This report is written primarily for teachers and teacher educators who, in their teaching, curricula, and relationships with students, are struggling with fundamental cultural questions: Who are my students? What kinds of cultural influences shape their lives? How do they — and I, as their teacher — shape and construct this culture on an ongoing basis? What are my own cultural assumptions and how do they influence my teaching? Much has been written about how schools should respond to the needs of diverse learners and how teachers should alter curricula and teaching practices to accommodate them. We do not intend to reiterate what has already been accomplished in this area. Rather, this report covers ground that we think has been less well covered — namely, the personalization of culture and how it can enhance teaching and learning. These pages represent a distillation of ideas and strategies shared in 1996 at a two-day institute for teachers and anthropologists.1 Many teachers realize that a key to creating a successful learning environment for all students is to tap into the prior knowledge and skills that students bring to school and to make connections between their prior knowledge and new knowledge. Norma Gonzalez (1996) confirmed this: Our experience indicates that when the children's background is recognized and incorporated into the classroom, children's motivation and engagement in the learning process increases dramatically. This is a necessary condition for improving students' achievement across all areas of the curriculum, including language arts, critical thinking skills, mathematics, and scientific inquiry. When teachers and students share similar cultural and linguistic backgrounds, making these connections is easier, because teachers already have some fairly well-grounded information about the child's culture. For example, they might already know what kinds of activities families participate in on weekends, what kinds of work parents do, and how discipline tends to be handled in the home. Gaps in the teacher's knowledge can readily be filled in by asking parents, who speak the same language as the teacher. On, the other hand, when teachers do not have a background similar to their students', they may lack cultural information that is relevant to teaching these children. Worse yet, they may rely on stereotypes and generalizations to inform curricular and pedagogical decisions. Information and strategies for acquiring accurate information may not be readily apparent, and even if it were possible for teachers to learn enough about the cultural background of each student, this can lead to the trap of essentialism (Spindler, 1996), in which we expect all children of a particular cultural background to act in a certain way. Many teachers wonder where they can turn for strategies and ideas that make meaningful use of culture in the classroom. The purpose of this report is to provide suggestions that will assist teachers in personalizing culture – that is, in moving away from broad generalizations about cultures toward specific knowledge about individual students and families, and toward awareness of the teacher's own culture. Through this personalization of culture, students' prior knowledge and skills can become a rich resource for teaching and learning. We view this as part of the larger effort to create culturally responsive schools. In the following paragraphs, we foreshadow five themes and related assumptions that frame our suggestions for personalizing culture.


Abstract The evolution of five alluvial fan systems is discussed in relation to chronology and possible tectonic and climatic triggering mechanisms. Two types of fan have evolved on the Spartan piedmont, Greece. First relatively large, low-angle fans, comprising four segments (Qf1–Qf4) composed of debris-flow and hyperconcentrated-flow deposits, with fluvial sediments restricted to the upper deposits of the distal segments. Second small, steep telescopically segmented fans, which consist of three segments (Qf1–Qf3), formed predominantly by debris-flow and hyperconcentrated-flow deposits. Morphological analysis of surface soils coupled with mineral magnetic and extractable iron (Fed) analyses of B-horizons suggest that individual segments can be correlated across the piedmont and have equivalent age. Luminescence dating of fine-grained deposits suggests that Qf1 segments formed during marine isotope stage (MIS) 6, Qf2 segments during MIS 5, Qf3 segments during MIS 4–2, and Qf4 segments during MIS 2 and 1. Tectonics has exerted a limited influence on fan systems. Regional uplift provides the gross relief conducive for fan development. The locations of fans were determined by transfer faults of Tertiary age, while Quaternary faulting initiated short phases of fan incision. Climate change as manifested by cycles of aridity and low vegetation cover during stadials, and humidity and deciduous woodland during interglacials and interstadials, played a key role in fan evolution during the later Middle and Upper Pleistocene. Aggradation occurred during stadials, with minor deposition and intermittent erosion during most interstadials, and entrenchment during the interglacials and longer interstadials. Deposition during the Holocene is limited in extent.


Abstract Support of optimum redox-homeostasis in the cells of microorganisms plays a substantial role in the processes of DNA synthesis, respiration, providing of immune and protective reactions, activity of enzymes, etc. The changes of the redox-status can be accompanied by the increase of the level of reactive oxygen species (ROS) which predetermine the damage of biologically active molecules. Adjusting of ROS concentrations is a very important process in development of microorganisms. Low-molecular antioxidants are effective inhibitors of free-radical processes. The authors of the review present the description of oxidants and consider the ways of origin and consequences of their influence on the living cells. An accent is done on phenomenological description of low-molecular antioxidants. The basic mechanisms of their action are considered. Special attention is given to the question of synergism between these protectors. The detailed study of mechanisms of functioning of low-molecular antioxidants in the cells of microorganisms will allow using these living objects in different spheres of human activity.


Psychiatric abuse, such as we usually associate with practices in the former Soviet Union, is related not to the misuse of psychiatric diagnoses, but to the political power intrinsic to the social role of the psychiatrist in totalitarian and democratic societies alike. Some reflections are offered on the modern, therapeutic state's proclivity to treat adults as patients rather than citizens, disjoin rights from responsibilities, and thus corrupt the language of political-philosophical discourse.


To compare learning algorithms that differ by the adopted statistical paradigm, model class, or search heuristic, it is common to evaluate the performance on training data of varying size. Measuring the performance is straightforward if the data are generated from a known model, the ground truth. However, when the study concerns real-world data, the current methodology is limited to estimating predictive performance, typically by cross-validation. This work introduces a method to compare algorithms' ability to learn the model structure, assuming no ground truth is given. The idea is to identify a partial structure on which the algorithms agree, and measure the performance in relation to that structure on subsamples of the data. The method is instantiated to structure learning in Bayesian networks, measuring the performance by the structural Hamming distance. It is tested using benchmark ground truth networks and algorithms that maximize various scoring functions. The results show that the method can produce evaluation outcomes that are close to those one would obtain if the ground truth was available.


Recent observational and analytical studies suggested that a new regime of kinetic turbulence may exist in plasma environments with low electron beta (Chen & Boldyrev 2017). Such a regime, termed inertial kinetic-Alfvén turbulence, is relevant for the solar corona, Earth's magnetosheath, and other astrophysical systems where the electron and ion plasma beta parameters satisfy the condition βe βi . 1. In this paper we present kinetic numerical simulations that confirm existence of the iKAW regime. Specifically, the simulations demonstrate a transition at scales below electron inertial length de when βe βi . 1. Spectral slopes and other statistical properties of turbulence at sub-de scales are consistent with the phenomenological theory of inertial kinetic-Alfvén Corresponding author: Vadim Roytershteyn email@example.com 2 Roytershteyn et al. turbulence proposed by Chen & Boldyrev (2017) and with the recent observations in the Earth's magnetosheath.


Most animal species sleep, from invertebrates to primates. We describe the electrophysiological hallmarks of sleep in reptiles. Recordings from the brains of Australian dragon Pogonavitticepsrevealed the typical features of slow-wave sleep and rapid eye movement (REM) sleep, suggesting that dragons can be a useful model for studying these sleep stages. In this presentation, I will focus on the claustrum. The mammalian claustrum, owing to its widespread connectivity with other forebrain structures, has been hypothesized to mediate functions ranging from decision making to consciousness. We report that a homolog of the claustrum, identified by single-cell transcriptomics and viral tracing of connectivity, exists also in reptiles. There, it underlies the generation of sharp-waves during slow-wave sleep. The sharp-waves, together with superimposed high-frequency ripples, propagate to the entire forebrain. It is also characterized by converging input from mid- and hind-brain areas involved in wake/sleep control. Periodic modulation of serotonin concentration in claustrum, for example, imposes a matching modulation of sharp-wave production. The claustrum is therefore an ancient brain structure, with a potentially important role in the widespread control of brain states due to its divergent projections to the forebrain and its role in sharp-wave generation during slow-wave sleep.


We study the Cooperative Guarding problem for polygons with holes in a mobile multi-agents setting. Given a set of agents, initially deployed at a point in a polygon with n vertices and h holes, we require the agents to collaboratively explore and position themselves in such a way that every point in the polygon is visible to at least one agent and that the set of agents are visibly connected. We study the problem under two models of computation, one in which the agents can compute exact distances and angles between two points in its visibility, and one in which agents can only compare distances and angles. In the stronger model, we provide a deterministic O ( n ) round algorithm to compute such a cooperative guard set while not requiring more than n + h 2 agents and O (log n ) bits of persistent memory per agent. In the weaker model, we provide an O ( n 4 ) round algorithm, that does not require more than n +2 h 2 agents. for helpful


High nut consumption is associated with reduced total and certain cause‐specific mortality in general populations. However, its association with cancer outcomes among long‐term breast cancer survivors remains unknown. We examined the associations of nut consumption (including peanuts and tree nuts), assessed at 5‐year postdiagnosis, with overall survival (OS) and disease‐free survival (DFS) among 3449 long‐term breast cancer survivors from the Shanghai Breast Cancer Survival Study, applying Cox regression analysis. During a median follow‐up of 8.27 years post dietary assessment, there were 374 deaths, including 252 breast cancer deaths. Among 3274 survivors without previous recurrence at the dietary assessment, 209 developed breast cancer‐specific events, that is, recurrence, metastasis or breast cancer mortality. At 5‐year post dietary assessment (ie, 10‐year postdiagnosis), regular nut consumers had higher OS (93.7% vs 89.0%) and DFS (94.1% vs 86.2%) rates. After multivariable adjustment, nut consumption was positively associated with OS (Ptrend = .022) and DFS (Ptrend = .003) following a dose‐response pattern, with hazard ratios (95% confidence interval) of 0.72 (0.52‐1.05) for OS and 0.48 (0.31‐0.73) for DFS, for participants with greater than median nut intake compared with nonconsumers. The associations did not vary by nut type. Stratified analyses showed that the associations were more evident among participants with a higher total energy intake for OS (Pinteraction = .02) and among participants with early stage (I‐II) breast cancers for DFS (Pinteraction = .04). The nut‐DFS associations were not modified by estrogen receptor/progesterone receptor status or other known prognostic factors. In conclusion, nut consumption was associated with better survival, particularly DFS, among long‐term breast cancer survivors.


In this paper, the mechanical behaviors of pipe roof and bolt of shallow and unsymmetrical tunnel in soft rock are analyzed. Through the finite element software Phase2.0, combined with the geological conditions that construction site often appear, the mechanical behaviors of pipe roof and bolt and surrounding rock in the process of horseshoe highway tunnel construction in the condition that surface is soft rock and underground for the bedrock are analyzed. Research results show that: after tunnel excavation in soft rock, surrounding rock near the tunnel is easy to suffer soft-rock large deformation even failure, which needs to timely support;Due to the impact of the unsymmetrical tunnel, the mechanical behaviors of surrounding rock are unsymmetrical, such as the maximum displacement of tunnel around 0.4 m distant from apex of arch ring, the stress is asymmetrical on both sides of the tunnel arch ring etc; In addition, pipe roof can effectively prevent from the displacement of soft rock strata, improve tunnel strength factor, reduce the plastic zone of surrounding rock. This paper provides theoretical basis for the design of pipe roof and bolt.


Cryptographic protocols provide frameworks for communicating, authenticating, and exchanging secrets in sundry situations. Protocol assessment for discovering design flaws requires modeling and analyzing the protocol. Protocol analysis reveals attacks that an intruder can use. The proposed methodology provides an effective means for analyzing protocols by using message-pattern matching and goal extraction. The algorithmic approach for goal extraction and analysis has potential for automated protocol analysis.


OBJECTIVE
To evaluate outcome (survival to discharge) among trauma types (blunt, penetrating, both) in dogs. The secondary objective was to evaluate if other trauma registry parameters differ between trauma types and influence survival.

DESIGN
Retrospective evaluation of veterinary trauma registry data.

SETTING
Veterinary Committee on Trauma (VetCOT) identified Veterinary Trauma Centers (VTCs).

ANIMALS
A total of 20,289 canine trauma patients with data entered in the VetCOT trauma registry from April 1, 2017 to December 31, 2019 INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS
Data were obtained from the VetCOT database and included patient demographics, trauma type (blunt, penetrating, both), Animal Trauma Triage (ATT) score, modified Glasgow Coma Scale (mGCS), abdominal fluid score (AFS), loss of glide sign on thoracic focused assessment with sonography for trauma (TFAST), pleural effusion on TFAST, surgical procedure performed and in what location (emergency room vs operating room), and outcome. Data from 20,289 dogs were collected over a 30-month period. The most common type of trauma was penetrating (10,816, 53.3%), followed by blunt (8360, 41.2%) and then combined blunt and penetrating trauma (1113, 5.5%). Dogs suffering only penetrating trauma had a 96.5% survival rate, blunt trauma had an 89.5% survival rate, and combined trauma had an 86.3% survival rate. Dogs suffering from both types of trauma had higher ATT scores, lower mGCS scores, and were more likely to be admitted to the ICU. Trauma type, mGCS, and ATT score were found to be associated with survival.

CONCLUSIONS
The present study highlights that dogs suffering from a combination of blunt and penetrating trauma are more likely to suffer moderate to severe injuries, have lower survival rates, and are more likely to be admitted to the ICU compared to dogs suffering from only blunt or penetrating trauma. Trauma type, mGCS, and ATT scores were found to be associated with survival in all groups.


Endophytic fungi found on a variety of medicinal plants may express particular benefit. These fungi provide an alternative to overcome the progressive microbial resistance and as an effort to combat infectious diseases that became one of the leading causes of mortality. The main objective of this study was to isolate endophytic fungi from leaf samples of five medicinal plants species collected from evergreen forests Baluran National Park and its use as laboratory manual for Micology. Research findings showed there were 3 isolates of endophytic fungi isolated from 2 medicinal plants namely Kesambi (Schleicera oleosa) and Ketapang (Terminalia catappa). All three isolates formed sporangiophores as asexual reproductive structures, while the structure of sexual still undiscovered therefore its classification has not been determined. The validity tests also showed that the lab manual is feasible for use with the percentage achievement 85.37% and 88.56%.


Within the context of environmental voluntary agreements (VAs), this paper analyzes the determinants of the degree of participation by firms in collective corporate political strategies that aim to shape government policy. We demonstrate that substantive cooperative strategies are more likely to be pursued by firms that enter a VA close to its initiation, while symbolic cooperation is more likely behavior by late joiners. We show that late joiners and early joiners within VAs adopt different cooperative strategies because they face different institutional pressures. Our analysis is based on the strategies of firms participating in the Climate Challenge program (1995–2000) established by the U.S. Department of Energy and representatives of the national electric utilities to reduce greenhouse gas emissions. Our results show that early joiners were subjected to higher levels of political pressure at the state level and were more dependent on local and federal regulatory agencies than late joiners were. Early joiners were also better connected to the trade association and more visible. Late joiners had undertaken significantly less investment in environmental improvements than early joiners. Our paper also illustrates the difficulty involved in using VAs to try to induce improved environmental outcomes when there are no sanctioning mechanisms. Although early entrants reduced their emissions more than nonparticipants, our results show no significant difference overall between participants and nonparticipants in the reduction of their emissions. Copyright © 2010 John Wiley & Sons, Ltd.


Nano-dimensional powder of iron cobalt cyanide hydrate in silica matrix (member of Prussian-blue family) was obtained using ferric chloride, cobalt chloride, potassium cyanide and silica in their dilute solution through coprecipitation method. The crystal structures and surface morphology of nanoparticles were characterized by the powder X-Ray diffraction (XRD) and transmission electron microscopy (TEM). The formation of compound Fe4 (Co(CN)6)3.16H2O was revealed by Fourier transform infrared (FTIR) spectroscopy. The magnetic properties of prepared samples were measured at room temperature using a Vibrating sample magnetometer (VSM). Effect of the thermal annealing on the phase decomposition and phase evolution of prepared samples for different temperature and time duration has been discussed. The results showed that the structure, phase and shape of the nanocrystallite are strongly influenced by the sintering temperature and time period. Results also showed that direct phase transition from Fe4 (Co (CN)6)3.16H2O to CoFe2O4 occurred at temperature 300 0 C (2h). The shape of embedded CoFe2O4 (a final product) in silica matrix is almost spherical and its average size ranges 15-25 nm. Copyright © 2013 VBRI press.


The coating of surfaces by plasma spraying is an important manufacturing process with many industrial applications. In the last several decades, numerical modeling of plasma spraying processes has met with considerable attention [1,2,3]. That is in order to well understand the complex phenomena the plasma spray involves, for economic constraints and to well predict the plasma-inflight-particles exchanges since this affects directly the coating formability and microstructure. This study deals with the investigation of plasma jets using an axisymmetric LB thermal model. Plasma jets have been very successful in many applications (such as spraying, cutting, welding,…). The excellent choice of high performance plasma gases and spraying materials has been the subject of several experimental and numerical efforts. An excellent choice will be the response of efficient numerical studies and the results of experimental tests. Plasma jets are high temperature flows (>8000K). Therefore, all diffusion parameters involved in conservation equations are temperature dependent. In the following, we present a plasma jet investigation in an axisymmetric LBM (Jian's model [4]). In the context of our knowledge, it is the first attempt to tackle this field by using the LBM. Further reading on solution procedure, the model implementation and assumptions may be found in [5,6].


H. G Wells's novel The Time Machine is a significant work of science fiction that dramatizes the themes of degeneration and social inequality, themes that were very relevant during the Victorian era in relation to the discovery of evolution. Degeneration was seen as the degradation of society into primitiveness far from the Victorian standards, and the problem of social difference, where the gap between poor and rich was very wide, became the visible proof of the difference between the evolved and civilized and the degenerated and primitive. The purpose of this essay is to analyse how the frame narrative, the story surrounding the main adventure, affects the theme of degeneration in the novel. The framework reveals the reactions of the people present at the dinner parties, where the Time Traveller recounts his journey into a degenerated future. The guests are all representing different factions of Victorian society, such as the Provincial Mayor, the Very Young Man and the Editor who all have their own motives and agendas in relation to degeneration, social differences and time travel. By examining the guests' individual motives, the essay argues that they do not want to believe in time travel since it would include believing in a degenerated future where all the glory of their present-day Victorian era would crumble into chaos and pandemonium. This essay shows that by denying the relevance of the Time Traveller's story, despite the evidence presented, the dinner guests are condemning themselves to the degenerated future they are afraid of, hence making the novel a warning example of not accepting new ideas.


The Clean Development Mechanism (CDM) is a global scheme intended to provide a flexible way to comply with carbon emissions reduction commitments through emissions trading. In this scheme, countries can purchase certified emission reduction (CER) credits, each equivalent to one tonne of avoided emissions, to meet part of their emission reduction commitments. The CER credits are generated from emission reduction activities that are undertaken in developing countries. Although the CDM has benefited several sectors, the building sector hitherto accounts for a meagre proportion of the globally registered CDM initiatives. However, recent research suggests that there is potential in using the CDM concept to address carbon emissions associated with buildings. Further to this suggestion, this paper presents a demonstration of how the CDM concept could be applied to building projects in a developing country, Uganda. A two-bedroom residential house was considered as the unit of analysis and carbon emissions associated with constructing its walls were derived, considering materials, plant, and workforce used. Two options for the house were considered: a baseline (i.e. constructed using typical materials, plant, and labour) and green alternative (i.e. constructed using provisions to reduce carbon emissions). The difference in carbon emissions in the two options was found to constitute a basis for a CDM whose structure is presented and discussed in this paper. Considering a bottom-up projection regarding construction of residential houses in Uganda, the findings show that using the CDM concept, carbon emissions reduction of over 200 ktCO2 could be achieved in a period of 10 years. These figures were found comparable with prevailing CDM initiatives which are not associated with buildings. The overall findings indicated that extending the CDM concept to building projects is plausible and could promote market-based mechanisms of enhancing sustainable construction.


The small island of Astypalaia in the southern Aegean Sea has produced two first millennium BC cemeteries, one containing remains of individuals of all ages, the other exclusively newborn babies and young children. The sites have been studied by the 22nd Ephorate of the Greek Archaeological Service since 1996. Since 2000 there has been a formal collaboration with the Institute of Archaeology to study the human remains, first described in Archaeology International 2001/2002. Here the leading scholars involved in the project describe the work undertaken over the last eight years.


This paper presents an investigation for analyzing the efficiency of axial piston pumps in a variety conditions using a proposed neural network. Since slippers affect the performance of the system considerably, the effects of surface roughness on lubrication have been studied in slippers with varying hydrostatic bearing areas and surface roughness. The neural network structure is very suitable for this kind of system. The network is capable of predicting the leakage oil quantity of the experimental system. The network has parallel structure and fast learning capacity. It is also easy to see from the experimental results that the leakage oil quantity was caused by surface roughness, orifice diameter and the size of hydrostatic bearing area, loading pressure and the number of rotations. It can be outlined from the results for both approaches, neural network could be modeled slipper bearing systems in real time applications.


Author(s): Borna, Ashkan | Advisor(s): Niknejad, Ali M | Abstract: The performance of wireless standards is improving steadily for a foreseeable future.Wireless communications are used for a variety of applications from data steaming to Internet access. There is an increasing need for wireless connectivity with emerging applications. More frequency spectrum is going to be opened-up and the number of standards seems to increase even further to cover this gap and the question arises of how to design the next generation of wireless receivers.From a general perspective it is very appealing to have a single handheld device that can support a large number of wireless standards. Consequently, mobile handsets have started supporting multiple modes over the past few years. Since there are too many standards, integrating multiple dedicated radios on one platform is leading to bulky, complex designs and hence hardware sharing is becoming the only solution.One of the last hurdles in the realization of a multi-standard receiver is the elimination of off-chip SAW filters. Direct conversion receivers are widely implemented due to low cost and high-levels of integration at the cost of sensitivity to interferes and second order distortion, which are key contributors to degrading system sensitivity.This thesis describes two linearity enhancement techniques for an RF receiver. A self-calibrating even-order distortions technique is presented whereby different mechanisms responsible for even-order distortions, characterized by IIP2 metric (Second Harmonic Input referred Intercept Point), were independently calibrated, resulting in robust performance independent of the amplitude and frequency of the blocker. Second, an active dynamic blocker-notching scheme is proposed and tested. The filter uses the blocker frequency to up-convert a DC null to the pass-band, attenuating the blocker before entering the receiver.The prototype circuits are fabricated in a 90nm CMOS technology. Measurements were performed on a PCB with a packaged chip. IIP2 measurements were performed with the blocker frequency and power swept. The IIP2 of more than 60dBm for wide range of blockers as high as -10dBm has been achieved which satisfy the most stringent IIP2 requirements. To test the functionality of the dynamic notch, a blocker signal and a desired signal are summed and injected into the front-end receiver. The amount of desired blocker attenuation and the amount of undesired in-band signal attenuation are both measured versus the offset frequency of the blocker. Blocker attenuation as large as 20dB is observed at only 40 MHz offset while the in-band attenuation increases by only 2dB. The resulting increase in noise figure due to the blocker is 4dB. When all of this data is taken into account, the overall SNR improvement due to the notch filter is as high as 14dB. This proves that the technique may be effective for attenuating blockers.


Experts agree that the exascale machine will comprise processors that contain many cores, which in turn will necessitate a much higher degree of concurrency. Software will require a minimum of a 1,000 times more concurrency. Most parallel analysis and visualization algorithms today work by partitioning data and running mostly serial algorithms concurrently on each data partition. Although this approach lends itself well to the concurrency of current high-performance computing, it does not exhibit the appropriate pervasive parallelism required for exascale computing. The data partitions are too small and the overhead of the threads is too large to make effective use of all the cores in an extreme-scale machine. This paper introduces a new visualization framework designed to exhibit the pervasive parallelism necessary for extreme scale machines. We demonstrate the use of this system on a GPU processor, which we feel is the best analog to an exascale node that we have available today.


The aim of an ongoing research project carried out by six European research and educational institutions is to establish a Virtual Institute for the Modelling of Industrial Manufacturing Systems (VIMIMS). The virtual institute is designed to become an international platform for teaching and research for this particular scientific field. VIMIMS is an Internet-based portal that offers students and researchers from around the globe opportunities to study, teach, research and communicate. The platform consists of three sections that are modelled on the structure of a real university: the "lecture theatres" contain custom-designed courses on the subject of manufacturing systems modelling; the "laboratory" allows practical explorations of the theory through the use of current software applications; and the "library" provides comprehensive records of Internet links and online material related to the field. Auxiliary functions of the Internet site, the VIMIMS chat and forum, facilitate communication amongst students and researchers. The modular design of the VIMIMS courses is a special feature of the virtual institute that allows their customisation according to particular requirements.


BACKGROUND
Diagnosis of head and neck (HN) squamous dysplasias and carcinomas is critical for patient care, cure, and follow-up. It can be challenging, especially for grading intraepithelial lesions. Despite recent simplification in the last WHO grading system, the inter- and intraobserver variability remains substantial, particularly for nonspecialized pathologists, exhibiting the need for new tools to support pathologists.

METHODS
In this study we investigated the potential of deep learning to assist the pathologist with automatic and reliable classification of HN lesions following the 2022 WHO classification system. We created, for the first time, a large-scale database of histological samples (>2000 slides) intended for developing an automatic diagnostic tool. We developed and trained a weakly supervised model performing classification from whole-slide images (WSI). We evaluated our model on both internal and external test sets and we defined and validated a new confidence score to assess the predictions that can be used to identify difficult cases.

RESULTS
Our model demonstrated high classification accuracy across all lesion types on both internal and external test sets (respectively average area under the curve [AUC]: 0.878 (95% confidence interval [CI]: [0.834-0.918]) and 0.886 (95% CI: [0.813-0.947])) and the confidence score allowed for accurate differentiation between reliable and uncertain predictions.

CONCLUSION
Our results demonstrate that the model, associated with confidence measurements, can help in the difficult task of classifying HN squamous lesions by limiting variability and detecting ambiguous cases, taking us one step closer to a wider adoption of AI-based assistive tools.


The seventh edition of this pioneering casebook continues its tradition of comprehensive coverage, with problems and exercises that allow students to hone skills as counselors, as litigators, and as policy advisors. At the same time, the casebook situates immigration and citizenship law within broader contexts of constitutional and administrative law as well as current political debates. This new edition is reorganized for more efficient coverage, with an introductory chapter on immigration history; treatment of unauthorized migration alongside lawful admissions; consolidated treatment of inadmissibility and deportability; reworked materials on state and local enforcement; and thorough redesign of materials on criminal convictions.


The main task of this paper was to evaluate the influence of hardfacing technique and service temperature on the fatigue properties of heat-resistant steel X45CrSi9-3 coated with Co-based alloy Stellite 12. The results of rotating bending fatigue tests showed that at room temperature (RT), the fatigue strength of specimens welded by the acetylene gas welding (AGW) was lower than that of specimens welded by the plasma transferred arc welding (PTAW). For PTAW specimens, the fatigue strength at 500oC was much higher than that at RT. Two failure modes were presented, one was termed as the coating failure mode at RT and the other was termed as coating-interface failure mode at 500oC. The fatigue life prediction was conducted by using a modified Murakami's model.


The present study is aimed at determining the resistance chosen of bacteria to selected heavy metals. The bacterial isolates were able to tolerate or resist the presence of selected heavy metals like Cd, Cu, Zn, Fe, Mn and Hg. Identification tests for all the bacterial isolates revealed that they to belong to the genera Aeromonas, Escherichia, Klebsiella, Pseudomonas, Proteus and Bacillus. The control experiment showed heavy growth of all the organisms.All the bacterial strains showed resistance against the heavy metals with Minimal Inhibitory Concentration (MIC) values ranging from 50 to 1000 ppm.


Abstract The rising demand for food quality as well as the crisis of food safety in recent years is increasing consumers' consciousness of the safety of food they consume. This study analysed the willingness of workers in tertiary institutions to pay for safe buka foods using the Federal University of Agriculture, Abeokuta as a case study. The Contingency Valuation Method (CVM) was used to assess the Willingness-To-Pay (WTP) of a total of 250 members of staff in the University including teaching and non-teaching sampled for the study. The respondents' were selected using a multistage simple random sampling technique. Data were collected with the aid of a structured questionnaire and analysed using descriptive statistics, and logit regression model. The study found that majority of the respondents' are still within the economically active age group with a mean age of 40 years. The respondents have spent an average length of 7 years working in the University. The commuting time between the respondents' home and the University is more than 30 min. Almost half of the respondents (46.8%) perceived foods from buka to be very unsafe for consumption. More than half (69.2%) of the respondents confirmed to have had food related ailments among which 57.8% were able to trace the ailment back to the buka foods they ate. An appreciable number of the respondents (83.2%) were willing to pay for the safety of buka foods with a mean WTP of ₦32.5 ($0.16) per plate on any of the buka foods reflecting the prevailing situations in Nigeria and valid exchange rates at the time the data were collected in 2015. The logit regression analysis revealed that bid amount, income, household size and commuting time were the significant factors influencing the probability of respondents' WTP for buka foods safety. The study concludes that WTP for safe buka foods among the respondents is positive and recommends that the government through her regulatory agencies should help to enforce the necessary standards procedures that buka foods operators will follow to ensure the safety procedures. Buka foods operators on the other hands should abide to the set standards as consumers are willing to pay more to ensure that they consume safe food. The respondents should also be encouraged to maintain small household size so that they will be able to pay more for the safety offoods they consume as smaller household size tends to reduce their financial responsibility.


Sir, Venous thromboembolism is one of major the causes of maternal mortality and morbidity in the western world and has in Denmark been estimated at around 1.3 per 100 000 live births (1). Systemically and locally administered thrombolytic agents have been used with success in extreme situations in pregnant and in puerperal women (2). It is important to emphasize the favorable outcome of these methods in the event of extreme life-threatening situations. We therefore wish to call attention to a woman with puerperal bilateral massive deep venous thrombosis, treated with catheter-directed thrombolysis and a temporary inferior vena cava filter. A 32-year-old woman presented with a history of lumbar pain and a painful and swollen right leg. Two weeks earlier, she had delivered vaginally at term without complications. She had several risk factors for thromboembolism, such as smoking, a pre-pregnancy body mass index of 39kg/m2, gestational diabetes mellitus and a current urinary tract infection. Duplex ultrasound and CT scan with contrast demonstrated iliofemoral deep venous thrombosis of her left leg, as well as massive thrombosis of her right leg (Figure 1). The patient was initially treated with low-molecular-weight heparin in therapeutic doses. A temporary inferior vena cava filter was inserted through her right jugular vein. Catheter-directed thrombolysis of her left iliofemoral deep venous thrombosis was initiated with recombinant tissue plasminogen activator and heparin. After 117hours, all thrombus was resolved. An underlying stenosis of her left common iliac vein was treated with stenting. Although the patient did not fulfil the inclusion criteria for catheter-directed thrombolysis of her right leg (3), this was attempted and completed after 66hours, with all thrombus material having resolved. The inferior vena cava filter was removed and anticoagulation initiated. The patient was discharged after 14days. One year later, duplex ultrasound demonstrated patent deep veins in the left lower limb, and some residual thrombus in the right common femoral vein. No signs of post-thrombotic syndrome were present. She was found to carry Factor V Leiden and prothrombin mutations, both in heterozygous form, and anticoagulation therapy was recommended indefinitely. Treatment of venous thromboembolism during pregnancy and in the puerperal period is challenging. The indication for thrombolysis must be considered as a risk–benefit evaluation and is usually only chosen on vital indications. The advantages of catheterdirected thrombolysis include a high local concentration of thrombolytic agents, resulting in rapid lysis and decreased risk of systemic bleeding complications (4). Major bleeding complications have only rarely been described. The use of an inferior vena cava filter in pregnant or puerperal women has likewise only been described in a few cases. The main risks of such filters are migration, perforation and thrombosis, but the latter two risks can be reduced with a retrievable filter. In a retrospective audit of prospectively collected data, including 560 inserted filters in 507 non-pregnant patients, major complications were seen in two cases (0.4%) (5). It is important to be aware of the different treatment modalities mentioned above, but the choice of modality must be individualized, based on risk factors, clinical presentation, diagnostic findings, local resources and experiences.


Introduction "Severe sepsis", defined as sepsis plus organ failure, is a heterogeneous and complex condition which occurs across all specialities, causes significant morbidity and mortality (case fatality rate about 30%), and consumes substantial healthcare resources. Yet the diagnostic coding schemes commonly in use do not have a code for this prognostically-important diagnosis, and epidemiological data are hence scarce. Our study aimed to develop an algorithm to ascertain cases of severe sepsis from routine hospital data. Method The algorithm was developed iteratively, utilising Scottish hospital activity data (n=133 597 selected admissions ie, having an infection code and/or hospital death), secondary analysis of national prospectively-collected critical care research data (n=2687) and expert clinical judgement, followed by validation against case note review (n=1058). Results The algorithm developed had sensitivity 74% (95% CI 69% to 78%) and estimated specificity was 94%. Applied to all Scottish hospital activity data for 2005 (n=883 K), the algorithm gave an estimate of annual incidence of severe sepsis (2.7%) and case mortality (34%). Analyses were undertaken of factors associated with severe sepsis and outcomes. For example, it was found that in those with severe sepsis, critical care admission was less common in females and those aged over 70 years. Conclusion Internationally, this is the first rigorously-validated algorithm to detect severe sepsis, and performance is impressive given the complex nature of the condition. Application of the algorithm to provide reliable hospital-wide case rates will allow monitoring of incidence and outcomes, and better-informed planning of intensive care services.


In this study, ethylene-vinyl acetate (EVA) foam orthotic shoe insoles with different surface roughnesses (Ra) are investigated in terms of CNC milling strategy. Based on a hybrid Taguchi-response surface methodology (TM-RSM) approach, machining parameters, including tool path strategy, spindle speed, feed rate, and step over, as well as material hardness, are of particular interest. The main aim of this work is to develop mathematical models and determine the optimum machining parameters. Experiments are conducted on a CNC milling machine with a standard milling cutter and run under dry coolants. The optimal conditions are established based on TM and then used to determine the optimum values in the RSM modeling. The main finding of the present work is that there are significant improvements in the Ra, by up 0.24% and 4.13%, and machining time, by up 0.43% and 0.41%, obtained with TM-RSM in comparison to TM analysis.


The author reviews research on actor's moral and legal responsibility for his or her actions. The review is restricted to the scene of present-day Poland. The focus is on the political class, who bear a singular responsibility for public affairs. Of particular interest are methods that serve to evade responsibility, such as shifting the blame on others, manipulating the evidence, or sublimation of the wrongdoing. Finally, the author outlines a method of raising people in a spirit of responsibility.


Unilateral pulmonary artery agenesis (UPAA) is a rare malformation that may present in isolation or being associated with cardiovascular malformations such as tetralogy of Fallot, transposition of the great vessels, septal defects and aortic arch malformations.1 Its prevalence in the absence of congenital cardiovascular malformations is of one in 200 000--300 000 individuals, and it is usually underdiagnosed in the paediatric age group. We present the case of a male infant aged 4 months with no relevant medical history and normal prenatal ultrasound findings that was admitted for acute bronchiolitis caused by human parainfluenza virus type 3, with evidence of lung contraction in the right hemithorax and increased density in the anterior segment of the upper right lobe on chest X-ray. The patient was admitted two more times, at 5 and 8 months, due to obstructive bronchiolitis manifesting with cough, hypoxaemia, wheezing and laboured breathing. In the second hospitalization, respiratory syncytial virus was isolated from a nasopharyngeal aspirate sample. The chest X-rays performed during these episodes showed progressive compression of the right hemithorax with ipsilateral mediastinal shift and hyperinflation of the left lung with herniation of the left upper lobe towards the right lung (Fig. 1). These findings led to the performance of a computed tomography (TC) scan with contrast, which revealed the absence of the proximal section of the right pulmonary artery with mild hypoplasia of the ipsilateral lung and the presence of two collateral vessels originating in the descending aorta (Fig. 2) and supplying the right lung, with a tortuous trajectory and extensive branching. The findings were compatible with right UPAA. The cardiologic workup was completed with an echocardiographic examination that ruled out the presence of other congenital malformations. The clinical manifestations of the patient included recurrent episodes of obstructive bronchitis of mild to moderate severity with absence of symptoms between episodes and normal


If you want to learn SQL, youve picked the right book. Unlike most SQL books, this one starts by showing how to use SQL queries to extract and update the data in a database, because that's what every programmer needs to know. Then, the book shows how to design and implement a database, and how to use the server-side features like views, procedures, and transactions. Because its CD includes everything you need for running SQL on your own PC, this book works great whether you want to learn SQL or the specifics of SQL for Microsoft SQL Server.


The switching from new European driving cycle (NEDC) to worldwide harmonized light vehicles test procedure (WLTP) will affect the energy consumption of plug-in hybrid electric vehicle (PHEV), and then affect the new energy vehicle (NEV) credit regulation and subsidy policy for PHEVs. This paper reveals the impact on energy consumption, NEV credit regulation, and subsidy policy for PHEV in the Chinese market of the switching from NEDC to WLTP based on qualitative analysis and quantitative calculation. The results show that the WLTP procedure is stricter than NEDC in the determination of road load, test mass, driving resistance forces, and tire selection. Firstly, the electricity consumption (EC) of PHEV in charge-depleting mode (CD) under the WLTP procedure is 26% higher than NEDC on average, which makes the all-electric range (AER) significantly lower under WLTP. The weight EC tested in the WLTP procedure is higher than NEDC. Secondly, the fuel consumption (FC) of PHEV in CD mode is related to the adjustment of the engine management system (EMS) and the size of battery energy under the WLTP procedure. For the FC in the charge-sustaining (CS) mode of PHEV under the WLTP procedure is 20% higher than NEDC on average. However, the weight fuel consumption of PHEVs under WLTP with a long AER may be lower than that of NEDC due to the characteristics of utility factor in the WLTP procedure. Thirdly, most PHEVs fail to meet the requirements of 50 km AER due to the switching of the test procedures. However, the Chinese government reduced the technical specification of PHEV's AER under the WLTP procedure to 43 km to support the development of PHEV technology. It ensures that the switching of test procedures does not change the treatment that they could obtain, the NEV credits, and subsidy as a NEV in China. However, the increasing of the EC in CD mode and the FC in CS mode under the WLTP procedure makes the PHEV obtain lower credit and subsidy multiple compared with NEDC procedure.


Motion estimation (ME) is an important part of any video encoding system since it could significantly affect the output quality of an encoded sequence. Unfortunately, this feature requires a significant part of the encoding time especially when using the straightforward full search (FS) algorithm. We propose two techniques, the generalized motion vector (MV) predictor and the adaptive threshold calculation, that can be used to significantly improve the performance of many existing fast ME algorithms. In particular, we apply them to create two new algorithms, named advanced predictive diamond zonal search and predictive MV field adaptive search technique, respectively, which can considerably reduce, if not essentially remove, the computational cost of ME at the encoder, while at the same time give similar, and in many cases better, visual quality with the brute force full search algorithm. The proposed algorithms mainly rely upon very robust and reliable predictive techniques and early termination criteria with parameters adapted to the local characteristics combined with the zonal based patterns. Our experiments verify the considerable superiority of the proposed algorithms versus the performance of possibly all other known fast algorithms, and FS.


We describe an aminooxy reagent for the capture of trace aldehyde and ketone volatile organic compounds (VOCs) in exhaled breath. The reagent, 4-(2aminooxyethyl)-morpholin-4-ium chloride (AMAH), when coated onto micropillars within a silicon microreactor, chemoselectively and covalently retains carbonyl VOCs from exhaled breath. The AMAH-carbonyl adducts are then rinsed from the microreactor with methanol and directly analyzed by Fourier transform-ion cyclotron resonance (FTICR) mass spectrometry (MS), where the aminium ion of the reagent enhances the sensitivity for high mass accuracy. We also outline a protocol for treatment of the AMAH-carbonyl adducts with poly(4-vinylpyridine) to afford the corresponding volatile carbonyl adducts that now can be analyzed by gas chromatography-mass spectrometry (GC-MS). This convenient protocol imparts flexibility for the identification and quantification of isomeric VOCs using both FT-ICR-MS and GC-MS. Representative breath analyses are given to illustrate this applicability of AMAH.


Abstract. The present article aims to consider the added value attached to the usage of new technologies in a project aimed to study heritage. Indeed, multimedia devices could be used to create representations useful to develop and disseminate information integrating the architectural and territorial framework and to reach a general understanding.The processed data come from a research project, based on an interdisciplinary approach, address to the study of medieval buildings in Armenia, Vayots Dzor region, with the aim of studying and understanding the cultural heritage.Three different technologies are used to visualize and disseminate the results of the analyses carried out: the video, the hologram, and the virtual reality. These digital visualization methods enable experts to make the topics investigated accessible and comprehensible to a wider general public with a didactic and informative aim.The solid 3D-model of the site allows to virtually reproduce the reality and to provide a spatial perception of the site. Indeed, it is a neutral base, represents the morphological conformation and settlements, a landscape whose reference points are easily identified with the historical architectures, helping the public and spectators to get oriented inside the territory. These methods of representation allow to move from general view to particular, or to a different frame appropriate to the addressed topic. Thus, it binds the scientific research with the visual part, and enable communication, even in a context where it is difficult to use a common spoken or written language.


For the testing of control and communications algorithms in cooperative behavior, a fleet of autonomous underwater vehicles (AUVs) is under development by the University of Idaho. This paper discusses one piece of the puzzle in this fleet: the communications module to manage multiple agents. The communications system provides multiple modes of operation. Different communications mediums to and from the vehicle support these modes of operation. The tools supplied by the different modes of operation assist the researchers in developing communications, control algorithms, and valuable hardware systems.


Conjunction analysis is the study of possible collisions between objects in space. Conventional conjunction analysis algorithms are geared towards computing the collision probability between any two resident space objects. Currently, there are few heuristic methods available to select which objects should be considered for a detailed collision analysis. A simple all-on-all collision analysis results in an O(N2) procedure, which quickly becomes intractable for large datasets. The main objective of this research work is to preemptively determine which catalogued objects should be considered for a more detailed conjunction analysis, significantly reducing the number of object pairs to be investigated. The heart of the approach lies in the efficient kd-tree algorithm. It has been found that this binary search method significantly reduces computational cost to a tractable complexity of O(N logN). The conventional tree-based search is modified slightly by accounting for probabilistic nearest neighbors via the Hellinger Distance. Finally, the method is extended to account for Non-Gaussian errors via the inclusion of Gaussian Mixture Models. It has been found that the reduced computational complexity of the kd-tree is maintained, while the applicability of the method is extended to uncertain cases.


The microbial CH4 production (methanogenesis) is one of the most prominent microbiological processes in wet terrestrial environments. During the anaerobic decomposition of complex organic matter, CH4 is formed by using metabolism end products of bacteria involved in the anaerobic foodchain (e.g. H2, CO2, acetate, formate). Here we analyzed the community structure of methanogenic archaea in arctic tundra soils by PCR using a specific primer set following DGGE and sequencing of 16S rRNA gene fragments. For the investigation of the methanogenic community composition we took samples from three different sites: (i) a low centre polygon, (ii) a floodplain (both sampling sites are located on Samoylov Island, Lena Delta) and (iii) a thermoerosion valley (Cape Mammontovy Klyk, ca. 400 km northwest the Lena Delta). DNA was extracted directly from soil using a commercial kit. First results showed both differences and similarities in the community structure of the three habitats. The banding patterns display the diversity of the methanogenic archaea which seems to be higher on Samoylov Island than at the sampling site of Mammontovy Klyk. It also seems that there are some methanogenes that probably can be found at any of the sampling sites.With increasing depth of the active layer, and thus decreasing temperature, the vertical profile of the microorganisms changed. However, the pattern also showed that some organisms were located both in the top layer and in the zone near the permafrost. Influence on the change of the methanogenic community could also have thawing-freezing processes or the variety of utilisable substrates.


In this work, we investigate circuit techniques to reduce the power consumption of Successive Approximation Register Analog-to-Digital Converter (SAR-ADC). We developed four low-power SAR-ADC design techniques, which are: 1) Low-power SAR-ADC design with split voltage reference, 2) Charge recycling techniques for low-power SAR-ADC design, 3) Low-power SAR-ADC design using two-capacitor arrays, 4) Power reduction techniques by dynamically minimizing SAR-ADC conversion cycles. Matlab simulations are performed to investigate the power saving by the proposed techniques. Simulation results show that significant power reduction can be achieved by using the developed techniques. In addition, design issues such as area overhead, design complexity associated with the proposed low-power techniques are also discussed in the thesis.


The role and the purpose of the collective character in the Romanian opera encompasses very broad and diverse directions and layers of research. The investigation imposed the structuring of the Romanian opera according to the source of inspiration and to the themes. The paper bring to attention the functions of the choir in the opera, pointing out the melody and the diversity of the multi-vocal proportions, its expressiveness and image complexity. The individual portrait of the collective character is a forceful tool in the dramaturgical epic, a musical instrument, both poetic and plastic.


Speech and learning therapy is motivated by a language and communication symptom, which distorts a person's expression, relationship to others and to the general environment. Therapy through play allows the personal creativity to emerge, the internal conflicts and their evolution to be expressed and the language to develop. Three situations will be described with children aged between 3 and 5. Certain games will be identified as a red line throughout the therapy, showing the children's personal evolution, as language progressively improves. A parallel will be made between therapy and art, as some formal aspects can be found in both environments and compared, to gain a different perspective on human development.


We present a solution to the Round-Trip Migration case of the Transformation Tool Contest 2020, based on the Henshin model transformation language. The task is to support four scenarios of transformations between two versions of the same data metamodel, a problem inspired by the application scenario of Web API migration, where such a round-trip migration methodology might mitigate drawbacks of the conventional "instant" migration style. Our solution relies on Henshin's visual syntax, which seems well-suited to capture the problem on an intuitive level, since the syntax is already similar to the scenario illustrations in the case description. We discuss the five evaluation criteria expressiveness, comprehensibility, bidirectionality, performance, and reusability.


ABSTRACT Cyanobacterial films and mats syndepositonally influence erosion, deposition, and deformation of sediments. The biomass levels surface morphologies, and microbial mats stabilize depositional surfaces and shelter the sediment against erosion or degassing. Growing microbial mats dredge grains from their substrate upwards, whereas cyanobacterial filaments that are oriented perpendicular to the mat surface reach into the supernatant water and baffle, trap, and bind suspended particles. These and similar biotic-physical interactions are reflected in syndepositional formation of microbially induced sedimentary structures. We distinguish structures on bedding planes (leveled bedding surfaces, wrinkle structures, microbial mat chips, erosional remnants and pockets, multidirectional ripple marks, and mat curls) and internal bedding structures (sponge pore fabrics, gas domes, fenestrae structures, sinoidal laminae, oriented grains, benthic ooids, biolaminites, mat-layer-bound grain sizes). We propose to place this group of microbially mediated structures as a fifth category (bedding modified by microbial mats and biofilms) in Pettijohn and Potter's (1964) existing classification of primary sedimentary structures.


Malaria infection rates determined by dissection and Plasmodium falciparum enzyme-linked immunosorbent assay (ELISA) were compared for 26,935 Anopheles gambiae Giles sensu lato and 17,739 Anopheles funestus Giles collected during 20 mo in western Kenya. ELISA infection rates were about 43% higher than dissection sporozoite rates. In dissection-negative Anopheles, circumsporozoite (CS) protein was detected by ELISA in 5.2% of 10,017 salivary gland samples and in 12.2% of 237 thorax samples. The accuracy of dissection and ELISA techniques was compared by the following tests on a group of 352 field-collected Anopheles (held 10 d to ensure sporogonic development): salivary gland dissection, examination of Giemsa-stained dissection slides, ELISA tests on salivary gland and thorax body parts, and microscopic techniques for determining sporozoite loads. Respective infection rates were 9.9%, 10.8%, and 15.6% for dissection, stained slides, and ELISA. Sporozoite loads were associated significantly with ELISA absorbance values (r = 0.76). Compared with Giemsa-stained dissection slide results, the sensitivity of sporozoite detection was 92.1% for dissection compared with 78.9% for ELISA; specificity was 100.0% for dissection versus 92.0% for ELISA. Immunological detection of CS protein in head-thorax samples of Afrotropical vectors overestimated the proportion of infective Anopheles because the comparison of techniques indicated that 45.4% of the ELISA positive Anopheles did not contain salivary gland sporozoites.


The "Extreme starbursts in the local universe" workshop was held at the Insituto de Astrofisica de Andalucia in Granada, Spain on 21-25 June 2010. Bearing in mind the advent of a new generation of facilities such as JWST, Herschel, ALMA, eVLA and eMerlin, the aim of the workshop was to bring together observers and theorists to review the latest results. The purpose of the workshop was to address the following issues: what are the main modes of triggering extreme starbursts in the local Universe? How efficiently are stars formed in extreme starbursts? What are the star formation histories of local starburst galaxies? How well do the theoretical simulations model the observations? What can we learn about starbursts in the distant Universe through studies of their local counterparts? How important is the role of extreme starbursts in the hierarchical assembly of galaxies? How are extreme starbursts related to the triggering of AGN in the nuclei of galaxies? Overall, 41 talks and 4 posters with their corresponding 10 minutes short talks were presented during the workshop. In addition, the workshop was designed with emphasis on discussions, and therefore, there were 6 discussion sessions of up to one hour during the workshop. Here is presented a summary of the purposes of the workshop as well as a compilation of the abstracts corresponding to each of the presentations. The summary and conclusions of the workshop along with a description of the future prospects by Sylvain Veilleux can be found in the last section of this document. A photo of the assistants is included.


The purpose of this article is to discuss the possibility of the application of the disregard doctrine in arbitration. The intent is to answer two questions regarding the application of art. 50 of the Brazilian Civil Code in arbitral proceedings. The first, whether the doctrine could be used to bound a third party which had not consented to the arbitration clause. The second, whether the disregard doctrine could be applied by the arbitrators when ruling on substantive issues of the dispute. The conclusion is negative to the first, as the consent is essential to the enforceability of the arbitration process, in light of art. 3 and 4 of the Brazilian Arbitration Act, and positive to the second, because the disregard doctrine contemplates a rule of liability determination that is applicable when the abuse of legal entity occurs. In sum, Brazilian Law does not admit the abuse of the legal entity as a criterion to make the arbitral process binding, as the analysis about the consent cannot be mixed with the requirements of the disregard doctrine.
Disregard doctrine; Civil Code, art. 50; criteria; liability determination; party and third-party; consent; Brazilian Arbitration Act, arts. 3 and 4.


Egypt displays a high‐hepatitis C virus (HCV) burden and almost 20% of the patients develop cutaneous manifestations HCV‐related. Direct acting antivirals (DAAs) drastically changed HCV patient's morbidity and mortality but their impact of the cutaneous manifestations remains elusive. Our aim was to find out the prevalence of different dermatological manifestations accompaning HCV infection in Egyptian patients. Also, to highlight the impact of DAAs on such manifestations and any potential dermatological side effects. A descriptive study was carried out at the Department of Tropical medicine and Gastroenterology in collaboration with the Department of Dermatology, Venerology and Andrology, Assiut University Hospitals. Medical history, full general, dermatological examination and photography were performed for all patients before the start of treatment with the full regimen of DAAs, every month and 3 months after reaching sustained virological response (SVR), and the changes of skin lesions were recognized and rated by two blinded dermatologists. Out of 1000 examined patient, 36.9% had skin manifestation. Itching was the commonenst presented in 190 patients (51.5%). Three months after reaching SVR, skin examination revealed improvement in the majority of patients (23 764.22%). Pruritis had significant clinical improvement in 152(80%) of patients with significant change in the Visual Analog Score (P = .000). Also, patients with both cutaneous vasculitis and eczema experienced improvement in their skin manifestations. Skin manifestations are common in Egyptian patients with HCV infection. Pruritis is the commonest. The use of DAAs in treatment of HCV is associated with significant improvement of skin lesions with very limited cutaneous adverse effects.


ABSTRACT As an initial approach to define the requirements for the replication of bovine viral diarrhea virus (BVDV), a member of theFlaviviridae family with a positive-strand RNA genome, full-length genomic and subgenomic RNAs were originated by in vitro transcription of diverse BVDV cDNA constructs and transfected into eucaryotic host cells. RNA replication was measured either directly by an RNase protection method or by monitoring the synthesis of viral protein. When full-length BVDV cRNA was initially applied, the synthesis of negative-strand RNA intermediates as well as progeny positive-strand RNA was detected posttransfection in the cytoplasm of the host cells. Compared to the negative-strand RNA intermediate, an excess of positive-strand RNA was synthesized. Surprisingly, a subgenomic RNA molecule, DI9c, corresponding to a previously characterized defective interfering particle, was found to support both steps of RNA replication in the absence of a helper virus as well, thus functioning as an autonomous replicon. DI9c comprises the 5′ and 3′ untranslated regions of the BVDV genome and the coding regions of the autoprotease Npro and the nonstructural proteins NS3, NS4A, NS4B, NS5A, and NS5B. Most interestingly, the NS2 polypeptide was thus determined to be nonessential for RNA replication. As expected, deletion of the genomic 3′ end as well as abolition of the catalytic function of the virus-encoded serine protease resulted in DI9c molecules that were unable to replicate. Deletion of the entire Npro gene also destroyed the ability of DI9c molecules to replicate. On the other hand, DI9c derivatives in which the 5′ third of the Npro gene was fused to a ubiquitin gene, allowing the proteolytic release of NS3 in trans, turned out to be replication competent. These results suggest that the RNA sequence located at the 5′ end of the open reading frame exerts an essential role during BVDV replication. Replication of DI9c and DI9c derivatives was found not to be limited to host cells of bovine origin, indicating that cellular factors functioning as potential parts of the viral replication machinery are well conserved between different mammalian cells. Our data provide an important step toward the ready identification and characterization of viral factors and genomic elements involved in the life cycle of pestiviruses. The implications for other Flaviviridae and, in particular, the BVDV-related human hepatitis C virus are discussed.


Invited chapter in the book Colour Design: Theories and Applications. In PART 3 COLOUR, DESIGN AND COLORATION this chapter covers:
 - Hardcopy colour: analogue versus digital
 - Colour theory in relation to printing
 - Overview of halftoning and digital print technologies
 - Overview and development of inks
 - Inkjet papers and inks
 - Recent and future trends in colour, printing inks and hardware.

This book differs from other existing books in the field, with the aim of an accessible yet precise and clear text on understanding colour, discussing how to produce colour and real examples of how the designer can apply colour in their work. The book is organised systematically into two distinct parts. Part one reviews the main underlying theories and principles and of what colour is. Topics include lighting in colour, colour illusions and colour trends. Part two examines how colour design is used in applications, such as fashion design, interior design, the World Wide Web and food. The avoidance of complicated descriptions will make this book suitable for a range of readers including designers, colour technologists, colour quality inspectors, product developers and anyone who uses colour in their work. It is also intended for academics and students studying colour and design.


Passenger compartment climate control is one of the largest auxiliary loads on a vehicle. Like conventional vehicles, electric vehicles (EVs) require climate control to maintain occupant comfort and safety, but cabin heating and air conditioning have a negative impact on driving range for all-electric vehicles. Range reduction caused by climate control and other factors is a barrier to widespread adoption of EVs. Reducing the thermal loads on the climate control system will extend driving range, thereby reducing consumer range anxiety and increasing the market penetration of EVs. Researchers at the National Renewable Energy Laboratory have investigated strategies for vehicle climate control load reduction, with special attention toward EVs. Outdoor vehicle thermal testing was conducted on two 2012 Ford Focus Electric vehicles to evaluate thermal management strategies for warm weather, including solar load reduction and cabin pre-ventilation. An advanced thermal test manikin was used to assess a zonal approach to climate control. In addition, vehicle thermal analysis was used to support testing by exploring thermal load reduction strategies, evaluating occupant thermal comfort, and calculating EV range impacts. Through stationary cooling tests and vehicle simulations, a zonal cooling configuration demonstrated range improvement of 6%-15%, depending on the drive cycle. A combined cooling configuration that incorporated thermal load reduction and zonal cooling strategies showed up to 33% improvement in EV range.


Southern Company Services (USA) has successfully implemented a continual transient security assessment (TSA) process utilizing Powertech's TSAT software at their system control center. Southern's EMS provides an updated powerflow case from the real-time state estimator to the TSAT application through Powertech's DSA Manager on an hourly (24times7) basis. One unique aspect of the enhanced state estimator model is a highly reduced external system model, which provides a virtually identical dynamic response as the much larger original from which it was derived. Southern has already benefited from this on-line TSA system during the post-Katrina system restoration. Further work is ongoing to enhance the selection of contingencies evaluated, and to integrate summary results of the stability studies into Southern's EMS alarms processing subsystem


INTRODUCTION: Expansion of medical school enrollment in the 1960s through 1980s has led to more baby boomer physicians reaching retirement age. The objectives were to determine the number of obstetrician–gynecologists nearing retirement age and how eventual retirement will affect the future supply of obstetrician–gynecologists. METHODS: This descriptive study was based on data from the most recent 5 years (2008–2013) of the American Medical Association Masterfile. A comparison of the data with the National Provider Identifier was used to correct for the known upward bias in retirement ages using the American Medical Association Masterfile alone. Physicians were included only if they described their active practice as being in obstetrics–gynecology. The primary outcome was discrete retention curves, akin to Kaplan-Meier curves. RESULTS: A decline in the number of obstetrics–gynecology practitioners began at 55 years old. The approximately 11,000 obstetrician–gynecologists nearing retirement (55–67 years old) is comparable to the number in residency and within 5 years of residency completion. Although those physicians nearing retirement were predominantly male, no differences in retirement curves were found between senior male and female obstetrician–gynecologists. The annual rate of retirement increased from 0.6% for 55 year olds to 4.3% for 65 year olds. Most retired by age 67 years. If all obstetrician–gynecologists retired 2 years later, an additional 900 health care practitioners would be available. CONCLUSIONS: The large cohort of obstetrician–gynecologists approaching retirement bears tracking, because the supply of young physicians is not anticipated to increase. Extending time until retirement will aid in reducing a pending shortage of obstetrician–gynecologists.


The question of the development of Anglo-Norman (the variety of medieval French used in the British Isles), and the role it played in the life of the medieval English kingdom, is currently a major topic of scholarly debate. The essays in this volume examine it from a variety of different perspectives and contexts, though with a concentration on the theme of linguistic contact between Anglo-Norman and English, seeking to situate it more precisely in space and time than has hitherto been the case. Overall they show how Anglo-Norman retained a strong presence in the linguistic life of England until a strikingly late date, and how it constitutes a rich and highly valuable record of the French language in the middle ages. Contributors: Richard Ingham, Anthony Lodge, William Rothwell, David Trotter, Mark Chambers, Louise Sylvester, Anne Curry, Adrian Bell, Adam Chapman, Andy King, David Simpkin, Paul Brand, Jean-Pascal Pouzet, Laura Wright, Eric Haeberli.


Abstract. Technological developments have paved the way for courses, trainings and assessments to be made online remotely in education and employment. In the meantime, over the years, the demand for online distance learning has increased rapidly. Eventually, it has been seen that this is a necessity and it has become widespread during the COVID-19 pandemic period. As can be seen in the example of massive online open courses, although remote learning is carried out online, perhaps the most important problem is how to evaluate the relevant courses safely and reliably. Thus, remote online proctoring is becoming an increasingly popular and needed issue. In this study, the issue of conducting the examination remotely online via internet-connected video and audio communication will be evaluated. Furthermore, the solution called vProctor was developed to contribute to the elimination of deficiencies in remote online proctoring using artificial learning. Overall, it has been observed that the proposed solution is managed to determine inappropriate behaviors like cheating in the online assessments.


This study seeks to understand the relationship between research data management (RDM) services framed in the data curation life cycle and the production of open data. An electronic questionnaire was distributed to US researchers and RDM specialists, and the results were analyzed using Chi-Square tests for association. The data curation life cycle does associate with the production of open data and shareable research, but tasks like data management plans have stronger associations with the production of open data. The findings analyze the intersection of these concepts and provide insight into RDM services that facilitate the production of open data and shareable research.


Objective —To test the hypothesis that human insulin may have a low immunogenicity and that short-term exposure may not cause endogenous insulin antibody production. Research Design and Methods —Randomized double-blind prospective study. Serum samples collected for insulin binding antibodies and measured by a sensitive immunochemical assay. Subjects were seven healthy nondiabetic patients who had never received exogenous insulin. Each subject received 6 separate monthly injections of human insulin. On four occasions, both regular and NPH insulin were administered. On the other two occasions, either NPH or regular insulin was administered alone. Results —Mean ± SE basal insulin antibody levels (1.2 ± 0.2 μg/L) increased to a maximal level of 4.5 ± 0.8 μg/L after four injections. Thereafter, antibody levels declined to an end-of-study value of 2.5 ± 0.3 μg/L. This represented a highly significant overall increase (P < 0.001). A control group of six insulin-dependent diabetic subjects treated with human insulin over the same period as the test subjects demonstrated no change in insulin antibody concentrations (2.8 ± 0.7–2.7 ± 0.6 μg/L). Conclusions —These results suggest that human insulin preparations, when administered subcutaneously, may be more immunogenic than previously considered. The antigenic response was rapid, because only four subcutaneous injections were sufficient to produce insulin antibody levels in nondiabetic patients similar to those observed in insulin-dependent diabetic patients receiving chronic insulin replacement therapy.


Obesity and obesity-related complications are on the increase both in the developed and developing world. Since existing pharmaceuticals fail to come up with long-term solutions to address this issue, there is an ever-pressing need to find and develop new drugs and alternatives. Natural products, particularly medicinal plants, are believed to harbor potential antiobesity agents that can act through various mechanisms either by preventing weight gain or promoting weight loss amongst others. The inhibition of key lipid and carbohydrate hydrolyzing and metabolizing enzymes, disruption of adipogenesis, and modulation of its factors or appetite suppression are some of the plethora of targeted approaches to probe the antiobesity potential of medicinal plants. A new technology such as metabolomics, which deals with the study of the whole metabolome, has been identified to be a promising technique to probe the progression of diseases, elucidate their pathologies, and assess the effects of natural health products on certain pathological conditions. This has been applied to drug research, bone health, and to a limited extent to obesity research. This paper thus endeavors to give an overview of those plants, which have been reported to have antiobesity effects and highlight the potential and relevance of metabolomics in obesity research.


Virginia Woolf and the Bloomsbury Avant-Garde: War, Civilization, Modernity by Christine Froula New York: Columbia University Press, 2005 (paperback 2007). 428 pages Christine Froula's scholarship has done much to transform modernist studies at the millennium and to encourage teachers and scholars to re-conceptualize the "received truths" that aggregate around high modernism. Her work on James Joyce has revolutionized pedagogical approaches to this canonical giant of Irish studies, and more recently she has made a successful attempt to demolish stereotyped images of Virginia Woolf as the haughty, aristocratic, tea-pouring Queen of Bloomsbury. Countermanding prevalent notions of a Bloomsbury aesthetic spawned by the late-nineteenth-century "art for art's sake" movement, Froula turns to social and political tenets emergent from the eighteenth-century Enlightenment project configured by Kant in Germany and by revolutionary, encyclopedic philosophers of human freedom in France. The Bloomsbury group, she insists, "carried forward and made new the Enlightenment project's self-critical and emancipatory force" (xii). Politically engaged and intellectually astute, Woolf distinguished herself "as powerfully analytic, critical, and imaginative a proponent as the Englightment project has had in the last century" (xii). Able to connect the high ideals of civilization with issues of class discrimination, racial bigotry, and a viciously unfair sex/gender economy, this Bloomsbury author functioned as spokesperson for the evolution of a sensus communis demanding the production of a heretofore unimagined "civilization that has never existed" (xiii). With John Maynard Keynes, Lytton Strachey, Leonard Woolf, and Sigmund Freud numbered among her mentors, Woolf reacted to the inequities residual in Europe after the Great War and analyzed, Cassandra-like, patriarchal and authoritarian forces that inadvertently colluded with the rise of fascism in Europe during the 1930s. Never had the causes of freedom, democracy, and women's rights been so imperiled and so little understood. Beset by unendurable personal losses and overwhelming cultural trauma, Woolf persisted in the "struggle to forge common values" (32) in a brave new world whose "now global public" was being summoned to intellectual arms. In A Room of One's Own, writes Froula, she "opens the door to a public arena and calls women-as-civilization's-creatures to speak on equal terms" (32). In chapter 2, "Rachel's Great War," Froula contends that Woolf self-consciously "sailed her first heroine, Rachel Vinrace, through a gap in empire" (37) to challenge Joseph Conrad's 1899 novella Heart of Darkness and its astonishing if unquestioned assumption that "men and women collaborate in history's lies and delusions, which persist under the sign of Eros" (37). If Rachel seems raw and uninitiated, her adolescent demeanor reflects the diminished resources of a girl whose education has been confined to sporadic tutorial sessions punctuating a life of sheltered ignorance in the company of two well-meaning Victorian aunts. Pleading for entrance into the male academy of learning, she remains naively unaware that the Oxbridge door to education may lead to a claustrophobic tunnel of misogynist, racist, and imperialistic values. Woolf's Voyage Out distinguishes itself as a profoundly self-conscious postcolonial narrative, critical of European imperialism and subsequent efforts to tame the savage heathen--from Renaissance voyages of conquest to twentieth-century global capitalism. The last Victorian bastion to collapse in The Voyage Out is the institution of marriage. Rachel Vinrace and Terence Hewet are both fiercely independent spirits, jealous of their privacy and contemptuous of conventional wedlock. In the jungles of South America they begin to construct an egalitarian relationship and momentarily forge an amorous affiliation exempt from the exigencies of conjugal masquerade. …


The challenge of ontology-driven modelling of information
components is well known in both academia and industry. In this paper, we present a novel approach to deal with customisation and abstraction of ontology-based model evolution. As a result of an empirical study, we identify a layered change operator framework based on the granularity,
domain-specificity and abstraction of changes. The implementation of the operator framework is supported through layered change logs. Layered change logs capture the objective of ontology changes at a higher level of granularity and support a comprehensive understanding of ontology evolution. The layered change logs are formalised using a graph-based approach. We identify the recurrent ontology change patterns from an ontology change log for their reuse. The identified patterns facilitate optimizing and improving the definition of domain-specific change patterns.


What is your approach to giving employment advice? Responses to this question from specialist and generalist advisers, as well as solicitors working with the CAB Service, emphasised a particular process. While the advice interview must start with clients' stories, this initial narrative account represents only the first step; it is in what comes after this that the critical work of advice is achieved. In this chapter I explore how advisers move from the story of a dispute to the law. The practice engaged in by advisers is far more than simply an exercise in legal diagnostics. As will be explained in this chapter, this represents just one stage. Other critical elements include teasing out the full range of relevant factual detail relating to the employment dispute, communicating the law to clients, and framing the law in terms of possible courses of action. These latter aspects of the process take into account contextual issues beyond the immediate law, and involve consideration of the hurdles inherent in the Employment Tribunal process, the disposition of the client, and the level of support that the adviser can offer throughout the course of the dispute.


ABSTRACT AN EXPLORATION OF CHARGE NURSE DECISION-MAKING RELATED TO THE NURSEPATIENT ASSIGNMENT ON ADULT MEDICAL-SURGICAL INPATIENT UNITS Colin Plover Julie Sochalski, PhD, RN, FAAN Statement of the Problem: In adult inpatient medical-surgical settings, the nurse-patient assignment serves as a strategy to organize the delivery of nurse-patient care. How nurse-patient care is organized through the nurse-patient assignment affects both nurse and patient outcomes, yet no best practice method of developing the nurse-patient assignment exists. Current literature demonstrates limited investigations of charge nurse reflections on their decision-making related to the nurse-patient assignment. Charge nurse perspectives are important because charge nurses drive the decision-making through which patient care is allocated. Despite their integral role, little is known about charge nurse perspectives on the process of the development of the nurse-patient assignment, what factors charge nurses consider and how they consider them when allocating patient care. Procedure and Methods: A qualitative descriptive approach was chosen and a semi-structured interview guide was used to conduct interviews with 18 charge nurses across four medical-surgical units. Attention was paid to the process of patient care allocation through the nurse-patient assignment, the factors which charge nurses found to be the most and least important, and how they prioritize these factors in their decision-making process. Results: The interviews revealed both common and divergent practices with respect to charge nurses' process of developing the nurse-patient assignment, the factors that they considered, and how they considered these factors when making patient care allocation decisions. These common and divergent practices were identified by themes and sub-themes respectively. Themes identified how all charge nurses described processes of gathering information involving the application of frameworks with shared aims through which they synthesized specific factors in common ways to develop an assignment that aligned with a common constellation of goals. Sub-themes identified variation with respect to where charge nurses sourced their information, the factors they considered, their strategies for considering factors, how they considered factors, factor terminology and their specific goals. Conclusions: The insight this investigation provides into charge nurse development of the nurse-patient assignment has implications for practice environments that include ways to inform research which may serve to improve patient safety, nurse outcomes and the efficiency and cost effectiveness with which patient care is organized and delivered. Degree Type Dissertation This dissertation is available at ScholarlyCommons: https://repository.upenn.edu/edissertations/2533 Degree Name Doctor of Philosophy (PhD) Graduate Group Nursing First Advisor Julie Sochalski


This National Strategy on Education for Sustainable Development (ESD) has been developed by the Department of Education and Skills (DES), in consultation with key stakeholders.  It provides a framework to support the contribution that the education sector is making and will continue to make towards a more sustainable future at a number of levels: individual, community, local, national and international.
This strategy is primarily influenced by the national strategy on sustainable development, Our Sustainable Future - A Framework for Sustainable Development in Ireland (hereafter referred to as Our Sustainable Future), which was published by the Department of the Environment, Community and Local Government in 2012. It is also framed within the current context of limited financial resources. The result is an ESD strategy that seeks to challenge individuals, organisations and society as a whole, but particularly in educational contexts, through recommendations that are pragmatic rather than aspirational in nature.


STUDY OBJECTIVES
Intermittent hypoxia (IH) mimicking obstructive sleep apnea (OSA) significantly modifies gut microbiota in mice. However, whether these IH-induced gut microbiome changes are reversible after restoring normal oxygenation (the equivalent of effective OSA therapy) is unknown. The aim of this study was to investigate gut microbiota composition and circulating endotoxemia after a post-IH normoxic period in a mouse model of OSA.

METHODS
Ten mice were subjected to IH (40 sec 21% O2-20 sec 5% O2) for 6 h/day for 6 w and 10 mice breathing normoxic air (NM) were used as controls. After exposures, both groups were subjected to 6 w in normoxia. Microbiome composition of fecal samples was determined by 16S ribosomal RNA (rRNA) pyrosequencing. Bioinformatic analysis was performed by Quantitative Insights into Microbial Ecology. Plasma lipopolysaccharide (LPS) levels were measured by endotoxin assay.

RESULTS
After normoxic recovery, the Chao and Shannon indices of each group suggested similar bacterial richness and diversity. 16S rRNA pyrosequencing analysis showed that IH-exposed mice had a significant decrease in the abundance of Bacteroidetes and a significant increase of Firmicutes and Deferribacteres compared to the NM group. After normoxic recovery, circulating LPS concentrations were higher in the IH group (P < 0.009). Moreover, the IH group showed a negative and significant correlation between the abundance of Lactobacillus and Ruminococcus and significant positive correlations between the abundance of Mucispirillum and Desulfovibrio and plasma LPS levels, respectively.

CONCLUSIONS
Even after prolonged normoxic recovery after IH exposures, gut microbiota and circulating endotoxemia remain negatively altered, suggesting that potential benefits of OSA treatment for reversing OSA-induced changes in gut microbiota may either require a longer period or alternative interventions.


∀-automata are non-deterministic finite-state automata over infinite sequences. They differ from conventional automata in that a sequence is accepted if all runs of the automaton over the sequence are accepting. These automata are suggested as a formalism for the specification and verification of temporal properties of concurrent programs. It is shown that they are as expressive as extended-temporal-logic (ETL), and in some cases provide a more compact representation of properties than temporal logic. A structured diagram notation is suggested for the graphical representation of these automata. A single sound and complete proof rule is presented for proving that all computations of a program have the property specified by a ∀-automaton.


We consider an infinite-horizon inter-generational economy with identical agents differing only in their inherited wealth and with a constant-returns-to-scale technology using capital and labour (called "effort") and displaying a purely idiosyncratic risk. If effort is contractible, full insurance contracts make the production deterministic and initial wealth inequalities cannot persist (just as in a neoclassical growth model). But if effort is not contractible the ability to commit is an increasing function of initial wealth so that in equilibrium poorer agents face tougher credit rationing and take smaller projects (i.e. use less capital); although there is no poverty trap, the initial distribution may have long-run effects: there can be multiple long-run stationary distributions, and all are continuous and ergodic on the same interval, but have different equilibrium interest rates (and therefore different degrees of intergenerational mobility). This provides an explanation for wealth differentials within a country as well as between countries, and a basis for redistributive policies with long-run effects.


Indices to Isis have appeared in Vol. I and in subsequent volumes of which the ordinal number is divisible by three. We would advise readers to put some mark (e.g. the word index) on the backs of the volumes containing, an index. Special pains have been taken to include in this index, as in the previous one, the names of every person about some information may he found. Casual references have been omitted. I1ON GUINET.


A string set avoids overlaps if it has the property that the prefix of each string in the set does not coincide with the suffix of any string in the set. The problem of avoiding overlaps in strings is extensively investigated since it plays an important role in the context of string matching and coding. The notion of overlap can be extended naturally to two dimensions; two pictures [Formula: see text] and [Formula: see text] have an overlap if one can put one corner of [Formula: see text] on some position in [Formula: see text] in such a way that all symbols in the common positions coincide. A picture with no self-overlaps is called unbordered and it is a generalization in two dimensions of an unbordered (or bifix-free) string.We first investigate the problem of generating all unbordered pictures of fixed size. Then, we study particular sets of unbordered pictures that are non-overlapping each others. We show that the frame of the pictures has a special role in defining these sets. In particular, we prove that there exist kinds of synchronization frames that can be put around the pictures of any set to make it non-overlapping. Finally, we present a construction of non-expandable non-overlapping sets of pictures which starts from some property of frame-completeness.


Background Facing higher than average unscheduled care use in a busy inner city paediatric unit, with a significant proportion of low acuity conditions, a need to become proactive in tackling the pressure was recognised. Collaborated as part of new innovative integrated paediatric care model with puppet company to produce Fix Freddie! Pilot tour Spring 2014. Objectives Better understanding of how local community accesses children's unscheduled care bringing together communities and professionals across the whole system, to support families in feeling confident to navigate system and care for their children's health needs reduce pressures on the local emergency and urgent care system Methods Explored different settings and workshop styles (Table 1). Abstract G321(P) Table 1 Pilot tour explored different settings and workshop styles Parents/carers asked to complete a pre show questionnaire. After the show, explored issues with: small parent focus groups classroom-based discussion and picture drawing fete style event with informal conversations with professionals Feedback obtained with Post-It comments on "Freddie Feedback" poster. Information leaflet distributed with advice about where to seek advice, self management, and information about local services. Filmed to capture impact of events on children, parents and professionals. Results Pre show questionnaire Completed by 46 parents of 85 children. 53% white british; 47% diverse ethnic mix. Chart A how seek child health advice – 85% GP, 21% ED, 42% family and friends, 37% internet. Chart B services use when worried – 89% GP, 52% ED Parents most consistently worried by fever, 52% would seek GP review 41% would go to A&E. Other concerns included cough, vomiting, diarrhoea, abdominal pain. Attended ED and the GP with similar illnesses. 26% reported issues in accessing care, primarily lack of same day GP appointments. Key themes surfaced from Fix Freddie! Feedback (Table 2) Abstract G321(P) Table 2 Better understanding of local services available, notably about 111 Improved knowledge and confidence about self managing minor illnesses and injuries Additional awareness raised about safety at home General positive feedback for puppet show and events Abstract G321(P) Charts A and B Conclusion Fix Freddie! has provided a fun and engaging way to make new connexions across the whole system, facilitating co-design of local solutions to problems of healthcare accessibility and confidence in self management. Local CCG commissioners are now funding a wider local tour and we are working on next steps to broaden reach of the events.