PURPOSE
To determine if glaucoma medications are associated with pregnancy and/or postnatal complications.

METHODS
Multicenter descriptive survey. Subjects were female patients 18-45 years who were previously pregnant with a diagnosis of glaucoma or ocular hypertension prior to pregnancy. Chart review queried diagnosis, glaucoma severity, and race. Survey questions were asked for each pregnancy and queried pregnancy age, medications used, and pregnancy outcomes/complications.

RESULTS
114 pregnancies of 56 patients (mean 2.0 pregnancies per patient) were included. Three pregnancies with therapeutic abortion were excluded from further analysis. Mean age during pregnancy was 29.1 ± 5.7 years. Of the 111 pregnancies, 20 (18.0%) used no medications and 91 (82.0%) used at least one medication. Medications were topical carbonic anhydrase inhibitors (n = 45), beta-blockers (n = 55), alpha-agonists (n = 56), and prostaglandin analogues (n = 28). Outcomes were: preterm contractions/labour (6.3%), miscarriage (4.5%), stillbirth (4.5%), induction of labour (11.9%), emergency/unplanned caesarean delivery (13.9%), neonatal intensive care unit (NICU) stay (15.8%), congenital anomalies (8.1%), and low birth weight (10.9%). Fisher exact test assessed outcome associations with individual agents, use of any agent, and different number of agents. Alpha-agonist use was associated with NICU stay: 25.5% rate (p = 0.012) in alpha-agonist use. Most of the alpha-agonist use NICU stays occurred in pregnancies with third trimester use. All other associations were not statistically significant.

CONCLUSIONS
The data from this survey suggest an overall favourable safety profile for topical glaucoma medications in pregnancy, but further investigation is needed. Caution should be employed regarding third trimester alpha-agonist use owing to association with NICU stay.


This work presents an intelligent automatic fingerprint identification and verification system based on Artificial Neural Networks (ANNs). In this work, the design processes of the system have been presented step by step. Fingerprints were first converted into digital images using a specific hardware. They were then processed by a computer. Fingerprint images were divided into grid blocks, and these blocks were classified as image area and background. An effective algorithm was used to detect the fingerprint singularities from gray level fingerprint images. In order to improve the performance of the system, fingerprint image enhancement was performed by using ANN. The adaptive backpropagation with momentum learning algorithm was used to train the ANN models. Binary images were obtained from the enhancement images using a regional binarization algorithm. Binary images were converted to thinned images. Ridge endings and ridge bifurcations of the fingerprints (minutiae) were extracted. A postprocessing algorithm was used to eliminate false minutiae patterns and the fingerprint matching process was finally applied. In order to automatise the system, a software for fingerprint identification and verification was developed in Delphi. The system developed in this work was tested 100 fingerprint images for identification and verification; it achieves the task with high accuracy. It is assumed that the developed system can be used in many security applications.


The dicarbonyl compound methylglyoxal (MG) potentiated the cell inactivating effect of cis-dichlorodiammine-platinum (II) (cis-DDP) when cultured human NHIK 3025 cells were treated with both drugs in simultaneous combination. While a 2 h treatment with cis-DDP alone resulted in a surviving fraction of 0.024 +/- 0.008, the simultaneous presence of 0.5 mM MG, a non-cytotoxic concentration, reduced the fraction of cells surviving treatment to 0.0009 +/- 0.0001. Although the cell inactivating effect of cis-DDP was potentiated, the amount of cell-associated platinum was not affected by MG. Glyoxal, another dicarbonyl compound, did not affect cis-DDP-induced cytotoxicity in any manner, nor did the aliphatic aldehydes acetaldehyde and propionaldehyde. Cell inactivation induced by MG alone at concentrations above 0.5 mM could be prevented by the simultaneous presence of cysteine or glutathione, indicating that cellular sulfhydryls may be involved in the expression of MG-induced cytotoxicity. Furthermore, MG-induced cell inactivation was increased by a dose-modifying factor of 2.6 when NHIK 3025 cells were first pretreated with buthionine sulfoximine, a glutathione synthesis inhibiting compound. We propose that MG reacts with cellular sulfhydryls which may also be involved in the mediation of cis-DDP cytotoxicity. Reactions between cellular sulfhydryls and MG therefore increase the cytotoxicity of cis-DDP by allowing more platinum to react with cellular targets, not by increasing the amount of platinum entering cells.


Background: Recent studies have highlighted the co-occurrence of gender dysphoria (GD) in adolescence and Autistic Spectrum Conditions (ASC). Systemising and empathising are two psychological dimensions linked to ASC. People with ASC score below average on the Empathy Quotient (EQ) and average or above average on the Systemising Quotient (SQ). Based on the results of previous studies we predicted that if the young people with GD shared aspects of the 'broader autism phenotype', their EQ would be lower, and their SQ would be the same or higher, compared to controls of their natal gender.  Methods: This preliminary study examined systemising and empathising in adolescents with GD using parent report questionnaires. 35 parents of adolescents with GD aged 12-18 attending the Gender Identity Development Service (London) took part. Parents of 156 typically developing adolescents aged 12-18 were used as a control group. The parents were asked to complete the Adolescent EQ and SQ.  Results: The mean EQ score of both the female-to-male, and male-to-female GD group was found to be significantly lower than typically developing females, but similar to that of control males. There was no significant difference on the SQ between the gender dysphoric groups and either female or male controls.  Conclusion: This study shows that on average adolescents with GD, specifically those who are female-to-male, have lower empathy than controls. For this group of adolescents it may be helpful to offer psychological interventions that improve their communication skills and their ability to take on board other people's views, to support their development. This may enable them to make better informed decisions regarding treatment and physical intervention options during adolescence and beyond.


We prove an abstract version of the Kuratowski extension theorem for Borel measurable maps of a given class. It enables us to deduce and improve its nonseparable version due to Hansell. We also study the ranges of not necessarily injective Borel bimeasurable maps f and show that some control on the relative classes of preimages and images of Borel sets under f enables one to get a bound on the absolute class of the range of f . This seems to be of some interest even within separable spaces.


Among mitogen-activated protein kinases (MAPKs), the c-Jun N-terminal kinases (JNKs) are of particular interest due to their involvement in cell signaling pathways associated with diabetes, cancer, neurodegenerative disorders such as Alzheimer's, and cellular apoptosis. Focusing on JNK3 specifically, the surrounding cascade mechanisms include numerous partner enzymes that regulate its activity via phosphorylation, and these interactions alter JNK3's overall protein conformation. Understanding the movements associated with forming these complexes will shed light on the mechanism by which these enzymes act, and a deeper understanding of these signaling systems will assist in developing treatments for associated pathologies. JNK3's molecular movements can theoretically be studied with the use of 19F NMR techniques, but the JNK3 molecules must first have 19F incorporated into their structure. To that end, we will develop a method to incorporate 19F into JNK3 in vivo, then confirm the location of the labeled amino acids with 19F NMR and mutagenesis studies. After establishing a connection between each amino acid and its signal, 19F NMR can be used to study the complexes formed between JNK3 and its upstream regulatory enzymes.


The present study investigated di�erence in voice characteristics between Call Center Operators (CCOs) reporting symptoms of vocal attrition and no symptoms of vocal attrition using acoustic and auditory perceptual measures of voice evaluation. A self-reported questionnaire was used to identify the CCOs experiencing vocal attrition symptoms and no vocal at- trition symptoms. The acoustic analysis of voice performed using MDVP (Multi-Dimensional Voice Program) using phonation sample of vowel /a/. Evaluation of perceptual voice quality was made using Consensus Auditory Perceptual Evaluation of Voice (CAPE-V) scale. No signi�cant di�erence in acoustic voice parameters observed between male CCOs reporting vocal attrition symptoms and no vocal attrition symptoms,whereas, in female CCOs there was signi�cant di�erence (p = 0.023) in NHR between two groups. However, when the acoustic parameters of CCOs (male & female) were compared with Indian normative values there were signi�cant di�erences in some of the MDVP acou tic voice parameters. Auditory perceptual rating scores between the two groups (with vocal symptoms and without) overlapped considerably such that, a substantial number of CCOs who did not report of any vocal symptoms and those who did were identi�ed as having deviancy or normalcy in the perceptual vocal parameters respectively. Eventhough acoustic and auditory perceptual measures of voice are found to be very useful in estab-lishing voice quality impairment, the agreement between these measures and self-perceived vocal symptoms remains inconsistent and they can- not quantify the amount of vocal dysfunction experienced by an individual.


Pentacene-5,7,12,14-tetraone was subjected to selective olefination and cross-coupling reactions to yield a new class of pentacene-based π-conjugated systems functionalized with geminal enediyne and 1,3-dithiole groups. The electron donating and accepting effects of enediyne and dithiole groups render these compounds intriguing structural, electronic properties, and redox activities which were systematically investigated by UV-Vis absorption and cyclic voltammetric analyses in conjunction with density functional theory (DFT) calculations. The bis(enediyne)-substituted pentacenedione showed potential application in the preparation of carbon-rich polymeric materials.


With the rapid growth in China's dairy industry, a number of recent papers have addressed either the supply or the demand trends for dairy products in China. None, however, presents a systematic explanation for the recent growth in both the supply and demand for dairy products. The goal of this paper is to sketch a more comprehensive picture of China's dairy sector and to assess the nature of the sector's development in the coming decades. Drawing upon several empirical studies, we examine the trends in dairy product consumption to create a composite picture of the factors underlying the recent growth. We also empirically investigate the sources of production gains in milk supply and assess the relative importance of expanding herd size, changes in the nature of production, technological change, and improvements in efficiency to the overall growth of milk production.


Abstract The work of disaster management can only properly be supported by data stored in certified databases, since correct decisions can be made on the base of such data. Nowadays these data can be found in databases managed by several organisations, or only a part of the necessary data is available through GIS services. The tasks of disaster management include prevention, i.e. the preparation for potential incidents and the elaboration of related scenarios and plans taking into consideration the altering risk landscape caused by climate change. The development of modelling processes and applications based on GIS databases and the integration of the results in work processes gain ground more and more in this work phase. Geoinformatics is able to provide support for decision-making in two ways: in strategic planning and in the operative task solution. The present study demonstrates a multi-hazard multi-scale GIS tool development in Csongrád County (Hungary) in accordance with the aims of the Sendai Framework. This geoinformatic tool is applicable to support the decision-making not only of the management board but the deployed rescue units in case of an evacuation through the optimized locations of the gathering places.


Abstract Objective: Our aim was to evaluate interrater reliability for the diagnosis of pediatric delirium by child psychiatrists. Method: Critically ill patients (N = 17), 0–21 years old, including 7 infants, 5 children with developmental delay, and 7 intubated children, were assessed for delirium using the Diagnostic and Statistical Manual–IV (DSM–IV) (comparable to DSM–V) criteria. Delirium assessments were completed by two psychiatrists, each blinded to the other's diagnosis, and interrater reliability was measured using Cohen's κ coefficient along with its 95% confidence interval. Results: Interrater reliability for the psychiatric assessment was high (Cohen's κ = 0.94, CI [0.83, 1.00]). Delirium diagnosis showed excellent interrater reliability regardless of age, developmental delay, or intubation status (Cohen's κ range 0.81–1.00). Significance of results: In our study cohort, the psychiatric interview and exam, long considered the "gold standard" in the diagnosis of delirium, was highly reliable, even in extremely young, critically ill, and developmentally delayed children. A developmental approach to diagnosing delirium in this challenging population is recommended.


The primary goal of this paper is to present, examine and exemplify the versatility and inclusiveness of the term 'mental health', i.e. the role of mental health as an integral component and affective factor in learning English as a foreign language. The most common mental health disorders and their early signs and symptoms are listed and described. Furthermore, the importance of teacher awareness of student mental health in the EFL classroom is elaborated as well as what and how much teachers should know about mental health and bullying so as to recognize and address them if need arises. It can even be said that the COVID-19 pandemic and school closures exacerbated this issue, and a suggestion to move forward could be building student resilience. Not only do teachers but also parents and guardians play a crucial role in their children's education, so how they can help protect their children's mental health has been additionally discussed. This paper will enrich the existing pool of theory on student mental health with the results and discussion from research conducted via interviews among 50 EFL teachers from various high schools in Skopje (North Macedonia), concerning their views on teacher awareness in respect to student mental health in the EFL classroom. The interview responses show an optimistic trend of increase of teacher interest in student mental health and empathy for students, albeit lack of institutional support. It is hoped that this paper will open avenues of thought for EFL teachers to probe even more into mental health in the EFL classroom. It is also important to acknowledge that while the overarching objective is to foster and promote mental health awareness among all educators across the board, this paper distinctly accentuates the significance within the domain of teaching EFL. This emphasis stems from the authors' perspective: one being an aspiring EFL teacher, and the other currently holding the position of an Assistant Professor (tertiary education). The aspiration is to highlight EFL teachers as influential figures capable of catalyzing transformative change for the future. / Keywords: mental health, bullying, resilience, students, awareness, EFL classroom


This paper studies the real consequences of relationship lending on firm activity in Italy following Lehman Brothers' default shock and Europe's sovereign debt crisis. We use a large data set that merges the comprehensive Italian Credit and Firm Registers. We find that following Lehman's default, banks offered more favourable continuation lending terms to firms with which they had stronger relationships. Such favourable conditions enabled firms to maintain higher levels of investment and employment. The insulation effects of tighter bank-firm relationships was still present during the European sovereign debt crisis, especially for firms tied to well capitalised banks.


Vaccination against Aujeszky's disease (AD) does not lead to eradication of the disease. Nevertheless, to reduce the economic losses, vaccination against AD is widely practised in many countries. With regard to control of AD, a method to distinguish infected from vaccinated pigs is a prerequisite in those countries. This paper deals with such a method. The assay (gI-ELISA) makes use of 2 monoclonal antibodies directed against 2 different epitopes on glycoprotein I (gI) of AD virus (ADV), and detects antibodies against those 2 epitopes. The gI-ELISA is sensitive, specific and suitable for serological screening on a large scale. Five of the 14 tested ADV vaccines did not elicit antibodies to gI in pigs, in other words they were gI-negative. On the other hand, all field strains of ADV tested so far did induce antibodies to gI. Pigs that were first given a gI-negative vaccine and subsequently were infected with a field strain of ADV produced antibodies to gI. These antibodies appear into the blood approximately 2 weeks after infection, and probably persist for over a year. Field experiments have demonstrated that it is possible to identify infected pigs in vaccinated herds. There is strong evidence, that ADV has been eliminated in a large multiplyer herd by removal of gI-seropositive pigs. The results described above provide a sound basis to implement a combined vaccination-control programme for AD in the Netherlands.


Industry concentration has been rising in the US since 1980. Firm operating margins have also been rising. Are these signs of declining competition that call for a new antitrust policy? This paper explores the role of proprietary information technology systems (IT), which could increase industry concentration and margins by raising the productivity of top firms relative to others. Using instrumental variable estimates, this paper finds that IT system use is strongly associated with the level and growth of industry concentration and firm operating margins. The paper also finds that IT system use is associated with relatively larger establishment size and labor productivity for the top four firms in each industry. Successful IT systems appear to play a major role in the recent increases in industry concentration and in profit margins, moreso than a general decline in competition.


Signal processing involves techniques that improve our understanding of information contained in received ultrasonic data. Simulation and data processing in ultrasonic testing plays an important role for analyzing results and performance demonstration. Another very common application is the design and optimization of inspection methods. However, comprehensive understanding of the processes taking place in the testing specimen is available only by fully investigating testing instrumentation and method. It includes analysis of the wave propagation in the structure under investigation and analysis of the characteristics of the instrumentation being used. This paper describes the digital signal processing techniques for ultrasonic wave propagation, which is validated for experimental study.


Driven by the expanding demand of location based services (LBS), the integration of satellite navigation receiver into mobile devices has received much attention in the last years. Snapshot positioning technique has turned out to be a very suitable candidate in LBS applications for its predominance of low cost and low power dissipation. However, the limited snapshot length is a major hurdle that limits the availability and accuracy of receivers. A code phase measurement technique is developed and used for snapshot receivers. By utilizing the features of the modernized global navigation satellite system (GNSS) signals and the characteristic of snapshot positioning, it uses a novel dual update-rate tracking loop with a non-causal smoothing estimator to obtain a relatively accurate estimation from a second or less snapshot data. Experiments with simulated data show that the proposed method has better estimation accuracy than the conventional code tracking loop in confined data length snapshot receivers.


Shared situation awareness is hard to measure, especially in operative environments such as crisis management. In this paper the purpose is to develop a novel method to measure to what extent the team has shared situation awareness that can be used in operations. 20 two person teams participated in a study where a dynamic and evolving tactical decision-making task was solved. Shared situation awareness, shared priorities, and team performance were assessed. The results show that the shared priorities measure in this study did not relate to shared situation awareness. Several methodological concerns was identified which could have affected the results. The measure did relate to subjective ratings of cooperation which is very interesting and it is suggested that the measure captured aspects of teamwork. The shared priorities measure was easy to employ, required little preparation, and is a promising addition to team research.


Syndecan-1 is a cell surface proteoglycan which participates in cell adhesion, differentiation, motility, morphogenesis and intracellular signaling. The two glycosaminoglycans heparan sulfate and chondroitin sulfate are covalently attached to the ectodomain of syndecan-1 via a tetra saccharide linkage sequence. However, the ectodomain can be modified having only one or neither of the glycosaminglycans attached. The glycosaminoglycans are capable of binding ligands such as fibroblast growth factors (FGFs) and support activation of receptors. The ectodomain is proteolytically cleaved from the cell surface by metalloproteinases in a process known as shedding. Shedding turns the ectodomain into a soluble effector which can stimulate other cells in the surroundings by delivering growth factors and also translocate into cells through endocytosis. In this study the aim was to find out if a modified ectodomain, which only contains chondroitin sulfate, could support intracellular signaling in the absence of heparan sulfate. The aim was also to find out whether a modified ectodomain could translocate into the cell. The methods used were cell culturing, isolation and purification of syndecan-1 ectodomain, cell signaling and immunohistochemistry. It was found that modified shed syndecan-1 ectodomain was able to support intracellular signaling almost to the same degree as wild type syndecan-1 ectodomain. This may suggest that heparan sulfate does not have to be present on the ectodomain to support intracellular signaling, although the signal is slightly higher when present. When trying to detect translocation of the ectodomain the results were too uncertain and further research is required.


Laplacean transport across and towards irregular interfaces have been used to model many phenomena in nature and technology. The peculiar aspect is that these phenomena take place in domains with small bulk and large interfaces in order to produce rapid and efficient transport. In this paper we perform the asymptotic homogenization analysis of Robin problems in domains with a fractal boundary.


Background

Escherichia coli lineage ST131 predominates across various spectra of extra-intestinal infections, including urinary tract infection (UTI). The distinctive resistance profile, diverse armamentarium of virulence factors and rapid global dissemination of ST131 E. coli makes it an intriguing pathogen. However, not much is known about the prevalence and genetic attributes of ST131 lineage in Pakistan.

Methods

We estimated the prevalence and genetic attributes of E. coli ST131 isolates causing UTI among 155 randomly selected samples. Samples were analyzed by phylogenetic grouping, O-typing, fumC/fimH typing. Isolates were further tested for ESBL and virulence factors using PCR.

Results

Overall, 59% of the UPEC isolates belonged to the phylogenetic group B2, followed by D=28%, B1= 8% and A= 5%. Among 18 different Sequence-types, ST131 was the dominant lineage (n=71; 46%) out of which 72% of the isolates were assigned to phylogenetic group B2 while 61% adhered to serogroup O25b. FumC/fimH typing confirmed 49% of the ST131 as H30 sub-types. In this study, significant numbers of the identified ST131 isolates were MDR and 42% showed ESBL phenotypes, out of which 57% carried blaCTX-M-15. Moreover, different virulence factors were detected in following percentages: fimH,155 (100%), iutA 86 (55%), feoB 76 (49%), papC 75 (48%), papGII 70 (45%), kpsMTII 40 (26%), papEF 37 (24%), fyuA 37 (24%), usp 22 (14%), papA 20 (13%), sfa/foc 20 (13%), hlyA 18 (12%), afa 15 (10%), cdtB 11 (7%), papGI 6 (4%), papGIII 6 (4%), kpsMTIII 4 (3%) and bmaE2 (1%).

Conclusion

Conclusively, this study provides important insights into the genetic and virulence attributes of pandemic MDR ST131 strains involved in UTIs. It also highlights high prevalence of ST131-O25b-H30 UPEC isolates in local population, which was previously unreported from this part of globe. Keywords: ST131, VF genes, ESBL, UPEC, MDR


Based upon state of the art biophysical experimentation, this article focuses on the different structural arrangements exchangeable apolipoproteins achieve when placed on Langmuir monolayers and subjected to changes in lateral pressure. We have studied the monolayers of apolipoproteins CI, CIII, AI, AII, and E that show as secondary structure a high percentage of amphipathic ahelix. This has been achieved employing techniques such as Brewster angle microscopy, synchrotron X-ray diffraction, and surface pressure measurements. In addition, the lateral order of protein arrays has been also studied by atomic force microscopy. These monolayers show that a phase transition from a two-dimensional disorder fluid to an ordered state is detected at relatively high lateral pressure, where unusual one-dimensional solid phases are discovered. While several helices that conform the apolipoprotein are confined to the interface, others are uniformly tilted toward the hydrophobic air or the phospholipid fatty acid chains. Our results suggest that a similar ordering might also occur when these apolipoproteins are attached to a lipoprotein particle such as a high density lipoprotein (HDL) particle. Therefore, changes from a nascent or discoidal HDL to a mature spherical HDL might in parallel involve structural changes as those described in our Langmuir interfaces. Current experimentation is being carried out in order to elucidate if the structural states already found are related to the efficiency of lipid transfer between lipoprotein particles or lipoproteins and the plasma membrane of cells, as well as receptor ligand recognition. 2004 Elsevier Inc. All rights reserved.


Abstract The frequency of probable migraine (PM) remains elusive; some of the published literature estimate PM to be at least as prevalent as definite migraine (DM) while others report PM to affect about 5% of the population or less. We conducted a cross sectional survey of female high school students using a validated questionnaire which covered the diagnostic features of DM, PM and tension type headaches as specified by the international classification of headache disorders. The survey also inquired about subjects' treatment history and analgesic use. Headache related disability was ascertained using headache impact test 6 (HIT-6). The participants included 309 girls with a mean age of 16.0 yr. The prevalence of DM and PM in our cohort were 18% and 25% respectively. Overall, headaches were more frequent in the DM group although this did not reach statistical significance (P < 0.06). There was no statistical significance between DM and PM in respect to seeking medical care (P < 0.30). The individuals with tension type headaches however, were less likely to seek medical care compared to the ones with PM or DM (P < 0.001). The preventative medications were under-utilized in all three groups. Moreover, individuals in the DM group reported higher frequencies of analgesic use (P < 0.001). The girls with DM experienced higher degrees of headache related disability as measured by HIT-6 (P < 0.0001). PM appears to be at least as prevalent of DM in our cohort of teenage girls. We propose that PM may produce a milder phenotype indicated by significantly lower HIT-6 scores.


&NA; Accelerating the science to revolutionize cancer care &NA; Symbol Symbol. No caption available. BACKGROUND: Precision medicine in cancer care uses specific information about a person's tumor to help diagnose, plan treatment, prognosticate, and surveil throughout the cancer trajectory. Applications exist for cancer prevention, early detection, cancer treatment, and supportive care. Several national initiatives (e.g., National Cancer Moonshot Initiative) support these efforts to accelerate this science forward. OBJECTIVES: This article presents an overview of the way in which precision medicine is revolutionizing cancer care. METHODS: Definitions, historic perspectives, and specific examples are provided, which illustrate the use of precision medicine in cancer care. FINDINGS: Oncology nurses and other healthcare professionals have a responsibility to learn about the science and national initiatives supporting precision medicine, provide clear patient education messages for optimal understanding, and address challenges.


Increasingly, environmental problems are recognized to involve linkages across multiple environmental variables (e.g., pollution and a fishery). Prior work on managing these complex, linked systems generally focuses on efficiency rather than implementation. However, implementation is important and will generally involve changing human behaviors within the multiple economic sectors that impact upon the multiple environmental variables. Tradable permit markets are generally seen as a coordinating mechanism, within a particular regulated sector, that enhances efficiency by incentivizing agents to respond to behavioral choices of others within the sector. However, prior work stops short of coordinating behaviors across multiple sectors for cases where society benefits from regulation in both sectors and one sector harms the other. We analyze a multi-sector permit market involving both the externality-generating sector and the affected sector. This multi-sector market provides a mechanism for agents in one sector to respond to environmental behaviors made within the other sector. Moreover, unlike traditional permit markets in which the regulated externality sector incurs only costs, we show that the multi-sector market generates efficiency gains that may be redistributed using appropriate allocations of initial endowments. Accordingly, the multi-sector market may generate gains that benefit both sectors, resulting in a win-win outcome for both sectors. We use a simple example of a polluted fishery to illustrate the approach.


Consumer behavior continued to attract additional researchers and publication outlets from 1993 through 1996. Both general interest and domain-specific scholarly contributions are discussed, along with limitations and suggested areas for future research. A concluding section observes that the integrity of consumer research is unnecessarily compromised by the failure of the major scholarly association in the field to develop and adopt a code of researcher ethics.


Renal cell carcinoma (RCC) is the most frequent kidney solid tumor, the clear cell RCC (ccRCC) being the major histological subtype. The probability of recurrence and the clinical behavior of ccRCC will greatly depend on the different clinical and histopathological features, already incorporated to different scoring systems, and on the genomic landscape of the tumor. In this sense, ccRCC has for a long time been known to be associated to the biallelic inactivation of Von Hippel-Lindau (VHL) gene which causes aberrant hypoxia inducible factor (HIF) accumulation. Recently, next generation-sequencing technologies have provided the bases for an in-depth molecular characterization of ccRCC, identifying additional recurrently mutated genes, such as PBRM1 (≈40–50%), SETD2 (≈12%), or BAP1 (≈10%). PBRM1, the second most common mutated gene in ccRCC after VHL, is a component of the SWI/SNF chromatin remodeling complex. Different studies have investigated the biological consequences and the potential role of PBRM1 alterations in RCC prognosis and as a drug response modulator, although some results are contradictory. In the present article, we review the current evidence on PBRM1 as potential prognostic and predictive marker in both localized and metastatic RCC.


Companies that seek to venture into providing services in addition to providing products have many business issues to consider as there are many differences between providing service and product offerings. One factor that needs to be considered in service offerings is the aspect of time, as services are offered for an extended period of time, creating a unique type of relationship between the customer and the service provider. With product offerings, the point of sale is usually the end of the product provider and customer relationship. The added time aspect in the service offering brings with it the issues of uncertainty as service contracts are made for a certain period of time in the future, where things are unknown. This thesis looked at types of uncertainties important to service offerings, especially in the manufacturing industry. The uncertainties have an impact on how service offering contracts are constructed, as they can affect the profit and costs of the service provider. The three types of uncertainties that were examined were product malfunction uncertainty, service delivery uncertainty, and customer requirement uncertainty. Using these three types of uncertainty, mathematical models were constructed to represent the cost and revenue of different contract types. The different contract types were identified through a case study with a product manufacturer in Sweden. Different probability distributions were selected to model the three types of uncertainty based on a literature review. The mathematical models were then used to construct a software program, the uncertainty simulator tool, which service contract designers can use to model how uncertainties affect cost and revenue in their contracts.


Sexual assault is among the gravest crime against the physical and moral integrity of an individual. When sexual assault results in pregnancy it causes further psychological and social damage. This study aims to examine the reasons for delayed reporting in cases of sexual assault that result in pregnancy, and the importance of abortion in such cases. Seven cases referred by the judicial authorities to Inonu UniversityÂ's Turgut Ozal Medical Center for uterine evacuation are included in the study. The cases were examined in terms of age, whether the parents were still alive, place of residence, assaulter characteristics, mental levels of victims, psychiatric examination results, and gestational week upon referral to the hospital. The mean age of the cases was 17.42±2.76 years. Six of the cases were referred from Malatya and one was referred from a neighboring province. Four of the cases were past their 10th gestational week. Abortions were performed in six of the cases. One of the women, in the 19th week of pregnancy, decided not to have the abortion upon consultation with her family. The women in the cases were, on average, 76 days pregnant upon referral to the center. Their medical histories indicated that five of the cases hid their pregnancy because they were concerned about their familyÂ's reaction. None of the cases knew that they were able to end the pregnancy until week 20. Pregnancy is one of the unwanted and preventable consequences of sexual assault. The familyÂ's attitude toward the victim plays an important role in earlier detection of the cases. In addition to legislation concerning ending pregnancies, victims and families should be informed about this topic to prevent further trauma for the victim and the to be born child.


In this thesis we consider the development of a general nonlinear input-output theory which encompasses systems with initial conditions. Appropriate signal spaces (i.e., interval spaces, extended spaces and ambient spaces) are introduced with some fundamental assumptions to constitute a framework for the study of input-output systems with abstract initial conditions. Both systems and closed-loop systems are defined in a set theoretic manner from input-output pairs on a doubly infinite time axis, and a general construction of the initial conditions (i.e., a state at time zero) is given in terms of an equivalence class of trajectories on the negative time axis. Fundamental properties (such as existence, uniqueness, well-posedness and causality) of both systems and closed-loop systems are defined and discussed from a very natural point of view. Input-output operators are then defined for given initial conditions, and a suitable notion of input-output stability on the positive time axis with initial conditions is given. This notion of stability is closely related to the ISS/IOS concepts of Sontag. A fundamental robust stability theorem is derived which represents a generalisation of the input-output operator robust stability theorem of Georgiou and Smith to include the case of initial conditions; and can also be viewed as a generalisation of the ISS approach to enable a realistic treatment of robust stability in the context of perturbations which fundamentally change the structure of the state space. This includes a suitable generalisation of the nonlinear gap metric. Generalisations of this robust stability result are also extended to finite-time reachable systems and to systems with potential for finite-time escape by extending signals on extended spaces to a wider space (ambient space). Some linear and nonlinear applications are given to show the effects of the robust stability results. We also present a generalised nonlinear ISS-type small-gain result in this input-output structure set up in this thesis, which is established without extra observability conditions and with complete disconnection between the stability property and the existence, uniqueness properties of systems. Connections between Georgiou and Smith's robust stability type theorems and the nonlinear small-gain theorems are also discussed. An equivalence between a small-gain theorem and a slight variation on the fundamental robust stability result of Georgiou and Smith is shown.


Elevated expression of the iron regulatory protein, ferritin heavy chain 1 (FTH1), is increasingly being associated with high tumor grade and poor survival outcomes in glioblastoma. Glioma initiating cells (GICs), a small population of stem-like cells implicated in therapeutic resistance and glioblastoma recurrence, have recently been shown to exhibit increased FTH1 expression. We previously demonstrated that FTH1 knockdown enhanced therapeutic sensitivity in an astrocytoma cell line. Therefore, in this study we developed a liposomal formulation to enable the in vitro delivery of FTH1 siRNA in patient xenograft derived GICs from glioblastomas with pro-neural and mesenchymal transcriptional signatures to interrogate the effect of FTH1 downregulation on their radiation sensitivity. Transfection with siRNA decreased FTH1 expression significantly in both GICs. However, there were inherent differences in transfectability between pro-neural and mesenchymal tumor derived GICs, leading us to modify siRNA: liposome ratios for comparable transfection. Moreover, loss of FTH1 expression resulted in increased extracellular lactate dehydrogenase activity, executioner caspase 3/7 induction, substantial mitochondrial damage, diminished mitochondrial mass and reduced cell viability. However, only GICs from pro-neural glioblastoma showed marked increase in radiosensitivity upon FTH1 downregulation demonstrated by decreased cell viability, impaired DNA repair and reduced colony formation subsequent to radiation. In addition, the stemness marker Nestin was downregulated upon FTH1 silencing only in GICs of pro-neural but not mesenchymal origin. Using liposomes as a siRNA delivery system, we established FTH1 as a critical factor for survival in both GIC subtypes as well as a regulator of radioresistance and stemness in pro-neural tumor derived GICs. Our study provides further evidence to support the role of FTH1 as a promising target in glioblastoma.


Context. The most recent minimum of solar activity was deeper and longer than the previous two minima as indicated by different proxies of solar activity. This is also true for the total solar irradiance (TSI) according to the PMOD composite. Aims. The apparently unusual behaviour of the TSI has been interpreted as evidence against solar surface magnetism as the main driver of the secular change in the TSI. We test claims that the evolution of the solar surface magnetic field does not reproduce the observed TSI in cycle 23. Methods. We use sensitive, 60-min averaged MDI magnetograms and quasi-simultaneous continuum images as an input to our SATIRE-S model and calculate the TSI variation over cycle 23, sampled roughly every two weeks. The computed TSI is then compared with the PMOD composite of TSI measurements and with the data from two individual instruments, SORCE/TIM and UARS/ACRIM II, that monitored the TSI during the declining phase of cycle 23 and over the previous minimum in 1996, respectively. Results. Excellent agreement is found between the trends shown by the model and almost all sets of measurements. The only exception is the early, i.e. 1996 to 1998, PMOD data. Whereas the agreement between the model and the PMOD composite over the period 1999–2009 is almost perfect, the modelled TSI shows a steeper increase between 1996 and 1999 than implied by the PMOD composite. On the other hand, the steeper trend in the model agrees remarkably well with the ACRIM II data. A closer look at the VIRGO data, which are the basis of the PMOD composite after 1996, reveals that only one of the two VIRGO instruments, the PMO6V, shows the shallower trend present in the composite, whereas the DIARAD measurements indicate a steeper trend. Conclusions. Based on these results, we conclude that (1) the sensitivity changes of the PMO6V radiometers within VIRGO during the first two years have very likely not been correctly evaluated; and that (2) the TSI variations over cycle 23 and the change in the TSI levels between the minima in 1996 and 2008 are consistent with the solar surface magnetism mechanism.


[1] We have conducted hydraulic experiments in an open channel with cubic and rectangular shaped solid blocks on the slope for investigating the boulder transport process by tsunami. In our experiments, the block was mainly seen to be transported by a bore due to rolling or saltation rather than by sliding. Previous models for the boulder transport by tsunamis assumed sliding as a mode of transport for the boulder. Therefore, these models underestimated the distance of the boulder moved by the tsunami when it was transported due to rolling or saltation. In this study, we have developed a practical model for the transport of a boulder by tsunami, which takes into account the various transport modes. We introduce an empirical variable coefficient of friction by assuming that the coefficient decreases with decrease in ground contact time when the block was transported by rolling or saltation. With the aid of this parameter, the model can explain various modes of transport, i.e., sliding, rolling, and saltation, and reproduces the experimental results well. We further applied this improved model to a tsunami boulder at Inoda area in Ishigaki Island, Japan, which was transported by the 1771 Meiwa tsunami. The calculated distance of transport of the boulder was approximately 650 m, which is consistent with the description in the historical document. Based on our calculations, we estimated hydraulic values of the tsunamis. Estimation of such hydraulic values is important for understanding the behavior and power of the historical tsunamis, besides aiding future disaster mitigation efforts.


Abstract We perform numerical simulations of dynamic rupture processes along the North Anatolian fault in the Sea of Marmara, which poses a high risk to the nearby city of Istanbul. Several fault geometry models, nucleation points, and initial stress states are tested. The likelihood of each earthquake scenario is evaluated, and a probabilistic assessment of the ground‐motion estimation is proposed. The simulation results suggest that the fault geometrical configuration is not favorable for producing an earthquake of magnitude 6–7, as no scenario is found. On the contrary, the probability of occurrence of an earthquake of magnitude greater than 7 is high. Most of these large events are characterized by epicenters located in the central or eastern parts of the Sea of Marmara. However, the possibility of a western‐initiated rupture propagating eastward, the worst scenario for the Istanbul region, cannot be ruled out. Many simulations led to supershear ruptures, as observed for the nearby 1999 Izmit earthquake, and this significantly influences ground‐motion prediction in the region.


Image processing is one of most growing research area these days and now it is very much integrated with the medical and biotechnology field. Image Processing can be used to analyze different medical and MRI images to get the abnormality in the image. This paper proposes an efficient K-means clustering algorithm under Morphological Image Processing (MIP). Medical Image segmentation deals with segmentation of tumor in CT and MR images for improved quality in medical diagnosis. It is an important process and a challenging problem due to noise presence in input images during image analysis. It is needed for applications involving estimation of the boundary of an object, classification of tissue abnormalities, shape analysis, contour detection. Segmentation determines as the process of dividing an image into disjoint homogeneous regions of a medical image. The amount of resources required to describe large set of data is simplified and is selected for tissue segmentation. In our paper, this segmentation is carried out using K-means clustering algorithm for better performance. This enhances the tumor boundaries more and is very fast when compared to many other clustering algorithms. This paper produces the reliable results that are less sensitive to error.


s of 1st International Haemophilia Conference. Bonn: Institut fur Experimentelle Hamatologie und Bluttransfusionswesen der Universitat Bonn, 1980:177. Less listening, more discussion A fanfare of trumpets may or may not precede the platitudes of the minister of health at opening ceremonies of international conferences, but the pattern of the rest of the meeting is more predictable. The keynote review address given by a star performer is often a rehash of his own textbook. Original papers read by the naive to the gullible are often strongly represented by speakers from the host country. Perhaps the most pernicious device for cementing international friendships is the round table composed ofthe same experts each year. A large proportion of original papers given even at national meetings would not stand up to the scientific rigour of a referee and are never published in full.' Instead, the conference proceedings are published between one and two years later, and most of the copies will never be removed from their shelves. What is the remedy? Instead of just moaning about the futility of these international jamborees Professor John Dobbing has tried to experiment with a new design of meeting. Seven authors were asked to write a paper on the role of maternal nutrition in the determination of fetal growth. The authors were chosen for their authority and for the variety of their views. Each paper was sent to the other authors in the group and also to six other people who had contributed substantially to the subject. All 13 were asked to criticise all the papers. The original papers and the criticism were circulated to all the participants several weeks before the meeting started-so giving them time to consider carefully all the written material, to examine appropriate references, and for the original authors to change their minds before the conference. The meeting itself consisted exclusively of discussion, with experts talking to each other and exposing the strengths and fallacies in their arguments. Such a format contrasts vividly with the conventional conference, where the pattern of presentation stifles discussion and the most valuable interchange of ideas is squeezed into the coffee break. The design of this meeting and the resulting book2 must be rated as a highly successful experiment in communication-but some features need further development, and in particular the omission from the book of the discussions which took place at the workshop means that the cut and thrust of important debates are entirely lacking. This type of meeting might seem to be suitable only for small groups, but the Society for General Microbiology holds annual meetings attended by several hundred doctors and has a similar arrangement. Its collection of papers is published by Cambridge University Press and sent to each participant a month before the meeting. Every member is expected to have read it before he attends. Though informed discussion takes place throughout the meeting, there is no method of publishing this material. Whatever else, conference proceedings need to be published quickly, if at all. With proper organisation it is not difficult to achieve this. Whatever their status, authors who do not provide a full and final copy of their papers by the deadline set before the conference should not be paid their expenses or invited in the future. Contributions can be recorded on tape and an edited, shorter version typed immediately for approval by the participants at the meeting. In this way an edited version of the entire approved script of the conference can be made available to the printers only a few hours after the conference is over. Organisers, editors, and authors will all benefit from changes designed to convert conferences from entertaining circuses to productive symposia, and Professor Dobbing is to be congratulated on showing us how. Goldman L, Loscalzo A. Fate of cardiology research originally published in abstract form. N EnglJ' Med 1980;303;255-9. 2 Dobbing J, ed. Maternal nutrition in pregnancy-eating for two? Based on Nestle Nutrition workshop, Chateau de Rochegude, Vaucluse, France, J7une 1980. London: Academic Press, 1981. Arthrogryposis multiplex congenita When the prevalence of a congenital disorder varies considerably between countries and also over time its aetiology might be expected to be clarified by detailed epidemiological investigation. Arthrogryposis multiplex congenita is such a disorder. Affected individuals have multiple congenital articular rigidities, characteristically accompanied by muscle wasting, but no identifiable neurological abnormality. During the 1960s the prevalence of arthrogryposis in Helsinki was reported to be three per 10 000 births,' whereas only one case was recorded among about 56 000 births in the Edinburgh register of newborn babies in the same period.2 Furthermore, hospital records in Britain, Australia, and the United States have shown a more than tenfold increase in diagnosis of the condition between the early 1940s and 1960s followed by a subsequent decline.3 In South Africa a nationwide investigation in 1974 found only 26 cases, mostly in children; the oldest patient was aged 24.4 Some of these variations in prevalence may have been due to differences in the extent to which associated abnormalities responsible for secondary congenital joint contractures were investigated and excluded from the figures; but in view of the similar pattern of changes over time in many countries diagnostic factors are unlikely to account for all the variation. BRITISH MEDICAL JOURNAL VOLUME 283 4 JULY 1981 3 A recent paper by Wynne-Davies and her colleagues3 describes an epidemiological survey of arthrogryposis multiplex congenita based on 132 patients from nine centres in three countries. Information obtained retrospectively from the mothers of affected individuals confirmed earlier work2 5 showing that the disorder does not have a purely genetic aetiology. None ofthe 532 first-degree and only one of the 3266 second-degree relatives of the index cases was known to be affected-and in this single case only a slight malformation was reported. Nor were other neuromuscular and orthopaedic abnormalities more common in the families of cases than might be expected in any large series. Retrospective obstetric inquiries from the mothers of affected individuals are likely to be unreliable-a problem familiar to Wynne-Davies and her colleagues. Such surveys are best used to test prior hypotheses, and only when the results show gross differences from controls are they convincing. Oligohydramnios has often been reported in association with arthrogryposis multiplex congenita and offers a plausible causal mechanism, since the consequential fetal compression might prevent muscle development. Information on oligohydramnios was available for 107 cases in the present series and 260' of the mothers reported it-a clear excess for such a rare condition-but medical confirmation could not generally be obtained. A whole range of complications or abnormalities of pregnancy other than oligohydramnios, including bleeding and loss of liquor, were reported; one or other abnormality had occurred in about one-third of cases. This proportion was remarkably high, but the range of complications mentioned was too broad to be informative. The survey provided no support for two hypothetical causes derived from animal experimentation-namely, hyperthermia and a viral agent. This failure to identify a single environmental agent may indicate that arthrogryposis multiplex congenita is not a single aetiological entity but simply a loose clinical characterisation. The large proportion ofmothers who reported oligohydramnios -at present a subjective diagnosis-suggests that undiagnosed fetal immobilisation or malposition might be the common cause. With the increasing use of ultrasound scanning in obstetrics and the development of techniques to estimate amniotic fluid volume6 future studies of arthrogryposis may be able to draw on more reliable obstetric data. What, then, of the clues to be had from the varying prevalence between countries and over time? Wynne-Davies and her colleagues compared epidemiological factors between the three countries (which had a threefold variation in prevalence) and between the periods before, during, and after the time of peak prevalence. No obvious differences emerged. Geographical and temporal variability is not necessarily helpful in illuminating the aetiology of a congenital disorder even when it is relatively common and therefore easier to study. Neural tube defects have an almost tenfold gradient in prevalence within Britain alone, from north east to south west, and have undergone strong cyclic changes in frequency throughout this century,7 with occasional localised epidemics. Diet, temperature, drugs, infections, and previous miscarriage are among the many factors that have been implicated at some time. Yet the causation of neural tube defect remains obscure-and that of arthrogryposis multiplex congenita will inevitably be much harder to clarify. I Laitinen 0, Harvensalo M. Arthrogryposis multiplex congenita. Annales Paediatriae Fenniae 1966 ;12 :133-8. 2 Wynne-Davies R, Lloyd-Roberts GC. Arthrogryposis multiplex congenita: search for prenatal factors in 66 sporadic cases. Arch Dis Child 1976; 51:618-23. 3 Wynne-Davies R, Williams PF, O'Connor JCB. The 1960s epidemic of arthrogryposis multiplex congenita. A survey from the United Kingdom, Australia and the United States of America. J Bone J7oint Surg (Br) 198 1 ;63:76-82. 4 Davidson J, Beighton P. Whence the arthrogrypotics ? J Bone J7oint Surg (Br) 1976 ;58 :492-5. 5 Friedlander HL, Westin GW, Wood WL Jr. Arthrogryposis multiplex congenita. A review of forty-five cases. J Bone Joint Surg (Am) 1968; 50:89-112. 6 Gohari P, Berkowitz RL, Hobbins JC. Prediction of intrauterine growth retardation by determination of total intrauterine volume. Am J Obstet Gynec


The classification of dihedral folding tessellations of the sphere and the plane whose prototiles are a kite and an equilateral triangle are obtained in a recent paper, [1]. In this paper, we extend this classification presenting all the dihedral folding tessellations of the sphere by kites and isosceles triangles in a particular case of adjacency. A list containing these tilings including its combinatorial structure is presented in Table 1.


This paper studies a novel method for creating M-channel nonsubsampled directional filter banks (DFBs). It is based on the pseudo-polar Fourier transform (PPFT) which evaluates the Fourier transform at points along rays equispaced in slope. We take some modifications on the arrangement of the euqispaced rays, making the two-dimensional (2D) PPFT grid to the Cartesian 2D discrete-Fourier transform grid. Then we apply one-dimensional (1D) filter banks (FBs) to the arranged PPFT along the slope direction. This can perform the decomposition of images into arbitrary directionally-oriented subbands. By using this method, the design of DFBs is reduced to that of 1D FBs, leading to the low design complexity and good design flexibility. Furthermore, by combining the proposed DFBs with Laplacian pyramid, we can achieve a multiscale and multidirection system. Experimental result is given to illustrate the proposed approach.


To determine whether minority patients were less likely to participate in biomedical research, perceive positive benefits from such participation, or to recommend research participation to other patients, an observational study was conducted. Sociodemographic and survey data were collected from 5436 users of Department of Veterans Affairs (VA) Ambulatory Care, which included questions about veterans' research participation and related attitudes. Bivariate and multivariate analyses were performed to determine if there were racial differences in the outcomes of interest, controlling for relevant sociodemographic factors. Bivariate and multivariate analyses indicated that there were no racial differences in self-reported research participation, but minority veterans were more likely to perceive a positive effect of research and less likely to recommend research to other veterans. However, subgroup analyses indicated that, of those veterans having negative attitudes about research, minority and less educated veterans were disproportionately represented. In the VA system, racial differences in research participation may dissipate because many sociodemographic factors are controlled. Although we did not observe consistent racial differences in research participation or attitudes, the fact that minority veterans were disproportionately represented among the group with the most negative attitudes about research suggests that further research is necessary to fully understand the racial dynamics of research participation in the VA.


The evolution of digital media has been accompanied by new ways of telling stories. Interactive nonfiction includes works that represent reality and employ interactive technology. This field has been studied from the perspective of production, especially in journalism where there is an emergence of interactive and immersive formats, but there are still questions about its value from the point of view of reception. The aim of this study is to identify the effects of nonlinearity and multimedia-interactive attributes on the user experience. The research is based on an experimental design (N = 110) with an interactive documentary in webdoc format. The results indicate that nonlinearity and multimediainteractive attributes have positive effects on perceived levels of engagement and immersion. These contributions can be applied in digital journalism, where publishers seek to engage new audiences, and other fields, such as education and health, with the effect of transforming viewing into an enhanced experience.


The Dirty War in Argentina refers to an eight-year period, between 1976 and 1983, in which a right-wing government purged Argentina of left-wing "subversives". The Dirty War is defined by violent tactics, repression, and cover up. This paper explores the dominant public narrative of the Dirty War by coding and analyzing primary sources from victims, families, and perpetrators. The final goal of this paper was to understand how key groups talk about the Dirty War and what the long-term consequences of that are for Argentina. The democratic governments that took power after the Dirty War followed the military junta's tactics of hiding key information and offering pardons to military officials, preventing people from knowing the truth about what happened to their loved ones. The torture and cover up tactics used by the government prevented Argentine citizens from receiving much needed closure in the Dirty War, which means there is still pain in society that people are reconciling with.


The spectra of a microwave cylindrical resonator with the embedded thin metal rod playing the role of a singular perturbation are studied both theoretically and experimentally. The intra- and inter-mode scattering caused by the perturbation are clearly distinguished and recognized to play essentially different parts in the appearance of spectrum chaotic properties. The analysis based on the mode-mixing operator norm shows that the inter-mode scattering dominates over the intra-mode scattering and basically determines statistical properties of the resonator spectrum. The results we have obtained in the experiment are in good conformity with our theory. Clear manifestations of quantum chaos are revealed for the resonator with the asymmetrically inserted rod, namely, the Wigner-type distribution of the inter-frequency intervals, the apparent correlation between spectral lines, and the characteristic curve of the spectral rigidity. By comparing the theory and the experiment we succeeded in establishing for the first time that it is just the inter-mode scattering that is responsible for the quantum chaos manifestations in the singularly perturbed integrable wave-billiard system.


Blood-borne hepatitis, hepatitis B and hepatitis C (HBV & HCV), are a worldwide health problem that affect millions of people annually. These viruses are transmitted parenterally, making health care professionals a risk group for infection. Dentists play a major role in the prevention & spread of hepatitis by taking every safety measures needed to prevent transmission. These measures include cross infection control and following standard precautions.


Background Therapeutic neurointerventional (NI) procedures have become a significant source of radiation exposure during the treatment of cerebrovascular disease. While there are well-established radiation dose reference levels (DRLs) for diagnostic imaging, no similar NI DRLs are available. We analyzed the patient radiation dose for therapeutic NI procedures at a tertiary teaching hospital, with an aim to develop local DRLs that could form the foundation for developing national NI radiation safety guidelines. Method Retrospective analysis of radiation dose area product (DAP) in Gy. Cm2 for consecutive patients undergoing therapeutic NI procedures between July 2011 and April 2014 was performed. NI procedures were categorized into arteriovenous malformation (AVM) embolization, cerebral aneurysm embolization (primarily coiling vs balloon/stent assisted) and cerebral vasospasm procedures. Median and inter-quartile radiation dose levels were calculated for each NI category. The 75th percentile was deemed to be the local DRL. Wilcoxon signed-rank test was performed for statistical correlation. Results A total of 303 NI procedures were included. Patients undergoing AVM embolization received a significantly higher radiation dose (n = 44; median 338 Gy. Cm2 [IQR 225–528 Gy. Cm2]) than patients undergoing cerebral aneurysm embolization (n = 188; median 211 Gy. Cm2 [IQR 130–328 Gy. Cm2]; p = 0.003). Patients treated with primary coiling received a significantly lower radiation dose (n = 96; median 170 Gy. Cm2 [IQR 125–282 Gy. Cm2]) than patients undergoing stent/balloon assisted aneurysm embolization (n = 92; median 241 Gy. Cm2 [IQR 145–369 Gy. Cm2]); p = 0.0002). Patients undergoing cerebral vasospasm procedures (n = 71) received median 161 Gy. Cm2 [IQR 106–219 Gy. Cm2] of radiation. Conclusion Therapeutic NI procedures are a significant source of radiation exposure, particularly for AVM embolization. Proposed NI radiation DRLs based on the 75th percentile for DAP were 528 Gy. Cm2, 328 Gy. Cm2 and 219 Gy. Cm2 for AVM embolization, cerebral aneurysm embolization and cerebral vasospasm procedures respectively. Disclosures L. Slater: None. C. Hadley: None. C. Soufan: None. H. Yu: None. M. Holt: None. W. Chong: None. H. Maroulis: None. S. Stuckey: None. R. Chandra: None.


Nations in the Middle East and North Africa have traditionally seen the primary function of social policy as serving the goal of economic growth. But the COVID-19 pandemic has demonstrated the need for a more balanced approach to make societies more resilient, with social protection policies that provide citizens with basic security throughout their lives. Beyond cash transfer programs and other emergency measures, governments should recognize the need for universal provision of health care and other essential assistance. Otherwise they risk leaving the Arab Spring's popular demands for dignity unheeded.


The paper begins with an objection to the DesireBased Reasons Model. The argument from reason-based desires holds that since desires are based on reasons (first premise), which they transmit but to which they cannot add (second premise), they cannot themselves provide reasons for action. In the paper I investigate an attack that has recently been launched against the first premise of this argument by Ruth Chang. Chang invokes a counterexample: affective desires. The aim of the paper is to see if there is a way to accommodate the counterexample to the first premise. I investigate three strategies. I first deal with the idea that the motivation for the premise may be the thesis that an action is intentional if and only if it is done under the guise of perceived reasons. This offers us a way of defending the premise: by showing that actions prompted by affective desires are not intentional. I, however, argue that this strategy is unworkable. This brings me to the second strategy. Here I consider the idea that the premise does not require a conscious normative thought on the part of the agent; in fact, it may not require any such thought, conscious or unconscious. I claim that this strategy too is a failure. Finally, the third approach builds normative judgment in the desire. This is the approach that I think works; in particular, recent work by Jennifer Hawkins may help us accommodate affective desires. The challenge of affective desires, I conclude, can be tackled.


Objectives: Caudal epidural steroid injection (CESI) is used frequently in the treatment of patients with chronic lumbar pain and leg. Obesity is one of the main reasons of lumbar pain. In this study of ours we tried to assess the effects of CESI on patients with normal weight, over weight and obese suffering from lumbar pain. Design: Retrospective Study. Settings: DiyarbakA±r Selahaddin Eyyubi State Hospital. Subjects and methods: Our study is conducted on 300 patients to assess the effects of CESI on whom lumbar and leg pain persisted for three months between January 2015-December 2016. US guidance used for all injections. Groups were allocated as: GroupI: BMI 25 kg/m2 and Group III: 30 ≤ BMI<40 kg/m2. Main outcome measures: 130 participants were identified as normal weight, 116 over weight, 54 obese. Pain scores were assessed by using Visual analogue scores (VAS). VAS scores were measured at preinjection, 1st, 3rd, and for a period of 6th months after injection. Life quality was evaluated with Short Form – 36 (SF-36). Results: After injection VAS scores were found lower for all repeated measured times during the six months interval (p<0.05). No statistical differences were found between the groups regarding age or gender. In all groups the number of patients suffering from chronic low back pain was high and the highest score was found in Group III but statically not significant. SF-36 scores were found improved after injection compared to baseline values. Conclusion: CESI is helpful in relieving pain for all patients at all weights and improves the quality of individual's daily life.


Cellulose from durian peel was isolated then esterified using citric acid with cellulose ratio used 1: 1, 1: 2, and 1: 3 (w / w). The formation of cellulose citrate from the esterification of cellulose with citric acid is evidenced by FT-IR spectroscopy analysis which gives the vibration spectrum of C = O carboxylate groups at the 1735 cm wave region and is supported by the -OH group vibration in the 3448 cm wave region. The results of morphological analysis using SEM also showed large morphological changes and cavities. Testing of adsorption power on Pb2 + metal ions (at concentrations of 100, 200, 300, 400 and 500 ppm) analyzed using atomic absorption spectrophotometers showed maximum absorption of cellulose present at a concentration of 100 ppm absorbing at 43.0804%, and maximum absorption of cellulose citrate 1 : 3 is present at a concentration of 100 ppm absorbing at 92.5000%.


AbstractWest Stow is an early Anglo-Saxon settlement site located on the banks of the River Lark in eastern England, occupied between the 5th and 7th centuries A.C. An extensive series of excavations at West Stow yielded an exceptionally well-preserved vertebrate faunal assemblage of over 180,000 bones and fragments that can inform us about the animal husbandry practices of the earliest Anglo-Saxon settlers in England.Analysis of the West Stow fauna indicated that pigs played an important role in the initial Anglo-Saxon settlement of eastern England. Once the farming community had been established at West Stow, cattle and sheep increased at the expense of pigs, and beef and mutton may have replaced pork in the Anglo-Saxon diet. All other aspects of the faunal assemblage showed broad continuities with the preceding Roman and Iron Age periods. The results of the West Stow study can shed light on the ways in which farming communities are established in new environments as a result of population movements and...


BACKGROUND
In addition to influences of exposure to carcinogenic compounds, the development of cancer may depend on an individual intrinsic cancer susceptibility. Biomarkers for cancer susceptibility can be powerful additions to epidemiologic analyses.

PURPOSE
This multicenter, case-control analysis combines previously published data and new data to substantiate the value of mutagen sensitivity as a biomarker of susceptibility to head and neck squamous cell carcinoma and, more importantly, to gain insight into the interaction between susceptibility and exposure to carcinogens.

METHODS
Mutagen sensitivity (mean number of chromatid breaks per cell of cultured lymphocytes treated with bleomycin in the late S-G2 phase of the cell cycle) was determined in 313 patients with head and neck cancer and in 334 control subjects at two major U.S. medical institutions and one European institution, yielding a unique study population. The ages of the case and control subjects, as well as their history of use of tobacco and alcohol, were also recorded. The relationships between variables were analyzed by use of Student's t tests, Spearman's rank correlations, and multiple linear regression. For estimation of cancer risk, crude odds rations (ORs) were measured and multiple logistic regression was performed. All P values were based on two-sided tests.

RESULTS
There were no differences across institutions in the distribution of mutagen sensitivity (Kruskal-Wallis test) for both case subjects and control subjects. Values for case subjects were consistently and significantly (P<.0001) higher than values for control subjects in the overall analyses. Age and tobacco or alcohol use did not influence the outcome in terms of mutagen-sensitivity values for either the case or the control subjects. A mean number of breaks per cell dichotomized at 1.0 was found to be the best predictor of a hypersensitive phenotype. For nonsensitive, heavy smokers, the OR was 11.5 (95% confidence interval [CI] = 5.0-26.6). This risk increased dramatically in mutagen-hypersensitive, heavy smokers to 44.5 (95% CI = 17.4-114.0). Multiple logistic regression analysis confirmed these results, and a significant trend was found (P<.01) for the dose-dependent increase in cancer risk by smoking. The consumption of alcohol potentiated the effects of smoking, resulting in an OR of 57.5 (95% CI = 17.5-188.0) in hypersensitive persons.

CONCLUSIONS
Mutagen sensitivity was found to be a biomarker of cancer susceptibility. This study underscores the importance of utilizing both susceptibility markers and the exposure data for the identification of persons at high risk of developing cancer.

IMPLICATIONS
More accurate risk estimation can define susceptible subgroups who might be targeted for intensive behavioral interventions, surveillance through screening, and enrollment in chemoprevention programs.


The aim of this thesis is to provide a support to the beginning of the conceptual development phase by offering designers the possibility to computationally synthesise technical processes in order to obtain operand transformation variants in the respect to known technological principles. To accomplish the aim the following objectives had to be met: a theoretical objective which considered the development of a method for generation of operand transformation variants; and an empirical objective as the implementation of the method as a computational tool built to a stage that allows verification of the research results. First, it was necessary to understand the phenomenon of problem solving and cognitive aspects of synthesis as a part of the problem solving activity. Then, the state-of-the-art review on the Computational Design Synthesis (CDS) [2] was conducted the purpose of which was the determination of theoretical and methodological background of the current research projects and the comparison and the systematization of those in order to focus this research. The efforts where turned to the exploration of the existent mathematical concepts which could be used for the modelling of technical processes and related synthesis method. Based on the findings from the field of CDS it was concluded to conceive the method as a knowledgebased with the solution emerging as a result of successive application of production rules in which the knowledge about technical processes and working principles is formalised. The theoretical objective concluded with the main scientific contribution of this thesis: (1) the creation of multigraph based formal model of technical process, (2) the definition of graphgrammar based formal model of technical process synthesis, (3) addition of stochastic search to technical process synthesis by applying grammatical evolution [3]. Within the empirical objective a computational tool was realised on the foundations of the developed method. During the research it was found that knowledge about technical processes still does not exists in the accessible open taxonomies or ontologies as per se, which required to propose (4) knowledge formalisation suggestions when defining the graph grammar of technical processes.


Background : Tuberculosis is one of the most important diseases with annually 8 million new cases worldwide. The purpose of this study was to investigate the risk factors for tuberculosis (TB) infection. Methods : In this descriptive study performed in Health center of Maznadaran province during 2010-2011, 183 patients with pulmonary and extrapulmonary TB infection were recruited. After measuring fasting blood sugar, and human immunodeficiency virus (HIV) antibodies, history of smoking was taken by using a questionnaire. Results : The mean age of the participants was 46.8±19.8 years. The most common risk factor was diabetes and the lowest was HIV infection. Moreover, the prevalence of diabetes in women compared with that of men (OR=0.19, 95% CI=0.07±0.46) and smoking in men compared with women (OR=12.4, 95% CI=2.8±54.4, P Conclusion : The results of this research show that diabetes and smoking could be risk factors for tuberculosis infection. It is concluded that, in case of respiratory symptoms in patients with diabetes and smoking, tuberculosis can be considered as an important differential diagnosis.


National arthroplasty registries reveal a higher risk of revision for periprosthetic fracture and dislocation after total hip arthroplasty (THA) in patients with a femoral neck fracture compared to those with osteoarthritis (OA). Since these registries may con- tain confounding factors, we conducted a single center cohort study comparing survival and reason for failure between THA for an acute femoral neck fracture and OA using the same hip prosthesis after a minimum follow-up of 2 years. We retrospectively analyzed 2782 patients who had undergone THA with an Accolade TMZF stem and a Trident cup between March 2009 and September 2014. Primary diagnosis before THA was osteoarthritis (OA group : n=2610) or acute femoral fracture (Fracture group : n=172). Patients in both groups were operated on by the same hip surgeons. Effect of diagnosis on THA survival was analyzed using Cox-regression analysis. Chi-square tests were used to illustrate the different reasons for revision between the groups. Mean follow-up was 4.6 years (2-7.6). A total of 100 revisions were performed. The revision risk was comparable between the OA and Fracture group (HR=1.04, 95% CI :0.46-2.39). No differences were found between the OA and Fracture group with respect to the occurrence of periprosthetic fractures (0.8% vs. 0.6%, p=0.71) and revisions for dislocation (0.6% vs. 1.2%, p=0.38). We found no difference in outcome or reason for revision between THA for OA or femoral neck frac- ture. Using an implant with a proven ODEP rating and having experienced hip surgeons carry out the procedures may be more important than the primary diagnosis.


Increasing the natural gas (NG) use in heavy-duty engines is beneficial for reducing greenhouse-gas emissions from power generation and transportation. However, converting compression ignition (CI) engines to NG spark ignition operation can increase methane emissions without expensive aftertreatment, thereby defeating the purpose of utilizing a low carbon fuel. The widely accepted explanation for the low combustion efficiency in such retrofitted engines is the lower laminar flame speed of natural gas. In addition, diesel engine's larger bowl size compared to the traditional gasoline engines increases the flame travel length inside the chamber and extends the combustion duration. However, optical measurements performed in this study suggested that a fast-propagating flame was developed inside the cylinder even at extremely lean operation. This was supported by a three-dimensional numerical simulation, which indicated that the squish region of the bowl-in-piston chamber generated a high turbulence intensity inside the bowl. However, the flame propagation experienced a sudden 2.25x reduction in speed when transiting from the bowl to the squish region. Such a phenomenon was caused by the large decrease in the turbulence intensity inside the squish region during the combustion process. Moreover, the squish volume trapped an important fuel fraction, and it is this fraction that experienced a slow and inefficient burning process during the expansion stroke. This resulted in increased methane emissions and reduced combustion efficiency. Overall, it was the specifics of the combustion process inside a bowl-in-piston chamber not the methane's slow laminar flame speed that contributed to the low methane combustion efficiency for the retrofitted engine. The results suggest that optimizing the chamber shape is paramount to boost engine efficiency and decrease its emissions.


The authors have presented a clear and concise discussion of the clinical findings of the more common forms of congenital heart disease. The cardiologist, however, will not find the detailed aspects of cardiac anomalies. A succinct description of cardiac catheterization and angiocardiography is presented. Great emphasis has been placed on the roentgenologic and angiocardiographic aspects of congenital heart disease. Superimposed diagrammatic illustrations of the cardiac contours on roentgenograms aid in protraying the abnormalities produced by heart disease. Associated electrocardiographic and phonocardiographic findings are illustrated. Although the reproductions of the phonocardiograms are not perfect, the supplemental descriptions are adequate. This book will not replace the conventional textbook of cardiology but does provide a succinct disussion of the clinical findings with an excellent presentation of the roentgenographic and angiographic features of the more common types of congenital heart disease.


The scientific research mission of the Survey Space Telescope (also known as the China Space Station Telescope, CSST) imposes rigorous requirements on the observation precision. However, micro-vibrations generated by the shutter mechanism can seriously affect the performance of the highly-precise and sensitive instruments onboard. This study presents a dynamic model and verifies its performance using experimental results. Indeed, a five-degree-of-freedom nonlinear dynamic model that considers all interference sources and bearing nonlinearity is established. The validity of the proposed model is verified using experimental measurements of the micro-vibration characteristics. The obtained results proved that the proposed dynamic model can accurately predict the characteristics of the micro-vibrations caused by the shutter mechanism in the design stage and provide a theoretical basis for the development of CSST.


Probabilistic expert systems based on Bayesian networks (BNs) require initial specification of both a qualitative graphical structure and quantitative assessment of conditional probability tables. This paper considers statistical batch learning of the probability tables on the basis of incomplete data and expert knowledge. The EM algorithm with a generalized conjugate gradient acceleration method has been dedicated to quantification of BNs by maximum posterior likelihood estimation for a super-class of the recursive graphical models. This new class of models allows a great variety of local functional restrictions to be imposed on the statistical model, which hereby extents the control and applicability of the constructed method for quantifying BNs.


Liu, Y., Fu, Y.-B. and Coulman, B. E. 2013. Evaluating genetic variation and relationships amongPuccinellia nuttallianapopulations using amplified fragment length polymorphism markers. Can. J. Plant Sci. 93: 1097-1104. Nuttall's salt-meadow, or alkali grass [Puccinellia nuttalliana (Shultes) Hitchc.], is a native grass species in North America, well known for its salt tolerance. Little information is available about the genetic diversity of natural populations of this species. Amplified fragment length polymorphism (AFLP) markers were used to examine the inter-population relationships and to compare variances within and among 23 populations collected from the Canadian Great Plains. Five AFLP primer pairs were employed to screen 15 genotypes (five sets of three half-sib plants) from each population, and 185 polymorphic AFLP bands were scored for each sample. The frequencies of these scored bands ranged from 0.02 to 0.99 with a mean of 0.60. The analysis of molecular variance revealed more than 96% of the total AFLP variation resided within populations. Populations were not highly differentiated with only 4% of the total AFLP variation residing among populations. A Mantel test revealed a significant but low correlation between genetic and geographic distances (r=0.29, P=0.024). Implications for P. nuttalliana conservation, germplasm sampling, and cultivar development are discussed.


This paper evaluates inflation forecasts made by Norges Bank which is a successful forecast targeting central bank. It is expected that Norges Bank produces inflation forecasts that are on average better than other forecasts, both 'naive' forecasts, and forecasts from econometric models outside the central bank. We find that the superiority of the bank's forecast cannot be asserted, when compared with genuine ex-ante real time forecasts from an independent econometric model. The 1-step Monetary Policy Report forecasts are preferable to the 1-step forecasts from the outside model, but for the policy relevant horizons (e.g., 4 quarters ahead), the forecasts from the outsider model are preferred with a wider margin. An explanation in terms of too high speed of adjustment to the inflation target is supported by the evidence. Norges Bank's forecasts are better than the 'naive' forecasts. Norwegian inflation appears to be predictable, despite the reduction in inflation persistence that has taken place over the last two decades.


Purpose

Caring for a person with a substance use disorder (SUD) and/or mental health disorder (MHD) represents a significant burden for family members. The features of "carers/family members" experiences reflect trauma signatures. Consequently, working through this trauma for carers corresponds with psychological recovery, empowerment processes and intrapersonal/interpersonal needs. The purpose of this paper is to outline a framework called the "personal and relational empowerment (PRE)" framework which enables family support practitioners to help family members to be able to take control of their own lives, develop meaningful relationships and live purposeful and fulfilling lives, regardless of whether the person with the SUD and/or MHD is in recovery or not.

Design/methodology/approach

This paper critically reviews existing frameworks for carer recovery, through a systematic literature search, and proposes a "PRE" alternative to redress the shortfalls in these existing frameworks.

Findings

The PRE framework takes a multi-level needs-based approach to understand carer recovery. This framework links the concepts – psychological recovery, empowerment processes and intrapersonal/interpersonal needs.

Practical implications

The PRE framework recognises the importance of recovery support practitioners being able to balance the immediate carer crisis intervention needs responses with personal growth and well-being supporting interventions.

Originality/value

The PRE framework of family recovery attempts to answer the need to broaden the focus on the family journey to better reflect the principles and practices of contemporary SUD and/or MHD recovery-based support.


The objective of this study was to compare the efficacy of two sources of omega 3 and 6, fish oil (FO) and linseed oil (LO), orally administered, alone or in combination, for treating experimentally induced keratoconjunctivitis sicca (KCS) in rabbits. Twenty-eight New Zealand rabbits were used in this study. Seven animals were allocated to the C group (negative control), and KCS was induced in 21 animals by topically applying 1% atropine sulfate drops for 7 days. Treatment with atropine was maintained throughout the study period (12 weeks). The rabbits were divided into 3 treatment groups containing 7 animals each: FO group, LO group and FLO group (FO and LO). The animals were evaluated using the Schirmer Tear Test I (STT I), Rose Bengal Test (RBT), fluorescein test (FT), tear film break-up time (TBUT), and conjunctival and histopathological analysis. There was a significant increase in STT I and TBUT values in treatment groups, but the increase occurred earlier in the FO group. The results of the RBT and FT were similar among treatment groups, except FT, in the FLO group, negative staining was only in 12 weeks. There was a significant decrease in the number of goblet cells in the FLO group compared with the other groups. The results demonstrated that orally administered of FO and LO improved the clinical signs of KCS. However, improvement occurred earlier in the FO group. Using oils in combination did not provide additional benefits. These results contribute to the future development of new oral formulations as adjuvant therapies for KCS.


In the present work, detached eddy simulation (DES) of the turbulent flow in an unbaffled stirred tank agitated by a six-pitched-blade turbine was carried out. The sliding mesh (SM) approach was applied to simulate the rotation of the impeller. For comparison, the computations based on the large eddy simulation (LES) model and RANS equations closed with Reynolds stress model (RSM) were also performed. The instantaneous velocity fluctuations, mean velocity and turbulent kinetic energy profiles were analyzed and compared with the laser doppler velocimetry (LDV) results from literature. Results show that DES model can capture the unsteady turbulent flow characteristics accurately. The mean velocity and turbulent kinetic energy profiles by the DES model are in good agreements with the LES results and the LDV data. Besides, the computational cost of DES is only about 80% of LES. By contrast, the results obtained by RSM are not so good. It can be concluded that the DES model can produce as similarly good predictions as LES with less computational cost, and can work as an alternative of the LES model in predicting the hydrodynamics in the stirred tanks.


The undesired charge recombination loss, occurring at photoanode/electrolyte interfaces, as well as the high redox potential of the currently used polysulfide redox couple electrolyte restrain the photovoltaic performance, particularly the open-circuit potential (Voc), of quantum dot sensitized solar cells (QDSCs). Herein, a valid and facile method to improve the performance of QDSCs is presented by modifying the polysulfide electrolyte with the addition of tetraethyl orthosilicate (TEOS). This approach is effective in a series of QDSC systems including the most commonly studied CdSe, CdSeTe, as well as Zn–Cu–In–Se (ZCISe) QDSCs. Experimental results indicate that with the use of 6 vol% TEOS additive in pristine polysulfide electrolyte at a staying time of 24 h, a remarkable enhancement in the conversion efficiency from 11.75% to 12.34% was obtained in ZCISe QDSCs. This photovoltaic performance is believed to be among the best result for all types of QD-based solar cells. The intrinsic mechanism for the performance improvement by the TEOS additive was verified by electrochemical impedance spectroscopy (EIS) and open-circuit voltage decay (OCVD) measurements.


Mastocytosis is a disease characterized by an abnormal increase in mast cells. Manifestations of the disease are provoked in large part by the resultant increase in mast cell-derived mediators, which have a variety of local and systemic effects. Mastocytosis is variable in respect to the organ systems involved, clinical manifestations, and association with hematologic diseases. This has suggested the need for an improved classification scheme to allow assessment of prognosis and therapy. The heterogeneity of the disease patterns in mastocytosis strongly suggests that more than one biologic lesion may occur in the developmental sequence that leads to placement of mature mast cells in tissues.


OBJECTIVE
Extraosseous multiple myeloma is rare (< 5%) and has not been systematically documented in the abdomen. Our aim is to catalogue and describe the manifestations of multiple myeloma affecting abdominal organs.

CONCLUSION
Extraosseous myeloma may involve multiple abdominal organs and may mimic other malignancies. Clinicians and radiologists should be aware of the potential for myeloma to involve extraosseous sites to avoid unnecessary interventions when this occurs.


BACKGROUND
South Africa has a serious shortage of human and financial resources to provide primary healthcare services especially in the historically under-served areas. It is a tedious task to carry out healthcare delivery for the masses without rationalizing human resources in the form of re-allocation and re-deployment of healthcare personnel. This study aimed to establish the level of adequacy and efficiency of nursing staff in the former Transkei region. The study was carried out in the child and family welfare clinic of the Umtata General Hospital.

OBJECTIVE
To assess adequacy and efficiency of nursing staff in a child welfare clinic.

METHOD
This was a retrospective study. The workload of two nurses allocated to the child welfare clinic at Umtata General Hospital South Africa was calculated based on the patient numbers and hours of work per week. Calculations excluded time breaks for tea, lunch and annual leave. This work load was compared to the norms of standard examination time that is 12 minutes per patient obtained from the sub directorate of Natalia Office of the Department of Health. Information regarding number of patients attended to by the nurses and their disease conditions was obtained from retrospective review of hospital records.

RESULTS
While each nurse was on duty for 8 hours per day each had only 6 reproductive hours. The two nurses examined only 310 patients giving staff utilization of 2.46% (i.e. 310/12600) and adequacy of staff of 0.0492 or 310/6300.

CONCLUSION
There is under-utilization of the staff in Umtata General Hospital, South Africa.

RECOMMENDATION
To increase utilization of the nurses a process of sharing and merging with a clinic or a ward with similar type of work is recommended.


This thesis examines the multiple meanings attached to risk by a small group of climbers based in the North of England. The study is anchored, empirically in sustained observational fieldwork, and in-depth interviews with adult subjects (9 females aged 22-77, 14 males aged 20-70). In completing this thesis, I believe I have made an original contribution to knowledge in three areas. In re-imagining risk in climbing, I argue that climbers do not participate in climbing because of a desire to take risks, rather, they make every effort to assess, manage and control risks when climbing. In reconceptualising risk in climbing, I present a conceptual model derived from the interviewees? accounts of risk. This model situates risk in climbing with risk in everyday life. The basis of my third original contribution to knowledge lies in the relationship between risk and identity. The interviewees differentiated between safe and unsafe climbers through reference to embodied climbing practices. The way a climber in this study assessed and managed risk marked them as a safe climber or conversely an unsafe climber. Furthermore, the data revealed both a gendered and an age-related dimension to the relationship between risk and identity. The desire to retain the identity of a climber over time was so strong that older climbers reported modifying their practices to sustain their status as a member of the insider group. In addition, the female interviewees described how perceived family responsibilities mediated membership of the insider group, and their identity as a safe and qualified climber. The female climbers in this study described how such responsibilities led them, like older climbers, to draw back from the edge. These findings have implications beyond the sport of rock climbing and its participants. This research has the potential to inform and enhance our appreciation of risk in other lifestyle sports and moreover, whilst there is a tendency to distinguish between lifestyle and traditional sports, there may be some application of the account of risk presented here to an exploration of risk in traditional sports. The arguments presented in this study also contribute to an understanding or risk more generally. A key conclusion from this study is that risk is best understood where the meanings attached to it are derived from individuals? everyday lived experience and relatedly where risk is situated within the broadest context of their lives. Finally, the data reported here suggests that risk activities and risk-taking should be explored in relation to an individual?s perceived identity and crucially, the significance of risk for the construction of that identity.


How relevant are language and translation to patent law? Patents are closely related to the universality of science, to foreign trade and to the consequences of globalization, including fast and automatic communication enabled by digital tools. Patent rights serve this vast, multilingual, complex global system, owing it reliable solutions. There are examples of patent disputes involving huge profits in fees for translations that extended to more than 100 million words. Translation is not only critical to patent disputes, but to the whole "life" of a patent and to all the international regulations and their internalization in national law. That involves the stages of application, examination and validation; opposition and infringement; and the whole process of patent bargain, with an emphasis on the disclosure of technological information. This research brought a contribution on the roles, features and future perspectives of patent translation and dissemination of disclosure of patent information in patent law. It also brought strong justification to the existence of the patent system, as the advent of quality machine translation universalized the dissemination of disclosure of patent information at the global level.