Summary The prevalance of anti-HCV in haemodialysis patients is higher than the healthy population. Chronic Hepatitis C virus (HCV) infection is important problem for hemodialysis patients. We aimed to determine the efficacy and safety of interferon monotherapy in hemodialysis patients with chronic HCV. Twenty-two hemodialysis patients were included in this study and followed up for a median time of 24 months. 3 million units (MU) interferon-α 2b (Intron A:Schering Plough) monotherapy was started three times a week (t.i.w) for 12 months to all of the patients who were clinically, biochemically and serologically diagnosed to have chronic HCV infection. HCV-RNA was determined with PCR in before of therapy, in 3th and the end of the 12th months of treatment. At the same time HCV-RNA and ALT levels were determined to evaluate whether the effectiveness of the therapy is of long-term after the end of therapy and in 6th and 12th months following the treatment. In the third month of interferon treatment, HCV-RNA was negative in 16 (72.7%) of 22 patients, and serum ALT level was normal. The treatment was stopped in 2 (9%) of the patients due to severe side effects. One of these 16 patients was learned to have died suddenly in his house in the 4 th month of the treatment. Of these 16 patients, 15 patients completed the treatment. HCV-RNA was detected to be positive in 4 and negative in 11 of these 15 patients in the end of treatment. However, sustained viral response (SVR) rate was 36.4 % in 12 months after the end of treatment.


Abstract Studies on climate change and sustainability have been gaining interest within the global preservation and conservation communities. However, studies related to sustainability in library preservation and conservation, especially in academic libraries, are still limited. This study aims to determine current practices of sustainable library preservation and conservation in academic libraries. The findings of this study will serve as a starting point to obtaining a comprehensive understanding of how academic libraries are implementing climate change–responsible preservation and conservation programs. This study applies quantitative and descriptive approaches to collect data. A questionnaire was distributed to the top 200 universities in the Universitas Indonesia (UI) GreenMetric World University Rankings 2021. The results show that current practices of sustainable library preservation and conservation implemented at the majority of academic libraries relate to sustainable energy use. Although some areas still need to be developed (e.g., policy and regulation toward sustainable library preservation and conservation practices, alternative eco-friendly preservation and conservation materials, and waste management practices), the fact that academic libraries have implemented sustainable practices in preservation and conservation is noted as a positive finding, since it represents success in universities' efforts to address the climate change issue.


I begin my argument by questioning Peirce's assumption that aesthetics exists only in the state of impulse and feeling (as opposed to method): if I can show how aesthetics necessitates reason, then abductive reasoning emerges as an aesthetic of creative logic useful for the interpretation of texts. Interpretation of the sign—Peirce defines the sign in terms of a triadic relation—to symbol (a word that stands for something that cannot be seen but is not meant to define or signify the object that it represents) evolution demands an aesthetic more than linguistic approach insofar as the symbol requires an interpretation that we attach randomly. I then draw on John Dewey who maintains that the highest transformative experience occurs at the non-cognitive level, and this experience gives way to the branching off of imagination, habit, and other ways to approach and create meaning. But where Peirce and Dewey dichotomize the cognitive and non-cognitive experience, I will show how the factual nature of an intellectual judgment does not preclude us from asserting an aesthetic judgment. The process of interpretation itself functions as a process of abducting (Peirce's notion) between the observed fact and the law of nature in order to create a testable hypothesis—in this case, a meaning assigned to a sign. I will test this method of abduction by applying it to The Name of the Rose in two ways: I will use the symbol of the rose to test this interactionist theory of metaphor, and I will show how the labyrinth operates as a metaphor for the abductive model that informs my theory. If the abductive method works favorably in terms of drawing out an interpretable and useful aesthetic, then the abductive method ought to guide readers and writers in their literary aesthetic.


This dissertation intervenes in the extensive literature within Cinema and Media Studies on the relationship between film and history. Challenging apparatus theory of the 1970s, which had presumed a basic uniformity and historical continuity in cinematic style and spectatorship, the 'historical turn' of recent decades has prompted greater attention to transformations in technology and modes of sensory perception and experience. In my view, while film scholarship has subsequently emphasized the historicity of moving images, from their conditions of production to their contexts of reception, it has all too often left the very concept of history underexamined and insufficiently historicized. In my project, I propose a more reflexive model of historiography—one that acknowledges shifts in conceptions of time and history—as well as an approach to studying film in conjunction with historical-philosophical concerns.My project stages this intervention through a close examination of the 'crisis of historicism,' which was widely diagnosed by German-speaking intellectuals in the interwar period. I argue that many pioneering and influential films of the Weimar Republic registered and responded to contemporaneous metahistorical debates, offering aesthetic answers to ontological and epistemological questions of the philosophy of history. In my analysis, the films' extraordinary innovations in aesthetic and narrative form can be associated not only with technological advances and sociopolitical ruptures, but also with concurrent efforts to theorize history in an age of 'absolute relativity.' Combining archival research, theory, and formal analysis, my work thus contributes to scholarship on German cinema, placing films of the Weimar era in constellation with developments in Central European intellectual history.


In Hungary, the growing area of potato area reduced dramatically in the last few decades, additionally we are lagging behind the Western European countries as regards yields and the competitiveness of production is further decreased by the great alternation in yields from year to year, the unpredictable market conditions, bad consumption habits and many times unfortunately the lack of quality products. The ecological and climatic conditions of Hungary are not everywhere suitable for potato, in the area of Debrecen the amount of rainfall was lower, and the monthly average temperature was higher than the requirement of potato in its growing season in 2002 and 2003. The experiment was carried out at the experimental site of the University of Debrecen, Farm and Regional Research Institute, at Latokep. In our experiment we examined the yield and some quality parameters of 8 and 9 medium-early varieties in large parcels in 2002 and 2003 respectively. Out of the examined varieties 3 are of Dutch, and 6 are of Hungarian breeding. The experiment was set up on 49.5 m parcels on calcareous chernozem soil after winter wheat as a forecrop in both years. The 9 varieties were examined in 4 repetitions in randomized blocks, out of which two repetitions were irrigated, and two were nonirrigated. We examined the yields of the varieties, the distribution of tubers according to size and their percentages, and the changes in specific parameters of quality and inner content due to irrigation. We studied the dry matter content, the starch content, the underwater mass, the amount of reducing sugars, the colour index of frying and the element contents of tubers. Summing up, it can be stated that among the agrotechnical year effect, variety and irrigation factors have considerable impact on potato yield quality and quantity. On the basis of our results, it can be stated that in potato production variety should be chosen in accordance with the aim of production and technology should be adapted to that specific variety.


BACKGROUND
Dramatic advances in ventricular assist device (VAD) design and patient management have made mechanical circulatory support an attractive therapeutic option for the growing pool of elderly heart failure patients.

METHODS
A literature review of all relevant studies was performed. No time or language restrictions were imposed, and references of the selected studies were checked for additional relevant citations.

RESULTS
In concordance with the universal trend in mechanical circulatory support, continuous flow devices appear to have particular benefits in the elderly. In addition, the literature suggests that early intervention before the development of cardiogenic shock, important in all patients, is particularly paramount in older patients.

CONCLUSIONS
The ongoing refinement of patient selection, surgical technique, and post-operative care will continue to improve surgical outcomes, and absolute age may become a less pivotal criterion for mechanical circulatory support. However, clear guidelines for the use of mechanical circulatory support in the elderly remain undefined.


Background: Reproductive health is a crucial feature of healthy human development and of general health. It may be a reflection of a healthy childhood, is crucial during adolescence, and sets the stage for health in adulthood and beyond the reproductive years for both men and women. Awareness of reproductive health among young boys and girls affects their health status, fertility and sets stage for health beyond reproductive years and affects the health of the next generation.Objectives: The objective of this study was to assess the awareness regarding reproductive health among young adults at a Higher Secondary school.Methodology: A descriptive cross-sectional study was conducted in one of the government higher secondary schools located at Karyabinayak municipality Lalitpur, Nepal. A total of one hundred and thirty eight students were selected purposively for the study. Data was collected through self administered questionnaire and data analysis was done by using Statistical Package for Social Sciences (SPSS) version 20.Results: Among 138 respondents, majority of the respondents (66.7%) had given the correct response regarding reproductive health. 76.8% knew that family planning is one of the components of reproductive health and 55.1% were aware of the legal age for marriage. Overall median percentage knowledge was 51.92 with range 17-78. Statistically significant association was found between level of knowledge and religion as well as respondents' mother's occupation (P< 0.05).Conclusion: On the basis of the findings of this study, it can be concluded that a majority of respondents were satisfactorily aware about reproductive health in superficial way, but in general, they had poor to average level of awareness regarding reproductive health.


It is shown theoretically that by the use of two radio-frequency fields of the same resonance frequency but with the different phases and directions the degeneracy of the energy spectrum of a spin system with I = 3/2 is removed. This leads to four non-degenerate spin states which can be used as a platform for quantum computing. The feasibility of quantum computing based on a pure (without DC magnetic fields) nuclear quadrupole resonance technique is investigated in detail. Various quantum logic gates can be constructed by using different excitation techniques allowing different manipulations with the spin system states. Three realizations of quantum logic gates are considered: the application of an additional magnetic field with the resonance frequency, the amplitude modulation of one of the applied RF fields by the resonance frequency field, and the level-crossing method. It is shown that the probabilities of the resonance transitions depend on the method of excitation and on the direction of the excitation field. Feasibility of quantum computing is demonstrated with the examples of constructing a controlled-NOT logic gate using the resonance excitation technique and SWAP and NOT2 logic gates using the level-crossing method.


In order to be effective an information system must be compatible with the structure and dynamics of the organizational functions it supports and with the adaptability of the organization. An important aspect of the structure of organizations is their control structure, that is, the way in which their control functions relate to each other and to the organizational functions they control. The potential impact of the information system on the adaptability of the organization is particularly important since it affects the ability of the organization to cope with the uncertainty of its environment. This paper addresses the need for an information system to be compatible with the structure and dynamics of the organization it supports and with its adaptability. Because of the effect that the control structure of an organization has on its adaptability, modeling organizations as distributed control structures is particularly useful in our case.


This article examines the commitment mechanisms which guided sovereign borrowing during the Napoleonic Wars by analyzing Sweden's default on its external debt in 1812. The default was driven by internal political bargaining concerning the division of resources, and the availability of subsidies provided by the major European powers. Thus, the Swedish government and the Diet made strategic choices when deciding which debts to pay. The reputational mechanisms and the creditors' attempts to force the Swedish state to honor its commitments did not work when the government had access to foreign subsidies.


Raman scattering from impurity so-d pair modes is reported in RbMnF3-Co near 263 cm-1. An Ising Hamiltonian leads to a — 4.3 cm-1 JMn-Co value and allows to calculate the frequencies of impurity modes. The calculated frequency of the s0 mode is in agreement with a value obtained by scaling the s0 mode measured in Co doped KMnF3 by neutron scattering. Selection rules are studied with and without an applied magnetic field for different samples orientations. Resulting from the low anisotropy it is shown both theoretically and experimentally that the selection rules have to be expressed with reference to the Oh paramagnetic cubic symmetry rather than the D4h(C4h) rigorous magnetic symmetry around the impurity : the s0-d mode then belongs to the Ɖ+3 representation in Oh. The selection rules are the same as in RbMnF3-Ni.


Ratchet writing is a method of writing information into certain nondestructive-readout (NDRO) magnetic memory elements. Writing is accomplished by reversing (or "ratcheting") the flux about one hole of the element with a word-oriented wire while simultaneously applying information-determined bit current to another hole called the storage hole. The effect of ratcheting is a threshold reduction for switching about the storage hole. It is established that ratchet writing is possible because some of the flux switched by the ratchet current closes by returning around the storage hole rather than through the "common volume" between the two holes. The detailed switching properties of a simple thin-wall core are computed and compared with experiment. The results are in excellent agreement within the limitations of the approximations made. It is found that there is a region where the bit-current threshold declines linearly with unit slope as ratchet current is increased. In this region there is a direct transfer of flux from the ratcheted hole to the storage hole, the common volume remaining an open circuit.


We present new U/Pb (monazite, zircon) and 40 Ar/ 39 Ar (biotite, amphibole) ages for 10 Tertiary plutons and dikes that intrude the Chugach–Prince William accretionary complex of southern Alaska. The Sanak pluton of Sanak Island yielded ages of 61.1±0.5 Ma (zircon) and 62.7±0.35 (biotite). The Shumagin pluton of Big Koniuji Island yielded a U/Pb zircon age of 61.1±0.3 Ma. Two biotite ages from the Kodiak batholith of Kodiak Island are nearly identical at 58.3±0.2 and 57.3±2.5 Ma. Amphibole from a dike at Malina Bay, Afognak Island, is 59.3±2.2 Ma; amphibole from a dike in Seldovia Bay, Kenai Peninsula, is 57.0±0.2 Ma. The Nuka pluton, Kenai Peninsula, yielded ages of 56.0±0.5 Ma (monazite) and 54.2±0.1 (biotite). Biotite plateau ages are reported for the Aialik (52.2±0.9 Ma), Tustumena (53.2±1.1 Ma), Chernof (54.2±1.1 Ma), and Hive Island (53.4±0.4 Ma) plutons of the Kenai Peninsula. Together, these new results confirm, but refine, the previously documented along-strike diachronous age trend of near-trench magmatism during the early Tertiary. We suggest that this event began at 61 Ma at Sanak Island, 2-4 m.y. later than previously supposed. An intermediate dike near Tutka Bay, Kenai Peninsula, yielded a hornblende age of 115±2 Ma. This represents a near-trench magmatic event that had heretofore gone unrecognized on the Kenai Peninsula; correlative Early Cretaceous near-trench plutons are known from the western Chugach Mountains near Palmer.


OBJECTIVE: To gain insight into the physical activity level of a sample of the Dutch population, to identify groups with an increased prevalence of physical inactivity and to investigate if increased moderate activity is associated with a more favourable cardiovascular risk profile and a higher self-rated health. DESIGN: Descriptive. METHOD: In 1993-1997 a monitoring project on risk factors and health has been carried out in a random sample of inhabitants of Doetinchem, Amsterdam and Maastricht. Using a questionnaire, information was obtained from the participants about physical activity, demographic characteristics, smoking behaviour and self-rated health. Also, height, weight and blood pressure were measured and a blood sample was taken. In this sample, the serum concentrations of total and high density lipoproteins were determined. This article concerns the activity in 1997 and the trend in activity in the period 1994-1997. In 1997, 4,029 persons, aged 20-64 years, took part. RESULTS: In 1997 46% (n = 1864) of the study population were, on average, active in moderate activities for less than half an hour per day, and 21% (n = 831) for less than half an hour per week ('inactives'). Inactivity was most common in subjects aged 50-59 years (28%), subjects with a low educational level (38%), widowed subjects (34%) and unemployed (36%) or disabled (42%) subjects. Since 1994, the proportion of inactive subjects increased among individuals with a low level of education. Regular physical activity, whether moderate or strenuous, was associated with a more favourable risk profile and a better self-rated health. CONCLUSION: Almost half of the persons examined were little active, which was associated with a less favourable cardiovascular risk profile and a less good self-rated health.


PURPOSE: This study assessed the long-term quality of life (QOL) of patients with aggressive lymphoma subtypes treated with autologous hematopoietic cell transplant (autoHCT) compared with those without history of transplant. METHODS: Patient-reported QOL measures were prospectively gathered from patients enrolled in the Iowa/Mayo Specialized Program of Research Excellence Molecular Epidemiology Resource cohort with aggressive lymphoma subtypes. QOL was measured using the Functional Assessment of Cancer Therapy-General (FACT-G), Functional Assessment of Chronic Illness Therapy–Fatigue Scale, State-Trait Anxiety Inventory (STAI), and Profile of Mood States instruments and with a numeric rating scale for overall QOL and spiritual QOL. The autoHCT group and no HCT groups were compared at 3 years (FU3) and 6 years (FU6) after lymphoma diagnosis. RESULTS: In total, 980 patients with lymphoma (106 autoHCT and 874 no HCT) diagnosed between 2002 and 2013 were included for analysis. The mean FACT-G total score was similar in the autoHCT and no HCT groups at FU3 (89.9 v 90.1, P = .64) and also at FU6 (91.5 v 89.6, P = .44). No differences between the autoHCT and no HCT groups were identified in the FACT subscales. The STAI identified lower anxiety in the autoHCT group by mean STAI1 (state) at FU3 (30.1 v 33.4, P < .01) and by mean STAI2 (trait) at FU6 (30.1 v 33.5, P = .02). No other clinically meaningful differences were identified between the two groups using the other QOL instruments. CONCLUSION: Patients remaining in remission at 3 and 6 years after diagnosis had a high level of QOL with no significant differences associated with history of treatment with autoHCT. No long-term quality-of-life difference for patients with lymphoma treated with or without transplant


Background: Mental health illnesses are major issues in Kano State, Nigeria. Therefore it is important for families to have the knowledge of mental healthcare illnesses, unfortunately, families lack knowledge of mental health education and that create negative beliefs and attitude about mental illness and that limit the optimal benefit of management to the patient. Objective: This cross-sectional study was conducted to evaluate relatives' knowledge, beliefs and attitude on mental illness and place of treatment in Kano State. Methods: This survey was conducted during the period of 5th June to 30th September 2016, where adult relatives (aged >20 years) of mentally ill patients receiving treatment for the period of 2 – 5 years in Dawanau Mental Health Hospital in Kano were invited for the study. Data was collected through face to face interview and focus group discussion method using semi -structured questionnaire guide and analyzed descriptively. All analysis was performed using Statistical Package for Social Sciences (SPSS) software (version 21). Results: In all, 266 participated in the study, of which 216 (81.2%) were males. Almost three quarter of respondents their ages were <40 years and about 188 (70.7%) were residing in the city of Kano. 112 (42.1%) were university graduates. 132 (49.6%) of the subjects thought that evil spirit was the major cause of mental illness, followed by personal weakness 126 (47.4%). While majority of the respondents 196 (73.7%) preferred home treatment. Those who believed in spiritual treatment for mental illnesses were 192 (72.2%); of this number, 99 (51.6%) believed in Quran, and 88 (45.8%) on both Quran and herbs. In fact, majority 194 (72.9%) of the participants believed that medicines can treat the mental illness. Conclusions: The study showed that negative beliefs about the causes and signs of mental illnesses were rampant. Negative attitudes were also noticed among the respondents. There is a need for health education awareness and interventions in communities for a better knowledge of mental illness and good beliefs and attitude.


Structural changes induced by the binding of agonists, antagonists and inverse agonists to the cloned delta-opioid receptor from human brain immobilized in a solid-supported lipid bilayer were monitored using plasmon-waveguide resonance (PWR) spectroscopy. Agonist (e.g. deltorphin II) binding causes an increase in membrane thickness because of receptor elongation, a mass density increase due to an influx of lipid molecules into the bilayer, and an increase in refractive index anisotropy due to transmembrane helix and fatty acyl chain ordering. In contrast, antagonist (e.g. TIPPpsi) binding produces no measurable change in either membrane thickness or mass density, and a significantly larger increase in refractive index anisotropy, the latter thought to be due to a greater extent of helix and acyl chain ordering within the membrane interior. These results are closely similar to those reported earlier for another agonist (DPDPE) and antagonist (naltrindol) [Salamon et al. (2000) Biophys. J.79, 2463-2474]. In addition, we now find that an inverse agonist (TMT-Tic) produces membrane thickness, mass density and refractive index anisotropy increases which are similar to, but considerably smaller than, those generated by agonists. Thus, a third conformational state is produced by this ligand, different from those formed by agonists and antagonists. These results shed new light on the mechanisms of ligand-induced G-protein-coupled receptor functioning. The potential utilization of this new biophysical method to examine structural changes both parallel and perpendicular to the membrane normal for GPCRs is emphasized.


Invasive aspergillosis is an important cause of morbidity and mortality in immunocompromised patients. Diagnosis of this infection frequently employs detection of the circulating galactomannan in the patient serum using enzyme immunoassay (EIA), a highly sensitive and specific system. Although there are many structural studies of the galactomannan of Aspergillus fumigatus, some inconsistencies are present in these results. In this study, to clarify the relationship between the growth conditions and structure of the galactomannans, we cultured A. fumigatus using two distinct yeast/fungal cultivation media, i.e. the yeast extract-peptone-dextrose (YPD) medium and yeast nitrogen base (YNB) medium. Galactomannans prepared from the resulting culture supernatants were structurally characterized by (1)H and (13)C nuclear magnetic resonance, methylation analysis, acetolysis and α-mannosidase degradation. These assays revealed that the galactomannan from the YPD cultivation had short β-1,5-linked galactofuranose (Galf) oligosaccharide chains in both the O- and N-linked carbohydrate moieties, while the galactomannan from the YNB cultivation incorporated long Galf oligosaccharide chains. The galactomannans derived from the two culture conditions significantly differed in reactivity based on the EIA diagnostic system. We also demonstrated the presence of a novel Galf-containing branched oligosaccharide in the O-linked moiety.


Metabarcoding, the coupling of DNA-based species identification and highthroughput sequencing, offers enormous promise for arthropod biodiversity studies but factors such as cost, speed and ease-of-use of bioinformatic pipelines, crucial for makingtheleaptfromdemonstrationstudiestoareal-worldapplication,havenotyet been adequately addressed. Here, four published and one newly designed primer sets were tested across a diverse set of 80 arthropod species, representing 11 orders, to establish optimal protocols for Illumina-based metabarcoding of tropical Malaise trap samples. Two primer sets which showed the highest amplification success with individual specimen polymerase chain reaction (PCR, 98%) were used for bulk PCR and Illumina MiSeq sequencing. The sequencing outputs were subjected to both manual and simple metagenomics quality control and filtering pipelines. We obtained acceptable detection rates after bulk PCR and high-throughput sequencing (80–90% of input species) but analyses were complicated by putative heteroplasmic sequences and contamination. The manual pipeline produced similar or better outputs to the simple metagenomics pipeline (1.4 compared with 0.5 expected:unexpected Operational Taxonomic Units). Our study suggests that metabarcoding is slowly becoming as cheap, fast and easy as conventional DNA barcoding, and that Malaise trap metabarcoding may soon fulfill its potential, providing a thermometer for biodiversity.


Poverty, and not medical and lifestyle factors, is the leading cause of cardiovascular disease in Canada, delegates attending a recent international conference were told, and recent political decisions that have exacerbated income and wealth differentials have only made the situation worse.

Dennis Raphael of York University told participants from 54 countries who attended the Conference of the International Society for Equity in Health (www.iseqh.org) in Toronto that Statistics Canada data indicate that Canada will face not only the added costs of treating these health problems but also more than 6000 premature deaths a year.

Other speakers pointed out that Canada still has better health indicators than the US despite spending far less per capita on health care. Claudia Sanmartin of Statistics Canada reviewed Canadian and US data and found a strong relationship between income inequality and mortality in US metropolitan areas. No such relationship was found in Canada, probably because of transfer payments to poor individuals and families. However, she did find that a relationship between unemployment and mortality exists in Canada.

Many speakers, especially those from developing countries, focused on the need to address health inequalities between rich and poor nations. Ron Labonte of the University of Saskatchewan and David Sanders of the University of the Western Cape, South Africa, presented a report card on G8 health and development commitments. They concluded that although some commitments have been met, they have done little to overcome the harmful effects of International Monetary Fund structural adjustment policies that require debtor countries to reduce public expenditures on health, education and social services. They said the highly touted New Partnership for Africa's Development is unlikely to mitigate health inequalities, either between or within countries.

Despite the prominence of the word "equity" in the conference title, many if not most of the presentations dealt with "(in)equalities." Presenters often used the 2 words interchangeably, despite the occasional admonition that they are significantly different. As one speaker pointed out, equality is a descriptive term, while equity is a normative/ethical term. In other words, not all health inequalities are inequitable. — John R. Williams, Director of Ethics, CMA


Various document types play an influential role in a lot of our lives activities today; hence preserving their integrity is an important matter. Such documents have various forms, including texts, videos, sounds, and images.  The latter types' authentication will be our concern here in this paper. Images can be handled spatially by doing the proper modification directly on their pixel values or spectrally through conducting some adjustments to some of the addressed coefficients. Due to spectral (frequency) domain flexibility in handling data, the domain coefficients are utilized for the watermark embedding purpose. The integer wavelet transform (IWT), which is a wavelet transform based on the lifting scheme, is adopted in this paper in order to provide a direct way for converting image pixels' integer values to integer coefficient values rather than floating point coefficients that could be produced by the traditional wavelet transform. This direct relation can enhance the processed image quality due to avoiding the rounding operations on the floating point coefficients. The well-known parity bit approach is also utilized in this paper as an authentication mechanism, where 3 secret parity bits are used for each block in an image which is divided into non-overlapped blocks in order to enforce a form of fragile watermark approach. Thus, any alteration in the block pixels could cause the adopted (even) parity to be violated. The fragile watermarking is achieved through the modification of least significant bits ((LSBs) of certain frequency coefficients' according to the even parity condition. In spite of this image watermarking operation, the proposed method is efficient. In order to prove the efficiency of our proposed method, it was tested against standard images using measurements like peak signal to noise ratio (PSNR) and structural similarity index (SSIM).  Experiments showed promising results; the method preserves high image quality (PSNR≈ 44.4367dB, SSIM≈ 0.9956) and good tamper detection capability.


Language transfer refers to the language that learners apply to the knowledge of one language to the language that they are learning. According to Bransford (2000), "all new learning involves transfer based on previous learning." Language transfer includes positive and negative transfer. Positive transfer means the previous knowledge that the language learner obtains from the first language----phonetics, grammar, expressions, and so forth to help the learner learn the new language, while negative transfer means the previous knowledge interferes with the learner's ability to learn the new language. In the United States, the number of Cantonese speakers who choose to study Mandarin has grown increasingly. While a number of past studies have focused on the language transfer of the phonetics system of the two languages, few studies have paid attention to the semantics system. Cantonese and Mandarin belong to Sino-Tibetan languages family and shared similar characters and grammars, however, the meanings of words with similar characters are comparatively different. Generally speaking, Cantonese speakers encounter more difficulties when learning Mandarin because of this difference of semantics system. The present study focuses on the language transfer of the semantics system from Cantonese language to Mandarin Chinese (Putonghua). By adopting Contrastive Analysis Hypothesis method, the current study (1) analyzed the difference of the meaning of the vocabulary (973 words) from the book, "Great Wall Chinese textbooks"; (2) identified the positive and negative language transfer via comparing the meaning of the words in Cantonese and Mandarin; and (3) explored the strategies that Cantonese-speaking leaner and L2 Mandarin Chinese teachers can use in Mandarin teaching and learning.


The thesis is an outline of a theory on the "culinarization of the self", which is linked with a theoretical framework, shaping the subject in an everyday experience by power dynamics related to discourse and ideology. Practises such as eating and cooking are flavoured by an exposed Western discourse in popular media. Where a multitude of culinary cultures are presented, by a somewhat equal group of actors, being men/women and to some extent from other cultures. The aim of the study is to critically reread food talks, culinary texts visualised in popular media. Culinary texts that contain and reproduce specific power technologies, which sustain boundaries between male and female, the West and the Rest, will be deconstructed. In order to highlight the complexity of this scheme, central concepts that are presented and applied are: Gender, "Race", and Class -Habitus - Distinction. The empirical material is of use in highlight the diversity of that discourse. Where ideological, marginalizing, features take the form of images and meaning related to commodity fetishism. Concluding the culinary discourse is flavoured by multiple sets of subtexts that reinforces power divisions between subjects in society, and is used as a tool for that distinction. The thesis contains a development of central concepts such as "body-space" in relation to a different spatial belonging, and double distinction as an appropriation of knowledge of the "Other". Central concepts: Discourse, Ideology, Hegemony, West and Rest, Commodity fetishism, Gender - Space - Domination, "Race", Class - Habitus - Distinction, Food - Culinary Culture.


General human rights instruments guarantee the right to a fair trial before independent and impartial court. International and national legislation explicitly provides that the court should be impartial. But how can we understand that the court is impartial? Should there be an objective decision or should there be impartial decision-making process? Nowadays we often think about how it is possible to ensure judicial impartiality. How an impartial court may exist in democratic society, and whether a society should have any criteria of judicial impartiality to ensure that the public trusts the courts and judges. The aim of the court's decision is not only to achieve an equitable settlement of the case, but the decision shall be understandable for the society, and the decision shall be made in way that the society can say that the court is impartial. Through the court decision the court obtains the public confidence to the whole legal system and to the idea of the judicial state. Impartial court is the base of an independent and democratic society. Namely, an impartial court is the fundamental of people basic rights, which also makes important that the casa law has the most important public role, and the court decision shall be comprehended and accepted by the society. Undoubtedly, political and economic changes affect the right, but the basic values of society remain. Even in ancient Egypt and in ancient Greece the judicial impartiality was the foundation of the fair trial. But that time concept meaning of 'judicial impartiality' has changed and is not equal to the modern understanding. That is happening due to the continuing changes in the society. Thus, it would have to say that the judge impartiality as a precondition for justice is derived from the values of society. Over the time public vision of how the judicial objectivity is attainable is changing, public perception of a fair decision and reasoning also is changing, but it does not affect the concept of 'judicial impartiality'. The concept of judicial impartiality has been changing within the changes in the society and it reveals in each of the societies life period. Today in the democratic European counties with the term 'judicial impartiality' we understand the court's ability to treat the parties equally (rather than judicial behavior must always be equal); the court's ability to make a ruling in such way that if a particular case will be ruled by another judge the ruling would be similar and with the same result. Today in all national legislation we are implementing the court's duty to be impartial because the public demands for judicial impartiality increases. DOI: http://dx.doi.org/10.5755/j01.eis.0.5.1081


Lake Urmia in northwestern Iran is the largest lake in Iran and the second largest saltwater lake in the world. The water level in Lake Urmia has decreased dramatically in recent years, due to drought, climate change, and the overuse of water resources for irrigation. This shrinking of the lake may affect local climate conditions, assuming that the lake itself affects the local climate. In this study, we quantified the lake's impact on the local climate by analyzing hourly time series of data on climate variables (temperature, vapor pressure, relative humidity, evaporation, and dewpoint temperature for all seasons, and local lake/land breezes in summer) for the period 1961–2016. For this, we compared high quality, long-term climate data obtained from Urmia and Saqez meteorological stations, located 30 km and 185 km from the lake center, respectively. We then investigated the effect of lake level decrease on the climate variables by dividing the data into periods 1961–1995 (normal lake level) and 1996–2016 (low lake level). The results showed that at Urmia station (close to the lake), climate parameters displayed fewer fluctuations and were evidently affected by Lake Urmia compared with those at Saqez station. The effects of the lake on the local climate increased with increasing temperature, with the most significant impact in summer and the least in winter. The results also indicated that, despite decreasing lake level, local climate conditions are still influenced by Lake Urmia, but to a lesser extent.


Background: Individuals with Parkinson's disease (PD) develop a significant disease burden over time that contributes to a progressive decline in health-related quality of life. There is a paucity of qualitative research to understand symptoms and impacts in individuals with early-stage PD (i.e., Hoehn and Yahr stage 1–2 and ≤2 years since diagnosis). Objective: The collection of qualitative data to inform the selection of clinical outcome assessments for clinical trials is advocated by regulators. This patient-centered, multistage study sought to create a conceptual model of symptoms and their impact for individuals with early-stage PD. Methods: Symptoms and impacts of PD were gathered from a literature review of qualitative research, a quantitative social media listening analysis, and qualitative patient concept elicitation interviews (n = 35). Clinical experts provided input to validate and finalize the concepts. Results: The final conceptual model consisted of 27 symptoms categorized into 'motor' or 'non-motor' domains, and 39 impacts divided into five domains. Most frequently reported symptoms in early-stage PD were 'tremors' (89%), 'stiffness and rigidity', and 'fatigue' (69%, both). Most frequently reported impacts included 'anxiety' (74%), 'eating and drinking' (71%), followed by 'exercise/sport' and 'relationship with family/family life' (66%, both). Conclusion: This study provides initial insights relating to the symptom and impact burden of early-stage PD patients. The conceptual model can be used to help researchers to develop and select optimal patient-centered outcomes to measure treatment benefit in clinical trials. These findings could inform future qualitative research and the development of outcomes specifically for early-stage PD patients.


Business networks are systems of business cooperation integrating several firms that have at the same time cooperation and competition relationships, what makes them a relevant phenomenon for Competition Law. This paper analyses whether some agreements between network members may infringe Art. 101.1 TFEU, taking as an example one of the most important features of business networks - the information exchanges inside them. To this aim, it delimits the different kinds information exchanges taking place in horizontal or vertical networks, identifies the most relevant cases for Competition Law, and proposes an adequate assessment methodology that takes into account the existence and features of the network. The paper therefore concludes that competition law rules cannot be automatically applied when the cooperating companies belong to a business network, and that an accurate competitive analysis in these cases has to consider also the existence, aims, interests, and organizational and functional needs of the network


From applicability to implementation in psycho-social areas, the interest upon the negotiation research domain has increased over the past years considerably. The propose of this present study is to demonstrate that sandbagging – self-presentation strategy that implies a false prediction of demonstrating ones incapacity (Gibson & Sachau, 2000) – is used by individuals frequently in distributive rather than in integrative negotiation processes, as a persuasion technique. It is known that this self–presentation strategy was studied in competitive situations but as a moderator variable in the cognitive process of responding to the pressure of being choose the favorite one (Gibson, Sachau, Doll, & Shumate, 2002). Also, viewed through a theoretical point of view, which underlines evident differences between men's' and women's' negotiation styles, as cooperative and assertive individual patterns for solving a conflict (Ruble & Thomas, 1976; Thomas, 1976), the second objective of this study is to demonstrate and synthesize the idea that in a situation that involves applicability of the specific technique through sandbagging – even if we talk about the distributive or integrative form of the negotiation process – there will be differences at an inter-individual level.


The issue of the relationship between our cogitative abilities, in particular the ability of thinking about something that does not exist, and modal characteristics, in particular those featuring unactualized (im)possibilities, i.e., the ways the world might (not) have been, has always been very intricate. In analytic philosophy, reflection on this matter has started by reviving an optimistic thesis traditionally ascribed to Hume, according to which conceivability entails possibility: if something is conceivable, then it is also possible. As Wittgenstein clearly suggests in the incipit of the Tractatus logico-philosophicus, where he says that that there is no room for conceptions of something impossible:


Adhesive attachment systems consisting of multiple tapes or strands are commonly found in nature, for example in spider web anchorages or in mussel byssal threads, and their structure has been found to be ingeniously architected in order to optimize mechanical properties: in particular, to maximize dissipated energy before full detachment. These properties emerge from the complex interplay between mechanical and geometric parameters, including tape stiffness, adhesive energy, attached and detached lengths and peeling angles, which determine the occurrence of three main mechanisms: elastic deformation, interface delamination and tape fracture. In this paper, we introduce a formalism to evaluate the mechanical performance of multiple tape attachments in different parameter ranges, where an optimal (not maximal) adhesion energy emerges. We also introduce a numerical model to simulate the multiple peeling behaviour of complex structures, illustrating its predictions in the case of the staple-pin architecture. Finally, we present a proof-of-principle experiment to illustrate the predicted behaviour. We expect the presented formalism and the numerical model to provide important tools for the design of bioinspired adhesive systems with tuneable or optimized detachment properties.


Crimean-Congo hemorrhagic fever (CCHF) is a disease prevalent among humans and animals and is endemic in Iran. Although CCHF has been reported in all of its neighboring provinces, in Mazandaran in northern Iran there have been no reports of any cases of human infection. This research has been carried out to clarify the epidemiological aspects of CCHF infection among sheep in various geographical regions of Mazandaran province. In this survey, 270 blood samples were collected from sheep in eastern, central, and western Mazandaran between 2010 and 2011, and the specific ELISA test for CCHF virus was carried out on the blood samples in the National Reference Laboratory in the Pasteur Institute, Tehran, Iran. The CCHF infection rate according to this study was 3.7%. A weak statistical relationship (p=0.063) was seen between the different geographical regions, with a gradual decrease in the infection rate noted, stretching from the eastern to the western portions of the province (eastern 6.8%, central 2.8%, and western 0%). Older sheep were 2.7 times more likely to be infected with the virus (OR 2.70; 95% CI 1.50,4.87; p<0.001). As the infection rate in Mazandaran is low among sheep, and as yet there have been no reports of human infection in this province, CCHF disease is not considered a serious health problem in Mazandaran. It is recommended that further research be carried out on other animals, high-risk human groups, and ticks, in order to more completely reveal the status of the disease in this province.


This paper deals with a practical approach for planning WLAN hotspots to be underlaid within an existing 3G network. Given the number of access points (APs) and access routers (ARs), their locations, call handling capacities of ARs as well as serving GPRS Support Nodes (SGSNs), intra-WLAN handoff costs, and 3G/WLAN inter-system handoff costs, an important consideration for a mobile telecom service provider (MTSP) is to identify: (a) the APs to be connected to the corresponding ARs, and (b) the ARs to be connected to the corresponding SGSNs in a cost effective manner. In this work, while planning a WLAN roll-out for an MTSP, we present an integrated approach based on the minimization of total system cost. Using a heuristic strategy, the planning attempts to determine simultaneously an optimal partitioning of APs with respect to the given set of ARs in each hotspot and also the assignment of ARs to SGSNs over the complete service area. Our study shows that acceptable results are achievable with a reasonable computational effort, which supports the engineered planning of a tightly coupled WLAN/3G integration.


Supplemental Digital Content is available in the text. Objectives: Fluid overload is associated with worse outcomes in adult and pediatric acute respiratory distress syndrome. However, the time-course of fluid overload and its relationship to outcome has not been described. We aimed to determine the relationship between the timing of fluid overload and outcomes over the first 7 days after acute respiratory distress syndrome onset in children. Design: Retrospective cohort study. Setting: Single tertiary care PICU. Patients: Intubated children with acute respiratory distress syndrome between 2011 and 2019. Interventions: None. Measurements and Main Results: Daily and cumulative total fluid intake, total output, urine output, and fluid balance were collected for each 24-hour period from days 1 to 7 after acute respiratory distress syndrome onset. We tested the association between daily cumulative fluid metrics with PICU mortality and probability of extubation by 28 days using multivariable logistic and competing risk regression, respectively. In a subset of children, plasma was collected on day 1 and day 3 of acute respiratory distress syndrome and angiopoietin-2 quantified. Of 723 children with acute respiratory distress syndrome, 132 died (18%). In unadjusted analysis, nonsurvivors had higher cumulative fluid balance starting on day 3. In multivariable analysis, a positive cumulative fluid balance on days 5 through 7 was associated with increased mortality. Higher cumulative fluid balance on days 4 to 7 was associated with lower probability of extubation. Elevated angiopoietin-2 on day 1 predicted early (within 3 d) fluid overload greater than or equal to 10%, and elevated angiopoietin-2 on day 3 predicted late (between days 4 and 7) fluid overload. Conclusions: Fluid overload after day 4 of acute respiratory distress syndrome, but not before, was associated with worse outcomes. Higher angiopoietin-2 predicted subsequent fluid overload. Our results suggest that future interventions aimed at managing fluid overload may have differential efficacy depending on when in the time-course of acute respiratory distress syndrome they are initiated.


This note investigates the multiplicity problem of principal curvatures of equifocal hypersurfaces in simply connected rank 1 symmetric spaces. Using Clifford representation theory, and the author also constructs infinitely many equifocal hypersurfaces in the symmetric spaces.


Background: When to allow an athlete to return to unrestricted sporting activity after anterior cruciate ligament (ACL) reconstruction remains controversial. Purpose: To report the results of functional performance testing reported in the literature for individuals at differing time points following ACL reconstruction and to examine differences between graft types. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of Medline, Scopus, and Cochrane Central Register of Controlled Trials was performed using PRISMA guidelines. Inclusion criteria were English-language studies that examined any functional rehabilitation test from 6 months to 2 years following ACL reconstruction. All patient-, limb-, and knee-specific demographics were extracted from included investigations. All functional rehabilitation tests were analyzed and compared when applicable. Results: The search term returned a total of 890 potential studies, with 88 meeting inclusion and exclusion criteria. A total of 4927 patients were included, of which 66% were male. The mean patient age was 26.5 ± 3.4 years. The predominant graft choices for reconstruction were bone–patellar tendon–bone (BPTB) autograft (59.8%) and hamstring autograft (37.9%). The most commonly reported functional tests were the hop tests. The results of these functional tests, as reported in the Limb Symmetry Index (LSI), improved with increasing time, with nearly all results greater than 90% at 1 year following primary ACL reconstruction. At 6 months postoperatively, a number of isokinetic strength measurements failed to reach 80% LSI, most commonly isokinetic knee extension testing in both BPTB and hamstring autograft groups. The knee flexion strength deficit was significantly less in the BPTB autograft group as compared with those having hamstring autograft at 1 year postoperatively, while no significant differences were found in isokinetic extension strength between the 2 groups. Conclusion: Hop testing was the most commonly reported functional test following ACL reconstruction. Increases in performance on functional tests were predictably seen as time increased following surgery. Those with hamstring autografts may experience increased strength deficits with knee flexion versus those having BPTB autograft. These data provide information that may assist providers in determining timing of return to unrestricted sporting activity.


This study was aimed to investigate the oxidative responses and genetic stability of date palm Phoenix dactylifera L. under different irrigation water salinity, date palm off shoots cv. Barhi subjected to different concentrations of NaCl (100, 200, 300 and 400 µM) for 180 days. The obtained results showed that, the date palm responses to salinity stress, this responses was increased of H 2 O 2 level, Peroxidase activity and Malondialdehyde MDA concentration with increase NaCl concentration, while opposite trend with membrane stability index, which H 2 O 2 was increased from(0.73 µM/g) in control to (2.20 µM/g) in 400 µM treatment, MDA was increased from (2.35 nmole/g) in control to (nmole/g) in 400 µM treatment, also peroxidase activity was reached to (39.59 U/min/g) in 400 µM treatment, while was (20.73 U/min/g) in control and Membrane stability index reduction significantly from (81.36%) in control to (64.13%) in 400 µM treatment.  In terms of genetic stability of date palm under salinity stress, the ISSR markers analysis showed that, the high concentrations of NaCl (200, 300 and 400 µM) produced more polymorphic fragments comparison to control treatment, while the DNA profile was identical between control and 100 µMtreatment.Dendogram was generated using similarity indices of ISSR markers showed, the lowest genetic similarity was found between 400 µM NaCl concentration and control and 100 µM treatment, followed with both 200 and 300 µM treatments, which the control and 100 µM treatment was grouped in one cluster, also treatments with 200 and 300 µM grouped in one cluster, while the treatment with 400 µM NaCl separated in cluster. Keywords : ISSR, Genetic stability, Oxidative stress, Peroxidase, MDA, membrane peroxidation


Abstract Using an ensemble of close- and long-range remote sensing, lake bathymetry and regional meteorological data, we present a detailed assessment of the geometric changes of El Morado Glacier in the Central Andes of Chile and its adjacent proglacial lake between 1932 and 2019. Overall, the results revealed a period of marked glacier down wasting, with a mean geodetic glacier mass balance of −0.39 ± 0.15 m w.e.a−1 observed for the entire glacier between 1955 and 2015 with an area loss of 40% between 1955 and 2019. We estimate an ice elevation change of −1.00 ± 0.17 m a−1 for the glacier tongue between 1932 and 2019. The increase in the ice thinning rates and area loss during the last decade is coincident with the severe drought in this region (2010–present), which our minimal surface mass-balance model is able to reproduce. As a result of the glacier changes observed, the proglacial lake increased in area substantially between 1955 and 2019, with bathymetry data suggesting a water volume of 3.6 million m3 in 2017. This study highlights the need for further monitoring of glacierised areas in the Central Andes. Such efforts would facilitate a better understanding of the downstream impacts of glacier downwasting.


Repeated ( > or = two visits) emergency department (ED) visits by HIV-infected (HIV+) drug users in New York State (NYS) vary widely by region and may reflect regional inequities in receipt of needed drug treatment and medical services. The study's objective was to evaluate receipt of drug treatment and medical care by HIV+ drug users by region and its effect on ED use. For NYS Medicaid-enrolled HIV+ drug users (N = 11,556) in 1996 and 1997, we identified receipt of long-term (> or = six months) drug treatment, HIV care, and a usual source of medical care from claims files. Regions were classified as New York City, downstate suburban, upstate urban, and rural/small city. We examined adjusted associations of these services with > or = two ED visits in the entire cohort and separately among patients who do and do not receive these three types of services. Repeated ED visits were greatest in rural/small cities (40.7 percent) and least in New York City (24.1 percent; p < 0.001), and receipt of drug treatment was also poorest (p < 0.001) in rural/small cities, whereas receipt of HIV care and usual source of medical care varied less by region. Adjusted odds of > or = two ED visits was increased for patients in rural/small cities (1.89 [confidence interval, 1.44 to 2.50]) vs. New York City and reduced for patients with long-term drug treatment (0.76 [confidence interval 0.69 to 0.84]). Among persons receiving long-term drug treatment, observed regional differences in ED use largely disappeared. Regional variations in receipt of long-term drug treatment by HIV+ drug users in one state appear to contribute to large differences in ED utilization.


Cathode materials for a lithium-ion battery were prepared using an industrial microwave furnace. The prepared materials were investigated by X-ray diffraction (XRD), scanning electron microscopy (SEM), and electrochemical properties. Single-phase LiMn2O4 powders could be prepared in a few minutes using an industrial microwave furnace. The obtained results showed that this microwave heating method is a promising industrial technique for efficient preparation of cathode materials.


A guide to searching and using the MLA International Bibilography and the MLA Directory of Periodicals at Washington University in St. Louis


While resistance mutations are often implicated in the failure of cancer therapy, lack of response also occurs without such mutants. In bladder cancer mouse xenografts, repeated chemotherapy cycles have resulted in cancer stem cell (CSC) enrichment, and consequent loss of therapy response due to the reduced susceptibility of CSCs to drugs. A particular feedback loop present in the xenografts has been shown to promote CSC enrichment in this system. Yet, many other regulatory loops might also be operational and might promote CSC enrichment. Their identification is central to improving therapy response. Here, we perform a comprehensive mathematical analysis to define what types of regulatory feedback loops can and cannot contribute to CSC enrichment, providing guidance to the experimental identification of feedback molecules. We derive a formula that reveals whether or not the cell population experiences CSC enrichment over time, based on the properties of the feedback. We find that negative feedback on the CSC division rate or positive feedback on differentiated cell death rate can lead to CSC enrichment. Further, the feedback mediators that achieve CSC enrichment can be secreted by either CSCs or by more differentiated cells. The extent of enrichment is determined by the CSC death rate, the CSC self-renewal probability, and by feedback strength. Defining these general characteristics of feedback loops can guide the experimental screening for and identification of feedback mediators that can promote CSC enrichment in bladder cancer and potentially other tumors. This can help understand and overcome the phenomenon of CSC-based therapy resistance.


Introduction: Constipation is one of the most common complaints during pregnancy that significant percentage of pregnant women experience the onset or worsening of it during pregnancy. In this article, recommendations for constipation treatment during pregnancy were extracted from traditional medicine resources and conventional medicine databases and were compared. Methods: In this review and library study, the recommendations related to pregnancy constipation were extracted from important textbooks of traditional medicine. Then, Persian and English articles of databases including Google scholar, Pubmed, Scopus, SID, Iranmed and Magiran were searched using the keywords of pregnancy, constipation, and the combination of two words and their equivalents in Persian with no time limitation. The results which were found in first stage obtained from traditional medicine sources were compared with the results which were obtained from the articles. Results: In Iranian traditional medicine, it is believed that constipation treatment and using of laxative if needed during pregnancy can reduce many of the pregnancy complications. Recommendations related to pregnancy constipation in Iranian traditional medicine textbooks included: nutritional recommendations such as eating fatty soups, medicinal recommendations such as Cassia fistula and Rosa damascene, non-nutritional recommendations such as mild walking and enema, and contraindications and cautions such as avoidance of spicy, bitter and astringent foods. In conventional medicine similar to traditional medicine, first-line treatment for pregnancy constipation is diet and lifestyle change, and medication use is prohibited as much as possible. Conclusion: The general approach for treatment of pregnancy constipation in traditional medicine resources is similar to conventional medicine, but the details of recommendations in traditional medicine resources didn�t have desirable level of evidences. Also, importance of constipation treatment during pregnancy is emphasized in traditional medicine resources that is worthy to do more studies in this field.


How can we use our understanding of the process of listening to help our students to become better listeners? How can we be sure that the listening tasks we use are worthwhile? In Teaching Second Language Listening, Tony Lynch uses listening lesson transcripts and sample listening activities to set out the principles of successful listening teaching. He ties this in with an up-to-date survey of listening research.


Abstract Stroke patients vary considerably in terms of outcomes: some patients present 'natural' recovery proportional to their initial impairment (fitters), while others do not (non-fitters). Thus, a key challenge in stroke rehabilitation is to identify individual recovery potential to make personalized decisions for neuro-rehabilitation, obviating the 'one-size-fits-all' approach. This goal requires (i) the prediction of individual courses of recovery in the acute stage; and (ii) an understanding of underlying neuronal network mechanisms. 'Natural' recovery is especially variable in severely impaired patients, underscoring the special clinical importance of prediction for this subgroup. Fractional anisotropy connectomes based on individual tractography of 92 patients were analysed 2 weeks after stroke (TA) and their changes to 3 months after stroke (TC − TA). Motor impairment was assessed using the Fugl-Meyer Upper Extremity (FMUE) scale. Support vector machine classifiers were trained to separate patients with natural recovery from patients without natural recovery based on their whole-brain structural connectomes and to define their respective underlying network patterns, focusing on severely impaired patients (FMUE < 20). Prediction accuracies were cross-validated internally, in one independent dataset and generalized in two independent datasets. The initial connectome 2 weeks after stroke was capable of segregating fitters from non-fitters, most importantly among severely impaired patients (TA: accuracy = 0.92, precision = 0.93). Secondary analyses studying recovery-relevant network characteristics based on the selected features revealed (i) relevant differences between networks contributing to recovery at 2 weeks and network changes over time (TC − TA); and (ii) network properties specific to severely impaired patients. Important features included the parietofrontal motor network including the intraparietal sulcus, premotor and primary motor cortices and beyond them also attentional, somatosensory or multimodal areas (e.g. the insula), strongly underscoring the importance of whole-brain connectome analyses for better predicting and understanding recovery from stroke. Computational approaches based on structural connectomes allowed the individual prediction of natural recovery 2 weeks after stroke onset, especially in the difficult to predict group of severely impaired patients, and identified the relevant underlying neuronal networks. This information will permit patients to be stratified into different recovery groups in clinical settings and will pave the way towards personalized precision neurorehabilitative treatment.


Sequential Recommender Systems (SRSs) are a popular type of recommender system that leverages user history to predict the next item of interest. However, the presence of noise in user interactions, stemming from account sharing, inconsistent preferences, or accidental clicks, can significantly impact the robustness and performance of SRSs, particularly when the entire item set to be predicted is noisy. This situation is more prevalent when only one item is used to train and evaluate the SRSs. To tackle this challenge, we propose a novel approach that addresses the issue of noise in SRSs. First, we propose a sequential multi-relevant future items training objective, leveraging a loss function aware of item relevance, thereby enhancing their robustness against noise in the training data. Additionally, to mitigate the impact of noise at evaluation time, we propose multi-relevant future items evaluation (MRFI-evaluation), aiming to improve overall performance. Our relevance-aware models obtain an improvement of 1.58% of NDCG@10 and 0.96% in terms of HR@10 in the traditional evaluation protocol, the one which utilizes one relevant future item. In the MRFI-evaluation protocol, using multiple future items, the improvement is 2.82% of NDCG@10 and 0.64% of HR@10 w.r.t the best baseline model.


Sexual violence is an essential part of the political economy of the self-proclaimed Islamic State. The terrorist group uses rape, sexual slavery, and other forms of sexual violence for recruitment; to terrorize communities into compliance and displace them from strategic areas; to torture and extract intelligence; to compel conversion and indoctrination through forced marriage; and to generate revenue through sex trafficking, slave trade, and ransoms. Sexual violence during armed conflict can violate the law of war and in some cases can amount to torture. Under the doctrine of command responsibility, leaders can be prosecuted for war crimes when they knew or should have known that their subordinates were committing such crimes and failed to take adequate steps to prevent the crimes or punish those responsible.

Holding the Islamic State accountable for sexual violence, particularly the systematic rape of women and girls from the Yazidi religious minority, would help disrupt the terrorist organization's authority and resources, but finding a court with jurisdiction over these crimes is a challenge. Iraq has not joined the International Criminal Court (ICC), the Islamic State is not a recognized state, and domestic courts face obstacles in addressing these complex transnational crimes. Despite the difficulties, the ICC offers the most promising venue to investigate and try these cases, secure justice and reparations for the victims, punish the perpetrators, and deter future crimes.

A version of this paper (under the same title) was published at on Just Security on August 11, 2017.


This is a conceptual paper to study the effect of organizational factors that have influence of costing system in the manufacturing companies of Libya. The study reviews literature on the organizational factors (organizational culture, organizational strategy and organizational structure and their influence on costing system. This research goes on to analyse three organizational factors that play role on influencing costing system. These factors are organizational culture, organizational strategy and organizational structure. Organizations have no choice but rebuilding and recovering the failure system due too many disadvantages. Such a process needs much more investment and using more resources. But this present study instead of focusing on the failure of the system, it will be more focused on the organizational factors. The factors outlined in this research will be analysed using the theoretical framework of contingency theory. This theory claims that to lead a company the course of action is contingent upon internal and external situations. The model is appropriate for this inquiry because it allows understanding the importance of organizational factors towards costing system in the manufacturing companies of Libya. It also describes the role of top management providing an effective system that leads to increase profitability of the company. (Ogbonna & Harris, 2000) suggested that organizational culture is associated with organizational performance. (Frey & Gordon, 1999) provided additional explanation by examining the contextual factors like competitive strategy and organizational culture that influence the adoption of costing system. Thus from the previous authors investigation on the organizational factors this study is employed to provide a theoretical construct that influence the costing system. By using appropriate organizational strategy the costing system can be much improved. The main contribution of this research is the investigation of the effect of uncertain organizational influence on costing system. The finding of the study would provide the importance of costing system associated with the performance of the Libya's manufacturing business unit. Both qualitative and quantitative research method will be applied to get an appropriate view of the managers towards the choice of costing system in their company. Qualitative method will investigate in deep on the main aspects of their costing system being used and the behavior of the top management towards decision making. Finally, the study suggests avenues for further research. Keywords: Costing System, Organizational Factors, Business Performance


Older adults often struggle to recall events from a specific time and specific place when presented with a cue word (Piolino et al., 2010). When they are able to successfully retrieve an event, they tend to recall fewer specific details, focusing instead on contextual and factual information (Levine, Svoboda, Hay, Winocur, & Moscovitch, 2002). These age differences are not relegated to the retrieval scenario alone; at encoding older adults also show differences in the way they segment ongoing information into discrete events (Zacks, Speer, Vettel, & Jacoby, 2006). The present work investigated age differences in the retrieval and definition of events from memory. First we delineated the age differences in neural activity during autobiographical recall. Second, we established how age alters event definitions during retrieval. Finally, we explored whether a more global change in event understanding could account for age differences in event memory. Our results highlight key differences in brain activity during autobiographical memory retrieval in the prefrontal cortex and anterior cingulate, and in the functional connectivity between these regions and the hippocampus. Further, our results demonstrate age differences in event definitions during perception and retrieval. We conclude by highlighting how these findings relate to the processes of memory retrieval and event segmentation.


In this paper, we propose a new super resolution technique based on the interpolation followed by registering them using iterative back projection (IBP). Low resolution images are being interpolated and then the interpolated images are being registered in order to generate a sharper high resolution image. The proposed technique has been tested on Lena, Elaine, Pepper, and Baboon. The quantitative peak signal-to-noise ratio (PSNR) and structural similarity index (SSIM) results as well as the visual results show the superiority of the proposed technique over the conventional and state-of-art image super resolution techniques. For Lena's image, the PSNR is 6.52 dB higher than the bicubic interpolation.


To evaluate the genetic diversity of Brazilian populations and contribute to the knowledge of their evolutionary history this study investigated three TP53 polymorphisms (BstUI and MspI RFLPs in exon 4 and intron 6, respectively, and a 16 bp duplication in intron 3). The populations studied were: 114 Amerindians from five Brazilian Indian tribes (Gavião, Surui, Zoró, Wai-Wai and Xavante), 95 Euro-Brazilians and 70 Afro-Brazilians. The polymorphisms were all analysed using PCR amplifications. Gene frequencies and haplotype prevalences were calculated using the ARLEQUIN software. The genetic affinities of these groups with other world populations were estimated by the D(A) distance and neighbour joining method, using the NJBAFD computer program. Neo-Brazilians (immigrants from Europe and Africa) generally presented more variability than Amerindians, Afro-Brazilians being the most variable population. Among Amerindians, Gavião is the only group polymorphic for the three markers. Wai-Wai showed variability in BstUI and MspI RFLPs, while the other tribes were monomorphic for the 16 bp A1 and MspI A2 alleles. A rare haplotype (1-2-1) was verified among the Wai-Wai. This haplotype was previously described in a Chinese sample only, but with low frequency. Therefore, either this combination was lost in the other tribes by genetic drift, recombination, or other factor, or it occurs in the Wai-Wai and Chinese by independent events. The Gavião also presented a haplotype (2-1-1) not observed in the other Amerindians; but since it is present in Euro- and Afro-Brazilians. its occurrence there is probably due to interethnic admixture. The relationships of several world populations obtained using TP53 indicates that this marker is very efficient in clustering populations of the same ethnic group.


Waldorf Schools (best known to U.S. math teachers through work of Hermann von Baravalle[l]) have continuing class-teachers who grow with their students from 1st to 8th grade, teaching almost everything (except foreign languages) in 1st and undergoing voluntary gradual diminishment from authority figures to friends by 8th grade (with ever more subjects left to specialty teachers). This is intended both to let ideas grow in natural progressions from year to year, with purposeful continuity, and to help ensure that behavioral problems (on part of both students and teachers) are dealt with and not merely passed on, thus helping to keep instruction lively (and life in~tructive). But subject-specialized high school teachers (9-12) in such schools face the same difficulty that most teachers have at all levels in other schools: how to maintain freshness when teaching basically the same things (the same "material"), year in year out, for many years? One solution I found was to embrace the vagaries of scheduling and make it a challenge to teach things in different ways at different times of year, befitting the changing seasons. An autumn math class on the Pythagorean theorem might apply it to optimizing bird flight paths over warm land and cold water, while the same class in winter might start with crystal forms and then derive proofs of that theorem from tilings. What follows are some things that have occurred to me as possible treatments of classical topics that would tie in either with hand-work lessons or the experiences of students who had been learning, say, about Celtic crosses in 9th grade art history, undergoing the usual year-long Euclidean geometry course in lOb, or being given a survey of astronomy in 11th. The last topic I have also developed further for master's-level courses in advanced Euclidean and non-Euclidean geometry, as part of secondary school teacher preparation at university.


After 50 years as an enigma, the text inscribed around the shoulder of the famous Calatagan Pot, the country's oldest cultural artifact with pre-Hispanic writing, has been deciphered. It seems to have been written in the old Bisayan language. This paper presents a review of the inscription puzzle, past and recent attempts at cracking the code, as well as the author's breakthrough in deciphering the symbols, determining its language and meaning, and inferring the possible use of the pot. It now appears that the Calatagan artifact was a ritual pot particularly used as native incense burner for the pag-uli (return) rite to retrieve the soul of a moribund person during the pre-Hispanic era. The inscription essentially provides the outline of a three-stage monologue, presumably elaborated by a babaylan (native priestess) in a trance during the pag-uli ritual. The pot was probably also used for ceremonies to retrieve victims of bugkut , disappeared persons believed to have been abducted by dwellers of the spirit world. The paper provides a glossary of 26 Bisayan words that could be derived from the Calatagan Pot inscription.


Strontium is one of the most common substituents in apatite crystals. The presence and behavior of Sr in apatite-group phases are of considerable significance in biology. The present paper investigates the substitution of strontium for calcium in a glass-ceramic of the following composition 4.5SiO23Al2O31.5P2O54CaO1CaF2. The glasses were characterized using Differential Thermal Analysis (DTA), X-ray powder diffraction (XRD), neutron diffraction (ND) and 19F Resonance Magic Angle Spinning Nuclear Magnetic Resonance (MAS-NMR). The all calcium glass crystallized to calcium fluorapatite (Ca5(PO4)3F). Substituting strontium partially for calcium resulted in the formation of a mixed strontium/calcium fluorapatites. In contrast complete substitution resulted in the formation of strontium fluorapatite. MAS-NMR showed the the F to be present as F-Ca(3) representing a fluoride ion surrounded by three Ca2+ ions in the all calcium glass and was present as F-Sr(3) in the all strontium glass. In the mixed glasses fluorine was present as FCa( 3), F-Ca(2)Sr, F-CaSr(2) and F-Sr(3). Ca had a higher tendency to occupy the F-M(3) sites than Sr which may reflect the higher charge to size ratio of Ca2+ relative to Sr2+ and its greater affinity for F- ions.


This essay looks at two recent Italian books about the evolution of the Italian Communist Party (PCI). Drawing on archival materials, the books trace the conflict between the radicals and the reformers within the PCI's ranks, a conflict that gave way to violent splinter groups that regarded the PCI as too staid and conciliatory. As the far left took a violent turn in Italy in the late 1960s, it paved the way for the spasm of grisly far-left and far-right terrorism in Italy in the 1970s and early 1980s. The books lend weight to the view that the PCI, through its exaltation of Communist revolution and its demonization of the Christian Democratic establishment, facilitated the emergence of extremist groups that perpetrated more than 8,400 terrorist attacks in the latter half of the 1970s.


Computational screening techniques have been found to be an effective alternative to the trial and error of experimentation for discovery of new materials. With increased interest in development of advanced electrical energy storage systems, it is essential to find new electrolytes that function effectively. This Perspective reviews various methods for screening electrolytes and then describes a hierarchical computational scheme to screen multiple properties of advanced electrical energy storage electrolytes using high-throughput quantum chemical calculations. The approach effectively down-selects a large pool of candidates based on successive property evaluation. As an example, results of screening are presented for redox potentials, solvation energies, and structural changes of ∼1400 organic molecules for nonaqueous redox flow batteries. Importantly, on the basis of high-throughput screening, in silico design of suitable candidate molecules for synthesis and electrochemical testing can be achieved. We anticipate that the computational approach described in this Perspective coupled with experimentation will have a significant role to play in the discovery of materials for future energy needs.


This paper adopts a narrative perspective on the study of mid-life experiences in sport. Different types of stories about sporting mid-life are identified and discussed. Drawing upon the concept of narrative mapping, the potential of these stories to serve as narrative maps for those approaching mid-life is considered. Data from an interview study with 26 participants aged between 35 and 55 years of age, from badminton, distance running, outdoor activities and health clubs is provided. Paradigmatic and structural analyses were conducted on the data in order to identify story types and predominant narrative themes. The findings revealed a master narrative for mid-life in sport, which is that 'age is a state of mind'. In addition two further narratives were apparent. One, 'life begins at forty' was a counter-narrative, which depicted mid-life as a time of rejuvenation and an opportunity to revisit the experiences of youth. The other was an antithesis narrative, which focused upon acceptance of the ageing process and the notion of 'growing old gracefully'. Sportsmen and women linked their own stories to these idealised narrative types, but via a process of narrative slippage, created their own personal narratives of sporting mid-life. Analysis of these personal narratives indicated that there are three different maps for an individual negotiating sporting mid-life.


Nowadays, the power system utility has started to consider the green power technology in order for the world to have a healthier environment. The wind energy and solar energy system are chosen in designing a hybrid renewable power system as they do not release any emission to the atmosphere. In addition, by maximizing the use of the renewable energy, the diesel generator used in the system could also be reduced. Therefore, this paper will discuss on the optimization of the renewable energy hybrid system based on the sizing and operational strategy of generating system. The optimization software used in this analysis is the Hybrid Optimization Model for Electric Renewable (HOMER). The sensitivity analysis is also performed to obtain the optimal configuration of hybrid renewable energy based on different combinations of generating system.


Comparisons have revealed large discrepancies among the many methods for measuring soil CO2 efflux indicating the need for an absolute calibration of methods. This study presents a calibration system, constructed to imitate an area of soil, and its application to two different chamber systems for the measurement Of Soil CO2 efflux: one open and one closed dynamic. Air rich in CO2 was allowed to diffuse through a layer of sand on top of a box of known volume. By measuring the decrease in CO2 Concentration inside the box, the exact CO2 efflux could be calculated. The CO2 efflux rates measured by the chambers could then be compared with the efflux rates calculated from the box. The error of the closed-chamber system ranged from an underestimate of 19% to an overestimate of 21%. The errors were most likely caused by a combination of underestimated chamber volume, causing an underestimation Of CO2 efflux, and turbulence within the chamber, which increased the flax by disturbing the boundary layer above the surface. The open-chamber system always overestimated the CO2 efflux. Disturbing the boundary layer alone was believed to cause a 17% increase in efflux. Increasing negative pressure difference caused a mass flow of CO2-rich air into the chamber. At a pressure difference of -0.15 Pa, the error was 11 to 40%, depending on air-filled soil volume. Accordingly, soil-water content, a parameter to which soil CO2 efflux is often related, was found to substantially affect the measurements made by both tested systems. These results point to the need of calibrating systems used for measuring soil CO2 efflux is measured against a known flux, to elucidate the limits and applicability of each system. (Less)


OBJECTIVE
To determine if rates of sinus disease are increased in patients with rheumatoid arthritis (RA) and whether RA treatment alters the risk of sinus disease.

METHODS
As part of a longitudinal study of rheumatic disease outcomes, 7,243 patients with RA, 1,667 with osteoarthritis (OA), and 447 with fibromyalgia (FM) were evaluated for important sinus problems in 2003. We defined an important sinus problem as one that required a physician visit.

RESULTS
The lifetime prevalence of sinus disorders among all patients was 42.9%. During the previous 6 months 22.3% of patients with RA, 23.9% with OA, and 25.1% with FM visited a physician for a sinus problem and 22.4%, 23.9%, and 25.1% , respectively, received a prescription medication for a sinus problem. After adjustment for age and sex, the rate of physician visits for a sinus problem was significantly lower for patients with RA (22.1%) compared to patients with OA (24.8%). The strongest predictor of sinus problems among all patients was a history of allergy or asthma. Sinus problems were more common among users of etanercept: odds ratio (OR) 1.2; 95% confidence interval (CI): 1.0-1.4 univariably, and OR 1.2; 95% CI: 1.0-1.4 multivariably. Sulfasalazine (OR 0.7; 95% CI: 0.5-0.9) and leflunomide (OR 0.8; 95% CI: 0.7-1.0) had a protective effect on sinus problems.

CONCLUSIONS
Sinus problems are decreased in patients with RA compared to OA and FM. Slight protective effects on sinus problems are noted with sulfasalazine and leflunomide, and a slight increase in risk of sinus problems is noted with etanercept.


In the Netherlands, there is a free choice of product for the treatment of haemophilia. Which product is chosen depends on the following considerations: medical, psychological, availability of clotting products, economics and government guidelines. Since the introduction of recombinant product in 1995, the percentage of Dutch patients treated with it has increased from 8% in 1995 to 20% in 1998. In 1999, an average of 48% of patients visiting the Van Creveldkliniek were treated with recombinant product. Children are more often treated with recombinant product than adults; 93% of children between 0 and 5 years, 53% of children between 6 and 20 years and 40% of adults are treated with recombinant product.


The nuances of the application of schoolwide positive behavior supports (PBS) in an urban high school setting were investigated. Impact of implementation was measured using qualitative interviews and observations, including the School-wide Evaluation Tool (SET), Effective Behavior Support Survey, Student Climate Survey, and office disciplinary referrals. The results indicated that schoolwide PBS was implemented in an urban high school setting with some success. The overall level of implementation of PBS reached 80% as measured by the SET. Staff and teachers increased their level of perceived priority for implementing PBS in their school. A decrease in monthly discipline referrals to the office and the proportion of students who required secondary and tertiary supports was noted. These findings seem to indicate that PBS may be an important process for improving outcomes for teachers and students in urban high school settings.


GOALS
(1). To describe what aspects are important when next-of-kin evaluate advanced palliative home care (APHC) and (2). to compare the expressed aspects and describe eventual differences among the three settings, which differed in terms of length of services, geographic location, and population size.

SUBJECTS AND METHODS
Four to 7 months after the patient's death (87% from cancer), 217 consecutive next-of-kin from three different settings in Sweden responded (response rate 86%) to three open-ended questions via a postal questionnaire. Qualitative content analysis was performed.

MAIN RESULTS
Service aspects and comfort emerged as main categories. The staff's competence, attitude and communication, accessibility, and spectrum of services were valued service aspects. Comfort, such as feeling secure, was another important aspect and it concerned the next-of-kin themselves, the patients, and the families. Additionally, comfort was related to interactional issues such as being in the center and sharing caring with the staff. The actual place of care (i.e., being at home) added to the perceived comfort. Of the respondents, 87% described positive aspects of APHC and 28% negative aspects. No major differences were found among the different settings.

CONCLUSIONS
Next-of-kin incorporate service aspects and aspects relating to the patient's and family's comfort when evaluating APHC. The importance of these aspects is discussed in relation to the content of palliative care and potential goals.


Background. Wound dressings are designed to keep the wound clean and free from contamination and also to promote wound healing, particularly in chronic wounds where there may be significant tissue loss. Objectives. This review evaluates the evidence for effectiveness and cost-effectiveness of dressings and topical preparations in pressure sores, leg ulcers and surgical wounds healing by secondary intention. Methods. Nineteen electronic databases, including MEDLINE, EMBASE, CINAHL and the Cochrane Wounds Group's specialised trials register and wound care journals were searched until October 1997. Organisations, manufacturers, researchers and healthcare professionals concerned with wound care were contacted for additional trials. The reference sections of obtained studies were also searched for further trials. Inclusion criteria: Randomised controlled trials (RCTs), published or unpublished, which assessed the effectiveness of a dressing or topical agent in the treatment of pressure sores, leg ulcers, sinuses and surgical wounds healing by secondary intention were included in the review. Where a particular dressing was not evaluated by an RCT, prospective controlled trials were included. Studies were only included if they reported either the proportion of wounds healed within a time period or the percentage or absolute change in wound area. Data extraction and synthesis: Trial data were extracted by one researcher and checked by a second. The results from each study were calculated as odds ratios and/or effect sizes and where appropriate, similar studies have been pooled in a meta-analysis. Results. Surgical wounds healing by secondary intention: Only five studies met the inclusion criteria. All the studies were of poor quality and had small sample size. One study found a statistical benefit for wet-to-dry dressings compared with topical applications of aloe vera. However, neither of these products is commonly used in the UK. Pressure sores: Twenty-eight trials evaluated 31 comparisons of treatments for the healing of pressure sores. The majority of trials were of poor quality. A single report suggested that the topical application of insulin was of significant benefit for wound healing when compared with standard nursing care. A meta-analysis of five reports comparing a hydrocolloid dressing with a traditional treatment suggested that treatment with the hydrocolloid resulted in a statistically significant improvement in the rate of pressure sore healing. Leg ulcers: Sixty studies were included that had evaluated dressings or topical agents in arterial and venous ulcers. Both mononuclear cultured cells in culture medium and topical ketanserin significantly increased healing rates compared with a control preparation in one trial of arterial leg ulcers. Collagen sponges appeared to be effective in two trials of leg ulcers but there were insufficient data to determine the significance of these results. Nine trials compared hydrocolloids with traditional dressings for venous ulcers but meta-analysis demonstrated no significant difference in the proportion of ulcers healed over the trial period. Two trials compared semi-permeable films with traditional dressings; one found a larger reduction in wound area under the film dressing but the other found no significant difference in healing rates. Two trials compared foam dressings and traditional or control therapies; one favoured the foam dressing but the other found no difference between treatments. Woven zinc oxide paste bandage was more effective than either an alginate dressing or a zinc oxide-impregnated stockinette in one trial. In two trials comparing different hydrocolloids, no significant difference in healing rates was found. Comparisons of hydrocolloids with foam dressings found no difference in effectiveness. In trials of topical agents, allopurinol and dimethyl sulfoxide improved healing in one trial compared with inert powder. Of two trials comparing hyaluronic acid with control, one found a difference in daily healing rate and the other found no difference in proportion of ulcers healed over the trial period. Four trials compared biological dressings with traditional therapies. None found statistically significant differences in results. Two trials compared dressings with topical preparations. There was no difference in the proportion of ulcers healed between patients treated with cryopreserved cultured allografts or a hydrocolloid, though the former-treated ulcers had a higher rate of epithelialisation. A collagen dressing was more effective than treatment with daily antiseptic. A comparison of buffered acidifying ointment and ointment reported there was no difference in the proportion of ulcers healed, but there was a higher rate of epithelialisation with the buffered ointment group. In another, trial there were higher healing rates when two amino acid solutions were compared with two groups treated in saline soaks. Publication bias: A funnel plot of all trials showed no evidence of publication bias. However, publication bias was indicated in a comparison of traditional and hydrocolloid dressings. Cost-effectiveness analysis: Nine trials provided data on costs of dressing materials and nursing visits. Six evaluated cost- effectiveness in pressure sore treatments and three papers reported cost- effectiveness data in leg ulcer trials. Conclusions. Implication for practice: There is little evidence to indicate which dressings or topical agents are the most effective in the treatment of chronic wounds. However, there is evidence that hydrocolloid dressings are better than wet-to-dry dressings for the treatment of pressure sores. In the treatment of venous ulcers, low adherent dressings are as effective as hydrocolloid dressings beneath compression bandaging. Recommendations for research: Research methodology could be significantly improved and commissioning groups may wish to consider the following aspects for future research. The number of patients in a trial should be based on an a priori sample size calculation. A truly objective outcome measure should be used or wound healing should be expressed as both percentage and absolute change in area. For each patient a single reference wound should be selected. Experimental groups should be comparable at baseline. Head-to-head comparisons of contemporary dressings are required and should use agents that are recommended for wounds of a similar nature. A complete and thorough description of concurrent treatments, including secondary dressings, should be given in trial reports. Assessment of outcomes should ideally be blind to treatment, or completely objective. Survival rate analysis should be adopted for all studies that assess wound healing. Studies to determine the biological mechanisms involved in wound healing are needed. Future trials should include cost-effectiveness and quality of life assessments, as well as objective measures of dressing performance. Economic evaluations should be incorporated within trials that are sufficiently large to detect appropriate economic and clinical outcomes. To prevent publication bias and ensure the inclusion of unpublished trials in systematic reviews, those involved in primary research should make their data available to those undertaking systematic reviews.


Bone morbidity remains a major problem even after successful renal transplantation. We investigated the role of calcium‐sensing receptor (CaSR) polymorphisms and 25‐hydroxyvitamin D levels on the persistence of secondary hyperparathyroidism (SHPT) and their relationships with vertebral fractures (VFx) in 125 renal allograft recipients transplanted 44 ± 23 months before. All patients underwent evaluation of the main biochemical parameters of calcium metabolism as well as vertebral and femoral bone density. In 87 patients, CaSR polymorphisms (A986S, R990G, and Q1011E) also were assessed. X‐ray images of the lateral spine were obtained in 102 subjects to perform vertebral morphometry. High parathyroid hormone (PTH) and 25‐hydroxyvitamin D lower than 80 nmol/L were found in 54% and 97% of patients, respectively, with 40% of these showing vitamin D levels lower than 30 nmol/L. VFx were detected in 57% of the subjects. After multiple adjustments, 25‐hydroxyvitamin D, age, and hemodialysis duration, but not CaSR polymorphisms, were found to be significant predictors of high PTH, whereas age and time since transplant were positively related with lower 25‐hydroxyvitamin D values. PTH and time since transplant were significantly associated with VFx. Patients with two or more VFx showed serum PTH levels 50% higher than patients without fractures. We therefore conclude that persistent SHPT is a very common feature after renal transplantation and that, unlike CaSR polymorphisms, low 25‐hydroxyvitamin D is involved in its pathogenesis. High PTH levels, in turn, are associated with an increased VFx risk, which confirms the need for strategies aimed at lowering serum PTH in this setting as well. © 2010 American Society for Bone and Mineral Research.