This study investigated product introductions, marketing and distribution patterns among specialty food retailers in the eastern U. S. Based on 547 responses to a mailed survey, the results portray specialty food retailers as an extremely diverse group ranging from those who carry small specialty food sections within standard grocery or department stores to those who exclusively sell specialty foods. Respondents reported that new introductions account for about 22% of their total specialty food sales and that on average, they introduce about 23 products in a typical year. When evaluating new products, their most important considerations are quality followed by uniqueness.


As he explained in his suicide note, abbé Jean-Baptiste Rousseau could not marry and would not seduce the young woman he loved, so he shot himself on 18 May 1784. Witnesses deposed by the police claimed that he was not in his right mind and therefore not legally responsible for his actions, but the authors of contemporary reports about the case accepted his lucid account of his dilemma. Nouvellistes and journalists provided multiple versions of his note and multiple judgments of his motives, options, and actions. This analysis of the sources from 1784 and the following years shows how they reworked the story of Rousseau's life and death against the background of larger issues. Changes in jurisprudence during the last decades of the ancien régime culminated in the decriminalization of suicide and other religious, moral, and sexual crimes in 1791. Debates about the causes and meanings of self-destruction continued, but in the press rather than the courts.


Pranajiwa (Euchresta horsfieldii (Lesch.) Benn) is a medicinal plant, which is growing wild and it is regarded as a rare plant. Currently, its existence in the wild increasingly threatened. Pengelengan Hill is one of the natural habitats of E. horsfieldii in Bali. Study of autecology aims to describe the ecology of E. horsfieldii in their natural habitat. E. horsfieldii was found abundant in plots II with 16.02% relative density, 9.68% of relative frequency and 25.69 of Important Value, grow clumped together with other plants (Idk 2.72).


Abstract Disentangling the drivers of diversity gradients can be challenging. The Measurement of Biodiversity (MoB) framework decomposes scale‐dependent changes in species diversity into three components of community structure: species abundance distribution (SAD), total community abundance, and within‐species spatial aggregation. Here we extend MoB from categorical treatment comparisons to quantify variation along continuous geographic or environmental gradients. Our approach requires sites along a gradient, each consisting of georeferenced plots of abundance‐based species composition data. We demonstrate our method using a case study of ants sampled along an elevational gradient of 28 sites in a mixed deciduous forest of the Great Smoky Mountains National Park, USA. MoB analysis revealed that decreases in ant species richness along the elevational gradient were associated with decreasing evenness and total number of species, which counteracted the modest increase in richness associated with decreasing spatial aggregation along the gradient. Total community abundance had a negligible effect on richness at all but the finest spatial grains, SAD effects increased in importance with sampling effort, and the aggregation effect had the strongest effect at coarser spatial grains. These results do not support the more‐individuals hypothesis, but they are consistent with a hypothesis of stronger environmental filtering at coarser spatial grains. Our extension of MoB has the potential to elucidate how components of community structure contribute to changes in diversity along environmental gradients and should be useful for a variety of assemblage‐level data collected along gradients.


A smoothing procedure, used as a filter and an observer is proposed. Given a linear dynamical process modeled by its input-output equation, where the output is supposed to be corrupted by a zeromean noise, we develop the numerical algorithm to smooth the real measured output and compute the reliable estimates of its derivatives by solving a constrained optimization problem. First we form an equivalent discrete norm to the L/sub 2/-norm of the input-output equation and consider that the solution of the smoothing problem is a spline function which minimizes the formed criterion subject to a linear inequality. Using the definition of the algebraic observability, the system states are then estimated. Satisfactory results of such a procedure is proved by numerical simulations.


In the last decades, many Western countries have undergone economy-wide reforms generally aimed to reduce the role of the State in the economy, by limiting public ownership of land and infrastructures. Privatization programs concerning States' immovables have taken many forms, and have often been coupled with the alleged benefits of the securitization of immovable property-related assets. In many cases, however, these programs have been carried out with no or little awareness of the variety of instruments that the law of security rights makes available to the privatizing State. The comparative survey conducted in this paper provides an overview of the ways in which Western legal rules and technical devices of security rights law may come to the aid of reforming (Western) States to ensure the fullest realization of public and private interests.


OBJECTIVES
To assess longitudinal patterns of community health center (CHC) utilization and the effect of insurance discontinuity after Oregon's 2008 Medicaid expansion (the Oregon Experiment).

METHODS
We conducted a retrospective cohort study with electronic health records and Medicaid data. We divided individuals who gained Medicaid in the Oregon Experiment into those who maintained (n = 788) or lost (n = 944) insurance coverage. We compared these groups with continuously insured (n = 921) and continuously uninsured (n = 5416) reference groups for community health center utilization rates over a 36-month period.

RESULTS
Both newly insured groups increased utilization in the first 6 months. After 6 months, use among those who maintained coverage stabilized at a level consistent with the continuously insured, whereas it returned to baseline for those who lost coverage.

CONCLUSIONS
Individuals who maintained coverage through Oregon's Medicaid expansion increased long-term utilization of CHCs, whereas those with unstable coverage did not.

POLICY IMPLICATIONS
This study predicts long-term increase in CHC utilization following Affordable Care Act Medicaid expansion and emphasizes the need for policies that support insurance retention.


In order to explain why successes of economic sanctions predominantly occur in the first two years of a sanction episode, we analyse the dynamic economic and political impact of an economic sanction. Our theoretical analysis of the dynamics of adjustment gives us two important results: firstly, the strongest impact in terms of utility forgone occurs in the initial phase of the sanction episode and, secondly, the long-term gain of compliance decreases during a sanction episode and is lower in the long run than acknowledged by the usual comparative static analysis. On both accounts we expect that sanctions have a higher probability of success in the early phase and a lower probability of success in the long run. Next we build a comprehensive set of vector autoregressive (VAR) models that we apply to the case of a boycott of Iranian oil. An important innovation is that we include both economic and political factors in a VAR model of economic sanctions. Our VAR models find significant impacts of economic sanctions both on key economic variables (government consumption, imports, investment, income) and on two indicators of the political system (the Polity variable that describes shifts in the autocracy–democracy dimension and the Vanhanen Index of Democratization that describes political competition and participation). The impact of an oil boycott on the Iranian economy is considerable: oil and gas rents are important drivers of the Iranian key macroeconomic variables and ultimately of its political system. A reduction of oil and gas rents creates economic costs that act as incentives to move towards a more democratic setting. However, this effect is only significant in the first two years and turns negative after six to seven years, as adjustment of economic structures mitigates the economic and political impact of the sanctions.


Much has been done to quantify exposure to poor outdoor air quality. However, the conclusions drawn from these quantitative assessments have a methodological myopia: the research assumes that outdoor air quality is an accurate indicator of personal exposure. Yet, on average, people spend more than 90% of their time indoors, where levels can be significantly more polluted than outdoors. The combination of both the length of time spent inside, and the potential for higher concentrations means that personal exposure is greater indoors rather than outdoors. To address this public health knowledge gap, National Air Quality Testing Services (NAQTS) has developed an integrated indoor air quality monitor, the NAQTS V2000 to help raise awareness of indoor air quality and provide scientific data for informed public policy. The NAQTS V2000 incorporates the latest developments in low-cost sensor technologies, alongside a regulatory grade Condensation Particle Counter (CPC), thermal desorption tubes (TD), and other environmental measurements. To address "real-world" patterns of exposure and improve public health, we need a better understanding of the air quality in our indoor environments. The NAQTS V2000 unit is a portable air quality monitoring station designed to be easy-to-use for high-volume, low-cost measurements, facilitating a holistic understanding of indoor air pollution. The NAQTS V2000 measures Particle Number (CPC - d50 15nm), Particle Mass (laser-based), CO2 (NDIR), CO, NO2, and VOCs (electrochemical and metal oxide) and is also fitted with Temperature, Pressure and Relative Humidity measurements. External GPS and Noise measurements are available through USB ports on the back of the equipment. The novel integration of TD tubes for GC-MS into a real-time air pollution monitoring device allows low-cost sensors to be used as triggers for VOC speciation, adding another layer to potential analyses. This presentation will introduce the community to this new technology, and will include data insights from more than four years of development and testing, including results from a range of different indoor environments, including: Homes - Investigating the sources, concentrations, and mitigation strategies for aerosols both generated from household habits and activities, as well as from outdoor ingress. This work also investigates the dichotomy between promoting good indoor air quality & energy efficiency, as modern buildings are considered particularly problematic because of the use of more energy-efficient construction, poorly designed heating, ventilation and air conditioning, and space design. Vehicles - Despite the relatively short period of time spent in vehicles (approximately one hour per day), exposure levels are of concern given the immediate proximity to other vehicles, plus in urban areas, high ambient concentrations compared to other micro-environments. NAQTS has collaborated with Emissions Analytics Ltd to benchmark vehicles on their vehicle interior air quality, which utilises the NAQTS V2000 for simultaneous measurements of inside-outside vehicles to understand Ingress Ratio (how much ambient pollution is getting into the vehicle cabin) and Stuffiness (how well the vehicle is ventilating CO2). Schools - A socioeconomic group of particular importance are children, as they are especially susceptible to air pollution. More than just exhibiting negative health consequences, exposure to air pollution has also been associated with poor academic performance among school- aged children. The NAQTS V2000 has been used for "citizen science" activities to measure inside the classroom during school drop off/pick up times. As our concept of the health effects of exposure to air pollution aerosols moves from emission source, to air quality, to personal exposure, we must further explore our dynamic patterns of exposure in space and time, which makes our exposures in indoor environments. To address "real-world" patterns of exposure and improve public health, we need a better understanding of the air quality in our indoor environments.


In this study, the effect of some ingredients such as skimmed milk powder, whey, sodium caseinate, calcium caseinate, whey protein concentrate (35, 60 kg/100 kg dry solids), whole milk powder, condensed milk and transglutaminase (TGase) on the properties of set-style yogurt was investigated. These protein and dry matter sources (2%) and TGase (1 U/g milk protein) were added into pasteurized milk and incubated prior to fermentation for 2 h at 40°C. After fermentation, enzyme action was stopped by heating for 1 min at 80°C. The control groups were conducted with addition of these materials into milk without TGase. All of the milk samples were inoculated with yogurt cultures at 45°C, until the pH was dropped to 4.4. Syneresis, gel-strength, acetaldehyde amounts, and the degree of TGase reaction were determined. As a result, yogurt products made from enzyme-treated milk showed increased gel strength and less syneresis. SDS-PAGE results showed that the enzyme TGase produced crosslink formation between different protein fractions of milk. In addition, it was also determined that TGase application caused a decrease in acetaldehyde amounts.


The Mahakam Delta in East Kalimantan contains large number of natural resources specially hydrocarbon
sources. Anthropogenic activities have influenced this ecosystem for many years. The aims of this work were
to find out dissolved metal and metals in sediment distribution in this area and to find out contaminant level
based on allowable guidelines. Twenty nine stations were sampled within the delta and metal content
analyses, both in sediment and water column, were established for Cd, Cu, Ni, Pb and Zn. Sediment analyses
were conducted using US EPA 3050B method and dissolved metals analyses were conducted using Back
Extraction method. Cd, Cu, Ni, Pb and Zn in sediment had 0.07 mg/kg dw, 18.64 mg/kg dw, 35.62 mg/kg dw,
10.56 mg/kg dw and 74.95 mg/kg dw in maximum concentration respectively. Whereas dissolved Cd, Cu, Ni,
Pb and Zn had 0.001 mg/l; 0.003 mg/l; 0.003 mg/l; 0.013 mg/l and 0.003 mg/l in maximum concentration
respectively. Based on allowable guidelines, metals contaminat levels, both in sediment and water column,
were below permitted value.


Stratified photosynthetic microbial mats are described from the Salar de Llamara, a salt flat basin located in the Atacama desert of northern Chile. Microscopic and spectrophotometric techniques were used. The thickness of the photic zone of these communities spans 8 to 30 mm. This is probably due to the grain size and mineralogical composition of associated sediments. Three different types of mats were recognized. A first one was characterized by a green pigmented layer; a second with orange and green coloured layers, and the third with orange and green layers and an additional purple layer. At one sampling site, no pigmented layers were present. Sediments underlying the mats were white, but in one site, black coloured sediments were observed; this dark colour is probably the result of iron sulphide precipitation. Predominant microorganisms in the orange pigmented layers were diatoms and unicellular cyanobacteria, mainly from the Cyanothece and Synechococcus groups. Filamentous cyanobacteria Microleus sp. and Oscillatoria sp. were the most abundant in the green layer. When interstitial brines reached salinities between 12 and 33 %, no diatoms were observed, and the coccoidal cyanobacteria from the Synechococcus, Cyanothece and Gloeocapsa groups and genus Gloeobacter predominated over filamentous Cyanobacteria in the green layer. The purple layer was built primarily of anoxygenic phototrophic bacteria similar to cells of the genera Chromatium and Thiocapsa. Absorption spectra revealed that chlorophyll a is the most abundant pigment in most of analyzed samples. Integrated values of chlorophyll a and bacteriochlorophyll a reached values of up to 230 and 144 mg m -2 along all of the pigmented zone, respectively. Abundant non-photosynthetic microorganisms were found in the mats, including unidentified cocci and bacilli. Sulphate reducing bacteria were present in all the sampled mats.


Sphoeroides testudineus (Linnaeus, 1758), is a common, widely distributed fish in coastal ecosystems. To better understand the trophic niche of S. testudineus, we collected individuals from tidal creeks on Abaco Island, The Bahamas, and employed stomach content and stable isotope analysis. Examination of stomach contents showed that mollusks, such as West Indian false cerith snails, cerith snails, and tellin clams, were the most common prey items. Diet data were consistent with stable isotopes data such that S. testudineus seem to feed at an intermediate trophic position in the food web. These preliminary data suggest that S. testudineus may be a critical intermediate link in these wetland food webs, serving as pathways through which energy is transferred from primary consumers to other predator species.


Since the appearance of my "Notes on the Rubiaceae of Surinam" (in Rec. d. Trav. bot. neerl. XXXI, 1934, 248; also in Meded. Bot. Mus. Herb. Utrecht no. 11, 1934) a number of species and varieties new to the flora of that country have come to light. The majority have been collected by Mr. Rombouts during the 1935/36 expedition of the Boundary Commission who is surveying at present the border in the southern part of the colony; they were found along the River Corantyne and in the savannahs in the south-western part. One species was secured by Dr. Lanjouw, and has been mentioned already in his "Additions to Pulle's Flora of Surinam I" (in Rec. d. Trav. bot. Neerl. XXXII, 1935, 258) and one, represented by a rather poor fruiting specimen collected years ago by the Forestry Bureau, was found among material provisionally consigned to another family. New to the flora of Surinam are the following twelve species: Alseis longifolia Ducke var. pentamera Brem. n. var., Sabicea cinerea Aubl., S. Romboutsii Brem. n. spec., S. surinamensis Brem. n. spec., Tocoyena surinamensis Brem. n. spec., Thieleodoxa nitidula Brem. n. spec., Guettarda Spruceana Mull. Arg., Psychotria Romboutsii Brem. n. spec., Declieuxia fruticosa (Willd. ex R. et S.) Kuntze, Diodia pulchristipula Brem. n. spec., Spermacoce guianensis Brem. n. spec, and Borreria verticillata (L.) G. F. W. Mey (the B. verticillata of the Flora of Surinam IV, 287 proved to be B. suaveolens G. F. W. Mey., under which name it had been recorded already by Miquel), and one variety: Sipanea pratensis Aubl. var. glaberrima Brem. n. var. Four of the ten genera to which these species belong, namely Alseis, Thieleodoxa, Declieuxia and Spermacoce, are also new to the flora of Surinam. Seven species and two varieties are entirely new, and will be described below. Before entering on this part of my task I will make a few remarks however on two of the species known already from elsewhere, namely on Guettarda Spruceana Mull. Arg. and on Borreria verticillata (L.) G. F. W. Mey, and on a third species, Coccocypselum guyanense (Aubl.) K. Sch., which is known since long from Surinam, but of which Mr. Rombouts collected a specimen differing somewhat from the older Surinam findings.


Business Ethics has increasingly become a concern among companies in the financial services industry. No insurance without reinsurance. Although it is traditionally assumed that insurance has a wider role in society, the ethical debate has mainly developed over the last decade. It is even emerging in the reinsurance industry. This dissertation aims at providing a useful piece of research to the development of ethics in reinsurance. Initial consideration of the reinsurance industry reveals that the shareholder theory has established as the core business theory. This forms mainly the 'return on equity' predominant approach in the vast majority of companies. Having developed a research using a variety of qualitative methods, including secondary data collection (literature review) and semi-structured interviews in the field of reinsurance, the I observed and was convinced that ethics should play a larger role than that of the restricted return on equity approach. The literature review reveals limited exploration of a link between ethics and reinsurance. Therefor it is reasonable to propose that there are links between the financial thinking of the industry and its approach to ethics. The literature review and the primary findings have revealed that trust remains at the heart of the reinsurance industry but seeks to reconcile the short-term and the long-term, and that the strong links between ethics and trust call for a larger ethics beyond the restricted shareholders' theory in the long run. No reinsurance without trust, no trust without ethics. Furthermore, I found that existing literature on reinsurance limits the ethical debate to the shareholders or stakeholders theory, and fails to explore links between societal ethics and this industry. Consequently, the dissertation has made a contribution to research in an area where there was a notable gap. Finally, this dissertation proposes a number of recommendations to the reinsurance industry to integrate societal focus and develop 'geo-ethics' (via the concept and implementation of societal insurance and reinsurance pools against natural catastrophes for instance), to reconcile short-term financial thinking and long-term partnership, and to regain the necessary public trust.


This paper proposes a new analytical model to evaluate the availability of a big data computing, namely, map-reduce computing on a Hadoop platform. Map-reduce computing is represented by a queueing model in this work in order to trace flow of tasks (either map or reduce) of their arrivals and exits in the course of computation. The objective of the model is to evaluate the probability for a map-reduce computation to be available at an instance of time, referred to as availability. The set of variables taken into account in this model lists the number of map and reduce tasks, the number of servers (or referred to as nodes in this paper) engaged, along with a few constants such as task arrival/exit rates and node failure/repair rates. The proposed model provides a comprehensive yet fundamental basis to assure and ultimately optimise the design of map-reduce computing in terms of availability with reference to its performance in a simultaneous manner. Parametric simulations have been conducted and demonstrated the efficacy of the proposed model in assessing the availability and the cost.


Linear optical sampling characterizes a sample by measuring the distortions on a transmitted optical field, thereby quantifying the sample's optical response. By exploiting the high mutual coherence between two phase-locked femtosecond fiber lasers, we achieve very high signal-to-noise ratio measurements of transmitted optical electric fields through coherent averaging. We measure the optical electric fields with 15.16 bits of dynamic range (91 dB in intensity) and with 525 fs timing resolution over a 10 ns time window, in a 5.1 s averaging period.


Partitioning is an important issue in a variety of applications. Two examples are domain decomposition for parallel computing and color image quantization. In the former we need to partition a computational task over many processors; in the latter we need to partition a high resolution color space into a small number of representative colors. In both cases, partitioning must be done in a manner that yields good results as defined by an application-specific metric. Binary dissection is a technique that has been widely used to partition non-uniform domains over parallel computers. It proceeds by recursively partitioning the given domain into two parts, such that each part has approximately equal computational load. The basic dissection algorithm does not consider the perimeter, surface area or aspect ratio of the two sub-regions generated at each step and can thus yield decompositions that have poor communication to computation ratios. We have developed and implemented several variants of the binary dissection approach that attempt to remedy this limitation, are faster than the basic algorithm, can be applied to a variety of problems, and are amenable to parallelization. We first present the Parametric Binary Dissection (PBD) algorithm, which takes into account volume and surface area when partitioning computational domains for use in parallel computing applications. We then consider another variant, the Fast Adaptive Dissection (FAD) algorithm, which provides rapid spatial partitioning for use in color image quantization. We describe the performance of PBD and FAD on representative problems and present ways of parallelizing the PBD algorithm on 2- or 3-d meshes and on hypercubes.


This is a study of tonal representation as a function of syllable structure constituency in Swedish. The results of a production experiment indicate that the onset of the focal accent rise – which we suggest to be best represented by a bitonal LH command – is associated with the consonant onset of the postaccented syllable. Furthermore, a vowel insertion is favored in certain intervocalic consonant clusters. In light of these findings, as well a parallel study on Greek, we claim: (1) syllabification is a basic prerequisite condition in tonal analysis and intonation studies, (2) tonal targets may define syllable boundaries and hence syllabification and (3) different tonal targets may be associated with different syllable structure constituents in different languages.


Objective: To examine the role of physical activity in determining the affect and executive functioning of children with symptoms of ADHD. Method: In Study 1, the association between physical activity and affect in the daily lives of children with varying degrees of hyperactivity was examined. In Study 2, children with ADHD were randomly assigned a physical activity or a sedentary task before working on a task requiring executive control. Results: Lack of physical activity was shown to relate to depressed affect, more strongly in participants with severe hyperactivity symptoms (Study 1). The physically active participants showed improved executive functioning after only 5 min of vigorous activity; the sedentary control participants showed no improvement (Study 2). Conclusion: These results indicate that interventions to increase the level of physical activity in children with and without ADHD might improve affect and executive functioning.


Planetary exploration missions avoid the destinations that offer the greatest scientific payout because they entail risks too great for a primary rover. Given the high costs of sending to extraterrestrial bodies, even the small possibility of losing a primary rover precludes the exploration of important, yet risky features. The solution to this problem is a new paradigm for planetary exploration wherein the primary rover is accompanied by multiple cheaper, lighter, and more expendable companion rovers with differing capabilities. These rovers would complement each others strengths and weaknesses through a strategy called Symbiotic Exploration. Several algorithmic challenges must be solved before symbiotic exploration in planetary environments can become a reality. The less featured companion rovers will often lack a direct line of communication to Earth, requiring that they remain within communication distance of the lander or more capable primary rover to relay data. Similarly, the secondary rovers may sacrifice the large, expensive solar panels and electric generators for a high-density rechargeable battery. Such a configuration would require resource aware planning, as well as occasional rendezvous with a rover or base station capable of recharging or swapping out that battery. A symbiotic planner must be able to develop plans in highly dynamic environments while meeting these constraints. Distributed Path Consensus (DPC) is an iterative approach to enforcing time-dependent multi-rover rendezvous constraints. It is limited, however, in that it can only apply such constraints based upon the time domain, and the value at which those constraints apply must be identical between the two rovers. This research proposes an evolution of the DPC algorithm (called DPC.TF) that allows it to enforce rendezvous constraints based upon any arbitrary resource, including those that are non-monotonic, even when their values differ across rovers. Furthermore, it allows for complex rendezvous and maximum separation distance constraints to be specified through an intuitive syntax. A planner based around the DPC.TF algorithm was developed, and its correctness proved on synthetic data. The planner generated routes using actual Lunar data for a variety of multiple rover configurations and symbiotic constraints. This research was able to show that routes do exist to high-interest, permanently shadowed sites while maintaining symbiotic constraints. Furthermore, capabilities that would be required of each rover to explore these sites was analyzed and determined. Such regions have been previously considered inaccessible but, through the paradigm of Symbiotic Exploration, can be thoroughly explored.


Summary
Carrot slices were dried from initial moisture content of 8.52 kg water kg−1 dry matter to 0.11 kg water kg−1 dry matter by infrared dryer. Experiments were conducted using three levels of infrared power (300, 400 and 500 W) and at air velocities (1.0, 1.5 and 2.0 m s−1). The effects of process variables on the drying kinetics of carrot, drying time, specific energy consumption and quality parameters of dried carrot (shrinkage, rehydration ratio and colour) were investigated. The drying time at infrared power of 300, 400 and 500 W was 252 and 277 min, 205 and 236 min, and 145 and 155 min at air velocities of 1.0 and 2.0 m s−1, respectively. The drying rate increased with increasing infrared power. The specific energy consumption values varied between 12.22 and 14.58 MJ kg−1-evaporated water for all the drying conditions. Shrinkage, rehydration ratio and colour parameters were found to be affected by process variables.


During the study period from January 2008 to December 2012, 177 women had transvaginal sacrospinous ligament fixation (SSF) for vault suspension at General Hospital Kuala Lumpur. Of the 177 women, 133 (75.1%) had severe uterovaginal prolapse while 44 (24.9%) had post-hysterectomy vault prolapse. All patients with severe uterovaginal prolapse and rectocele undergone vaginal hysterectomy and posterior colporrhaphy respectively. A hundred and seventy-four patients (98.3%) had anterior repair whilst 48 (27.1%) received midurethral sling as concomitant procedure to vault suspension (SSF). The mean duration of surgery was 92.1±30.2 minutes and the mean estimated blood loss was 319±199.3mls. There was no surgical mortality. Two patients (1.1%) had rectal injuries. No patient had bladder injury or de novo urinary symptoms. The commonest immediate postoperative complications was fever (98; 55.4%) followed by buttock pain in 18 (10.2%) patients. Both complications were resolved with conservative measures. Seven patients (3.9%) had sutures erosion as late complications. Of the 177 women, 158 (89.3%) and 141 (79.7%) came for the 6 and 12 months follow-up, respectively. The success rate for all three compartments ranged from 92.4% to 98.1% at 6 months and reduced to range from 85.7% to 94.4% at 12 months. The highest success rate was observed in the posterior compartment followed by apical and anterior compartment. Equally, the recurrence rate was lowest in the posterior compartment (1.9%), followed by the central (3.8%) and anterior compartment (7.5%) at 6 months' review. This increased to 5.7% for rectocele, 7.8% for vault prolapse and 14.2% for cystocele at 12 months' follow-up. None had repeated surgery for prolapse recurrence during the study period. In conclusion, SSF remains a high priority in our therapeutic regime for the treatment of severe uterovaginal and vault prolapse as it has a reasonably good success rate with lower serious complications in the skillful hands.


Problem statement: Post-Traumatic Meningitis (PTM) is a serious
complication followed trauma. It sounds to have different pattern and characteristics.
The aim of the current study was to determine the characteristics and outcome
of PTM in referral neurosurgery department in Iran. Approach:
During 5 years period-2003-2008, all records from meningitis patients in neurosurgery
department in the unique referral trauma center in Kerman, Iran were evaluated
by researchers, retrospectively. The PTM cases were selected and their data registered
in the data collection form. The outcome of the disease as live or death considered,
too. Analysis was conducted based on outcome and multivariable ANOVA was done
to determine factor associated with death in PTM cases. Results:
The incidence of PTM in head trauma patients estimated 3.1% (95% CI = 2.5-3.9%).
The most frequent cases were male 89.7%. Average of age was 28.4±17.2 years. Klebsiella was the most common organism in CSF culture. Hospital staying time average in these patients was 25.7±15.8 days. Surgery was done for 52 (66.6%) cases. The fatality rate was 24.4%, (95% CI = 15.4-35.4). All death had undergone operation. Multivariable ANAOVA declared that blood sugar and CSF protein differed statistically between two groups, died and survived. Conclusion: PTM is an important phenomenon that has great mortality. Certainly, it needs antibiotic prophylaxis and immediate intervention and preventive services to reduce its morbidity and mortality rate.


PurposeThis paper has three aims: Firstly, it puts the pandemic-induced surge in homeworking into context by charting trends in homeworking in the UK since the early 1980s. Secondly, it examines what effect the growth in homeworking during the pandemic has had on employees' self-reported levels of productivity. Thirdly, it assesses whether the spike in homeworking is a flash in the pan or a permanent feature of the post-pandemic world.Design/methodology/approachThe paper uses cross-sectional and longitudinal data taken from three nationally representative surveys of workers: (1) the Labour Force Survey (LFS), an official government survey carried out between 1981 and 2019; (2) a special module of the Opinions and Lifestyle Survey (OPN), also an official government survey, which has been run every week since the pandemic began in March 2020; and (3) the Understanding Society Covid-19 Study, an online survey of the same people interviewed on six occasions during 2020.FindingsThe recent surge in homeworking in the UK during the pandemic has been dramatic. Before 2020, it had taken almost 40 years for homeworking to grow by three percentage points, but its prevalence grew eight-fold virtually overnight as people were instructed to work at home if they can because of the pandemic. Despite theories and predictions to the contrary, employees reported that their productivity was not adversely affected. Seven out of ten employees said that they were able to get as much done while working at home in June 2020 as they were able to do six months earlier. By September 2020, this proportion had risen to 85%. However, around one in six homeworkers reported that their productivity had fallen.Research limitations/implicationsWhile there are solid theoretical reasons for the paper's findings, these data do not allow us to test all of the mechanisms involved. In addition, our outcome measure relies on employees' self-reports of how their hourly productivity changed when working at home and is not based on a direct measure of changes to output per hour. However, surveys of employers also suggest that, on average, productivity has not been reduced by the pandemic-induced surge in homeworking.Social implicationsThis paper argues that a higher level of homeworking is here to stay. Nine out of ten employees who worked at home during the pandemic said that they would like to continue working at home when they did not have to. Furthermore, those keenest to continue working at home were the most productive, hence providing a business case for a sustained increase in the prevalence of homeworking after the pandemic has passed. Nevertheless, the experience of homeworking varies with those with higher domestic commitments reporting significantly lower levels of productivity.Originality/valueThere is an urgent need to investigate what effect enforced, as opposed to voluntary, homeworking has had on employee productivity. In addition, in order to decide whether continued homeworking should be encouraged or discouraged, policymakers and employers need to know what effect continuing with these arrangements is likely to have on employee productivity. This paper answers these questions using robust survey data collected in the UK throughout 2020, complemented by evidence taken from a variety of employer surveys.


The U.S. Coast Guard sponsored this project to assess control measures (technological advancements as well as safety management systems) for preventing or mitigating the impacts of fuel oil or lube oil spray fires on board vessels particularly in the engine room. For this purpose, we identified a number of proposed control measures to prevent/mitigate the impacts of spray fires, and then we evaluated the reduction in task that can be expected from the implementation of each measure. As part of our evaluation, we identified many sources of relevant incident investigation reports. These sources provided a total of 143 fires caused by releases of fuel oil/lube oil; of these 9 are known to have resulted in fatalities, and another 8 are known to have resulted in personnel injury. Our research findings substantiated several (and refuted a few) previous findings beliefs regarding spray fires. In addition, our investigation resulted in 18 feasible, practical control measures (recommendations) to reduce risks associated with fuel oil/lube oil spray fires in engine rooms. The first 12 recommendations address specific changes to: (1) existing fuel oil/lube oil equipment and systems and (2) management issues. The next three recommendations address more significant changes to fuel oil/lube oil equipment, and they are presented for new (or significantly modified) ships. We also identified two areas that require additional research and development efforts, and we developed two recommendations to address these areas. Finally, we determined that much of the risk associated with fuel oil/lube oil spray fires stems from deficiencies in (or lack of) safety management systems. That is, the root cause of these incidents is generally the absence of, neglect of, or deficiencies in management systems. This report consists of three volumes.


Abstract. A global data set of vertical profiles of polar stratospheric cloud (PSC) volume densities has been derived from Michelson Interferometer for Passive Atmospheric Sounding (MIPAS) space-borne infrared limb measurements between 2002 and 2012. To develop a well characterized and efficient retrieval scheme, systematic tests based on limb-radiance simulations for PSCs from in-situ balloon observations have been performed . The finally selected wavenumber range was around 830 cm−1. Optical constants of nitric acid trihydrate (NAT) have been used to derive maximum and minimum profiles of volume density which are compatible with MIPAS observations under the assumption of small, non-scattering and larger, scattering PSC particles. These max/min profiles deviate from their mean value at each altitude by about 40–45 %, which is attributed as the maximum systematic error of the retrieval. Further, the retrieved volume density profiles are characterized by a random error due to instrumental noise of 0.02–0.05 μm3 cm−3, a detection limit of about 0.1–0.2 μm3 cm−3 and a vertical resolution of around 3 km. Comparisons with co-incident observations by the Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) on the CALIPSO (Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observations) satellite showed good agreement regarding the vertical profile shape. Quantitatively, in the case of supercooled ternary solution (STS) PSCs, the CALIOP dataset fits to the MIPAS retrievals obtained under the assumptions of small particles. Unlike for STS and NAT, in the case of ice PSCs the MIPAS retrievals are limited by the clouds becoming optically thick in limb-directions. In these cases, the MIPAS volume densities represent lower limits. Among other interesting features, this climatology captures the on-set of PSC formation very near to the South Pole, a process observed by no other instrument before with this spatial and temporal coverage. Further, the large variability of the PSC volume densities between different Arctic stratospheric winters is striking.


Introduction Severe, drug-unresponsive gastroparesis is a debilitating condition. Treatment with gastric electrical stimulation using Enterra® was granted humanitarian device exemption status by the FDA in 2000. The largest case-series (N=221) reports that 54% of patients had >50% symptom-reduction with Enterra.1 We audited outcomes from Enterra therapy, with routine use of a trial of temporary stimulation to refine patient selection. Methods Patients considered for Enterra during 2008–2011 were identified from a prospectively maintained database. Patients had been previously extensively investigated and treated for gastroparesis; 48% were referred by gastroenterologists and 37% by upper GI surgeons. Gastric emptying was assessed by scintigraphy in all cases. Candidates for Enterra had a 2-week trial of temporary stimulation, via a trans-nasal electrode that was endoscopically implanted into the gastric submucosa. Only those with good response proceeded to laparoscopic implantation of a permanent Enterra device. 50% or greater symptom-reduction was classified as a good response. Results There were 71 patients (51 women, 72%), with median age 42 years (range, 14–69). The aetiology of gastroparesis was idiopathic (43 patients, 61%), diabetes (15, 21%) or post-surgical (13, 18%). At presentation, oral nutrition was supplemented by naso-jejunal tube feeding in seven patients, surgical jejunostomy in eight or parenterally in one (total, 16 patients; 22%). Previous intervention included endoscopic injection of Botulinum toxin (Botox) into the pylorus in 16 patients (22%), pyloroplasty in two, distal gastrectomy in one and gastrojejunostomy in one. It was decided to directly proceed with permanent Enterra in four patients. Of the remaining, 51 patients have currently completed a trial of temporary stimulation; 39 (77%) had a good response and were selected for permanent Enterrra, which has been completed in 35 patients. Outcome data are currently available for 31 patients (idiopathic, 21 patients; diabetes, three; post-surgical, seven), with median follow-up period of 10 months (1–28). 22 patients (71%) had a good response to permanent Enterra; these included 14 (68%) with idiopathic, 5 (71%) with post-surgical and all three with diabetic gastroparesis. Conclusion 71% of well-selected patients with intractable gastroparesis had good response to permanent gastric electrical stimulation with Enterra at follow-up up to 2 years. These data compare advantageously with reported data (>50% symptom-reduction in 54%)1 and support the inclusion of a trial of temporary stimulation in the selection algorithm for permanent Enterra therapy. Competing interests None declared. Reference 1. McCallum, et al. Gastric electrical stimulation improves outcomes of patients with gastroparesis for up to 10 years. Clin Gastroenterol Hepatol 2011;9:314–19.


: The control of blood glucose levels in diabetes involving devices are critically reviewed, and the role of blood-contacting biomaterial components analyzed. These include mechanical insulin-delivery systems of the closed-loop type that require an electronic glucose sensor and feedback, and open-loop systems that deliver insulin without a sensor and feedback. Whole pancreatic and islet transplantations, islet encapsulation, and the potential role of polymeric sustained drug delivery systems are discussed. The medical and social impacts of diabetes mellitus are of prime public health concern and of even greater magnitude than those of heart disease in the United States. While future advances in device design, miniaturization, and biomaterials technology will significantly add to the arsenal of therapeutic alternatives, devices capable of controlling blood glucose levels ought to be viewed as mere interim phases rather than as final goals of the problem.


As one of the Coordinated Multipoint (CoMP) techniques, Joint Transmission (JT) can improve the overall system performance. In this paper, from the load balancing perspective, we study how the maximum load can be reduced by optimizing JT pattern that characterizes the association between cells and User Equipments (UEs). To give a model of the interference caused by cells with different time-frequency resource usage, we extend a load coupling model, by taking into account JT. In this model, the mutual interference depends on the load of cells coupled in a non-linear system with each other. Under this model, we study a two-cell case and proved that the optimality is achieved in linear time in the number of UEs. After showing the complexity of load balancing in the general network scenario, an iterative algorithm for minimizing the maximum load, named JT-MinMax, is proposed. We evaluate JT-MinMax in a Heterogeneous Network (HetNet), though it is not limited to this type of scenarios. Numerical results demonstrate the significant performance improvement of JT-MinMax on min-max cell load, compared to the conventional non-JT solution where each UE is served by the cell with best received transmit signal.


According to the Simple View of Reading, reading ability can be divided into decoding and language comprehension. In the present study, decoding and comprehension's contribution to reading ability was studied both in children with reading difficulties and in children with typical reading ability. Decoding and comprehension was further divided into sub-components, and the contribution from non-verbal ability and general processing speed was also studied. The results demonstrated that decoding made the largest contribution to reading ability for children with reading difficulties, while language comprehension contributed the most for children with typical reading ability. The contribution of non-verbal ability was not significant, and general processing speed only made a significant contribution to decoding for typical children. The two factors in the Simple View of Reading, decoding and comprehension, together explained less of the variance in reading ability for children with reading difficulties than for children with typical reading ability.


SUMMARY We studied basalt sills and dykes and kimberlite pipes from the eastern part of the Siberian platform. These are spread out over a few hundred kilometres and are divided into two age groups: Late Permian–Early Triassic (Mir, Aikhal and Olenyek regions) and Late Devonian–Early Carboniferous (Viluy and Markha basins, Aikhal region). The palaeomagnetic poles determined for each sill or dyke are statistically different from each other, but averaging all corresponding directions from these sills and dykes with those from kimberlites of different generations yields results with acceptable statistics. This is probably due to the averaging out of secular variation and /or changes in magnetic polarity. The resulting palaeomagnetic poles allow one to reconstruct the palaeopositions of Siberia during the two large flood basalt events at about 360 and 250 Ma. A significant rotation of the Siberian platform during the Devonian and Carboniferous is suggested. The new data are in general agreement with some earlier palaeomagnetic poles for the Late Permian–Early Triassic traps of the Tungusska basin, and significantly reduce uncertainties for previous Late Devonian–Early Carboniferous Siberian poles, which were very scattered. Together with geological and absolute age data, the palaeomagnetic data support the hypothesis that kimberlite magmatism and trap intrusions were both rapid and relatively close in time. The 360 Ma event is emerging as a magmatic event with considerable extent over the Russian and Siberian platforms, related to incipient continental break-up and triple junction formation, possibly at or near the time of the Frasnian–Famennian mass extinction.


The chromate resistance determinant of Pseudomonas aeruginosa plasmid pUM505 was cloned into broad-host-range vector pSUP104. The hybrid plasmid containing an 11.1-kilobase insert conferred chromate resistance and reduced uptake of chromate in P. aeruginosa PAO1. Resistance to chromate was not expressed in Escherichia coli. Contiguous 1.6- and 6.3-kilobase HindIII fragments from this plasmid hybridized to pUM505 but not to P. aeruginosa chromosomal DNA and only weakly to chromate resistance plasmids pLHB1 and pMG6. Further subcloning produced a plasmid with an insert of 2,145 base pairs, which was sequenced. Analysis of deletions revealed that a single open reading frame was sufficient to determine chromate resistance. This open reading frame encodes a highly hydrophobic polypeptide, ChrA, of 416 amino acid residues that appeared to be expressed in E. coli under control of the T7 promoter. No significant homology was found between ChrA and proteins in the amino acid sequence libraries, but 29% amino acid identity was found with the ChrA amino acid sequence for another chromate resistance determinant sequenced in this laboratory from an Alcaligenes eutrophus plasmid (A. Nies, D. Nies, and S. Silver, submitted for publication).


Automated production systems are in operation for a long time and are continuously being changed. Therefore, for these systems it is important to have the ability to react efficiently to changes. Change propagation analysis approaches allow predicting the effects of changes before they are actually implemented. Such approaches often use predefined change propagation rules that indicate how the change propagates in a system. However, the change propagation rules used by these approaches are limited to a discipline such as information systems, to the structure of system elements in a discipline, or to a programming language such as Java. In this paper, we present a cross-disciplinary language to specify change propagation rules. The proposed language is independent of a particular discipline, structure of system elements, or programming languages. To show the improvement of the readability and the coverage of the change propagation rules with our language, we apply it to two existing approaches to change propagation analysis for the electronic and mechanical components, as well as control software of automated production systems.


The paper analyzes the incidence of the major infectious complications (regional and systemic) developing in neurosurgical patients (3630 patients with neurosurgical diseases and 872 with abnormalities of the posterior cranial fossa (PCF)) in the postoperative period after removal of subtentorial tumors. Regional pyoseptic complications are shown to occur in patients with PCF abnormalities three times more frequently. The basic diagnostic and therapeutic approaches to pyoseptic complications in neurosurgical patients are also considered.


Speech perception is a central component of social communication. While speech perception is primarily driven by sounds, accurate perception in everyday settings is also supported by meaningful information extracted from visual cues (e.g., speech content, timing, and speaker identity). Previous research has shown that visual speech modulates activity in cortical areas subserving auditory speech perception, including the superior temporal gyrus (STG), likely through feedback connections from the multisensory posterior superior temporal sulcus (pSTS). However, it is unknown whether visual modulation of auditory processing in the STG is a unitary phenomenon or, rather, consists of multiple temporally, spatially, or functionally discrete processes. To explore these questions, we examined neural responses to audiovisual speech in electrodes implanted intracranially in the temporal cortex of 21 patients undergoing clinical monitoring for epilepsy. We found that visual speech modulates auditory processes in the STG in multiple ways, eliciting temporally and spatially distinct patterns of activity that differ across theta, beta, and high-gamma frequency bands. Before speech onset, visual information increased high-gamma power in the posterior STG and suppressed beta power in mid-STG regions, suggesting crossmodal prediction of speech signals in these areas. After sound onset, visual speech decreased theta power in the middle and posterior STG, potentially reflecting a decrease in sustained feedforward auditory activity. These results are consistent with models that posit multiple distinct mechanisms supporting audiovisual speech perception. Significance Statement Visual speech cues are often needed to disambiguate distorted speech sounds in the natural environment. However, understanding how the brain encodes and transmits visual information for usage by the auditory system remains a challenge. One persistent question is whether visual signals have a unitary effect on auditory processing or elicit multiple distinct effects throughout auditory cortex. To better understand how vision modulates speech processing, we measured neural activity produced by audiovisual speech from electrodes surgically implanted in auditory areas of 21 patients with epilepsy. Group-level statistics using linear mixed-effects models demonstrated distinct patterns of activity across different locations, timepoints, and frequency bands, suggesting the presence of multiple audiovisual mechanisms supporting speech perception processes in auditory cortex.


Almost all the Ca(2+)-dependent protein kinase activity in nuclei purified from etiolated pea (Pisum sativum, L.) plumules is present in a single enzyme that can be extracted from chromatin by 0.3 molar NaCl. This protein kinase can be further purified 80,000-fold by salt fractionation and high performance liquid chromatography, after which it has a high specific activity of about 100 picomoles per minute per microgram in the presence of Ca2+ and reaches half-maximal activation at about 3 x 10(-7) molar free Ca2+, without calmodulin. It is a monomer with a molecular weight near 90,000. It can efficiently use histone III-S, ribosomal S6 protein, and casein as artificial substrates, but it phosphorylates phosvitin only weakly. Its Ca(2+)-dependent kinase activity is half-maximally inhibited by 0.1 millimolar chlorpromazine, by 35 nanomolar K-252a and by 7 nanomolar staurosporine. It is insensitive to sphingosine, an inhibitor of protein kinase C, and to basic polypeptides that block other Ca(2+)-dependent protein kinases. It is not stimulated by exogenous phospholipids or fatty acids. In intact isolated pea nuclei it preferentially phosphorylates several chromatin-associated proteins, with the most phosphorylated protein band being near the same molecular weight (43,000) as a nuclear protein substrate whose phosphorylation has been reported to be stimulated by phytochrome in a calcium-dependent fashion.


Purpose: To understand the process of discovery and decision-making for adults with the CDH1 marker for hereditary diffuse gastric cancer (HDGC) and inherited breast cancer. Participants and Setting : Purposeful sampling included 20 participants; 17 adults (11 women and 6 men, ages 23–77) recruited through the No Stomach for Cancer organization; six participants were interviewed two times;with three healthcare providers also interviewed. Nineteen interviews were by telephone; one was in person. Methodological Approach: Grounded theory with constant comparison. Findings: The person diagnosed with the genetic marker CDH1 undergoes the decision-making process of Paving the way as they address this healthcare challenge. Paving the way explains the entry points for learning the risk, discerning testing for confirmation, choosing iterative individual cycles of surveillance, surgery, and ongoing adjustments postoperatively while normalizing to live longer. Implications for Nursing: Understanding the process of Paving the way explains and describes the nine key factors for decision-making and predicts the timing for nursing interventions for both post-genetic testing and pre- and postoperative assessment and planning. Knowledge Translation: Advocacy for the self and family is key to Paving the Way . Nursing has an opportunity to develop and expand the roles for navigator and counselor in the area of genetic testing. Patients undergoing PTG have chronic healthcare needs. Family implications for genetic testing require assessment beyond the individual.


ABSTRACT In young people, interactions with horses may contribute to the development of social skills and self-efficacy. Our aim was to identify relationships between psychological variables and young people's experience of activities with horses. Participants in this study were 13–15-year-old adolescents (n = 25), given a 4-month intervention consisting of weekly sessions of stable work and horseback riding. We investigated the relationship between psychological variables from survey data with video-recorded behavioral observations during tasks and contact with horses. From the behavioral data, we calculated the frequency per hour of "trying again" when met with a challenge, as a measure of participants' persistence in horse-related tasks. The number of times per hour that that participant initiated contact with the horse was used as a measure of frequency of physical contact (petting). We examined correlations between the change from early to late stages of the intervention in trying again during horse-related tasks and for physical contact and three psychological variables measured prior to the intervention: perceived social support, self-esteem, and general self-efficacy. We detected an association between lower pretest levels of perceived social support and general self- efficacy, and an increase during the intervention in persistence of trying again when met with challenges during tasks with the horse. In a linear regression analysis, controlling for initial levels of persistence during horse-related tasks, self-esteem, and self-efficacy, social support was the only unique predictor of an increase in persistence during the intervention. No association was found between the psychological variables and change in frequency of petting the horse. The results indicate that adolescents with lower levels of perceived social support at the start of the intervention showed greater increases in their persistence in trying again after being met with challenges during horse-related tasks. Since persistence is a central aspect in the development of mastery of tasks, the possible positive social impact of the horse/stable environment should be given more attention in future intervention research.


In the Priestly texts, holiness is understood both as an absolute and as a relative term to demarcate the hierarchy within the holy sphere. Rather than primarily redefining the term "holy," the present work aims to determine the term's function in describing spaces, objects, offerings, and people in the Priestly account. While there are several different levels of holiness for people, places, objects, and offerings, the Priestly writers have only two terms at their disposal, "holy" and "most holy," which they use in a dizzying combination to situate elements hierarchically. Nonetheless, once the Priestly language is clarified, elements in the holy sphere fit into a fairly consistent hierarchy. Within this taxonomic system, people have access to spaces and objects of one level of holiness higher than they themselves possess. While accessing one degree higher is acceptable, two degrees proves fatal. The Priestly labels "holy" and "most holy" mediate access, express the privilege and unnaturalness of access, and indicate the consequences of improper contact, thereby safeguarding the divine abode from improper encroachment and humanity from the corresponding punishment.


Alkali carbonatite lavas and ashes that erupted from Oldoinyo Lengai, Tanzania, in June 1993 provide evidence for coexisting carbonatite and silicate magmas. The lavas and ashes contain immiscible silicate spheroids of ijolitic composition, which themselves contain carbonatite segregations. In contrast to earlier, very mobile flows, the 1993 lava flows were very viscous; the viscosity of one crystal-rich flow is within the range for rhyolites. They are also the largest carbonatite flows yet recorded from the volcano.


Brain-eating amoebae cause devastating infections of central nervous system in humans, having a mortality rate of 95%. There are limited effective therapeutic options available clinically for treating granulomatous amoebic encephalitis and primary amoebic meningoencephalitis caused by Acanthamoeba castellanii and Naegleria fowleri, respectively. Here we report for the first time that guanabenz conjugated to gold and silver nanoparticles has significant antiamoebic activity against both A. castellanii and N. fowleri. Gold and silver conjugated guanabenz nanoparticles were synthesized by one-phase reduction method and were characterized by ultraviolet-visible spectrophotometry and atomic force microscopy. Both metals were facilely stabilized by the coating of guanabenz which was examined by surface plasmon resonance determination. The average size of gold nanoconjugated guanabenz was found to be 60 nm, whereas, silver nanoparticles were produced in larger size distribution with the average diameter of around 100 nm. Guanabenz and its noble metal nanoconjugates exhibited potent antiamoebic effects in the range of 2.5 to 100 µM against both amoebae. Nanoparticles conjugation enhanced the antiamoebic effects of guanabenz, as more potent activity was observed at lower effective concentration (2.5 and 5 µM) compared to drug alone. Moreover, encystation and excystation assays revealed that guanabenz inhibits the interconversion between the trophozoite and cyst forms of A. castellanii. Cysticdal effects against N. fowleri were also observed. Notably, pre-treatment of A. castellanii with guanabenz and its nanoconjugates exhibited significant reduction in the host cell cytopathogenicity from 65% to 38% and 2% in case of gold and silver nanoconjugates, respectively. Moreover, the cytotoxic evaluation of guanabenz and nanoconjugates revealed negligible cytotoxicity against human cells. Guanabenz is already approved for hypertension and crosses the blood-brain barrier; the results of our current study suggest that guanabenz and its conjugated gold and silver nanoparticles can be repurposed as a potential drug for treating brain eating amoebic infections.


The quantitative evaluation of computer performance is needed during the entire life cycle of a computer system. We survey the major quantitative methods used in computer performance evaluation, focusing on post-1970 developments and emphasizing trends and challenges. We divide the methods used into three main areas, namely performance measurement, analytic performance modeling, and simulation performance modeling, which we survey in the three main sections of the paper. Although we concentrate on the methods per se, rather than on the results of applying the methods, numerous application examples are cited. The methods to be covered have been applied across the entire spectrum of computer systems from personal computers to large mainframes and supercomputers, including both centralized and distributed systems. The application of these methods has certainly not decreased over the years and we anticipate their continued use as well as their enhancement when needed to evaluate future systems.


BACKGROUND
Species-specific reference intervals are needed for interpretation of laboratory tests. Reference interval studies of alpacas have been limited by low numbers and use of outdated methods.

OBJECTIVES
The aims of this study were to establish reference intervals for hematologic and coagulation tests in alpacas using a laser-based hematology analyzer and a mechanical clot detection coagulation analyzer, respectively; to compare results for automated and manual differential WBC and platelet counts and fibrinogen concentrations; and to examine the effect of herd and sex on hematologic tests in a population of alpacas.

METHODS
Blood collected from clinically healthy female and male adult alpacas (Vicugna pacos) from 5 herds underwent full CBC analysis using an ADVIA 2120 (n = 65). Blood smears were examined for manual differential WBC counts, platelet estimates, and morphologic examination of blood cells. PCV and plasma protein and heat-precipitable fibrinogen concentration measured by refractometry were also determined. Partial thromboplastin time, prothrombin time, and clottable fibrinogen concentration were measured using a STA Compact analyzer (n = 13). Reference intervals were established using 2.5th and 97.5th percentiles for hematologic analytes and minimum and maximum values for coagulation tests. Automated and manual differential WBC counts, platelet counts, and fibrinogen concentrations were compared. Results were also evaluated for herd- and sex-associated effects.

RESULTS
Hematologic reference intervals for alpacas were similar to those reported previously, except for lower RBC-related results, which showed a herd bias. Correlations between automated and manual neutrophil, lymphocyte, eosinophil, and platelet counts were moderate to good, with weak to poor correlations for monocyte and basophil counts and fibrinogen concentrations. Owing to the low number of samples analyzed, reference intervals for coagulation tests should be considered estimated intervals.

CONCLUSIONS
Reference intervals will be useful guides for interpreting hematologic and coagulation results in alpacas, particularly when using the same instrumentation and reagents.


A black surface treatment without using hexavalent chromium and applicable to bolts of motorcycles has been developed. The surface treatment also satisfies the requirements of bolts for motorcycles such as fastening performance, corrosion resistance, weather resistance and appearance of outer finish.There is a method of coating a black chemical conversion film using trivalent chromium on the zinc-plated surface as one of the surface treatments that do not use the hexavalent chromium. Such a black film, however, is thinner than the film using hexavalent chromium, and unable to ensure satisfactory black appearance. Meanwhile, although the dip-coating using a black paint can provide a sufficient black color, it is necessary to apply coating two times to eliminate an irregular color. As a result, thick paint films are formed on the roots of thread, making it difficult to fit into the internal thread. To simultaneously solve the above-mentioned two issues, two measures were executed. One was to apply the black film using trivalent chromium as an undercoat of dip-coating. The second was to develop paints that the amount of pigments in paints was adjusted on the assumption of the color of the undercoat. Thus a proper fit of thread was ensured when fastening in addition to a satisfactory black appearance even with the dip-coating only once. Also, the friction coefficient was controlled at an appropriate level by the selection of friction modifier. Moreover, the adhesion was improved by the enhancement of anchor effect of coating with the elimination of finishing process of the black chemical conversion film, and the requested corrosion resistance was achieved.


Blood pressure (BP) is a highly heritable trait and hypertension is a major risk factor for cardiovascular diseases. Recent genome-wide association studies (GWAS) have implicated a number of susceptibility loci for systolic (SBP) and diastolic (DBP) blood pressure. However, these loci together only explain 1% of the BP variability and the underlying mechanisms remain elusive. In this study, we utilized an integrative genomics approach that leveraged multiple genetic and genomic datasets including 1) GWAS from CHARGE (The Cohorts for Heart and Aging Research in Genomic Epidemiology) Consortium for DBP and SBP, 2) expression quantitative trait loci (eQTLs) from genetics of gene expression studies of human tissues related to hypertension (such as peripheral blood, whole blood, human aortic endothelial cells, and adipose tissue), 3) knowledge-driven biological pathways, and 4) data-driven regulatory gene networks. The integration of these diverse data sources enabled tissue-specific investigations on whether the genetic variants associated with BP concentrated on specific parts of gene regulatory networks, termed as "subnetworks", and whether novel key regulators in the subnetworks could be identified based on data-driven network topology. We identified 10 and 8 subnetworks for DBP and SBP respectively. Among these, subnetworks associated with ion homeostasis, ALK in cardiac myocytes, B cell receptor signaling, and Regulation of Insulin Secretion, were shared between DBP and SBP. More interestingly, we detected tissue-specific pathways, for example, L1CAM interactions in aortic endothelial cells and Leukocyte transendothelial migration in adipose. Among the trait-specific subnetworks, those involved in megakaryocyte development and cytoskeleton remodeling were found to be SBP-specific while GAB1 signalosome subnetwork was DBP-specific. Finally, by utilizing the gene-gene relationships revealed by the network architecture, we detected key regulator genes, both known (e.g. COL1A1, KL, and OSR1) and novel (e.g. EFEMP1, and CRABP2), in these blood pressure subnetworks. Our results shed lights on the complex mechanisms underlying blood pressure and highlight potential novel targets for hypertension and cardiovascular diseases.


Acoustic underwater positioning and navigation systems still evolve in a few directions. Improvements in underwater navigation sensor technology and underwater navigation algorithms cause development of new underwater vehicles and new underwater vehicle missions. Up-to-date navigation multi-sensor systems based on USBL become very popular. This paper presents experimental investigation of hydroacoustic multi-sensor based on tetrahedral antenna configuration. The preliminary investigations were led in water tank as first phase before multi-sensor measurement in real conditions, in sea water environment.


Four years ago, when we began to examine digital games from the perspective of the history of ideas, we entered uncharted territory in several respects, specifically in how and with which methods to approach digital games. Since the turn of the millennium, many analysis tools have been developed and tested in game studies, fueled above all by the supposed methodological dispute between narratologists and ludologist. And yet we are still far from being provided with the appropriate instruments for all possible scientific questions about games.


Electricity networks are becoming more complex due to the integration of renewable and distributed energy resources, which necessitates tools to simulate more advanced management methods and multi-stakeholder interactions. To facilitate simulation, this article introduces a distributed communications platform. Unlike earlier platforms, this applies loose coupling and abstract software interfaces, enabling the users to flexibly select and parametrize simulation components. Furthermore, the components can operate on any software runtime. The components communicate via a RabbitMQ message bus, which provides asynchronous publish-subscribe communication. The work is in progress but has a functional prototype, enabling the simulation of an electricity grid and distributed energy resources. The prototypes under development will simulate the management of energy communities and electricity grids including the consideration of energy pricing, demand and weather conditions. The study contributes to the development of zero-emission energy systems and flexibility markets for grid operators and flexibility service providers.


Objective: To examine the effects of a home-based arm exercise programme of sensory and motor amplitude electrical stimulation. Design: Non-concurrent, multiple-baseline, single-subject design. Subjects: Ten adults with chronic arm hemiparesis following stroke. Subjects ranged in age from 38 to 74 years and were 2-16 years post stroke. Three subjects had right-sided involvement; seven had left. Intervention: Subjects completed an eight-week, individualized, home programme of neuromuscular and sensory amplitude electrical stimulation. All subjects engaged in stimulation-assisted task-specific exercises for 15 minutes 2 -3 times daily. Participants with sensory deficits received an additional 15 minutes of sensory amplitude stimulation twice daily. The Action Research Arm Test was used to examine arm function; the Stroke Rehabilitation Assessment of Movement was used to examine movement quality; and the Modified Ashworth Assessment of Spasticity was used to examine muscle tone. Results: A statistically significant improvement was demonstrated by six of the 10 subjects on the Action Research Arm Test, and five subjects on the Stroke Rehabilitation Assessment of Movement. Four subjects had ≥ 10% improvement on the Modified Ashworth Assessment of Spasticity. Two subjects demonstrated significant improvement on all three outcome measures; six subjects improved on two or more measures; and seven subjects improved on one or more measure. Subjects who improved on two or more measures tended to have had more recent onset of stroke, were older and had higher baseline motor and functional capacity. Conclusion: Subjects with chronic stroke can experience impairment and functional improvements following a home-based programme of motor and sensory amplitude electrical stimulation.


The present study investigates whether coastal benthic communities are affected by tourist activities along the coast, which persist for a limited time period. The analysis of benthic macrofauna is based on the ecological parameters (quantitative analyses) as well as on the ecological identity of the species (qualitative analyses). Microbial contamination and some population statistics are correlated with ecological parameters. The disturbance of benthic communities in the vicinity of summer resorts is summarized by a reduction in species number and dominance of opportunistic species characteristic of disturbed and polluted environments. It is found that community diversity and evenness of distribution decrease with the deterioration of water quality, expressed as grade of microbial contamination, which implies that benthic community is also a significant element in assessing the quality of coastal waters. The above parameters were statistically negatively correlated with the number of tourists.


Background: Survivorship care plans will be mandated for use by 2015. Few studies have focused on the care transition process, and few show an impact on the patient experience or health outcomes. This study examines the effect of a patient-owned survivorship care plan (POSCP) intervention on patient outcomes and care coordination. Based on a conceptual model that incorporates IOM survivorship priorities and the chronic care model, the POSCP intervention is a single coaching encounter utilizing motivational interviewing to engage patients in the development of a POSCP that incorporates health goals and strategies related to surveillance, symptom management, and health behavior. Methods: 79 recent breast cancer survivors Stage I-IIIB were randomized to receive POSCP intervention (n=40) or usual care (n=39). Patient outcomes were assessed using SF-36 Health Survey (SF-36), Social/Role Activities Limitations, Self-Efficacy for Managing Chronic Disease Scale, and Personal Health Questionnaire Depression Scale (PHQ-9) at baseline and 3 month follow up. Care coordination was assessed using confirmed primary care physician (PCP) visits and reported discussion of survivorship plan at follow up. Logistic and linear regressions were conducted to examine the effect of intervention on care coordination, patient experience, and health outcomes. Results: In this sample age M= 58.35, SD = 10.62, 81% (N=64) non-hispanic white, 16.5% (N=13) African American. A greater proportion of participants in the intervention group reported a confirmed appointment (59.5% vs. 51.4%) and discussed survivorship issues (47.4% vs. 35.1%) with their PCPs compared to those in the usual care group, however these differences did not achieve statistical significance (p= .70 and .65). After controlling for education and perceived financial adequacy, participants in the intervention group demonstrated significantly higher self-reported health (F (3, 70) = 3.57, p Conclusion: This pilot study of a POSCP process utilizing motivational interviewing techniques to enhance patient engagement has a positive impact on patient outcomes and demonstrates promise as a strategy to improve survivor patient experience, care coordination, and health outcomes. Citation Format: Elizabeth A Kvale, Wendy Demark-Wahnefried, Karen Meneses, Sejong Bae, Chao-Hui S Huang, Casey B Azuero, Christine S Ritchie. Patient centered support in the survivorship care transition: Outcomes from the patient-owned survivorship care plan intervention [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-09-07.


Native to South and Southeast Asia, white jabon (Anthocephalus cadamba) and red jabon (Anthocephalus macrophyllus) are ideal choices for plantation and community forestry. Fast-growing and resistance to pests, the wood of these species have multiple uses. The species are preferred by local communities due to their adaptability and economic profitability. However, a lack of propagation technology appropriate for rural communities limits the domestication of jabon species. The research aimed to identify the best practices for seed germination and seedlings growth under rural conditions. The study used a completely randomized design, testing five treatments for germination media and nine treatments for growing media. Each treatment was replicated three times. All media tested were well-drained, of light texture, fertile, and can be easily produced by farmers by mixing appropriate portions of soils, sand and organic matter. The best soil media for germinating jabon seed is pure soil medium (100%) with the number of germinants equally 634 per 0.5 gram of seed, followed by the mixed soil-sand medium (1:1), which produced 514 germinants per 0.5 grams of seed. The best soil medium for height growth, diameter growth, and total dry weight of jabon seedlings was the mixed soil, cow-manure compost, and husk charcoal medium (3:1:1). These media can be produced under rural conditions with material easily available and improve local propagation of jabon species. Results are widely applicable.


This paper proposes using intermediate features of traffic simulations in a genetic algorithm designed to find the best scenarios in regulating traffic with multiple objectives. A challenge in genetic algorithms for multi-objective optimization is how to find various optimal scenarios within a limited decision time. Typical evolutionary algorithms usually maintain a population of diversified scenarios whose diversity is measured only by the final objectives available at the end of their simulations. We propose measuring the diversity by also the time series of the objectives during the simulations. The intuition is that simulation scenarios with similar final objective values may contain different series of discrete events that, when combined, can result in better scenarios. We provide empirical evidence by experimenting with agent-based traffic simulations showing the superiority of the proposed genetic algorithm over standard approaches in approximating Pareto fronts.


OBJECTIVES
Surgical knots on the suture line provide an anchoring function, but also represent a potential source of infection and irritation on the donor leg after coronary artery bypass surgery. Knotless barbed sutures were designed to prevent knot-related complications. This study compared knot-related wound complication rates between patients receiving traditional monofilament sutures and those receiving barbed knotless sutures for closure of the donor leg.

METHODS
One hundred and forty-two patients were randomized into two groups. Group 1 (n = 70) received traditional monofilament sutures and Group 2 (n = 72) received barbed knotless sutures. All wounds were assessed on postoperative days 3 and 5 and weeks 2, 4 and 6 using a validated wound scoring system. Antibiotics usage and general practitioner and district nurse visits were recorded.

RESULTS
No demographic differences were observed between groups. Leg wound skin closure times were significantly shorter in Group 2 compared with Group 1 (P < 0.001). Group 1 demonstrated a greater incidence of excessive scarring (P < 0.001), itching (P < 0.001), irritation (P < 0.001) and adverse skin tissue reactions (P < 0.001) than Group 2. Fewer general practitioner visits were recorded in Group 1 compared with Group 2 (P = 0.051).

CONCLUSION
Knotless barbed suture usage significantly reduces the incidence of knot-related leg wound complications compared with traditional monofilament knotted sutures. This may be related to differences in the rate of absorption of the suture material or an associated decrease in the incidence of adverse skin tissue reactions that may delay postoperative wound healing.


Abstract Foundations and Applications depend ultimately for their existence on each other. The main links between them are education and the axiomatic method. Those links can be strengthened with the help of a categorical method which was concentrated forty years ago by Cartier, Grothendieck, Isbell, Kan, and Yoneda. I extended that method to extract some essential features of the category of categories in 1965, and I apply it here in section 3 to sketch a similar foundation within the smooth categories which provide the setting for the mathematics of change. The possibility that other methods may be needed to clarify a contradiction introduced by Cantor, now embedded in mathematical practice, is discussed in section 5.


Integrating literature on entrepreneurial business models and community-based experiential learning, we propose a new framework to advance the practice of curriculum innovation. Grounded in principles of design thinking, the curriculum innovation canvas provides a human-centered, collaborative, and holistic platform for instructors, curriculum developers, and administrators to engage in innovation and implementation of experiential courses or programs—particularly those that involve community or organizational partnerships. The canvas promotes a creative and fluid approach to curriculum development. It prompts the consideration of the value propositions offered to various stakeholders (students, community partners, faculty peers, etc.) as well as how to involve stakeholders in the development and implementation process toward mutually beneficial outcomes in a complex and challenging environment. Evidence from an extensive prototyping process indicates that it can effectively assist instructors, administrators, students, and community partners in a variety of contexts.


We present a semantic part detection approach that effectively leverages object information. We use the object appearance and its class as indicators of what parts to expect. We also model the expected relative location of parts inside the objects based on their appearance. We achieve this with a new network module, called OffsetNet, that efficiently predicts a variable number of part locations within a given object. Our model incorporates all these cues to detect parts in the context of their objects. This leads to considerably higher performance for the challenging task of part detection compared to using part appearance alone (+5 mAP on the PASCAL-Part dataset). We also compare to other part detection methods on both PASCAL-Part and CUB200-2011 datasets.


Objective It is well documented that recurrence after pelvic exenteration remains high (up to 50%), and patients may require a prolonged period of recuperation following this aggressive surgery. We conducted a retrospective review to evaluate the feasibility of administering adjuvant chemotherapy after pelvic exenteration for gynecologic malignancies. Methods We reviewed the medical records of patients with any gynecologic cancer who underwent exenterative surgery between January 2005 and February 2011 at our institution. Patients were referred for postexenteration adjuvant chemotherapy based on surgeon's discretion and/or presence of high-risk features: positive margins, positive lymph nodes, and/or lymphovascular space invasion. Suitability for chemotherapy was assessed by a gynecologic medical oncologist. Regimens consisted of 4 to 6 cycles of platinum-based doublet chemotherapy. Chemotherapy-related toxicities were assessed using the Common Terminology Criteria for Adverse Events version 4. Results We identified 42 patients who underwent pelvic exenteration during the study period. Eleven (26%) were referred for adjuvant chemotherapy. Three (27%) of the 11 patients did not receive chemotherapy because of delayed postoperative recovery or physician choice. Seven (88%) of the remaining 8 patients completed all scheduled chemotherapy. Grade 2 toxicities or greater were documented in 6 patients (75%), the most common being neutropenia, neuropathy, and fatigue. Median follow-up time was 25 months (range, 6–56 months). The 3-year progression-free and overall survival rates of the 8 patients who received chemotherapy were 58% (95% confidence interval, 18%–84%) and 54% (95% confidence interval, 13%– 83%), respectively. Conclusions The administration of adjuvant chemotherapy is feasible for a select group of patients after pelvic exenteration for gynecologic malignancies. Our results need to be interpreted with caution because of the small and heterogeneous cohort of patients included.


The present work demonstrates the fabrication methodology of a 3-D, aluminum wire filament, bonded mesh deployed as a heat exchange surface. A model of the effective thermal conductivity of the mesh is developed. Apparatus to measure the coolant pressure-drop and heat transfer coefficient are described. Measurements are reported for fabricated test samples of varying thickness. Mesh Stanton number and friction factor correlations for a coolant with Prandtl number equal to 9.5 (chilled water) are reported. A heat exchanger performance evaluation, comparing the 3D woven mesh technology to another exchanger surface technology, is described. We have found that the weaving/wire bonding process must be carefully controlled to insure that target porosity, specific surface area and effective thermal conductivity are achieved. Effective thermal conductivities are found to be at least two-times larger than achieved in other comparable porous media configurations. Mesh friction factor and Stanton number are comparable to those achieved with other exchanger surface technologies. The exchanger performance comparison shows that exchangers having superior performance can be configured.


The importance of building a robust oil and gas company is currently more relevant than ever. Volatile oil prices, challenging governmental relations and uncertain outcomes of exploration activities are all elements affecting operating companies in the global oil and gas industry. Another important element is the cost of upstream services, which has increased dramatically since the beginning of the new millennium. There are no reason to believe that future challenges will be any easier to overcome. Simultaneously, the global community is in need of more energy to meet the predicted increase in demand. It is therefore important for operating companies to focus on increased recovery and secure safe and effective operations. By emphasizing quality in the well delivery process (WDP) operating companies can reduce time spent on planning wells, accelerate pro- ject development and increase focus on safety. A high quality WDP can secure proper technology assessment, process ownership, staff accountability, improve allocation of key resources and secure continuos improvement. With a properly functioning WDP future well projects can be delivered in an improved manner, thus helping operating companies build a robust organization able to meet an uncertain future. This study has analyzed the WDP of an operating company located in the Middle East with emphasis on revealing existing challenges. The findings have been compared to a base case WDP of an operating company located on the Norwegian Continental Shelf (NCS). Based on analysis and lessons learned from the NCS improvements have been suggested. The WDP defines the set of activities in place to plan, execute and deliver a well. The process is important as it secure the presence of several critical elements during well planning and drilling operations. It must be able to secure participation of experienced employees, cooperation between important departments, use of technical solutions and documentation of lessons learned. The difference between a well functioning and poorly functioning WDP can be severe. A poor process will reduce HSE focus, fail to secure use of new drilling technology, increase costs and lead to an inecient allocation of resources. Several challenges reducing the quality of the WDP of the OME were revealed during the analysis. A high number of change orders combined with a lack of processes to deal with change reduce the quality of the WDP significantly. Other important challenges discovered include lacking interdisciplinary communication, insucient focus on conti- nuos improvement and absence of process ownership among employees in the drilling and well department. In addition, a lack of formal decision points to support the WDP was revealed. The study also found similar challenges between the WDP's of the two companies. It was revealed that both operating companies use deviating targets and performance indicators that compromise cooperation. Companies also experience difficulties in com- municating lessons learned, challenges with an insucient supply of drilling rigs and a scarcity of qualified personnel. This reduceS quality of the WDP and increase risk. A greater number of challenges in the WDP were discovered for the operating company in the Middle East. As oppose to the operating company on the NCS, the operator in the Middle East has little or no focus on implementing lessons learned and lack process ownership among employees. The OME also lack a dynamic planning regime and has an insucient focus on HSE. Several opportunities for improving the WDP of the operator in the Middle East were discovered during the study. Suggested improvements include establishment of cooperation forums to enhance flow of information and increase collaboration between the field development and drilling and well department. It is also suggested to implement rigid processes and revise the use of targets and performance indicators. KPI's that favor cooperation across departments should also be established. Based on lessons learned from the NCS it is suggested to implement decision gates to support existing processes. It is also recommended to establish post activities and implement dedicated change management process steps. This will support lessons learned and increase the focus on managing risk and uncertainty in the WDP. The suggested improvements will increase the quality of the WDP. They will help secure process ownership and staff accountability, reduce time spent on planning the well and accelerate project development, increase safety aspects, improve allocation of key resources and secure continuos improvement. The study also analyzed future opportunities and challenges in the two regions using a PESTEL-analysis. Future opportunities in the Middle East include elevated political influence as an increasing part of remaining global oil and gas resources will be located in the region. Future challenges include an increase in resource complexity, volatility in the political environment and diculties in attracting the necessary expertise and technology. Common opportunities for the two regions include future predictions of high oil prices, technological progress making previous unavailable resources available, improved carbon capture and storage (CCS) methods to mitigate the environmental impact of the industry and opportunities as a result of an increased focus of the importance of providing energy to the global community. Common challenges include the chance of oil and gas becoming redundant and a strong dependency on prices of hydrocarbons. This makes regions vulnerable for a decline in oil and gas prices. Suggested future work includes analysis of the WDP in an increased number of operating companies to confirm or invalidate the presented findings. It would also be interesting to investigate the use of incentives and performance indicators and analyze their effect the WDP. Studies investigating methods to improve eciency in drilling and well operations are also interesting. It is also suggested to compare average recovery rates in oil and gas regions and investigate reasons for any existing differences.


Background: Missed outpatient appointments cost the health services millions every year. Rates are particularly high amongst clinics designed for older people, many of whom later attend the accident and emergency department (AED) and require admission. The purpose of this project was to examine reasons for non-attendance, including the demographics and level of area deprivation. Methods: Patient information was retrieved from routinely collected data in those aged 65 years and above, for those who did not attend (DNA) their hospital outpatient older people's clinic between January and December 2016. Data analysis was conducted on multiple variables, including age, area deprivation, reasons given for late cancellations and AED attendances. The Index of Multiple Deprivation (IMD) was used to assign the patient's postcode to their appropriate Deprivation Quintile to allow comparison between different areas. Results: The overall rate of non-attendance was 13.29%. 59% of these non-attenders were aged over 80. IMD analysis revealed that 49% of patients fell into the 5th Quintile, more than quadruple the number in any other group. Amongst those who cancelled, 45% were ill and 14% were admitted so could not attend. Further analysis into reasons for cancellations found that illness was consistently the leading reason across all age groups. A total of 268 people attended the AED in the 3 months following, with 88% being classed as Majors. 55% of these AED presentations were found to be aged over 80. Conclusions: Those aged 80 and over were most likely to not attend, with illness being the main reason. The majority were from the most deprived areas and presented to hospital with a major illness. Further work and interventions need to be conducted to explore these findings, as there is a suggestion of missed opportunities to provide equitable access.


The objective of this research is to investigate the rheological and thermal properties of bentonites for water base drilling fluids. Rheological experiments were performed with 4 different bentonite samples and clay percentages, cation-exchange capacity (CEC), swelling volume, pH, and physical and rheological properties of the samples are determined. The thermal behaviors of bentonite samples were investigated using simultaneous thermogravimetry (TG/DTG) and differential thermal analysis (DTA) techniques. It was observed that all bentonite samples exhibit 2 weight loss events on heating. Similar behavior was observed with the bentonite samples studied in the literature.


The avidity indices of Borrelia burgdorferi-specific IgG antibodies were estimated using ELISA in sera from patients with different stages of Lyme disease. In addition, sera from healthy students with proof of borrelial-specific IgG antibodies from standard serology were tested. Low avidity indices were detected predominantly in sera from patients with early-stage Lyme disease [erythema migrans (EM); n = 25]. High avidity indices were found in healthy students (n = 72) and in most of the patients with neuroborreliosis (NB; n =44) and chronic late-stage Lyme disease [acrodermatitis chronica atrophicans (ACA); n = 36]. In conclusion, early-stage Lyme disease (EM) could be differentiated from advanced and chronic stages (NB, ACA) and from ''seropositive'' healthy persons using avidity determination in the majority of patients in this study.


Exploration remains a significant challenge to reinforcement learning methods, especially in environments where reward signals are sparse. Recent methods of learning from demonstrations have shown to be promising in overcoming exploration difficulties but typically require considerable high-quality demonstrations that are difficult to collect. We propose to effectively leverage available demonstrations to guide exploration through en-forcing occupancy measure matching between the learned policy and current demonstrations, and develop a novel Policy Optimization from Demonstration (POfD) method. We show that POfD in-duces implicit dynamic reward shaping and brings provable benefits for policy improvement. Furthermore, it can be combined with policy gradient methods to produce state-of-the-art results, as demonstrated experimentally on a range of pop-ular benchmark sparse-reward tasks, even when the demonstrations are few and imperfect.