Introduction Within the UK, there is anecdotal evidence of disparity in the training, practice, supervision, and perception of efficacy amongst practitioners of biofeedback therapy for chronic constipation. Methods Between October 2012 and October 2013, a prospective service evaluation was distributed to biofeedback practitioners in the UK through academic conferences or by invitation to complete an online assessment form. Results 76 practitioners responded, consisting of nurses (47%), physiotherapists (35%), physiologists (12%) and others (7%). Only 45% described 'biofeedback' consistent with an accepted definition. 86% use equipment to provide sensory feedback. Methods of biofeedback varied: balloon catheter (54%), brace pump technique (78%), urge resistance (83%), irrigation (16%), and relaxation (12%). Only 65% of practitioners had attended formal training courses, and 52% considered themselves to be self-tau, UKght. 36% receive formal supervision and only 38% of those by a senior. Regular audit of outcomes is undertaken by 67%. UK-wide perception of treatment response for chronic constipation is markedly variable (mean response = 57% [IQR: 50–75%, SD 23%]); there were no differences in perception of treatment response between nurses or physiotherapists. Practitioners' free responses demonstrated strong positive themes of a holistic approach and an overall perception of effectiveness. Negative themes included service restrictions. Abstract PWE-172 Figure 1 Conclusion There is marked variation in practice, training, and supervision of biofeedback therapists throughout the UK. Perceptions of efficacy vary greatly. Development of training and supervision standards is a priority as well as consensus to standardise therapy. Disclosure of Interest None Declared.


This paper identifies a set of critical assessment indicators (CAIs) that can evaluate the multifaceted benefits of rural infrastructure investment in China. Research data were collected from a questionnaire survey to three groups of experts including government officers, professionals and business practitioners who are working in China's housing and urban-rural development sector. The Fuzzy Set theory is used for establishing the CAIs, which appreciates the fuzziness of data from the questionnaire survey and thus increases the adequacy in the selection of the CAIs. The CAIs can help the local governments to make better decisions in investing in rural infrastructure in China. These critical indicators can also be generalized to provide valuable references for the investigation of rural infrastructure investment in other developing countries.


Be prepared to the unknown is the mantra of modern high-risk industries, which are concerned about the effectiveness of their workplace safety & emergency procedures and the performance of their operators in safetycritical tasks. Virtual Reality (VR) applications and Serious Games (SG) provide a quasi-real testing environment that allows industries to detect whether operators are able to perform tasks without performance degradation due to an unbalanced workload. The present study proposes an eXpanded NASA Task Load indeX (X-NASA-TLX) and an Overall Workload Judgement (OWJ) to assess quantitatively the operators' workload during a synthetic emergency scenario. The case study is represented by a fire caused by a faulty gas line in a steel mill during which the operators are required to comply meticulously with the emergency procedure. The emergency scenario is experienced by using a head mounted display, motion controllers and audio equipment to convey a high sense of immersion. This study shows that VR and SG coupled with the X-NASA-TLX results can be considered as a reasonable means for investigating workload balancing problems. Insights based on the OWJ are reported, thus demonstrating the potential of this approach to support the workplace safety and emergency procedures analysis and (re)design.


type="main"> The factors responsible for the spatial reorganization of contemporary manufacturing are presented here and the predictive power of long-standing notions of comparative advantage revisited. While a growing number of commercial tasks and technologies are in principle mobile internationally, giving rise to the perception of evermore footloose manufacturing firms and greater job insecurity, there is much in the modern organization of manufacturing that is both viscid and involves location-specific competitive advantages. This calls for a more nuanced assessment of the impact of an open world trading system on the spatial division of labor and on living standards.


Modern programming environments automatically collect lots of data on software development, notably changes and defects. The field of mining software archives is concerned with the automated extraction, collection, and abstraction of information from this data. This is the introduction to a special issue of IEEE Software presenting a selection of the exciting research that is taking place in the field.


Hepatocellular carcinoma (HCC) is the leading cause of deaths in cirrhotic patients and the third cause of cancer related deaths. Most HCC are associated with well known underlying risk factors, in fact, HCC arise in cirrhotic patients in up to 90% of cases, mainly due to chronic viral hepatitis and alcohol abuse. The worldwide prevention strategies are conducted to avoid the infection of new subjects and to minimize the risk of liver disease progression in infected patients. HCC is a condition which lends itself to surveillance as at-risk individuals can readily be identified. The American and European guidelines recommended implementation of surveillance programs with ultrasound every six months in patient at-risk for developing HCC. The diagnosis of HCC can be based on non-invasive criteria (only in cirrhotic patient) or pathology. Accurately staging patients is essential to oncology practice. The ideal tumour staging system in HCC needs to account for both tumour characteristics and liver function. Treatment allocation is based on several factors: Liver function, size and number of tumours, macrovascular invasion or extrahepatic spread. The recommendations in terms of selection for different treatment strategies must be based on evidence-based data. Resection, liver transplant and interventional radiology treatment are mainstays of HCC therapy and achieve the best outcomes in well-selected candidates. Chemoembolization is the most widely used treatment for unresectable HCC or progression after curative treatment. Finally, in patients with advanced HCC with preserved liver function, sorafenib is the only approved systemic drug that has demonstrated a survival benefit and is the standard of care in this group of patients.


The NA60 experiment, at CERN SPS, has studied muon pairs production in p-A and A-A collisions at 158 GeV. After an introduction to explain why the dimuon measurements are a useful tool to investigate the formation of a deconfined medium and how these measurements can be performed, from an experimental point of view, a review of the status of the field is presented, with particular emphasis on the NA60 results. The NA60 experimental apparatus, in fact, allows to perform high precision measurements, and therefore to obtain high quality results. Concerning the so called "low mass region" (0.2 annihilation through the ρ . Furthermore, the associated space-time averaged ρ spectral function shows a strong broadening, but no shift in mass. The extraction of the inverse slope parameter Teff , from the transverse momentum spectra, allows an even deeper understanding. Teff rises with mass up to the ρ, followed by a sudden decrease. While the initial rise is consistent with the expectations for the radial flow of a hadronic decay source, the decline signals a transition to an emission source with much smaller flow, which may be of partonic origin. The "high mass region" ( Mμμ > 2.9 GeV) is dominated by the J/ψ whose suppression is usually considered one of the main signatures for the formation of a deconfined medium. However also cold nuclear matter effects, not related to the hot matter, may reduce the J/ψ yield. Therefore, the study of p-A collisions allows the determination of the J/ψ behaviour in cold nuclear matter, representing the reference with respect to which the J/ψ yield in A-A collisions must be compared. NA60 results show that indeed an "anomalous suppression" is present in central In-In collisions. However, it is clear that to correctly quantify the amount of suppression exceeding the one due to cold nuclear matter, a precise determination of this reference must be performed. To advance in this direction, NA60 has also collected high quality p-A data at the same energy as the one of the A-A interactions.


The paper deals with a study of various factors affecting the release of ammonia from conventional power plant fly ash after introduction of SNCR (Selective non-catalytic reduction). SNCR is a method of flue gas denitrification based on the chemical reduction of nitrogen oxide into nitrogen and water vapour. Reduction has many by-products, various ammonia salts, which could contaminate fly ash and deteriorate its properties and application. The chemical and phase composition of fly ash was determined by X-Ray Fluorescence and X-Ray Diffraction. To predict the contaminated fly ash behaviour, the samples of fly ash with known ammonia content was prepared by mixing fly ash with exact amount of ammonia hydrogensulfate. Tests were performed on the samples prepared from contaminated fly ash as it was, contaminated fly ash with deionized water and as a mixture of contaminated fly ash, lime, gypsum and water (further stabilizate). Effects of various storage and mixing conditions on prepared samples properties were studied.


The knowledge of genomic discoveries has been expanding daily, holding enormous potential to improve population health. Nevertheless, the training of health educators about genomics is lagging behind. To facilitate the movement of genomics into health promotion practice, as the first step, we conducted the first national survey to examine genomic education needs among health educators in the United States. A total of 980 health educators holding the Certified Health Education Specialist designation completed our web-based survey. The majority of participants reported that they had limited knowledge and training in genomics and were interested in seeking genomic education. Their first three preferred educational topics included genomic disorders/diseases (68.2%), family health history or genetic risk assessments (55.5%), and how to link genomics to health promotion (51.0%). A few contents, including basic genomic concepts, communication skills, and how to integrate genomics into routine professional tasks, were important to health educators' practice in genomics, but respondents seemed to be less favorable toward learning these contents. Continuing education (89.4%), web-based training (85.9%), and professional conferences (76.7%) were participants' top three desired delivery methods. This study will help guide the development, implementation, and evaluation of future genomic training programs for U.S. health educators.


Tilting-pad journal bearings (TPJBs) ensure rotordynamic stability that could otherwise produce dangerously large amplitude rotor oil-whirl/whip motions in high speed rotating machinery. Currently, highly efficient turbo compressors demand an ever increasing rotor surface speed and specific load on its support bearings. The accurate prediction of bearing performance is vital to guarantee reliable products, specifically with regard to reducing maximum bearing pad temperature and drag power losses, and operating with the least flow rate while still maximizing load capacity. The hydrodynamic pressure and heat generation in an oil film acting on a bearing pad produce significant mechanical and thermal deformations that change the oil film geometry (clearance and preload) to largely affect the bearing performance, static and dynamic. In addition, a high surface speed bearing often operates in the turbulent flow regime that produces a notable increase in power loss and a drop in maximum pad temperature. This paper details a thermoelastohydrodynamic (TEHD) analysis model applied to TPJBs, presents predictions for their steady-load performance, and discusses comparisons with experimental results to validate the model. The test bearing has four pads with a load between pads configuration; its length L = 76.2 mm and shaft diameter D = 101.6 mm (L/D = 0.75). The rotor top speed is 22.6 krpm, i.e. 120 m/s surface speed, and the maximum specific load is 2.94 MPa for an applied load of 23 kN. The test procedure records shaft speed and applied load, oil supply pressure/temperature and flow rate, and also measures the pads' temperature and shaft temperature, as well as the discharge oil (sump) temperature. The TEHD model couples a generalized Reynolds equation for the hydrodynamic pressure generation with a three-dimensional energy transport equation for the film temperature. The pad mechanical deformation due to pressure utilizes the finite elemental method, whereas an analytical model estimates thermally induced pad crowning deformations. For operation beyond the laminar flow regime, the analysis incorporates the eddy viscosity concept for fully developed turbulent flow operation. Current predictions demonstrate the influence of pressure and temperature fields on the pads mechanical and thermally induced deformation fields, and also show static performance characteristics such as bearing power loss, flow rate, and pad temperatures. The comparisons of test results and analysis results reveal that turbulent flow effects significantly reduce the pads' maximum temperature while increasing the bearing power loss. Turbulent flow mixing increases the diffusion of thermal energy and makes more uniform the temperature profile across the film.


The U.S. government has dramatically increased expenditures in preparation for potential bioterror attacks, but one security risk should receive much more attention than it has. The more than 40 million Americans without health insurance would pose a serious national security threat in the event of a bioterror attack with a transmissible agent. Even if all Americans cannot obtain full health insurance, significant barriers to seeking evaluation for suspected infectious illnesses should be reduced. Any threats of deportation or financial loss due to testing for and reporting infectious illnesses should be removed, and the cost for these evaluations should be borne by the government as a necessary national security expense.


Background: Dengue is a kind of infectious disease that was distributed in the tropical and sub-tropical areas. To date, there is no clinically approved dengue vaccine or antiviral for humans, even though there have been great efforts towards this end. Therefore, finding the effective compound against dengue virus (DENV) replication is very important. Among the complex compounds, copper(II)-imidazole derivatives are of interest because of their biological and medicinal benefits. Materials and Methods: In the present study, antiviral activity of [Cu(2,4,5-triphenylimidazole)2]n, was evaluated against different stages of dengue virus type 2 (DENV-2) replication in Vero cell using focus forming unit reduction assay and quantitative ELISA. Results: [Cu(2,4,5-triphenylimidazole)2]n inhibited DENV-2 replication in Vero cells with IC50 = 2.3 μg/ml and SI= 19.42 when cells were treated 2 days after virus infection, whereas its CC50 for cytotoxicity to Vero cells was 44.174 μg/ml. Conclusion: The compound has high anti-DENV2 activity, less toxicity, and a high possibility to be considered a drug candidate.


Previous studies using adenoviral (Ad) vectors expressing human alpha1-antitrypsin (hAAT) under the control of ubiquitous promoters (RSV, mPGK) elicited the production of antibodies to hAAT in some mouse strains (C3H/HeJ and BALB/c) but not in others (C57BL/6J). In contrast, when a helper-dependent Ad vector (AdSTK109) with all viral coding sequences deleted and expressing hAAT from human genomic DNA with the endogenous promoter was used, C3H/HeJ mice failed to develop antibodies and demonstrated long-term expression. These results suggested that promoter choice and/or properties of the vector itself might influence the host immune response to the transgene product. Direct comparison of first-generation vectors expressing the hAAT cDNA from a ubiquitous mouse PGK promoter rather than from a liver-specific mouse albumin promoter demonstrated that an antibody response to hAAT occurred with the mPGK promoter but not with the albumin promoter in C3H/HeJ mice. As expected, neither vector elicits an antibody response in C57BL/6J mice. Coinjection of the two first-generation vectors containing the mPGK and albumin promoter in C3H/HeJ mice induced an antibody response with resulting loss of detectable hAAT from the sera of the injected mice in 3-4 weeks. From these data, we conclude that under certain conditions, the choice of promoter with its associated liver-specific expression can modulate the host immune response to the transgene independent of viral backbone.


The FIGO 2000 gestational trophoblastic neoplasia (GTN) staging and classification has recommended three major changes in the management of GTN. The criteria for diagnosis of GTN following molar pregnancy were defined. The methods used for investigation of spread of the disease were recommended. A major change in the concept of FIGO staging in adding risk scoring to anatomical staging is novel but considered essential to best reflect the behavior of this disease which is different from other solid tumors. The history of evolution of this staging and classification system and practical points in applying this system were discussed. If this system would be used worldwide, it would be a big leap in the management of GTN where results can be compared among different centers and large multicenter trials would be possible.


This chapter looks at three plays by Samuel Beckett - Oh les beaux jours, La Derniere bande and Quad - in order to highlight his emphasis on resilience, stoicism and "going on". In the case of Winnie in Oh les beaux jours it is the disparity between her awful circumstances and her forced optimism and cheerfulness that is relevant. She is indeed an "unsung heroine" in the face of the human condition but persists even in Act 2 where her situation becomes dramatically worse. In another sense she is a "sung heroine" because her song is one of her resources, the "heure exquise" from The Merry Widow helping her to end her day. With La Derniere bande we have Krapp as a representation of the ravages of life, time and old age but again he is an "unsung hero" who fights on against physical and mental decline. He also refers to the possible song of an old woman and this raises again the idea of singing in the face of adversity. Finally, Krapp himself sings a Vespers hymn in what is like a swan song as death nears. Krapp's human tragedy of isolation and decay is ultimately a musicalized and sung tragedy. Finally, in the case of Quad we have a minimalist drama with no dialogue but forms of musical accompaniment to the shuffling and coming and going of four players. These four represent the mass of humanity pushing on through the pain and meaningless of life with stoic heroism and they are unacclaimed warriors. Each of the four has his/her internalized music to help them through life and so they, like Winnie and Krapp, exemplify Beckett's dictum : "Quand on est dans la merde jusqu'au cou, il ne reste plus qu'a chanter."


Background: Despite a constant number of prescriptions, the expenditures of the statutory health insurance funds for pharmaceuticals are rising sharply. This is due to high prices for orphan drugs and advanced therapy medicinal products (ATMPs). Despite attempts by policymakers to intervene, such as the 2011 German Pharmaceutical Market Restructuring Act (Arzneimittelmarktneuordnungsgesetz, AMNOG), the use of these therapies poses numerous challenges for the healthcare system, especially insurance companies and healthcare providers.Results: Using data from the University Hospital Heidelberg, we found that the division of pediatric neurology is experiencing a disproportionate increase in drug costs, caused by two drugs for the treatment of spinal muscular atrophy (SMA), Nusinersen and Onasemnogen Abeparvovec. A survey of 41 German SMA treatment centers revealed a lack of human and infrastructural resources to manage therapy and follow-up care, which currently is insufficiently reimbursed. Disease-independent registers that comply with the rules of the European Union for medication surveillance and which are not tied to the pharmaceutical industry are necessary.Conclusion: Innovative forms of therapy require a critical discussion and regulation of application, aftercare and reimbursement as well as (inter)national industry independent registry work. Based on the model of evidence-based dynamic pricing by the Techniker Krankenkasse, we propose a concept which offers an internationally scalable solution to combat these challenges.


The Benchmarking Forum at the International Conference on Digital Preservation (iPres) 2015, held in Chapel Hill, North Carolina, November 2 - 6, 2015, brought together digital preservation researchers, community organizations and practitioners to discuss opportunities and challenges in adopting software benchmarking as a systematic tool for evaluating digital preservation tools. Outcomes included an initial set of benchmark specifications for targeted scenarios elaborated jointly during the workshop, and a set of concrete collaborative actions that will take place in 2016.


Transfer learning, where the goal is to transfer the well-trained deep learning models from a primary source task to a new task, is a crucial learning scheme for on-device machine learning, due to the fact that IoT/edge devices collect and then process massive data in our daily life. However, due to the tiny memory constraint in IoT/edge devices, such on-device learning requires ultra-small training memory footprint, bringing new challenges for memory-efficient learning. Many existing works solve this problem by reducing the number of trainable parameters. However, this doesn't directly translate to memory saving since the major bottleneck is the activations, not parameters. To develop memory-efficient on-device transfer learning, in this work, we are the first to approach the concept of transfer learning from a new perspective of intermediate feature re-programming of a pre-trained model (i.e., backbone). To perform this lightweight and memory-efficient reprogramming, we propose to train a tiny Reprogramming Network (Rep-Net) directly from the new task input data, while freezing the backbone model. The proposed Rep-Net model interchanges the features with the backbone model using an activation connector at regular intervals to mutually benefit both the backbone model and Rep-Net model features. Through extensive experiments, we validate each design specs of the proposed Rep-Net model in achieving highly memory-efficient on-device reprogramming. Our experiments establish the superior performance (i.e., low training memory and high accuracy) of Rep-Net compared to SOTA on-device transfer learning schemes across multiple benchmarks. Code is available at https://github.com/ASU-ESIC-FAN-Lab/RepNet.


This article studies public welfare preferences in Armenia, Azerbaijan, Belarus, Georgia, Moldova and Ukraine. Generalised ordered logistic regression models and predicted probabilities are employed to analyse comparable attitudinal survey data. The results vary considerably among the countries, but age is the most important covariate of welfare preferences, followed by individuals' socio-economic characteristics. The findings also indicate that popular perceptions of transition, notably in Ukraine and Moldova, are most strongly linked to preferences concerning the state's involvement in reducing the gap between the rich and the poor rather than to preferences regarding the main welfare state programmes such as pensions and healthcare.


Purpose: To examine the characteristics and effects of culturally adapted substance use interventions with Latino adolescents on substance use outcomes. Methods: Systematic review and meta-analytic methods were used to synthesize effects across studies on substance use outcomes at posttest and follow-up time points. Results: Ten studies comprising 12,546 Latino adolescents met eligibility criteria. Meta-analytic results suggest positive, yet small effects on substance use outcomes at posttest and slightly larger effects at follow-up. A moderate amount of heterogeneity was observed; however, no variables tested explained the variance. The risk of bias assessment revealed that most studies were at high risk for performance and selection bias. Conclusions: Culturally adapted substance use interventions with Latino adolescents may be slightly more effective than other active interventions. We also uncovered important gaps and deficiencies in this body of research, including the need to examine potential secondary benefits of culturally adapted interventions.


Background: The breathing intolerance index, BIT, a noninvasive derivation of the tension-time index of respiratory muscles, has been recently used to evaluate patients with respect to their need for noninvasive ventilation. Comparing the BIT index in different disorders with mild to moderate respiratory impairment, such as COPD and obesity, would be useful in determining differences in threshold for respiratory muscle fatigue amongst cohorts. Objectives: The purpose of this study was to compare control of ventilation and BIT in individuals with obesity, chronic obstructive pulmonary disease (COPD), and control subjects free of cardiorespiratory disorders. Because change in posture can alter respiratory load and control of ventilation, variables were assessed in two postures. Methods: We assessed 142 subjects consisting of 81 with obesity, 42 with COPD, and 19 non-smoking healthy adults. All subjects underwent evaluation of pulmonary function, control of ventilation and BIT index [(Ti/Ttot) × (Vt/FVC)] in seated and supine postures. Findings: BIT index was significantly greater in seated posture in all 3 cohorts due primarily to an increase in Vt in this position. BIT index was similar in value amongst cohorts in both postures, but tended to be higher in patients with obesity and COPD. Conclusion: While BIT index is higher in seated posture, and tends to be higher in patients with obesity and COPD as compared to control subjects, discrimination between cohorts is not found in our study because of small inter-group variations of respiratory function amongst cohorts. Thus, in clinically stable patients whose vital capacities are mild to moderately reduced, the BIT index alone cannot be recommended as a predictive guide for initiating assisted ventilation for respiratory failure. Nevertheless, because it is easy to perform, and is comfortably tolerated by patients, its potential usefulness may be in periodic measurements to monitor its increase as respiratory reserve declines.


ABSTRACT Coarse dolomite crystals in the Taum Sauk Limestone (Upper Cambrian, southeast Missouri) contain both calcite and iron oxides in rhombohedral zones and along fractures and cleavage traces. The dolomite crystals are demonstrably nonstoichiometric, averaging 57 mole percent CaCO3, and are compositionally zoned, ranging from 1.40 to 4.56 mole percent FeCO3. Cathodoluminescene study and microprobe analyses of the dolomite, coupled with scanning electron microscope (SEM) examination of etched fracture surfaces reveal that: 1) Scattered dolomite within the calcite/iron oxide zones is the most iron-rich. 2) Calcite within dolomite rhombs is brightly luminescent, nonferroan and is intergrown with iron oxides. 3) The iron oxides display two crystal habits--thin, red (hematite?) circular plates, typically 0.7 to 1.0 microns across, grouped in rosettes; and prismatic bundles and prismatic radiating aggregates of brown crystals (goethite?), typically 1 to 3 microns in length. 4) Narrow veinlets of dolomite associated with calcite and iron oxides along cleavage traces form a three-dimensional network. This feature, which aided in interpreting the iagenetic history of the dolomite, was not observed during petrographic examination but was readily observed with the SEM. The occurrence of nonferroan calcite and ferric oxides in rhombohedral zones in Taum Sauk dolomite suggests that dedolomitization occurred by the oxidation and alteration of ferroan dolomite zones and probably reflects alteration related to Recent weathering.


The purpose of this study is to investigate the effects of Information and Communication Technology (ICT) development on technology diffusion and firm's capacity to absorb new technologies. The study analyses the relationship between ICT development measured by mobile broadband subscriptions, broadband internet, percentage of internet users and mobile-cellular telephone subscriptions on one hand and firm-level technology absorption on the other by examining the mediating role played by Information Technology (IT) usage by businesses and governments. A quantitative approach based on Partial Least Squares (PLS) Structural Equation Modelling (SEM) is employed to analyse country-level data across 134 countries for the year 2016 from both developing and developed countries. Analysis of the results presents evidence of ICT development having a significant role in shaping technology absorption by firms and that this direct relationship is also positively mediated by IT usage. The study provides implications for research, practice, and policy.


The childbirth experience is a complex event and an important life experience for women, with long-term
impacts throughout life. The experience influences the future well-being of the woman, her child, and their relationship,nas well as the woman's relationship with her partner. The aim of the study was to assess the maternal satisfaction and views about biofeedback and aromatherapy during childbirth among primigravida mothers. In this study, 400 low risk nulliparous women were randomly divided into two groups as aromatherapy massage (n=200) and biofeedback therapy (n=200). The mothers were received either aroma therapy or biofeedback during their intrapartum period, and they were
interviewed a day after their childbirth to know about their satisfaction and views about the special interventions. Results of research showed that aromatherapy provides more comfort and relaxation than biofeedback therapy (P=0.2997). Most of the mothers reported that they would like to suggest these interventions to their friends and relatives, because these interventions provide comfort and relaxation than regular interventions (P=0.225). When considering the satisfaction during childbirth 78.5% of women in aromatherapy and 68% of women in biofeedback therapy described that they were satisfied with the experience. Listening to women's views and understanding their different perspectives, the study was suggested that, non pharmacological pain relief methods like aromatherapy or biofeedback can be used in every hospitals to improve maternal satisfaction and to promote labour outcomes.


Context: Using a reliable fixation method after ramus sagittal split osteotomy in order to reduce the chances of treatment relapse and condyle changes is still one of the most noteworthy issues discussed among maxillofacial surgeons. In this study, the results of the up-to-date papers were collected, which identify the eects of the fixation method on the post-operative results, to give the reader a comprehensive view of the new concepts. Evidence Acquisition: The most frequent mandibular surgeries, setbacks, and advancements via the bilateral sagittal split os- teotomy technique were used for a literature search due to the abundance of related articles. Consequently, the following keywords were applied: sagittal split ramus osteotomy, orthognathic surgery, rigid fixation, non-rigid fixation, postoperative relapse, and postoperative stability. Results: The articles were classified according to the surgery procedure: mandibular advancement surgery or mandibular setback surgery. The relapse pattern can be divided into two categories: an early relapse, which is strongly related to the surgery proce- dure, and a late relapse, which can be attributed to the physiologic changes, such as a growth map. The contributing factors can be considered to be the following: a change in ramus in inclination, the mandibular plane, and the fixation type. Conclusions: Using rigid fixation techniques after bilateral sagittal split ramus osteotomy will optimize the stability, but this sta- bility is not influenced by the method of this rigid fixation; although the most commonly suggested technique, bicortical screws, is in the inverted-L position


Consumption of wettable powders (WP) and water-soluble granules (WSG) have increased in last years in the pesticide market. Main problems faced with these kinds of pesticides are the requirement of continuous mixing due to sedimentation in sprayer tanks. To solve this problem, usage of hydraulic jet agitators in sprayer tanks have increased in last years. However, position of agitator in tank, mixing pressure and technical specifications of hydraulic jets are important for an effective agitation. In this study, we determined the agitation performances of a hydraulic jet in a 400 L sprayer tank by using one jet nozzle at 3 different jet nozzle sizes (orifice size: 1.0, 1.5 and 3.0 mm) and 3 different agitating pressures (3, 6 and 8 bar). Kaolin clay and Cooper oxide chloride were used as a tracer material for simulating WP and WSG solutions in the tank. And, International ISO 5682-2:1997 (E) Standard has been used for sampling method in the tank level. To measure the rate of tracer material in the tank, turbimetric and drying method were used and results were comparted with reference solution concentrations to determinate of deviation rates. As a result, deviation rates of all agitation configuration used in this research were higher than the defined acceptable limits in ISO 5682-2:1997 (E) at all measurements in the sprayer tank.


Grants are important part of municipal budgets. Due to horizontal and vertical imbalance, there are no possibility to resign from this source of financing local governments. According to theoretical model, which is discussed in this paper the impact of grants on municipal spending depend on income and price effect. Previous empirical research presented, that due to political rent-seeking behaviours' we could suspect also other effects, such as leakage of funds from granted project and increase of other expenditure not related to the project. In this paper we presented panel data analysis for Polish rural municipalities. We tried to find if and how investment grants from European Union influence other-operational spending of municipalities. The results are not obvious, but analysed model presented that potential impact of EU investment grants on operational spending policy is very limited.


OBJECTIVE: To compare the short and long term rates of transient ischemic attack (TIA)/ ischemic stroke and mortality between intracranial stent placement and medical therapy alone for treatment of symptomatic intracranial arterial stenosis.
DESIGN/METHODS: We identified all prospective and retrospective studies comparing intracranial stent placement and medical management using a search on PubMed and Cochrane libraries, stroke trials database, proceedings of neurology and neurosurgery related conferences, and supplemented by a review of bibliographies of selected publications. The incidences of adverse effects, namely TIA/stroke and/or death at 30 days post treatment and TIA/stroke, myocardial infarction and/or death at 1 year post treatment were ascertained from all studies. For the meta-analysis, Forest plots and calculation of odds ratios [OR] with 95% confidence intervals [CI] using both fixed and random models were performed. The presence of publication bias was interrogated by funnel plot of Standard Error by log odds ratio.
RESULTS: Three prospective studies including two randomized clinical trials and one retrospective study were identified and included in the meta-analysis. There were a total of 46/347 (13.2%) stroke-and/or-deaths reported in the stent treatment group compared with 16/351 (4.5%) TIA/stroke-and/or-deaths in the medical therapy alone group at 30 days (OR, 2.97; P<0.001; CI 1.64-5.39). The pooled incidence of 1-year TIA/stroke-and/or-deaths in patients with stenting was 51/347 (14.7%), compared with 45/351 (12.8%) in the patients managed with medical therapy alone (OR 1.093; P = 0.815; CI 0.51-2.30). There was no publication bias.
CONCLUSIONS: Despite the higher risk of 1 month TIA/stroke-and/or-deaths, patients undergoing intracranial stent placement have similar rates of TIA/stroke-and/or-deaths at 1 year compared with medical treatment alone. Disclosure: Dr. Jadhav has nothing to disclose. Dr. Qureshi has nothing to disclose. Dr. Qureshi has nothing to disclose.


We dejine a graph-based visual query language for object databases, called QUIVER. Most graph-based query languages proposed in the literature view queries either as constraint (pattem) graphs or as data-flow graphs. QUIVER, howevel; allows constraints and data-$ow to be combined in queries. This combination of constraints and data-flow is motivated by the need to support comprehensive object models, such as that proposed by the Object Data Management Group (ODMG). QUIVER supports all ODMG object model constructs, including computational constructs such as operations (methods). In addition, QUIVER supports computational query constructs such as subqueries and (aggregate) functions.


Modern handheld computers are certainly capable of running general purpose applications, such as Java virtual machines. However, short battery life rather than computational capability often limits the usefulness of handheld computers. This paper considers how to reduce the energy consumption of Java applications.Broadly speaking, there are three interleaved steps in running Java programs in a compiled environment: downloading the bytecodes, compiling and possibly optimizing the bytecodes, and running the compiled code. Optimized code typically runs faster than non-optimized code but the optimization process itself may consume significant energy. We consider the possibility of moving compilation (optimizing or non-optimizing) to a tethered server. We demonstrate that there is a significant benefit to moving compilation to a server (up to 67% reduction in energy for a realistic handheld configuration). We also demonstrate that there is no single best compilation strategy for all methods.


The World Wide Web's constant growth and transformation offers great opportunities - and poses many challenges for exploitation. The semantic Web has emerged as a possible answer to these challenges by offering an approach in organizing and sharing the Web, but it doesn't explicitly consider user needs and requirements. Heraclitus is a framework for semantic Web adaptation in which user needs and requirements are the driving force, using text and Web usage mining to support Web site ontology and topology evolution. The result is improved user interaction with the semantic Web


Modern fly-fishing is only the latest chapter in a two-millennia saga of technological creativity and passionate observation of the natural world. In "Fly-Fishing Secrets of the Ancients", historian-naturalist Paul Schullery explores the earlier chapters in that saga and unearths a host of provocative theories, techniques, and insights that helped shape the modern fly-fisher. Schullery demonstrates that whether we're looking for a good fish story, a clearer understanding of why we fish the way we do, or even a way to improve our own sport, we ignore our elders at our peril. "Fly-Fishing Secrets of the Ancients" offers the beginning fly-fisher an unprecedented opportunity to come to terms with some of the sport's most fundamental theoretical and practical challenges. It offers the expert fly-fisher a chance to test current angling dogma - and his or her own pet theories - against that of the sport's greatest past masters. And it offers all readers a fresh, probing, and often-humorous take on the great endless fish story we perpetuate and enrich every time we cast a fly.


Abstract This paper developed from Shelah's proof of a zero-one law for the complexity class "choiceless polynomial time," defined by Shelah and the authors. We present a detailed proof of Shelah's result for graphs, and describe the extent of its generalizability to other sorts of structures. The extension axioms, which form the basis for earlier zero-one laws (for first-order logic, fixed-point logic, and finite-variable infinitary logic) are inadequate in the case of choiceless polynomial time; they must be replaced by what we call the strong extension axioms. We present an extensive discussion of these axioms and their role both in the zero-one law and in general.


This volume addresses the means and ends of sacrificial speculation by inviting a selected group of specialist in the fields of philosophy, history of religions, and indology to examine philosophical modes of sacrificial speculation — especially in Ancient India and Greece — and consider the commonalities of their historical raison d'être. Scholars have long observed, yet without presenting any transcultural grand theory on the matter, that sacrifice seems to end with (or even continue as) philosophy in both Ancient India and Greece. How are we to understand this important transformation that so profoundly changed the way we think of religion (and philosophy as opposed to religion) today? Some of the complex topics inviting closer examination in this regard are the interiorisation of ritual, ascetism and self-sacrifice, sacrifice and cosmogony, the figure of the philosopher-sage, transformations and technologies of the self, analogical reasoning, the philosophy of ritual, vegetarianism, and metempsychosis. The first section of the volume, "Historical and Comparative Approaches to Ritual Thought in Ancient India and Archaic Greece," is devoted to changes in religious behaviour and the place of sacrifice in early Indian intellectual history. Instead of searching for origins and closures, the individual contributions rather attempt to map changes, and sometimes to catalogue the complexity in thinking and acting that comes to light in the early Indian material. What becomes clear then, instead of a simple one-way causality between thought and performance, is an ongoing transformation mediated by both intellectual activity and ritual reflexivity. Beginnings and ends in this sense never actually take place as clearly definable moments in time. The precarious act of historical and/or logical comparison can of course not be disregarded in this connection,because the terminology underlying one's research is always confronted with the general problem of translation. The themes forming the backbone of the book's midsection, "Ritual Thought in Late Antiquity," are all grounded in textual sources from Late Antiquity, such as the Corpus Hermeticum, the Nag Hammadi texts, and the letters of Paul. As will become clear, however, they also point in quite different directions, both spatial and temporal, by evoking ancient Egyptian material, ethnographic comparanda and 20th century philosophy. The last section, "Repercussions of Sacrifice in Western Philosophy," closes the historical circuit by addressing the continuation of sacrificial themes in contemporary continental philosophy.


Background Adherence to antiretroviral treatment can prevent virological failure in HIV patients. Pharmaceutical intervention in these patients is important and it is a key point to increase adherence to treatment. Purpose Analysis of the impact of a pharmaceutical care (PC) program on the evolution of adherence to antiretroviral treatment (ART). Materials and methods A descriptive and interventionist study on the adherence of HIV patients to ART through the analysis of each patient's dispensing records throughout 2007–2012, obtained from the external patient management program Dipex®v2.6. and APD-ATHOS prisma®. The PC program consisted in: 1)creating adherence reports, sent daily to each doctor, of patients consulted with the following variables: current ART, adherence, pharmaceutical observations, doctor's commentary and compliance, viral load and CD4. This adherence report is returned to our unit, becoming a feed-back tool of all information between the doctor and pharmacist; 2)selecting patients with incidents in their adherence; 3)interviewing patients with bad evolution in their adherence during the last 6 months.% Adherence is calculated = number of dosage units dispensed/number of dosage units planned for a period of six months. Good adherence was defined as >95%,irregular adherence 85–94%,poor adherence <85%. Results 635 patients received ART during the study period. There were 4802 reports in total (2 reports/patient/year). Patients with good adherence went from 57.4% in 2007 to 73.8% in 2012, displaying an increase of 16.4% and an average of 66.46% ± 8.2. The rate of patients with irregular adherence went from 17.3% at the start of the study period to 8.05% at the end, resulting in a decrease of 9.25% in adherence to ART and an average during the period of 12,3% ± 3,42. The initial percentage of patients with poor adherence was 17.6% vs. 8.62% in the last year, representing a decrease of 8.98%. Poor adherence had an average of 13.67% ± 2.42. The average percentage of patients whose adherence worsened during the study period was 9.7% ± 3.48%. 36.88% ± 8.83 of patients improved their adherence (to irregular or good) to ART. Conclusions The PC program has helped improve the rate of ART adherence. Joint assessment of adherence in real time by different professionals through reports and clinical interviews, allow us to determine more exactly the compliance of ART and thus detect possible opportunities for better adherence by our patients. No conflict of interest.


A primary goal of biodiversity research is to uncover the processes acting in space and time to create the global distribution of species richness. However, we currently lack an understanding of how recent versus ancient biodiversity dynamics shape patterns of diversity for most groups. Here, we introduce a method to partition lineage turnover into recent and ancestral components, and use it to identify hotspots of turnover at the global scale for 8,296 bird species. Counter to the tropical niche conservatism hypothesis, we find extra-tropical regions such as Greenland and the Sahara are hotspots of ancestral turnover, while areas with high climatic variation such as (sub)tropical mountains and biome transitions are recent turnover hotspots. We can now quantify the relative contribution of contemporary and ancient lineage dynamics to assemblage structure, which enables future research to explore the processes generating earth's diversity in a more temporally-explicit framework.


Siraitia grosvenorii is a dioecious cucurbitaceae plant that is native to southern China and prevalent in Guangxi Province. Natural pollination of this species is difficult, and artificial pollination is therefore the main approach for its cultivation. The fruit set of the plants largely depends on the biosynthesis and crosstalk of phytohormones. Here, we show that parthenocarpic fruit can be induced by 1-(2-chloro-4-pyridyl)-3-phenylurea (CPPU, an active cytokinin) and gibberellin (GA3) in S. grosvenorii. In addition to pollination, similar changes were detected in the external quality and sweet mogrosides of parthenocarpic fruits. Furthermore, the transcriptome of S. grosvenorii fruits was assessed by RNA sequencing (RNA-Seq). Differentially expressed genes (DEGs) in the fruits set were compared with those in untreated ovaries. Excluding 2794 common DEGs, large numbers of genes expressed specifically in parthenocarpic (2281) or pollinated (6191) fruits were found. In conclusion, CPPU and GA3-induced parthenocarpic fruits offer novel insights for the large-scale cultivation of S. grosvenorii. This study yielded a number of candidate genes that can be applied in further studies to improve fruit quality and yield.


Previous research demonstrates a history of sexual assault is a substantial risk factor for future sexual assaults [1, 2]. Several studies suggest differences in risk detection may contribute to this pattern [e.g., 3]. The purpose of this study was to investigate if sexual victimization impacts perception and response in dating scenarios; and assessed if differences existed between the perceived risk and benefits of remaining in risky interpersonal situations as a function of sexual assault history. One hundred and eleven female college students viewed and responded to two videos depicting dating vignettes. Results indicated participants did not differ in their perception of risk as a function of sexual assault history; however, those with a sexual assault history indicated they would stay in the situation longer in some instances. Additionally, when asked to predict what would happen if the scenario continued, participants with a history of sexual assault were significantly more likely to predict the characters would have consensual sex if the female remained and negative social consequences if she chose to leave. The potential clinical implications of these findings are discussed.


BACKGROUND
The clinical significance of the circulating levels of activin A and matrix metalloproteinase-2 (MMP-2) and -9 (MMP-9) was investigated in patients with breast cancer (BC) or prostate cancer (PC) with (M1) or without (M0) bone metastasis.

PATIENTS AND METHODS
MMP-2, MMP-9 and activin A blood concentrations were measured by enzyme immunoassays in 79 cancer patients and in 57 healthy blood donors (HS) who served as a control group. The diagnostic accuracy of these molecules to discriminate between M0 and M1 patients was evaluated by the receiver operating characteristic curve (ROC) and compared to that of tumor markers CA15.3 or prostate-specific antigen (PSA).

RESULTS
Activin A and MMP-2 were significantly increased in BC and PC patients as compared to sex-matched HS while MMP-9 levels were more elevated only in the PC patients. Interestingly, in the PC patients, activin A levels were significantly higher than those measured in the BC patients. In this latter group, activin A and CA15.3 but not MMP-2 or MMP-9 were increased in the M1 patients as compared to M0 patients. Furthermore, a significant relationship was also highlighted between activin A concentration and the number of bone metastases and tumor grade, between MMP-9 and tumor grade, and between MMP-2 and CA15.3. ROC curve analysis showed a good diagnostic accuracy for activin A and CA15.3 but a poor accuracy for MMP-2 and MMP-9 in discriminating between M0 and M1 patients. However, CA15.3 retained the best diagnostic accuracy in this respect. In the PC group, only activin A and PSA levels were significantly increased in the M1 patients as compared to the M0 patients. A similar although not statistically significant trend was noted for MMP-9. Interestingly, a significant correlation was observed between PSA and activin A and MMP-9, and between Activin A and Gleason score and the number of skeletal metastases. ROC curve analysis showed a good diagnostic accuracy for activin A, MMP-9 and PSA and a poor diagnostic accuracy for MMP-2 in detecting M1 patients. However, PSA showed the highest diagnostic accuracy.

CONCLUSION
Activin A, MMP-2 and MMP-9 may be regarded as possible therapeutic targets in the treatment of metastatic bone disease. However, their usefulness as additional markers of bone metastasis remains to be better defined.


The paper means to repropose Therapeutic Community importance and adequacy as treatment process and therapeutic Method. An intensive treatment process to those people who have clinical and existential situations of a certain seriousness and complexity, wich can not find a result so articulated in other treatment contexts and methods. We describe the characteristic of treatment model and therapeutic community professional operative organisation so that this very specialistic offer does not lose its own Identity, risking to devaluate both clinic and treatment Subjects. Assessment, clinical decision, treatment guidelines and clinical Research, when they are based on the experience of a therapeutic Model highly professional actually tested during the time as for Therapeutic Community one, define an institutional identity today dangerously questioned by paradigms always less scientific and clinical. The essay highlights the clinical quality of work done by the therapeutic community when the institutions don't allow own identity alienation and selfhybrid transformation with significant consequences on the results.


In this technical report we describe our efforts towards a field deployable Sense and Avoid system for Unmanned Aerial Vehicles (UAVs) which uses passive vision as the main sensing modality. The ability of UAVs to operate safely in the presence of other air traffic is critical towards acceptance of UAVs in civilian and military airspace. This will allow UAVs to be used to their fullest potential. In order to operate freely in the presence of manned airborne traffic UAVs must demonstrate a Sense and Avoid capability that meets or exceeds that of an equivalent human pilot. Furthermore this capability should be achieved without the use of cooperative communication with other aircraft or prior knowledge of other aircrafts' flight plans. We describe our collision avoidance algorithm and software-in-the-loop testing, vision based detection method with a 98% detection rate out to a range of 4.5 miles which exceeds the FAA regulation of 3 statute miles. A field deployable Sense and Avoid system must be able to operate with consistent performance across a variety of atmospheric conditions including cloud, fog and haze of various degrees that can occur under conditions commonly described as Visual Meteorological Conditions (VMC). In order to model the effect of all these conditions on the performance of the detection system we developed an atmospheric image formation modelling system that takes as inputs weather conditions and can predict the appearance of the image of an aircraft of given geometry at various ranges. This predictive model also determines the minimum resolution needed to guarantee the required detection performance. Passive vision provides the bearing to the intruding aircraft. Range estimation is only possible by executing additional maneuvers which causes significant mission interference. We investigate the feasibilty of a flash lidar system that can be used as a confirming sensor to further reduce the false positive rate and provide range of the intruding aircraft.


When thwarted in a behaviour, laying hens show an increase in stereotyped pacing, displacement preening and a specific vocalisation known as the 'gakel-call'. How these behaviours, which might serve as indicators of welfare, are influenced by social factors is not yet known. In this study, we investigated the effect of an audience (another bird or a human) on the expression of the gakel-call and other behaviours indicating frustration. Twenty-four Lohman Brown hens were trained to gain free access to food in a test cage. Sixteen hens were used as test birds and eight as non-test audience birds. The food-deprived test hens were tested for 15 min in a non-thwarting situation (food freely available) and for 15 min in a thwarting situation (food covered but visible). For both situations we investigated four different treatments: no audience in the adjacent cage; a non-thwarted audience bird in the adjacent cage; a thwarted audience bird in the adjacent cage; and finally a human audience. The durations of stereotyped pacing and displacement preening were significantly higher in test birds during thwarting than during non-thwarting; thwarted birds also gave significantly more gakel-calls compared to non-thwarted birds. The test birds, and also the audience birds, gave more gakel-calls when thwarted in the presence of a thwarted conspecific than when in the presence of a non-thwarted bird, but there were no significant differences in stereotyped pacing or displacement preening, which are usually associated with frustration. In conclusion, this study supports the view that the gakel-call signals frustration in laying hens. Furthermore, the state of the audience influences the occurrence of gakel-calls in thwarted hens. Thus, when using the gakel-call as a welfare-indicator, the social aspects of the vocal expression of frustration in laying hens should not be overlooked.


The authors attempted to grow a semi-insulating SiC epitaxial layer by in-situ vanadium doping. The homoepitaxial growth of the vanadium-doped 4H-SiC layer was performed by MOCVD using the organo-silicon precursor, bis-trimethylsilylmethane (BTMSM, [C7H20Si2]) and the metal-organic precursor, bis-cyclopentadienylvanadium (Verrocene, [C10H10V]). Vanadium doping effect on crystallinity of epilayer was very destructive. Vanadium-doped epilayers grown on normal condition had various surface or crystal defects such as micropipes, polytype inclusions. But this crystallinity degradation was overcome by high growth temperature. For the measurement of the resistivity of the highly resistive vanadium-doped 4H-SiC epilayers, the authors used the on-resistance technique. Based on the measurements of the on-resistance of the epilayers using the current-voltage technique, it is shown that the residual donor concentration of the epilayers was decreased with increasing partial pressure of verrocene. The resistivity of the vanadium-doped 4H-SiC epilayer was about 107 /cm.


We use metals for thousands years and still discover new properties they possess. Here it is experimentally shown that one the unknown properties of metal is its inertial explosion induced by mechanical impact. Unexpected characteristics of this explosion and parameters of its products are presented in comparison to the previously described electrical explosion of thin metal films and wires.


The war in Afghanistan (1978 to the present) is one of the longest and bloodiest wars in modern history. From the early 1980s war intensified between the Leftist regime and the opposition Mujahideen and touched the life of every citizen. Bombardments, rockets and landmines killed and injured hundreds of thousands of civilians and caused massive displacement. Women were the direct and indirect targets of the war; some women lost members of their immediate family, others were displaced and emigrated, some were raped, and others were enslaved and sold. Thus trauma and mourning mark the lives of the majority of Afghanistani women. Given the political nature of the conflict—with superpowers and regional powers behind the warring sides—and the nature of socio-cultural bonds that required women to keep silent, how did women deal with these traumas? One of the areas in which this can best be seen is in women's literature—most notably narrative works. These works, in which the authors were themselves either victims or witnesses, voice women's resistance to the war and portray war and its consequences for ordinary women's everyday lives. In the narrative works of Spozhmai Zaryab (the pioneer of the anti-war fiction in Afghanistan), women and trauma are multi-dimensional. In some of her short stories women mourn publicly; in others, women cope with war and resist it by whatever means available to them. In others, women visualize war, invasion and destruction of all socio-cultural bonds. Women are transformed by a profound change, including in their perception of gender relations.


Hong Kong experiences a strongly seasonal climate, with distinct hot, wet summers and cool, dry winters, which has a great influence on intertidal assemblages. The impacts and relative importance of disturbance events on assemblage structure and subsequent recovery in this environ- ment were examined on semi-exposed rocky shores. In August 1997, Typhoon Victor affected Hong Kong coastal waters bringing high seas and strong winds. Effects on mid-shore assemblage structure were patchy, with an increase in free space and a decrease in the abundance of the dominant mollus- can grazer Monodonta labio occurring on one 10 m site on a shore, but not at other areas 10s of m away. The long-term impacts of this pulse disturbance were, however, negligible, as at this time of year there is little algal cover and grazer abundances are low, due to predictable annual disturbance caused by an increase in temperature with the onset of summer. Monitoring of plots artificially dis- turbed at different times of the year showed that recovery to undisturbed conditions was rapid follow- ing pulse disturbance events such as typhoons. Such disturbances had no lasting (> 6 mo) effect, as the die-off of species in the summer caused assemblages on shores to dissipate, and any long-term impacts of these disturbances were not obvious after one summer. It appears that the short-term effects of pulse disturbances on Hong Kong shores are rapidly eclipsed by annual, summer die-off events.


Copyright © 2020 Batovska et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license. Volume 9, no. 2, e01476-19, 2020, https://doi.org/10.1128/MRA.01476-19. After publication, the authors were made aware of a short sequence on GenBank (JQ749729.1) with high similarity to Yada Yada virus (YYV). The 331-bp sequence is part of the nonstructural polyprotein (NSP4) and shares 97% nucleotide identity and 99.1% amino acid identity with YYV. This sequence was detected in an Aedes notoscriptus mosquito collected in North Melbourne, Australia, in 2011. The similarity of this sequence to YYV suggests that the virus from which it originated is part of the mosquito-specific alphavirus complex, which consists of viruses that have been detected only in Anopheles and Culex mosquitoes.


A high carbohydrate (CHO) diet has previously been shown to lessen the severity of the symptoms of Acute Mountain Sickness (AMS). The aims of this study were to ascertain whether selected military field rations provided adequate nutritional support, and assess the effectiveness of a high CHO food supplement in reducing the severity of the symptoms of AMS at high altitude. An experimental group (n = 32) received field rations plus a CHO food supplement and a control group (n = 35) only received field rations. Food intakes for 15 consecutive days were recorded using a visual estimation technique and 24-h dietary log. Food acceptability was assessed with a 9-point hedonic scale. Daily urine samples and body weights were obtained from all subjects and a 24-h urine sample obtained from a subsample of the combined groups (n = 30) for the first and last two days of the study. Results show that energy intake decreased for the first three days at altitude, improved on day four and leveled out thereafter. Mean daily energy intakes were 2265 kcal for the supplemented group and 2140 kcal for the control group; body weight losses were 1.71 kg and 1.68 kg. Mean CHO intake was 271 and 244 g per day; 48 and 46% of energy intake. Ration acceptability was generally good and did not decline over time. It was concluded that rations used at sea level could also be satisfactorily used at altitude, but given an ad libitum dietary regimen and a CHO food supplement, CHO intake was not automatically increased. Supplementation via a beverage component, rather than a food supplement, may therefore be more effective in increasing CHO intake.


RATIONALE, AIMS AND OBJECTIVES
Transcatheter aortic valve implantation constitutes an example of a technology introduced into the Galician Health Care System basket and subjected to a post-introduction observational study after coverage. This paper aims to describe the process and results of this experience, illustrating the main challenges and opportunities in using these studies for supporting decision making.

METHODS
The study protocol was developed by a multidisciplinary team consisting of experts from the Galician HTA Agency (avalia-t), interventional cardiologists and cardiac surgeons. Together they agreed on the information that was relevant and feasible for collection, and planned the study design, data collection and analysis of results.

RESULTS
During the 1-year recruitment period, 94 patients underwent percutaneous aortic valve replacement in the three authorized centres. Implantation rate and prosthesis models differed substantially across the centres. Overall, procedural success rate was 96.8% and hospital mortality was 7.4%. Complications during post-surgical admission were recorded in 40.4% of patients. Moderate residual aortic regurgitation was observed in 10% of patients, and the procedure was associated with a stroke rate of 3.3% at 30 days and 5.3% at 1 year.

CONCLUSIONS
Post-introduction observation has made it feasible to determine the use of this procedure within the SERGAS context and has enabled the assessment of performance in real-life conditions. The proposed strategic actions and interventions have been drawn up based upon the collective judgement of a group of experienced professionals, and have served to establish recommendations on further research that would be required to optimize health benefits.


We present a framework for online imitation of human motion by the humanoid robot HRP-2. We introduce a representation of human motion, the Humanoid-Normalized model, and a Center of Mass (CoM) anticipation model to prepare the robot in case the human lifts his/her foot. Our proposed motion representation codifies operational space and geometric information. Whole body robot motion is computed using a task-based prioritized inverse kinematics solver. By setting the human motion model as the target, and giving the maintenance of robot CoM a high priority, we can achieve a large range of motion imitation. We present two scenarios of motion imitation, first where the humanoid mimics a dancing motion of the human, and second where it balances on one foot. Our results show that we can effectively transfer a large range of motion from human to humanoid. We also evaluate the tracking errors between the original and imitated motion, and consider the restrictions on the range of transferable human motions using this approach.


Virtue is a fundamental aspect of well-being. Past research has proposed that emotional-driven design can be a powerful mediator towards supporting virtue. However, virtue-focused solutions generally target isolated actions. Here, using saving as an example of virtuous behavior we present a design case—Billy Cash, a digital piggy bank that allows users to reflect during the saving process and extend the appreciation of the purchased item—that aims to demonstrate how design can facilitate virtuous behavior that is sustainable and can promote actual change. Through the analysis and evaluation of the design case, we propose a framework of design for virtuous behavior. The framework sets a scenario for design interventions that contemplate virtuous actions to be transformed into virtuous behaviors mediated by the resignification of resources and stimuli behind the experience.


Despite recent advances in knowledge representation, automated reasoning, and machine learning, artificial agents still lack the ability to understand basic action-effect relations regarding the physical world, for example, the action of cutting a cucumber most likely leads to the state where the cucumber is broken apart into smaller pieces. If artificial agents (e.g., robots) ever become our partners in joint tasks, it is critical to empower them with such action-effect understanding so that they can reason about the state of the world and plan for actions. Towards this goal, this paper introduces a new task on naive physical action-effect prediction, which addresses the relations between concrete actions (expressed in the form of verb-noun pairs) and their effects on the state of the physical world as depicted by images. We collected a dataset for this task and developed an approach that harnesses web image data through distant supervision to facilitate learning for action-effect prediction. Our empirical results have shown that web data can be used to complement a small number of seed examples (e.g., three examples for each action) for model learning. This opens up possibilities for agents to learn physical action-effect relations for tasks at hand through communication with humans with a few examples.


The aim of the present article is to contend the widespread but largely unfounded claim that MAHT tools (popularly known as translator 's work-benches) are best suited for translating so-called technical texts. The article calls for establishing a separate MAHT tool-specific text typology by pre-senting what are – in the author 's opinion – the most important features characteristic of an MAHT-suitable text. It transpires that it is difficult to simply relate this particular type of text to any of the existing classifications of translation-related or general text typologies (such as those advocated by, for example, Hatim & Mason 1990; Reiß 1983; Snell-Hornby 1988 or Kussmaul 1997) since the existing methodologies do not take MAHT-specif¬ic attributes into account. Therefore, the present article calls for an empi¬rical, corpus-based study that would help establish the relation between the proposed underlying features and actual text types as described elsewhere.


Two compositional factors that control the lithium (de)intercalation capacity of nickel-doped Li2MnO3 have been identified. First is the Ni2+ content and (de)intercalation associated with the Ni2+/4+ redox-active couple. Second is the amount of oxygen deficiency achieved by preparing samples at different temperatures, together with creation of Mn3+ ions for charge balance and (de)intercalation associated with the Mn3+/4+ redox-active couple. Results demonstrating this effect are presented for composition Li1.93Mn0.97Ni0.10O3–. The creation of an oxygen deficiency provides a novel method for enhancing the electrochemical performance of layered, rock-salt structured oxides.


Continuous measurements play a pivotal role in the study of dynamical open quantum systems. ``Dyne'' detections are among the most widespread and efficient measurement schemes, and give rise to quantum diffusion of the conditioned state. In this work we study under what conditions the detector dependency of the conditional state of a quantum system subject to diffusive monitoring can be demonstrated experimentally, in the sense of ruling out any detector-independent pure-state dynamical model for the system. We consider an arbitrary number $L$ of environments to which the system is coupled, and an arbitrary number $K$ of different types of dyne detections. We prove that nontrivial necessary conditions for such a demonstration can be determined efficiently by semidefinite programming. To determine sufficient conditions, different physical environmental couplings and Hamiltonians for a qubit and different sets of diffusive monitorings are scrutinized. We compare the threshold efficiencies that are sufficient in the various cases, as well as cases previously considered in the literature, to suggest the most feasible experimental options.


The authors review the scientific data on nutritional problems in patients with acute decompensation of COPD and present their own experience in the nutritional management of such condition. Artificial nutrition (enteral and parenteral) allowed a reduction in the duration of hospitalization, a lower incidence of infections, and a shorter weaning time from mechanical ventilation in comparison to a homogeneous group of patients treated in the same unit in an earlier period, when less attention was paid to nutritional problems. The importance of artificial nutrition in patients with acute decompensation of COPD is highlighted.


Rivers export increasing amounts of nitrogen (N) and phosphorus (P) to the coastal waters of China. This causes eutrophication problems that can damage living organisms when oxygen levels drop and threaten human health through toxic algae. We know that these problems result from human activities on land such as agriculture and urbanization. However, the relative importance of these human activities for river export of nutrients to Chinese seas is not well studied. There are two important issues that need further investigation: the relative importance of upstream pollution on downstream impacts and the relative importance of typical sources of nutrients in Chinese rivers that are often ignored in existing modeling studies. My PhD thesis, therefore, aims to better understand trends in river export of nutrients to the coastal waters of China by source from sub-basins, and the associated coastal eutrophication. To this end, I developed the MARINA model: M odel to A ssess R iver I nputs of N utrients to se A s. For this, I used the existing Global NEWS-2 model (Nutrient Export from WaterSheds) as a starting point. I formulated five sub-objectives to achieve the main objective:   To analyze the original Global NEWS-2 model for river export of nutrients and the associated coastal eutrophication (Chapter 2); To develop a sub-basin scale modeling approach to account for impacts of upstream human activities on downstream water pollution, taking the Pearl River as an example (Chapter 3); To quantify the relative share of manure point sources to nutrient inputs to rivers at the sub-basin scale (Chapter 4); To quantify the relative share of sources to river export of nutrients at the sub-basin scale (Chapter 5); To explore optimistic futures to reduce river export of nutrients and coastal eutrophication in China (Chapter 6). The study area includes rivers draining roughly 40% of China. This includes the most densely populated areas, and areas with intensive economic activities. The rivers include the Yangtze (Changjiang), Yellow (Huanghe), Pearl, Huai, Hai and Liao. In the MARINA model, the drainage areas of the large Yangtze, Yellow and Pearl rivers are divided into up-, middle- and downstream sub-basins. The principle of the sub-basin approach of MARINA is that nutrients from human activities are transported by tributaries to outlets of sub-basins and then to the river mouth (coastal waters) through the main channel. The model takes into account nutrients that are partly lost or retained during transport towards the river mouth. The model quantifies river export of nutrients by source from sub-basins for 1970, 2000 and 2050. The main six findings of the MARINA results for China are:  Finding 1: Dissolved N and P export by Chinese rivers increased by a factor of 2-8 between 1970 and 2000; Finding 2: The potential for coastal eutrophication was low in 1970 and high in 2000 in China; Finding 3: Most dissolved N and P in Chinese seas is from middlestream and downstream human activities; Finding 4: Manure point sources are responsible for 20-80% of dissolved N and P in Chinese rivers; Finding 5: In the future, river export of nutrients may increase in the Global Orchestration (GO) scenario of the Millennium Ecosystem Assessment. Current policy plans (CP scenario) may not sufficient to avoid this increase; Finding 6: In optimistic scenarios (OPT-1 and OPT-2), the potential for coastal eutrophication is low in 2050, mainly as a result of assumed full implementation of: (1) high recycling rates of animal manure (OPT-1 and OPT-2), and (2) high efficiencies of nutrient removal in sewage systems (OPT-2, see Figure 1).  Figure 1. Illustration of future scenarios for coastal water quality in China. GO is Global Orchestration of the Millennium Ecosystem Assessment and assumes environmental actions that are either absent or ineffective in reducing water pollution. CP is based on GO, but incorporates the "Zero Growth in Synthetic Fertilizers after 2020" policy. OPT-1 and OP-2 are optimistic scenarios that assume high nutrient use efficiencies in agriculture (OPT-1, OPT-2) and sewage (OPT-2). My PhD thesis reveals novel insights for effective environmental policies in China. It shows the importance of manure point sources in water pollution by nutrients. Clearly, managing this source will likely reduce coastal eutrophication in the future. Furthermore, the implementation of advanced technologies is essential when dealing with urban pollution. My PhD thesis may also be useful for other world regions with similar environmental problems as in China. The new, sub-basin scale MARINA model is rather transparent and thus can be applied to other large, data-poor basins that may benefit from the allocation of effective management options. With this I hope to contribute to future availability of sufficiently clean water for next generations, not only in China, but also in other world regions.


A simple method was used to create a graphene oxide/chitosan (GO/CS) nanocomposite, which was then used in batch experiments to remove copper ions from industrial wastewater under various conditions of initial concentration, adsorbent weight, pH, and contact time. Maximum removal percentage equal to 99.4 % for initial copper ion concentration of 5x10-2 mol/L at pH 6, time 75 min, temperature 25 °C, and adsorbing dose 0.1 g. The pseudo-second order kinetic model and the Freundlich isotherm adequately fit the experimental results. The process was spontaneous and endothermic, according to thermodynamic studies.


This paper analyzes the stability problem of the grid-connected voltage-source inverter (VSI) with LC filters, which demonstrates that the possible grid-impedance variations have a significant influence on the system stability when conventional proportional-integrator (PI) controller is used for grid current control. As the grid inductive impedance increases, the low-frequency gain and bandwidth of the PI controller have to be decreased to keep the system stable, thus degrading the tracking performance and disturbance rejection capability. To deal with this stability problem, an H∞ controller with explicit robustness in terms of grid-impedance variations is proposed to incorporate the desired tracking performance and the stability margin. By properly selecting the weighting functions, the synthesized H∞ controller exhibits high gains at the vicinity of the line frequency, similar to the traditional proportional-resonant controller; meanwhile, it has enough high-frequency attenuation to keep the control loop stable. An inner inverter-output-current loop with high bandwidth is also designed to get better disturbance rejection capability. The selection of weighting functions, inner inverter-output-current loop design, and system disturbance rejection capability are discussed in detail in this paper. Both simulation and experimental results of the proposed H∞ controller as well as the conventional PI controller are given and compared, which validates the performance of the proposed control scheme.


This passage develops a set of arithmetic process for the image of the weld seam in flanges, which suits the weld process according to the feature of the seam. In terms of the arithmetic process for image, traditional methods are replaced by the opening and closing of mathematical morphology, which effectively smoothes the interferences of weld points, surface scratches, glistens and false edges, thus forming sharp and smooth image of weld seam. The arithmetic process of image proves to be brief and highly effective, which meets the practical need of the construction supported by the image of the weld seam. This passage also, taking weld seam as an example, focuses on the discussion of the erosion and dilation of the opening and closing calculations, which are of great value towards administering the process of processing editing the image.


Investigation of species abundance has become a vital component of many ecological monitoring studies. The primary objective of these studies is to understand how specific species are distributed across the study domain, as well as quantification of the sampling efficiency for detecting these species. To achieve these goals, preselected locations are sampled during scheduled visits, in which the number of species observed at each location is recorded. This results in spatially referenced replicated count data that are often unbalanced in structure and exhibit overdispersion. Motivated by the Baltimore Ecosystem Study, we propose Bayesian hierarchical binomial mixture models, including Binomial Conway-Maxwell Poisson (Bin-CMP) mixture models, that formally account for varying levels of spatial dispersion. Our proposed models also allow for variable selection of model covariates and grouping of dispersion parameters through the implementation of reversible jump Markov chain Monte Carlo methodology. Finally, using demographic covariates from the American Community Survey, we demonstrate the effectiveness of our approach through estimation of abundance for the American Robin (Turdus migratorius) in the Baltimore Ecosystem Study.


Flextronics Industrialization Group (FIG) is an international company specialised in Industrialisation services for the mobile phone industry. Industrialisation services include everything that is done to prepare a product for high-volume manufacturing. This mainly involves developing production processes, production equipment, test processes and test equipment. The high-volume manufacturing is located in low-cost countries.This study has been performed at FIG in Linkoping, where the work is carried out as projects. In 2004, a new project model called the Product Development Process (PDP) was introduced at Flextronics worldwide. As the name implies, the PDP was originally created to support product development projects, which is why it has been hard to completely utilize the PDP at FIG. The PDP has so far been considered more trouble than support. This has lead to that project managers at FIG are working differently.The purpose of this master thesis was to develop an application of the PDP suitable for the Industrialisation projects performed at FIG. During our work internal PDP documentation was studied and interviews with project managers and sub-project managers were performed. Review meetings were held frequently during the entire study and our solutions were revised several times.Our work has above all resulted in new processes applicable for Industrialisation projects. To make these Industrialisation processes easy to follow we have produced a guideline. This guideline provides a framework for Industrialisation projects at FIG and explains the interconnection between the PDP and our new Industrialisation PDP application. It also includes detailed descriptions of the Industrialisation processes, checklists, decision structure, project organisation and project roles and responsibilities. Due to confidentiality reasons, our solutions could not be included in their entirety in this report.We believe that the Industrialisation PDP application will improve the work at FIG. It will be easier to follow a working method that is adapted to the specific business. Using the same working methods will support the project work, improve the way of working and make it more efficient.


The paper gives the results on researches of sporadically and accessory components of the amphibolites rocks in the south rim of the Krivaja – Konjuh ophiolite complex in Bosnia and Herzegovina. By optical analyses and x-ray fluorescene spectroscopy examinations as well as electronic microprobes, it was established that in analyzed amphibolites were sporadically found these: corundum, spinels (chrome spinel, hercinite, chrome hercinite and magnesium-chromites), chlorites (clinochlore and ripidolite), zeolite minerals (thomsonite and mesolite), prehnite, epidote-clinocoisite, analcime, albite and serpentine. Examinations indicated that corundum has been found in amphibolites schists as important, secondary and accessory component in form of grain aggregates, like porphyroblast and root mineral. Corundum porphyroblasts contain small inclusions of clinochlore and tchermakite partially transformed into margarite and anorthite, what was proved by x-ray fluorescene spectroscopy and microsonde analyses. Corundum roots which cut corundum amphibolites rarely appear stretch parallel with pholiatia, and they arouse by post-cinematic secretion. The investigations of flaw minerals covered polarization microscopic examinations, x-ray examinations, and electronic micro-probe cmemical analyses. The flaw minerals found are as follows: prehnite, zeolite minerals including thomsonite, mesolite, epidote-clinocoisite, chlorite, calcite and less frequently plagioclase-albite, anorthite, quartz, corundum and analcime formed in the post-consolidation stage of hydro-thermal activities mainly under low-degree metamorphic conditions. Corundum veins and seams crosscuting corundum amphibolites formed post-kinematic secretion. By the researches on amphibolites rocks, there were established the presence of accessory components, with dominant participation of magnetite, titanite, ilmenite, rutile, zircon, apatite, phlogopite and biotite


Movement is planned and coordinated by the brain and carried out by contracting muscles acting on specific joints. Motor commands initiated in the brain travel through descending pathways in the spinal cord to effector motor neurons before reaching target muscles. Damage to these pathways by spinal cord injury (SCI) can result in paralysis below the injury level. However, the planning and coordination centers of the brain, as well as peripheral nerves and the muscles that they act upon, remain functional. Neuroprosthetic devices can restore motor function following SCI by direct electrical stimulation of the neuromuscular system. Unfortunately, conventional neuroprosthetic techniques are limited by a myriad of factors that include, but are not limited to, a lack of characterization of non-linear input/output system dynamics, mechanical coupling, limited number of degrees of freedom, high power consumption, large device size, and rapid onset of muscle fatigue. Wireless multi-channel closed-loop neuroprostheses that integrate command signals from the brain with sensor-based feedback from the environment and the system's state offer the possibility of increasing device performance, ultimately improving quality of life for people with SCI. In this manuscript, we review neuroprosthetic technology for improving functional restoration following SCI and describe brain-machine interfaces suitable for control of neuroprosthetic systems with multiple degrees of freedom. Additionally, we discuss novel stimulation paradigms that can improve synergy with higher planning centers and improve fatigue-resistant activation of paralyzed muscles. In the near future, integration of these technologies will provide SCI survivors with versatile closed-loop neuroprosthetic systems for restoring function to paralyzed muscles.


CONTEXT
Dynamic balance deficits exist following a concussion, sometimes years after injury. However, clinicians lack practical tools for assessing dynamic balance.

OBJECTIVES
To determine if there are significant differences in static and dynamic balance performance between individuals with and without a history of concussion.

DESIGN
Cross sectional.

SETTING
Clinical research laboratory.

PATIENTS OR OTHER PARTICIPANTS
45 collegiate student-athletes with a history of concussion (23 males, 22 females; age = 20.0 ± 1.4 y; height = 175.8 ± 11.6 cm; mass = 76.4 ± 19.2 kg) and 45 matched controls with no history of concussion (23 males, 22 females; age = 20.0 ± 1.3 y; height = 178.8 ± 13.2 cm; mass = 75.7 ± 18.2 kg).

INTERVENTIONS
Participants completed a static (Balance Error Scoring System) and dynamic (Y Balance Test-Lower Quarter) balance assessment.

MAIN OUTCOME MEASURES
A composite score was calculated from the mean normalized Y Balance Test-Lower Quarter reach distances. Firm, foam, and overall errors were counted during the Balance Error Scoring System by a single reliable rater. One-way ANOVAs were used to compare balance performance between groups. Pearson's correlations were performed to determine the relationship between the time since the most recent concussion and balance performance. A Bonferonni adjusted a priori α < 0.025 was used for all analyses.

RESULTS
Static and dynamic balance performance did not significantly differ between groups. No significant correlation was found between the time since the most recent concussion and balance performance.

CONCLUSIONS
Collegiate athletes with a history of concussion do not present with static or dynamic balance deficits when measured using clinical assessments. More research is needed to determine whether the Y Balance Test-Lower Quarter is sensitive to acute balance deficits following concussion.


Abstract Background: The macroscopic appearance of the normal squamocolumnar junction (SCJ) is often described as serrated with short projections of columnar mucosa that extend into the esophagus. As studies of the normal SCJ are sparse, the aim of this study was to test the hypothesis that the normal SCJ is even and that irregularities are manifestations of acid reflux. Method: Fifty asymptomatic subjects and 149 patients with symptoms suggestive of gastroesophageal reflux disease underwent endoscopy and 48-h pH monitoring with a pH electrode positioned immediately above the SCJ. The shape of the SCJ was assessed according to the Z-line appearance classification and correlated with clinical characteristics and the degree of esophageal acid exposure in the most distal esophagus. Results: Even SCJs without irregularities were significantly more common in asymptomatic subjects compared with patients (50% versus 10%, p < .001) and were never found in patients with erosive esophagitis. The median degree of distal esophageal acid exposure in individuals with an even SCJ was within normal limits. With increasing degree of irregularity of the SCJ, the frequency and duration of reflux episodes, the degree of distal esophageal acid exposure, and the prevalence of abnormal acid exposure increased progressively and significantly. Conclusion: The shape of the normal SCJ is even and also minimal irregularities are a consequence of acid reflux, likely due to the formation of small areas of metaplastic columnar mucosa.


Physics
The mass of the electron is one of the fundamental constants of nature. It is known to a high precision, but improvements are desirable in order to facilitate continued precision testing of the Standard Model of particle physics. The tiny mass, however, makes direct measurements very challenging. Sturm et al. use an indirect technique, in which an electron is bound to a carbon nucleus in a hydrogen-like configuration. This positively charged ion follows a circular orbit in an external magnetic field at the cyclotron frequency, which is proportional to the local magnetic field B . At the same time, the spin of the electron precesses at a frequency also proportional to B . By measuring the ratio of these two frequencies, one can determine the electron mass, knowing the mass of the ion and the g factor of the bound electron, which is different from its well-known free-space value; to estimate it, the authors used the theory of quantum electrodynamics and related measurements in a silicon system. The measurements were performed in a Penning-trap setup and yielded a relative precision of 3 × 10−11 in the electron mass, a value 13 times smaller than the uncertainty of the current accepted mass obtained by weighted averaging of literature values. It is expected that the improved result will enable future fundamental physics experiments that were previously impossible.

Nature 10.1038/nature13026 (2014).


Author(s): Chen, Jie Rou | Advisor(s): Paulson, Suzanne E | Abstract: One of the most uncertain aspects of the climate system are aerosol particles and their interaction with clouds. Aerosol aging in the aqueous phase often involves reactive oxygen species such as hydroxyl radicals (OH), hydrogen peroxide (H2O2), superoxide (O2•-), and organic peroxides. In clouds, chemistry driven by hydroxyl radicals is a well-known contributor to production of secondary organic aerosols. OH in cloud and fog droplets originate from various sources, and models currently assume the main source of hydroxyl radicals in clouds is uptake from the gas phase. Work done previously in the group suggested a new, potentially substantial source of OH in cloud droplets when exposed to near UV light. In this study, we are able to produce similar behavior to field sample observations from mixtures of Fe(II) and peracetic acid (PAA) in the presence of light. We investigate this reaction to see if we can explain the 'OH burst' which occurs within moments of sample preparation. This is a previously unrecognized reaction and we observe a concentration-saturation effect to the amount of OH produced in the burst. We observe the OH burst from the reaction of Fe(II) and PAA in 320 nm light and in dark conditions. The reaction in the presence of near UV light immediately produces almost double the OH as the reaction in the dark demonstrating a clear light dependence. This is a possible photo-Fenton like reaction cycling Fe(II) amplifying the OH production. At higher concentrations of Fe(II) and PAA molar yield of OH decreases in both the light and dark conditions, producing less OH per �M of reactant compared to lower concentrations of either Fe(II) or PAA. Inhibition from iron-organic complexes or saturation effects are possibly limiting OH yield at high concentrations of initial reactants.


Traditional Versus Nontraditional Instructional and Assessment Differences in 8th-Grade History-Social Science Achievement by John David Landers MEd, Azusa Pacific University, 1995 BA, Azusa Pacific University, 1986 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Education Walden University April 2018 Abstract In southern California school districts, 8th grade students in history-social science (H-SS) classes did not perform well on the California Standards Test (CST). To improve student performance, middle school H-SS teachers in some districts received staff development in the use of authentic assessment, the understanding and application of multipleIn southern California school districts, 8th grade students in history-social science (H-SS) classes did not perform well on the California Standards Test (CST). To improve student performance, middle school H-SS teachers in some districts received staff development in the use of authentic assessment, the understanding and application of multiple intelligences theory, and the application of a student centered focus in lesson design and instruction. The purpose of this comparative pretest/posttest study was to determine if there was significant achievement difference between 2 8th-grade U.S. H-SS classes taught in 2 districts. The research question addressed a significant difference in CST HSS achievement scores between 8th-grade students taught using multiple intelligences strategies and authentic assessments (n = 28) and those who were taught using traditional strategies and curriculum assessments (n = 31). The theoretical foundation for this study was constructivism. Post-data from archived student scores on the CST H-SS test were collected and analyzed using an analysis of covariance (ANCOVA), controlling for varying differences in CST pre-test H-SS scores. There was a statistically significant difference in posttest CST H-SS scores between the 2 groups (F = 10.491, p < .002), with the nontraditional group scoring higher. Based on the findings, it is recommended that district leaders provide professional development opportunities for teachers in nontraditional constructivist instructional strategies that support student-centered instruction. These endeavors may lead to positive social change if H-SS teachers change instruction and assessment methods to improve student achievement, thus, meeting graduation requirements and enhancing citizenship development. Traditional Versus Nontraditional Instructional and Assessment Differences in 8th-Grade History-Social Science Achievement by


Vitamin D deficiency is known to be common in the general population and has been linked to all-cause mortality. The classically recognized role of vitamin D is its involvement in calcium and phosphorous homeostasis and bone health. Recent evidence suggests that vitamin D may also play a role in other nonskeletal processes, such as anti-proliferation, immunity, regulation of hormone section, and muscle strength. An extensive literature review of vitamin D and critical illness from 2000 to 2015 (PubMed and CINAL) produced multiple observational studies revealing a high prevalence of vitamin D deficiency in intensive care patients. Many of these studies have indicated that there is an association between vitamin D deficiency and clinical outcomes such as mortality, sepsis, duration of mechanical ventilation, and length of stay. This review article provides an overview of vitamin D physiology in adults, a summary of observational studies on vitamin D deficiency in critical illness, and an examination of the few clinical trials on vitamin D supplementation in intensive care patients.