RE proportion of patients in ideal rang: 58.3%). This study 1) defined the relative contributions of age, body surface area, and polymorphisms in CYP2C9, VKORC1, and CYP4F2 to the optimal steady-state dosage of warfarin; 2) established a dose prediction algorithm for populations in this region that takes into account the clinical, pharmacological and genetic polymorphism data; and 3) clarified the advantages of this algorithm over the established prediction equations. Our algorithm can assist clinicians in Southeast China in prescribing appropriate anticoagulation therapy.


Musculoskeletal joint conditions are among the most prevalent disease processes in the United States. These disease processes are second only to heart disease in causing significant disability that affects work status. Osteoarthritis, otherwise known as degenerative joint disease, is the most prevalent form of arthritis. This disease process represents a slowly evolving condition of cartilage and bone in arthrodial joints. The Centers for Disease Control and Prevention1,2 predicted that by 2020 arthritis will gain more new patients than any other disease form in America. As in other disease processes in the body, multiple factors lead to the development of osteoarthritis.

Maintenance of normal joint homeostasis involves a balanced process of cartilage matrix degradation and repair that are performed predominantly by the resident chondrocytes. Chondrocytes respond to cytokines, growth factor signals, and physical stimuli in a complex manner to maintain joint integrity. If this balance is disrupted, cartilage matrix degradation, mediated by proteolytic enzymes that are no longer balanced by protease inhibitors, results in the release of matrix fragments into the synovial space.3 In the latter stage of the disease, catabolism outweighs matrix repair (anabolism). Phagocytosis of cartilage matrix degradation products by the synovial macrophages is related to chronic inflammation of the synovium, which in turn results in the local synthesis of more proteases and proinflammatory cytokines. These proteases diffuse through the synovial fluid to the cartilage and induce additional cartilage matrix breakdown by direct macromolecular proteolysis. The cytokines stimulate the chondrocyte to synthesize more proteases. Cell apoptosis and necrosis can also be seen. A vicious feedback cycle occurs with matrix degradation leading to inflammation, which in turn stimulates further degradation.

Numerous causal factors can lead to this breakdown in joint homeostasis. A traumatic event is one of the most obvious initiating events. This can be in the form of a single occurrence or multiple microtraumatic events over a prolonged period. Other risk factors for the development of osteoarthritis exist, including systemic risk factors such as genetic deformities, dietary intake, estrogen use, and bone mineral density. Other issues that can affect the joints directly include muscle weakness, joint hyperlaxity, and obesity; all can predispose individuals to osteoarthritis.

According to National Institutes of Health4 guidelines, roughly 20% of men and 25% of women are categorized as obese (body mass index [calculated as weight in kilograms divided by height in meters squared] ≥30). The number of individuals in this category has increased by 50% over the past 10 to 15 years.5 Studies have demonstrated that obese individuals can reduce their risk of developing osteoarthritis through weight loss. In the Framingham Study,6 an observational study, women who lost an average of 5 kg decreased their risk for knee osteoarthritis by 50%. Despite this finding, few studies demonstrate a direct correlation between weight loss and alleviation of clinical symptoms. A small randomized study7 showed that weight loss may be associated with a reduction in clinical symptoms of osteoarthritis. This study used appetite suppressants to obtain the weight loss.

It has been harder to demonstrate a clear relationship between obesity and osteoarthritis of the hip. While bilateral hip disease has been associated with excessive weight, unilateral involvement has not. Developmental dysplasia of the hip (failure of the acetabulum in the pelvis to assume normal concavity) is associated with the development of osteoarthritis in a high percentage of affected joints.8,9 Investigations in this patient population have demonstrated a strong correlation between greater articular surface contact stress and the development of osteoarthritis. This demonstrates a correlation between cumulative articular surface contact stress above a critical threshold and subsequent joint degeneration.

As stated previously, an association between traumatic events and osteoarthritis exists. Experimental work assessing articular surface incongruities showed that an articular cartilage step-off of greater than 3 mm increases local contact stress.10,11 Articular surface fractures, joint dislocations, and ligament and meniscal ruptures are associated with an increased risk for the development of osteoarthritis later in life.12,13

Biomechanically, each 0.5-kg increase in weight leads to an increase in force across the knee by 0.9 to 1.4 kg, an important mechanism by which obesity leads to osteoarthritic conditions. Other factors working in concert with obesity can exacerbate this mechanism, and this is the more usual scenario. I often hear an obese patient inquire "Why is my other knee or hip feeling fine right now, doctor?" There is probably low-level deterioration of the contralateral joint occurring at that time as well. A subacute event in the involved knee has caused a baseline cartilage flare-up that is characterized by joint effusions, stiffness, and difficulties with activities of daily living.

Our ability to consciously or unconsciously perceive joint position and movement without looking directly at the joint is termed proprioception. This ability is important in maintaining joint stability under dynamic conditions. Ligamentous injuries disrupt this mechanism by damaging the neurovascular supply to the ligaments. In the obese patient, there has been low-level microtrauma to the cartilage structures in the weight-bearing joints, a process that is clinically silent to the patient. During a ligamentous disruption in the knee, a direct contusion to the knee compartments typically occurs. This results from the traumatic subluxation of the femur relative to the tibia that occurs while the ligament is being torn. Typically, these individuals develop rapid deterioration in the status of the involved joint. Loss of proprioception contributes to the development of osteoarthritis in this setting. Studies have shown that proprioception at the knee declines with age14 and is severely limited in sedentary older persons.15 In both the involved and uninvolved knees of patients with osteoarthritis, proprioception was worse than that in age-matched control subjects.16 This implicates proprioception or the lack thereof as an early predisposing factor that contributes to subsequent development of arthritis. The proprioceptive abilities of the joint being severed by the ligament tear adds to the progression of osteoarthritis.

The mechanical axis (the alignment of the leg when measured from the hip to the ankle) is another important factor that can exacerbate deterioration of the knee joint in particular. As stated earlier, there is a direct correlation between body weight and forces across the knee joint. In malaligned individuals (such as individuals with severe varus [bowed] or valgus [knocked] knee alignment), forces across the joint are concentrated at smaller and smaller surface areas, and (as in the case of developmental dysplasia of the hip) this increased contact stress to the cartilage leads to rapid deterioration of the joint in the overloaded knee compartment. In the obese patient, the already excessive forces across the joint are concentrated on a smaller area than in the neutrally aligned patient. One study17 showed that the magnitude of torque adducting the knee during the stance phase of gait correlates with the severity of osteoarthritis in the knee, suggesting a correlation with the rate of disease progression and malalignment.

With this clear correlation between obesity and osteoarthritis, I always recommend weight reduction before embarking on operative treatments. This applies most directly to interventions in the knee and particularly to biologic reconstructive procedures such as microfracture, autologous chondrocyte implantation, osteochondral allograft and meniscal transplantation, tibial osteotomy, and minimally invasive arthroplasty procedures. Mithoefer et al18 demonstrated a correlation between body mass index exceeding 30 kg/m2 and poor clinical outcomes using the microfracture technique for treatment of articular cartilage lesions in the knee. Weight reduction has other well-known health benefits such as reduction in cardiac risk factors that lead to myocardial infarction, but there is also an association between obesity and osteoarthritis. This fact always seems less obvious to many of my patients, but I will continue to measure this objective information during their visits. When patients walk in with musculoskeletal complaints, it is important to effectively direct their attention to factors that they can control in treating or slowing the progression of the osteoarthritic condition. Weight reduction through all available means at the patient's disposal is an important treatment option to consider.


The paper estimates an influence of government alcohol policies on the road accidents dynamics in Russian regions. The research was based on the regional data provided by Rosstat, for years 2001-2013. The sample included 962 observation units from 74 regions of the Russian Federation. Alcohol deterrence measures under review included temporal bans on alcohol sales and price instruments (increase in alcohol prices due to excise taxes for spirits and floor price for vodka). Among other controlled for variables were population density, unemployment, number of automobiles per person in a region. The authors also differentiated between the regions with developed illegal alcohol markets and those where illegal alcohol trade was not widespread. To do so, the authors used the number of audits by authorized bodies that revealed law infringements in alcohol production or trade. Econometric analysis revealed a favorable influence of temporal bans on the number of road accidents. In addition it was proved that in the regions with strict control over illicit trafficking of alcohol the number of traffic accidents decreased as a result of reducing the permitted alcohol trading hours. The number of accidents in a region is negatively correlated with unemployment level and population density. At the same time, the presented data does not show definite correlation between price mechanisms and the number of road accidents in Russian regions.


This study was conducted to investigate the effects of thermal manipulation at 5 days of age and short-term fasting during the warmest part of the day on responses to prolonged heat stress of broilers. A total of 240-day-old Ross 308 female broiler chicks were divided into three groups: control, thermal manipulation (chicks were exposed to 36 °C for 24 h at 5 days of age) and short-term fasting during the warmest part of the day (10.00-17.00 h). Prolonged heat stress was induced daily from 28 to 42 days by heating until the ambient temperature reached 32-35 °C between 10.00 and 17.00 h. Both thermal manipulation and short-term fasting resulted in a decrease in rectal temperatures and haematocrit values at 35 and 41 days of age. Thermal manipulation improved body weight, feed consumption and feed conversion. However, short-term fasting caused a reduction in body weight and a deterioration in feed conversion. Short-term fasting lowered the percentages of carcass, whereas thermal manipulation highered breast yield. Both thermal manipulation and short-term fasting decreased heart mass and abdominal fat.


W e appreciate Dr. Chalew's comments in his letter (1) regarding our recent study (2). Modification of the levels of staffing may have contributed to improved metabolic outcome in two of the Hvidoere study centers that achieved reductions in mean clinic A1C levels in contrast to the lack of improvement seen in other centers without staffing changes. Most would agree that comprehensive, structured (intensive) education is a key factor in metabolic outcome; and therefore, it would not be surprising that a sufficient number of trained experienced staff is a necessity and not a luxury in managing diabetes successfully. However, several centers have achieved excellent outcomes in previous Hvidoere Study Group (HSG) studies and have maintained their high standards without changes in staff (3). Criteria for choosing the type of insulin therapy and for insulin dose alteration and different personal and team characteristics are probably important, but other services (availability of a 24-h hotline, possible differences in background population, frequency of clinic attendance) have been suggested as influential (4,5). Also, in this most recent HSG study, more frequent visits to the doctor by adolescents were reported to be associated with better metabolic control, whereas more frequent visits to the nurse/ educator or the psychologist were significantly related to poorer metabolic control (4). We have found, however, that not only the number of health care professionals involved in the delivery of care but also the treatment targets identified by the team members may influence metabolic outcome. It appears that identification of consistent A1C targets by team members has a major impact on outcome, as does the perception of the treatment goals by adolescents and parents (4). We acknowledge the significance of Dr. Chalew's question regarding staffing levels. Various national bodies have tried to estimate acceptable ratios of specialist staff to patients, and there has been some attempt to measure outcomes in terms of the availability of specialist teams (6). Although the Diabetes Control and Complications Trial provided evidence that good metabolic control reduces the risk for late complications, achieving optimal metabolic control in different cultures and environments remains a major challenge. At the end of the day, small numbers of motivated, organized, and effective staff may achieve excellent outcomes, whereas well-resourced but poorly functioning teams may produce the opposite. Further indepth analysis of the twenty-one HSG centers with respect to center structure, staffing arrangements, and targeting is ongoing and may provide answers to Dr. Chalew's questions.


The recent interest in the smart grid vision and the technological advancement in the communication and control infrastructure enable several smart applications at different levels of the power grid structure, while specific importance is given to the demand side. As a result, changes in load patterns due to demand response (DR) activities at end-user premises, such as smart households, constitute a vital point to take into account both in system planning and operation phases. In this study, the impact of price-based DR strategies on smart household load pattern variations is assessed. The household load datasets are acquired using model of a smart household performing optimal appliance scheduling considering an hourly varying price tariff scheme. Then, an approach based on artificial neural networks (ANN) and wavelet transform (WT) is employed for the forecasting of the response of residential loads to different price signals. From the literature perspective, the contribution of this study is the consideration of the DR effect on load pattern forecasting, being a useful tool for market participants such as aggregators in pool-based market structures, or for load serving entities to investigate potential change requirements in existing DR strategies, and effectively plan new ones.


Faced with the challenge of rapidly screening a huge expanse of frontier exploration acreage, often characterized by sparse vintage data, it is our experience that a combination of appropriate air‐ and ground‐based geophysical techniques contributes positively to the exploration value chain. Airborne gravity gradiometry in conjunction with conventional gravity and magnetic data, as well as geological knowledge, add significant value to the screening process. This combination can subsequently assist in optimizing the location of the more time‐consuming and expensive seismic programme. In addition, analysis and inversion of passive seismic data have also proven useful in providing depth to basement estimates, and results derived from all the techniques investigated have been consistent within several study areas. Following initial tests, where the data were independently analysed and cross‐checked for consistency (including comparisons with active source seismic data and well data, when available), the company now routinely adopts the integration of these techniques in our frontier exploration acreage to support sedimentary basin delineation and mapping. This allows the optimal positioning and focussing of the higher spend and higher footprint programmes, such as active reflection seismic.


ABSTRACT Tourism companies that offer wildlife watching experiences share a unique property—they build their business on a promise they have no guarantee of fulfilling (showing wild animals). The factor of luck becomes important, as evident in the advertisement texts of wildlife watching tours. Understanding commercialization of uncontrollable natural phenomena (wild animals) in a similarly uncertain natural setting (wilderness) is the aim of our article. In this illustrative case study, we examine wildlife watching companies in Sweden, focusing on free ranging bear, moose, wolf, roe-deer, beaver, and seal. Through interviews and participant observations with eight wildlife watching entrepreneurs, we elaborate on the following major themes that help understand specific challenges associated with these businesses: lack of control as an inherent property of wildlife watching tourism, agency and continuous negotiation of uncertainties within the operational setting, importance of guide performances and "secondary" experiences, and using uncertainty as a way of enhancing authenticity.


Background: Among different factors, accreditation is being widelyused across the world to improve quality and safety in hospitals.Therefore, the purpose of the present study was to develop anaccreditation model for teaching hospitals in Iran.Methods: This qualitative study was conducted in four phases fromJanuary, 2017 to March, 2018. To this end; firstly, existingaccreditation models were extracted and reviewed comparatively.Within the second stage, dimensions and components of theaccreditation model were extracted through semi-structuredinterviews. In the third stage, a new instruction was developed viaintegrating the findings from the first and the second stages.Finally, the model was validated in two phases of Delphi methodand a specialized forum in the fourth step. Qualitative findingswere then analyzed using content analysis method.Results: Models of Joint Commission International (JCI) andWord Federation for Medical Education (WFME) in other 6countries were reviewed and compared with the current Iranianmodel. Extracted dimensions discovered to complement the presentmodel included learner assessment, continuous reviews andrevisions, and educational productivity. The final model was alsodeveloped with 12 dimensions and 94 standards. Content validityratio (CVR) and content validity index (CVI) were also estimated tobe 0.40 and 0.80, respectively. As well, the second round of Delphimethod could increase the number of model standards to 97.Moreover, Cohen's kappa coefficient was calculated to be at least0.71.Conclusion: This study led to the development of a comprehensivemodel for scientific accreditation of teaching hospitals throughreviewing documentation, combining and comparing globalapproaches, as well as integrating them with the views of domesticexperts.


Although a number of studies have focused on the role of neuropilin-2 (NRP2) in early embryological development and in various cancer cells, very little is known about the biological roles of NRP2 in microvascular endothelial cells (ECs). Here, we show that siRNA depletion of NRP2 decreases fibronectin (FN)-dependent migration, adhesion and focal adhesion assembly and disassembly in murine lung microvascular endothelial cells (ECs). Compared to control cells, NRP2-depleted cells exhibit elevated levels of total cellular integrin-α5 (ITGA5 - the main FN receptor in ECs), but this increase does not translate to the cell surface. MS analysis identified the major FN receptors α5β1 as NRP2 binding partners. However, ITGA5 internalization and recycling assays revealed that NRP2 knockdown suppress ITGA5 recycling to the cell surface and a direct interaction between NRP2 and ITGA5 is observed by co-immunoprecipitation. This suggests that NRP2 controls microvascular EC behaviour on FN by regulating ITGA5 function.


This article seeks to consider evidence of post-feminist and "post-equality" gender narratives contained in the discourses of law in the UK and European contexts. Analysis of perennial ghosts of gender in the areas of gender-neutrality in policy, legislative regulation of sexual crimes, and the adjudication of gendered issues by judges will be undertaken in order to renew and reinstate the focus of the legal feminist project and advocate for continued scrutiny in these three practical areas.


Abstract Urban parks have the potential to serve as places that facilitate intergroup contact between racially and ethnically diverse users. However, there is limited evidence identifying the conditions under which intergroup contact occurs in urban park settings. Existing literature suggests that the psychosocial conditions of safety, community engagement, psychological ownership, and sense of welcome and belonging may be related to park-based intergroup contact. The purpose of this study was to test the hypothesized structural relationships between these factors and intergroup contact among park visitors at three parks in Philadelphia, PA (n = 324). Results demonstrated that intergroup contact is more common when visitors feel a greater sense of welcome and belonging at parks. Moreover, indirect relationships suggest that efforts to engage community residents in decision making, stimulate psychological ownership, and improve safety can help diverse users to feel more welcome, and in turn, engage in more intergroup contact.


Effective security mechanisms are essential to the widespread deployment of pervasive systems. Much of the research focus on security in pervasive computing has revolved around distributed trust management. While such mechanisms are effective in specific environments, there is no generic framework for deploying and extending these mechanisms over a variety of pervasive systems. We present the design and implementation of a novel framework called Distributed Trust Toolkit (DTT), for implementing and evaluating trust mechanisms in pervasive systems. The DTT facilitates the extension and adaptation of trust mechanisms by abstracting trust mechanisms into interchangeable components. Furthermore, the DTT provides a set of tools and interfaces to ease implementation of trust mechanisms and facilitate their execution on a variety of platforms and networks. In addition to the adaptability and extensibility provided by this design, we demonstrate through simulation that use of DTT improves utilization of resources and enhances performance of existing trust mechanisms in pervasive systems. We are currently developing an implementation of the DTT that can be easily deployed in pervasive environments.


Abstract Madrid, E.N.; Armitage, A.R., and Quigg, A., 2012. The response of photosystem II to soil salinity and nutrients in wetland plant species of the Northwestern Gulf of Mexico. The photosynthetic response of many wetland plant species to soil salinity and nutrients has been described in the laboratory, but less is known about the cumulative effect of these abiotic factors in the natural environment. In this investigation we correlated field measurements of chlorophyll fluorescence with simultaneous measurements of soil nitrogen and phosphorus content, soil salinity, and relative leaf nitrogen content in Spartina alterniflora (Loisel), Spartina patens ((Aiton) Muhl), Schoenoplectus californicus ((C.A. Mey.) Steud.) and Schoenoplectus robustus ((Pursh) M.T. Strong), common in brackish and salt marshes of the northwestern Gulf of Mexico. The relationship between chlorophyll fluorescence and soil N ∶ P ratio was not significant in S. alterniflora, nonlinear in S. patens and S. robustus, and significant and positive in S. californicus. The relationship between leaf nitrogen content and effective quantum yield was significant and positive in S. alterniflora and S. robustus, but only S. alterniflora appeared to be able to increase relative leaf nitrogen content over a wide range of soil nutrient and salinity regimes. Schoenoplectus californicus had the greatest potential for photosynthetic light capture but also had the narrowest ecological distribution. Thus, the species best adapted to high levels of abiotic stress (S. alterniflora) was less dominant at lower salinities, and the species with the highest potential for photosynthetic performance (S. robustus and S. californicus) were only found in locations with favorable abiotic conditions. We found that the range of environmental conditions experienced by each species in the field is greater than what has been considered in laboratory investigations.


Domestic milk production in the major CARICOM states appears to be in crisis, with shrinking domestic production and increasing milk imports. This paper therefore investigates the impact of trade liberalization on domestic milk production and imports in Jamaica, Trinidad and Tobago and Barbados and determines trade factors that influence changes in these variables. The study demonstrates the dominance of dairy imports into CARICOM from New Zealand and the EU and the significant effects of trade liberalization in causing structural changes in domestic milk production and imports in the cases of Barbados and Jamaica. Changes in GDP per capita highly influence changes in milk imports for the three countries and for Jamaica also the price of imported powdered milk. The Nestle countries, Jamaica, and Trinidad and Tobago show greater declines in milk production than Barbados, therefore further research is recommended on the role of Nestle in the Caribbean milk industry.


New report shows that Oxford's mortality is in the middle of the national range

T he NHS in the United Kingdom fears another "Bristol," where preventable or excess adverse outcomes may go undetected and unresolved for a prolonged period. In Bristol, reports of excessive surgical mortality among children having heart surgery in the early 1990s led to an independent public inquiry, which concluded that the mortality in children younger than 1 year who were having open cardiac surgery was unacceptably high.1 In October 2004 the BMJ published an article saying that similar problems may be emerging in relation to surgery for congenital heart disease in Oxford.2 Is this really the case?

The Bristol Royal Infirmary inquiry had explored several sources of data that may have detected this inferior performance, and all were found deficient in one way or another. The UK cardiac surgical register run by the Society of Cardiothoracic Surgeons was not only anonymised, but it was based on diagnosis rather than operation and so could not detect differences in outcome where more than one operation existed to treat a single diagnosis. Hospital episode statistics, compiled from routine administrative data, were also not designed …


Background: Evidence proposes that maternal calcium (Ca) supplement during pregnancy may be inversely associated with the off spring's blood pressure (BP) level. It is suggested that increased maternal Ca intake during pregnancy may result in lower BP in the off spring. The reduction in the incidence of hypertension in mothers is documented but the effects on the off spring are uncertain. Materials and Methods: We conducted a systematic review of the literature to summarize the evidence supporting an association between maternal dietary Ca intake during pregnancy and the BP in the off spring. In this systematic review, relevant papers were selected in three phases. After quality assessment, a reviewer extracted the data while the other one checked the extracted data. We summarized the information regarding the association of maternal Ca intake either by food or supplements with BP in the off spring. Results: Four randomized trials and three observational studies were included in this review. The results were more consistent among the studies including older children (1-9 years) where a higher maternal Ca intake was associated with a reduction in the off spring's systolic BP. One large randomized trial found a clinically and statistically significant reduction in the incidence of elevated BP in 7-year-old children [relative risk (RR) = 0.59, 95% confidence interval (CI) 0.39-0.90]. Conclusion: Overall, our findings confirm the beneficial effects of maternal Ca intake during pregnancy for the off spring's BP level.


This book presents a new degree theory for maps which commute with a group of symmetries. This degree is no longer a single integer but an element of the group of equivariant homotopy classes of maps between two spheres and depends on the orbit types of the spaces. The authors develop completely the theory and applications of this degree in a self-contained presentation starting with only elementary facts. The first chapter explains the basic tools of representation theory, homotopy theory and differential equations needed in the text. Then the degree is defined and its main abstract properties are derived. The next part is devoted to the study of equivariant homotopy groups of spheres and to the classification of equivariant maps in the case of abelian actions. These groups are explicitely computed and the effects of symmetry breaking, products and composition are thorougly studied. The last part deals with computations of the equivariant index of an isolated orbit and of an isolated loop of stationary points. Here differential equations in a variety of situations are considered: symmetry breaking, forcing, period doubling, twisted orbits, first integrals, gradients etc. Periodic solutions of Hamiltonian systems, in particular spring-pendulum systems, are studied as well as Hopf bifurcation for all these situations.


We introduce a novel top-down end-to-end formulation of document level discourse parsing in the Rhetorical Structure Theory (RST) framework. In this formulation, we consider discourse parsing as a sequence of splitting decisions at token boundaries and use a seq2seq network to model the splitting decisions. Our framework facilitates discourse parsing from scratch without requiring discourse segmentation as a prerequisite; rather, it yields segmentation as part of the parsing process. Our unified parsing model adopts a beam search to decode the best tree structure by searching through a space of high scoring trees. With extensive experiments on the standard RST discourse treebank, we demonstrate that our parser outperforms existing methods by a good margin in both end-to-end parsing and parsing with gold segmentation. More importantly, it does so without using any handcrafted features, making it faster and easily adaptable to new languages and domains.


Subject to engineering constraints, bridges should present a pleasing visual aspect to their user communities. The research team extended its structured public involvement (SPI) protocol using casewise visual evaluation (CAVE) to the field of context-sensitive large-scale bridge design. The context-sensitive design process was used for Section 2 of the Louisville Southern Indiana Ohio River Bridges project. Key design parameters including bridge type, height, symmetry, complexity, and tunnel effect (superstructure shape) were identified by bridge designers. During a 3-month period, an SPI protocol was used to determine community preferences from Kentucky and Indiana participants. Group preferences were gathered rapidly, anonymously, and fairly from a focus group by using electronic polling technology to evaluate potential designs. A preference model was built by using CAVE, and a range of nonlinear preference variations relative to the design parameters was investigated. The favorable public evaluation results of the SPI process using CAVE are presented, and the reasons for its high performance are discussed. Emphasis is placed on the need for a close collaboration between bridge designers and public involvement specialists. The project demonstrates how an analytic approach to public involvement that integrates technology into the dialogic relationship between designers and the public allows for the achievement of inclusive, successful context-sensitive design even for large, complex infrastructure projects.


The product packaging has a crucial role to attract consumer, force them to choose the product and act as a brand communication vehicle. The point of focus is how the elements of the package design affect consumer's perceptions about products and brand. In this study, we collected data through a questionnaire that covered areas such as design elements of the package (size, shape, material, graphic design of package, typography, images and pictures), user's perception (attention, purchase and repurchase) and their experience (feelings evoked and functional benefits). There is a difference with the professional status and age involvement with respect to response on packaging. The findings also suggest that consumers associate different benefits to various elements of package design.


The electronic structure and optical response of silicane to strain are investigated by employing first-principles calculations based on many-body perturbation theory. The bandgap can be efficiently engineered in a broad range and an indirect to direct bandgap transition is observed under a strain of 2.74%; the semiconducting silicane can even be turned into a metal under a very large strain. The transitions derive from the persistent downward shift of the lowest conduction band at the Γ-point upon an increasing strain. The quasi-particle bandgaps of silicane are sizable due to the weak dielectric screening and the low dimension; they are rapidly reduced as strain increases while the exciton bound energy is not that sensitive. Moreover, the optical absorption edge of the strained silicane significantly shifts towards a low photon energy region and falls into the visible light range, which might serve as a promising candidate for optoelectronic devices.


The Couples Coping Enhancement Training (CCET) (Bodenmann, 1996, 2000a) gives theoretical imputs and practical advice in regard to the enhancement of couples' stress management during eighteen hours. Further the improvement of their dyadic communication and their problem-solving are addressed. The general effectiveness of the training is evaluated within one year with satisfying results. The couples could significantly benefit from the training. The quality of their relationship, their competences and their general life satisfaction improved highly. An analysis of different improvement factors indicated that especially those couples improved most who practised the skills during everyday life. Together with the couple's own motivation we assume that the quality of the training itself as a treatment factor has an influence on the compliance of the participating couple. As empirical studies have shown, treatment factors (beside client factors) are of high importance for the compliance in psychotherapy. Path analysis reveal an indirect impact of the evaluation of the perceived increase of cognitive and behavioral competences during the training on the improvement of the relationship quality two weeks and one year after the training. Implications for a further enhancement of the couple's benefit are discussed with regard to the teaching setting and coaching conditions.