Surface sediments from a transect across the mid-ocean ridge north of Iceland (Kolbeinsey Ridge) have been analyzed according to their compositional, textural and hydromechanical characteristics. The results were used to reconstruct sediment formation and depositional processes. The ridge sediments are dominated by volcaniclastic particles of hyaloclastic and pyroclastic origin. These particles show a wide variety in size, shape and density. Single-grain settling velocities of the different glass types reveal the suitability of this parameter as a reflector of the particle properties of size, shape and density, which are also known to be relevant to grain transport. Observations concerning different current expositions of central ridge sediments, combined with the parameters of settling velocity distribution, grain-size distribution and sediment particle composition, were applied to distinguish between transport association with rare, easily movable glass shards and poorly sorted sediments in sheltered ponds. A bimodal settling velocity distribution of steep ridge-flank sediments probably indicates the effect of sediment admixture from poorly sorted mass flows. Alternating coarse- and fine-grained layers characterize the transition between ridge-glass sands and the ridge-adjacent plain, which is dominated by slow-settling pelagic material.


OBJECTIVES
Central blood pressure (BP) can be used to define hypertension. A central BP approach may be more sensitive than a conventional brachial BP approach in detecting hypertension. We aimed to compare the 2 approaches in estimating the prevalence hypertension in a nationally representative population.

METHODS
A total of 2,742 adults older than 19 years participated in the 2013-2016 National Nutrition and Health Survey in Taiwan. Central and brachial BP were simultaneously measured using a cuff-based stand-alone central BP monitor purporting to measure invasive central BP (type II device). Central hypertension was defined by central systolic (SBP)/diastolic BP (DBP) ≥130 or 90 mm Hg or using antihypertensive medications, and brachial hypertension was defined by brachial SBP/DBP ≥140 or 90 mm Hg or using antihypertensive medications.

RESULTS
The World Health Organization-standardized and national weighted prevalence rates of central hypertension were 27.95% and 32.48%, respectively, and both were significantly higher than those of brachial hypertension (20.80% and 25.43%, both P < 0.001). The national weighted prevalence rates of concordant central and brachial hypertension, concordant central and brachial nonhypertension, isolated central hypertension, and isolated brachial hypertension were 25.13%, 67.22%, 7.35%, and 0.30%, respectively. Most subjects with the isolated central hypertension (97%) were within the range of brachial prehypertension, but only 38.0% of subject with brachial prehypertension had central hypertension.

CONCLUSION
Almost one-third of a nationally representative population had hypertension detected by a central BP approach. Hypertension detection using a conventional brachial BP approach may underestimate the prevalence of hypertension and result in a less effective hypertension control.


The growing incidence of Noncommunicable Diseases has increased focus on the promotion of physical activity within the therapeutic environment. Research demonstrates a shift in mentality away from the pathogenic orientation of health promotion, resulting in the formation of salutogenic health promotion concepts and assistive technologies that actively promote health.


BACKGROUND
Prostate cancer (PCa) shows a substantial clinical heterogeneity. The existing risk classification for PCa prognosis based on clinical factors is not sufficient. Although some biomarkers for PCa aggressiveness have been identified, their underlying functional mechanisms are still unclear. We previously reported a gene-gene interaction network associated with PCa aggressiveness based on single nucleotide polymorphism (SNP)-SNP interactions in the angiogenesis pathway. The goal of this study is to investigate potential functional evidence of the involvement of the genes in this gene-gene interaction network.

METHODS
A total of 11 angiogenesis genes were evaluated. The crosstalks among genes were examined through coexpression and expression quantitative trait loci (eQTL) analyses. The study population is 352 Caucasian PCa patients in the Cancer Genome Atlas (TCGA) study. The pairwise coexpressions among the genes of interest were evaluated using the Spearman coefficient. The eQTL analyses were tested using the Kruskal-Wallis test.

RESULTS
Among all within gene and 55 possible pairwise gene evaluations, 12 gene pairs and one gene (MMP16) showed strong coexpression or significant eQTL evidence. There are nine gene pairs with a strong correlation (Spearman correlation ≥0.6, P<1×10-13). The top coexpressed gene pairs are EGFR-SP1 (r=0.73), ITGB3-HSPG2 (r=0.71), ITGB3-CSF1 (r=0.70), MMP16-FBLN5 (r=0.68), ITGB3-MMP16 (r=0.65), ITGB3-ROBO1 (r=0.62), CSF1-HSPG2 (r=0.61), CSF1-FBLN5 (r=0.6), and CSF1-ROBO1 (r=0.60). One cis-eQTL in MMP16 and five trans-eQTLs (MMP16-ESR1, ESR1-ROBO1, CSF1-ROBO1, HSPG2-ROBO1, and FBLN5-CSF1) are significant with a false discovery rate q value less than 0.2.

CONCLUSIONS
These findings provide potential biological evidence for the gene-gene interactions in this angiogenesis network. These identified interactions between the angiogenesis genes not only provide information for PCa etiology mechanism but also may serve as integrated biomarkers for building a risk prediction model for PCa aggressiveness.


Implementation has long been a vexed issue in the mainstream public policy literature. The literature has remained more concerned with the design of policy and evidence of its impact than on the process by which it plays out. While implementation is often portrayed as a simple process
 of adopting best practice, experiences indicate that it is a far more complex process involving a range of actors translating policy into practice under varying conditions. Substantial changes to public service environments over the past few decades, both incremental and disruptive, have compounded
 this complexity. Commentators argue that it is time to look beyond current 'best practice' for new conceptual tools to tackle implementation challenges, particularly relating to those that take place around the many boundaries of public services (Dickinson and Sullivan, 2014a). In this paper
 we consider how post-structural feminist perspectives, with scope to actively challenge orthodoxies and embrace diversity and competing views, might further contemporary policy implementation research and practice.


The creation of a reliable system of land registration and valuation is a necessary condition for the further development of the real estate market in Russia. The purpose of this study is to analyse the currently existing problems in state cadastral registration and land valuation in the Russian Federation, both at the Federal and regional levels. In the present paper, information on the results of the cadastral valuation of land parcels in the Sverdlovsk region is presented. Based on an analysis of the data, it is possible to distinguish the following problems in this area: the imperfection of the methods of valuation and regulatory framework, the lack of accurate land boundaries: secrecy and opacity in the system of assigning information. The main stages of professional cadastral registration in the Russian Federation are reviewed. The approaches taken to determine the cadastral value of land according to Russian practices are discussed. It is shown that the cadastral value established can vary by several times according to the different valuation techniques employed. The possibility of challenging the results of an erroneous determination of cadastral value is demonstrated based on an analysis of legal precedents established in the Urals region. A conclusion is reached about the need to improve the methodological and legislative frameworks of cadastral valuation of land parcels as real estate. A number of possible paths forward are proposed and specific activities that should contribute to an improvement of the quality of land relations are outlined. It is proposed that regional experiences of cadastral assessment of lands can be used to support reform at the Federal level.


Though the stratigraphical and palaeogeographical framework of the Quaternary in Poland is still to be completed, several crucial points have been confirmed recently. The preglacial series, accepted for years as belonging to the Lower Pleistocene, is undoubtedly of Early Pliocene age, with a huge hiatus above almost until the uppermost Lower Pleistocene. The earliest glaciation in Poland (Nidanian) occurred at about 900 ka BP when the ice sheet reached the mid-southern part of the country. The following Podlasian Interglacial embraced the Brunhes/Matuyama boundary in the middle, in a similar fashion to the corresponding Cromerian Complex in Western Europe. The late Early and early Middle Pleistocene interglacials in Poland comprised 2-3 optima each, whereas every one of the younger interglacials was characterised by a single optimum only. The Late Vistulian ice sheet was most extensive in the western part of Poland (Leszno Phase) whereas the younger Poznan Phase was more extensive in the central and eastern part of the country. This was due to the varied distance from the glaciation center in Scandinavia, making the ice sheet margin reach a terminal position in different times. Palaeoclimatological research in the Tatra Mountains has provided new evidence for the atmospheric circulation over Europe. During cold phases of the Pleistocene in Poland a continental climate extended further westwards, quite the opposite that occurring during warmer intervals.


The original synthesis of dopamine in the laboratories of H.E. Dale in South London, followed some 50 years later by the seminal mapping of the mesencephalic dopamine (DA) pathways into ramifying mesostriatal, mesolimbic and mesocortical projections, the identification of several DA receptors and their signalling pathways, and the discovery of phasic and tonic modes of dopaminergic activity, have led to important questions about the functions of this modulatory neurotransmitter. The triadic division of these projections has suggested discrete and even parallel functions in movement (eg, Parkinson's disease, dorsal striatum), reward (eg, drugs of abuse, nucleus accumbens) and cognition (eg, schizophrenia and attention deficit/hyperactivity disorder (ADHD), prefrontal cortex). However, several lines of evidence show that this division to be artificial, it also being important to consider interactions between prefrontal and striatal systems, between the various sectors of the striatum itself, and even its component "direct" and "indirect" pathways. This lecture will provide several examples of how work performed in experimental animals has informed these functional considerations, while also having profound implications for understanding the functions of dopamine in health and disease. A prime example is the discovery that prefrontal cortical dopamine modulates cognitive functions such as working memory, which our own work has suggested to be a consequence of stabilising representations of the world via dopamine D1 receptor actions. This contrasts with findings that striatal dopamine often serves to promote behavioural switching, as occurs for example in Parkinson's disease, ADHD and stimulant abuse following dopaminergic therapy with l-dopa, methylphenidate, and a D2/3 agonist, respectively. The hypothesis that there exist optimal levels of dopamine activity for efficient cognitive functioning in the prefrontal cortex also has applicability in the sub-cortical brain, based for example on the discovery that optimal titration of dopaminergic therapy for motor function in Parkinson's disease can lead, not only to cognitive enhancement, but also behavioural dysregulation in certain domains, possibly arising as a consequence of an "over-dosing" of ventral striatal dopamine pathways with probable motivational consequences. Such a motivational role is consonant with the discovery that rewarding effects of psychomotor stimulant drugs such as cocaine and amphetamine were mediated by dopamine-dependent functions of the nucleus accumbens in rats. Recent work has shown that addiction to such drugs is predicted by individual differences in the propensity for impulsive behaviour, associated with variations in dopamine receptor number in the ventral striatum. This impulsivity may reflect an aberrant engagement of pavlovian approach behaviour. However, work in animals has suggested that during the addictive process, there is a shift in control of drug-seeking behaviour from the ventral to dorsal striatum that is consistent with a role for dopamine in stimulus-response habit learning. Implications for recent findings in chronic drug abusers will also be discussed.


Abstract This template was produced by the Working Group on Multiple Pregnancy and was endorsed by the International Board of the World Association of Perinatal Medicine. The purpose of this document is to expand the 2007 Istanbul international consensus statement on the perinatal care of multiple pregnancy and to focus on the care of monochorionic (MC) twins. The document represents the view and opinion of individuals who composed this ad hoc committee and discusses various aspects that are specific and relevant to the care of MC twin gestations.


The purpose of this study was to investigate the oxidative status in experimental hypothyroidism and the antioxidant effect of taurine supplementation. Forty male Sprague Dawley rats were randomly divided into four groups (group 1, control; group 2, control + taurine; group 3, propylthiouracil (PTU); group 4, PTU + taurine). Hypothyroidism was induced by giving 0.05% PTU in drinking water for 8 weeks. Taurine was supplemented in drinking water at a concentration of 1% for 5 weeks. Plasma (p < 0.05), red blood cell (p < 0.01), liver (p < 0.001) and kidney tissue (p > 0.05) malondialdehyde levels were increased in the PTU group compared with those of the control rats and were decreased in the PTU + taurine group compared with the PTU alone group. No significant changes were observed in glutathione levels of kidney and liver in the PTU group, but taurine supplementation significantly increased the glutathione levels of these tissues. Paraoxonase and arylesterase activities were decreased in the PTU group while taurine supplementation caused no significant changes in paraoxonase and arylesterase activities. These findings suggest that taurine supplementation may play a protective role against the increased oxidative stress resulting from hypothyroidism. Copyright © 2004 John Wiley & Sons, Ltd.


The purpose of this study was to assess the determinants of poor academic performance in community secondary schools in Tanzania. Four research objectives were addressed namely; the analysis of the methods used by teachers to impart knowledge and skills in community secondary schools; the influence of school factors on students' academic performance; investigation of the challenges facing the students ; and finally to find out the extent to which these challenges affect students' academic performance. A descriptive survey design was used for data collection and analysis. The population for study involved students, teachers, and headmasters/headmistress in community secondary schools in Kinondoni Municipality, parents, school inspectors and District Education Officer.71 respondents were purposively selected while questionnaire and interview methods were used for collecting data. Qualitative data analysis method (QDA) was used for analysing the data collected. The findings revealed that the choice and use of some methods of teaching had a negative impact on the teaching and learning. Community schools are face with challenges such as the lack of fencing, the use of a double shift system and the lack of science teachers as well as the lack of teaching and learning resources. In addition, the access to internet, students and teachers rates of classroom attendance and overcrowded in the classroom affect negatively student academic performance. It was recommended that schools should fence to improve security, and avoid unnecessary interferences. The government must ensure that resources are available.


Chips are classified as types of snacks that are categorized as crackers, foods that are dry, crisp (crispy). In general, the manufacture of chips is by way of direct material cut so many consumers who do not love because they do not obtain the desired level of crispness. It is therefore necessary to add starches such as tapioca to improve the crispiness of the chips. In this study, sweet potato being processed first and the addition of starch such as tapioca to increase the crispiness. But the addition of starch is not more than 30% by the weight of sweet potato dough for undesirable development of large volumes such as chips which are made by flour. The addition of tapioca starch will also affect the physicochemical and organoleptic properties of the chips. The study was conducted to determine the effect of tapioca proportion to the physicochemical properties and organoleptic orange sweet potato chips. The study design used is Random Group non factorial. Factors studied were concentration of tapioca which consists of 7 (seven) standard of treatment in the form of 0% (w / w); 5% (w / w); 10% (w / w); 15% (w / w); 20% (w / w); 25% (w / w); 30% (w / w), with a repeat of four (4) times in order to obtain a total of 28 experimental units. The use of the higher tapioca starch increases the water content of the raw chips, volume expansion, oil absorption and lightness, while the water content of the cooked chips, redness, yellowness, chroma and texture decreases. The results showed that the best processing is the concentration of tapioca 30% with the moisture content of 7.61% raw chips, cooked chips water content of 2.91%, volume expansion of 57.24%, oil absorption of 34.58%, texture (hardness) of 232.38 g, beta carotene of orange sweet potato flour 88.34 mg/kg, beta carotene of orange sweet potato chips after being fried 40.68 mg/kg, the acceptance level panelists in terms of the ability to fracturing (6.95), the crispness (7.33), color (7.16) and flavor (6.76) with a standard score of 1-9.


Wild tigers are being annihilated. Tiger range countries and their partners met at the 1st Asian Ministerial Conference on Tiger Conservation in January 2010 to mandate the creation of the Global Tiger Recovery Program to double the number of tigers by 2022. Only 3200-3600 wild adult tigers remain, approximately half of the population estimated a decade ago. Tigers now live in only 13 countries, all of which are experiencing severe environmental challenges and degradation from the effects of human population growth, brisk economic expansion, rapid urbanization, massive infrastructure development and climate change. The overarching challenge of tiger conservation, and the conservation of biodiversity generally, is that there is insufficient demand for the survival of wild tigers living in natural landscapes. This allows the criminal activities of poaching wild tigers and their prey and trafficking in tiger derivatives to flourish and tiger landscapes to be diminished. The Global Tiger Recovery Program will support scaling up of practices already proven effective in one or more tiger range countries that need wider policy support, usually resources, and new transnational actions that enhance the effectiveness of individual country actions. The program is built on robust National Tiger Recovery Priorities that are grouped into themes: (i) strengthening policies that protect tigers; (ii) protecting tiger conservation landscapes; (iii) scientific management and monitoring; (iv) engaging communities; (v) cooperative management of international tiger landscapes; (vi) eliminating transnational illegal wildlife trade; (vii) persuading people to stop consuming tiger; (viii) enhancing professional capacity of policy-makers and practitioners; and (ix) developing sustainable, long-term financing mechanisms for tiger and biodiversity conservation.


The HANDS question-answering and direction application, consisting of Answer Tree and Address Guesser modules is described in relation to the EDEN project from which it is derived. The use of an Open Source (OSS) model for application development and service delivery is considered in the context of European policy. The interaction of HANDS with Public Bodies' (PBs) existing business process is described. We then consider the evaluation of the factors that affect acceptance by PBs, including those that go beyond technical effectiveness. We describe the underlying language processing engine used by HANDS and discuss the advantages of using Natural Language Processing (NLP) over keyword-based question-answering techniques in terms of increasing the potential for take-up from all citizens, not just the most literate or IT skilled.


From the Publisher:
The practical guide to evaluating and improving the quality of mission-critical software.

Large software systems will never be perfect, but decision makers need better ways to evaluate and enhance software quality—especially where software is mission critical or used in life-or-death environments. Solid Software presents realistic techniques for analyzing and improving the quality and robustness of any software system or software-intensive product.

Solid Software isn't theoretical: it's a relentlessly practical decision maker's guide to making intelligent, responsible trade-offs that lead to the best software at the best cost.

Understand what levels of quality are reasonable to expect at every stage of the software life cycle, including development, deployment, and maintenance
Discover the key "design leverage points" that lead to robust software
Learn sophisticated new ways to predict software quality and assess systems in production
Make the most of hazard analysis, testing, design analysis, reviews, static code analysis, and other techniques
Choose the best tools—and use them more effectively

Solid Software draws upon dozens of real-world examples, based on the authors' extensive experience as software quality consultants, and interviews with key software decision makers worldwide. Whether you're a developer, project manager, architect, executive, manager, or regulator, it's your single source for improving software quality—in the real world.


11.5%) or they managed the drug supply chain (n=17; 11%), medical devices (n=14; 9.2%), drug monitoring (n=8; 5.5%), clinical trials (n=8; 5.2%), sterilisation of reusable medical devices (n=4; 2.9%) or as radiopharmacists (n=3; 1.8%), as well as several other settings (49 (32%)). Regarding their training, 142 (92%) had an additional diploma: 91 (59%) had a specialised university diploma, 34 (22%) had a master's degree and 5 (3%) had a PhD. Finally, most of them worked in a university hospital (39%), 35% in other public hospitals, 14% in private hospitals, 4.5% in industrial establishments and 4.5% in other structures, such as health agencies or humanitarian organisations. Conclusion and relevance This survey raises awareness of the increasing involvement of pharmacists in hospitals. The results of the survey are in line with the EAHP's European Statements. Furthermore, we can see the responsibilities of French hospital pharmacists in the fields of medical devices, sterilisation of reusable medical devices, radiopharmacy and health agencies.


A non-intrusive quality predictor constitutes a mapping from signal features to a (typically one dimensional) representation of the perceived quality. Assuming that the regression model performing the mapping is suited to the data, the performance of the predictor largely depends on how well the parameters of this regression model can be inferred from the training data. In situations where the training data is scarce, model performance is degraded due to over-fitting. The effects of over-fitting can be mitigated by feature selection but the model performance remains low due to the insufficiently representative training data. The objective we pursue is to enhance the performance of a quality predictor by augmenting the feature set with the output of a pre-trained quality predictor. This approach introduces an implicit dependence of the regression model parameters on a larger amount of training data. In view of the increasing usage of speech signals with higher bandwidth, and the dearth of training data for such signals, an augmentation of particular interest is that of a wide-band feature set with a narrow-band quality prediction. Experimental results for additive noise and non-linear distortions encountered in hearing aids, using quality labels from an intrusive quality predictor, illustrate the performance enhancement capabilities of the proposed approach.


Energy-efficient design requires exploration of available algorithms, recurrence structures, energy and wire tradeoffs, circuit design techniques, circuit sizing and system constraints. In this paper, methodology for energy-efficient design applied to 64-bit adders implemented with static CMOS, dynamic CMOS and CMOS compound domino logic families, is presented. We also examined 65 nm, 45 nm, 32 nm, and 22 nm technology nodes to explore the applicability of the results in deep submicron technologies. By applying energy-delay tradeoffs on various levels, we developed adder topology yielding up to 20% performance improvement and 4.5× energy reduction over existing designs.


Unlike general approaches to learning, the Causalitic-Thinking Approach, aims to construct phenomena that have more than one possible answer. However this approach requires scaffolding strategies. This study aims to investigate the strategy of developing scaffolding in learning with the Causalitic-Thinking Approach to increase students' problem-solving abilities; namely, understanding, selecting, differentiating, determining, applying, and identifying. An embedded experimental two-phase design with a sample of 33 senior high school students (21 -females, 12 -males). The differences between preand post-tests, and between the problem-solving ability -gain of the low and high groups were tested with Wilcoxon signed-ranks-test. Results show that the scaffolding that was implemented was effective in increasing problem-solving abilities but there was no significant difference between the two groups of


Hypothesis: The fact that the anatomy of the basal turn of the human cochlea, especially, is essentially different from that of other species is likely to influence the outcome of cochlear implantation. Background: Multichannel cochlear implants give better speech understanding than single-channel devices. They are intended to make use of the tonotopic organization of the cochlea by selectively stimulating subpopulations of the auditory nerve. At higher stimulus levels and with monopolar stimulation, excitation of nerve fibers from other turns may interfere with this concept, especially with modiolus-hugging electrodes. Methods: A three-dimentional spiraling computer model of the human cochlea, based on histological data, was used to test the spatial selectivity and the dynamic range before cross-turn stimulation takes place for the Clarion HiFocus implant with and without a positioner. The results were compared with a similar model of the guinea pig cochlea. Results: In humans (in contrast to the guinea pig), a well-designed modiolushugging electrode yielded reduced current thresholds and high spatial selectivity without reduction of the useful dynamic range. The apical turn of the human cochlea, however, is largely comparable in this respect with the guinea pig cochlea, where cross-turn stimulation reduces the dynamic range substantially. Conclusion: The clinical success of cochlear implantation in humans and the favorable results with modiolus-hugging devices depend on the anatomy of the human cochlea.


Entrepreneurs starting new firms face two sorts of asymmetric information problems. Information about the quality of new investments may be private, leading to adverse selection in credit markets. And, entrepreneurs may not observe the quality of workers applying for jobs, resulting in adverse selection in labor markets. We construct a simple model to illustrate some consequences of new firms facing both sorts of asymmetric information. Multiple equilibria can occur. Stable equilibria can be in the interior, or at a corner in which no entrepreneurs enter. Stable interior equilibria can involve involuntary unemployment, as well as credit rationing. Equilibrium outcomes mismatch workers to firms, and will generally result in an inefficient number of new firms. With involuntary unemployment, there will be too few new firms, but with full employment, there may be too many or too few. Taxes or subsidies on new firms and employment can be used to achieve a second-best optimum. Alternative information assumptions are explored.


This paper applies genetic simulated annealing algorithm (SAGA) to solving geometric constraint problems. This method makes full use of the advantages of SAGA and can handle under-/over-constraint problems naturally. It has advantages (due to its not being sensitive to the initial values) over the Newton-Raphson method, and its yielding of multiple solutions, is an advantage over other optimal methods for multisolution constraint system. Our experiments have proved the robustness and efficiency of this method.


A two-year-old Swiss Braunvieh cow was referred to our clinic because of tenesmus and weight loss. Clinical examination revealed a moderately abnormal general behaviour and condition, thin body condition and a rectal temperature of 40.1 degrees C. Tenesmus was evident, and rumen and intestinal motility were markedly reduced. All tests for a reticular foreign body were positive. On rectal examination, a round, smooth, firm, non-painful mass with a diameter of approximately 15 cm was palpated far cranially on the right side. Abnormal haematological and biochemical findings included marked anaemia, neutrophilic leucocytosis, markedly elevated concentration of fibrinogen and mildly elevated gamma-glutamyl-transferase activity. The clotting time of the glutaraldehyde test was one minute. Ultrasonographic examination revealed abscesses involving the liver and extending caudally into the right flank region. The liver parenchyma had diffuse changes. Because of a grave prognosis, the cow was euthanized. Postmortem findings substantiated ultrasonographic results; there were abscesses, caused by Fasciola hepatica infestation, originating in the liver and extending into the right flank. As well, there was severe, bilateral, multifocal, suppurative nephritis due to thromboembolism. Based on all the findings, a diagnosis of liver abscess caused by fascioliasis and bilateral suppurative nephritis was made.


BACKGROUND
Computed tomography pulmonary angiography (CTPA) detects incidental findings that require follow-up. In just over 50% of cases, those incidental findings are pulmonary nodules. Fleischner guidelines recommend that patients with nodules that have a high risk of malignancy should undergo CT follow-up within 3-12 months.

OBJECTIVE
We examined the proportion of patients with pulmonary nodules requiring follow up who received repeat imaging within six weeks of the time frame recommended by the radiologist.

DESIGN
This retrospective cohort study included all patients who underwent CTPA in the emergency department and inpatient settings at three teaching hospitals in Toronto, Canada between September 1, 2014, and August 31, 2015. Natural language processing software was applied to a linked radiology information system to identify all CTPAs that contained pulmonary nodules. Using manual review and prespecified exclusion criteria, we generated a cohort with possible new lung malignancy eligible for follow-up imaging; then we reviewed available health records to determine whether follow-up had occurred.

RESULTS
Of the 1,910 CTPAs performed over the study period, 674 (35.3%) contained pulmonary nodules. Of the 259 patients with new nodules eligible for follow-up imaging, 65 received an explicit suggestion for follow-up by radiology (25.1%). Of these 65 patients, 35 (53.8%) did not receive repeat imaging within the recommended time frame. Explicit mention that follow-up was required in the discharge summary (P = .03), attending an outpatient follow-up visit (P < .001), and younger age (P = .03) were associated with receiving timely follow-up imaging.

CONCLUSIONS
Over 50% of patients with new high-risk pulmonary nodules detected incidentally on CTPA did not receive timely follow-up imaging.


Clubroot caused by Plasmodiophora brassicae is a severe threat to the production of Brassica napus, worldwide. The cultivation of resistant varieties is the most efficient and environmentally friendly way to limit disease spread. We developed a highly resistant B. napus line, ZHE226, containing the resistance locus PbBa8.1. However, ZHE226 seeds contain high erucic acid content, which limits its cultivation owing to its low edible oil quality. A segregation population of BC3F2 was developed by crossing ECD04, a resistant European turnip donor, with Huangshuang5, an elite variety with no erucic acid in its seeds, as a recurrent plant. Fine mapping using the bulk segregation analysis sequencing (BSA-Seq) approach detected PbBa8.1 within a 2.9 MB region on chromosome A08. Interestingly, the previously reported resistance gene Crr1a was found in the same region. Genetic analysis revealed that the CAP-134 marker for Crr1a was closely linked with clubroot resistance (CR). Thus, PbBa8.1 and Crr1a might be allelic for CR. Moreover, comparative and genetic analysis showed that high erucic acid in the seeds of ZHE226 was due to linkage drag of fatty acid elongase 1 (FAE1) in the ECD04 line, which was located in the interval of PbBa8.1 with a physical and genetic distance of 729 Kb and 1.86 cm, respectively. Finally, a clubroot-resistant line with a low erucic acid content was successfully developed through gene-specific molecular marker assistant selection from BC4F4. These results will accelerate CR breeding programs in B. napus.


The single-minded (sim) gene encodes a transcriptional regulator that functions as a key determinant of central nervous system (CNS) midline development in Drosophila. We report here the identification of two murine homologs of sim, Sim1 and Sim2, whose products show a high degree of sequence conservation with Drosophila SIM in their amino-terminal halves, with each containing a basic helix-loop-helix domain as well as a PAS domain. Sim1 maps to the proximal region of mouse chromosome 10, whereas Sim2 maps to a portion of the distal end of chromosome 16 that is syntenic to the Down syndrome critical region of human chromosome 21. Recent exon-trapping studies have identified in the critical region several exons of a human sim homolog which appears to be the homolog of murine Sim2; this has led to the hypothesis that increased dosage of this sim homolog in cases of trisomy 21 might be a causal factor in the pathogenesis of Down syndrome. We have examined the expression patterns of the Sim genes during embryogenesis. Both genes are expressed in dynamic and selective fashion in specific neuromeric compartments of the developing forebrain, and the expression pattern of Sim2 provides evidence for early regionalization of the diencephalon prior to any overt morphological differentiation in this region. Outside the CNS, Sim1 is expressed in mesodermal and endodermal tissues, including developing somites, mesonephric duct, and foregut. Sim2 is expressed in facial and trunk cartilage, as well as trunk muscles. Both murine Sim genes are also expressed in the developing kidney. Our data suggest that the Sim genes play roles in directing the regionalization of tissues where they are expressed. Moreover, the expression pattern documented for Sim2 may provide insights into its potential roles in Down syndrome.


Grotta della Monaca is a karstic cave in Calabria (southern Italy) that plays an important role in reconstructing the oldest strategies for the acquisition of mineral resources in the Mediterranean. In fact, systematic archaeological excavations carried out by the University of Bari allowed the identification of intense prehistoric mining activities aimed at the exploitation of iron and copper ores. Archaeological evidence suggests different phases of frequentation of the cave spanning from the Upper Paleolithic, Neolithic, Copper and Bronze ages up to the Middle Ages. In order to establish an absolute timeframe for the different phases, a radiocarbon dating campaign was carried out and the results presented in this paper.


We aimed to compare the hypothesized local anesthetic action of amantadine (1‐adamantanamine) with that of the known local anesthetic mepivacaine. Motor, proprioceptive, and nociceptive functions were evaluated in rats after intrathecal administration. Amantadine elicited spinal anesthesia in a dose‐related fashion and produced a better sensory‐selective action over motor blockade (P < 0.01). On the 50% effective dose (ED50) basis, the rank of potency on spinal motor, proprioceptive, and nociceptive block was mepivacaine > amantadine (P < 0.01 for the differences). Amantadine (63.5 μmol/kg) and mepivacaine (7.1 μmol/kg) produced complete spinal block of motor function, proprioception, and nociception. On an equipotent basis (ED25, ED50, and ED75), the duration of amantadine was longer (P < 0.01) than that of mepivacaine on spinal motor, proprioceptive, and nociceptive block. Our preclinical data demonstrated that amantadine was less potent than mepivacaine at producing spinal anesthesia. The spinal block duration produced by amantadine was greater than that produced by mepivacaine. Both amantadine and mepivacaine produced a markedly nociceptive‐specific blockade.


How do we make sense of a movement like the Islamic State, where violence and religion seem to be inextricably intertwined? Though observers sometimes accuse religion as causing the problem, and other observers think that such movements have nothing to do with it, my approach is to focus on what some scholars have called the culture of violence: the analysis of worldviews. The sociological task is to understand these worldviews in social context, to determine the social and political factors that have shaped communities that embrace distinctive worldviews. This essay focuses on the social and political development of Islamic State of Iraq and Syria, explores the notion of worldview analysis in general and as applied to this movement, and determines that there are at least three different kinds of worldviews related to groups of followers who may survive, in different ways, the eventual collapse of the territorial control of the movement.


This report was produced by The Wildlife Conservation Society and Forest Trends. This report begins by providing a short overview of biodiversity offset principles and their development in the international arena. This is followed by a review of the current status in Peru of biodiversity offsets along with a comparison to existing best practice. The authors then focus on the necessary scientific baseline and metrics required for establishing a biodiversity offset system. The report concludes with the elements and activities for a roadmap and next steps on implementing a biodiversity offset scheme in Peru in the short, medium, and long-term, with specific actions identified that can help move the process forward in coordination with MINAM, SENACE, and other stakeholders.


The cerebellum's role in sensory-motor control and adaptation is undisputed. However, a key hypothesis pertaining to the function of cerebellar circuitry lacks experimental support. It is universally assumed that the discharge of mossy fibers accounts for modulation of Purkinje cell "simple spikes" (SSs). This assumption acts as a prism through which all other functions of cerebellar circuitry are viewed. The vestibulo-cerebellum (nodulus and uvula) receives a large, unilateral, vestibular primary afferent mossy fiber projection. We can test its role in modulating Purkinje cell SSs by recording the modulated activity of both mossy fiber terminals and Purkinje cell SSs evoked by identical natural vestibular stimulation. Sinusoidal rotation about the longitudinal axis (roll) modulates the activity of vestibular primary afferent mossy and climbing fibers as well as Purkinje cell SSs and complex spikes (CSs). Remarkably, vestibular primary afferent mossy fibers discharge 180 degrees out of phase with SSs. This indicates that mossy fibers cannot account for SS modulation unless an inhibitory synapse is interposed between mossy fibers or vestibular climbing fibers and Purkinje cells. The authors review several experiments that address the relative contributions of mossy and climbing fiber afferents to the modulation of SSs. They conclude that climbing fibers, not mossy fibers, are primarily responsible for the modulation of SSs as well as CSs and they propose revised functions for these two afferent systems.


This paper concerns design considerations (kinetics and hydraulic criteria) for a biological nitrification-denitrification attached culture process for sewage treatment. The treatment system is composed of two submerged filters. The first one, an anoxic reactor, denitrifies and retains wastewater suspended solids. The second one oxidizes organic carbon and ammonia nitrogen. It was found that the main parameter for the system is the recycle ratio since it sets the real hydraulic detention time in reactors and determines the quantity of nitrogen available to the denitrification process.


Sequential aggregate signature schemes allow n signers, in order, to sign a message each, at a lower total cost than the cost of n individual signatures. We present a sequential aggregate signature scheme based on trapdoor permutations (e.g., RSA). Unlike prior such proposals, our scheme does not require a signer to retrieve the keys of other signers and verify the aggregateso-far before adding its own signature. Indeed, we do not even require a signer to know the public keys of other signers! Moreover, for applications that require signers to verify the aggregate anyway, our schemes support lazy verification: a signer can add its own signature to an unverified aggregate and forward it along immediately, postponing verification until load permits or the necessary public keys are obtained. This is especially important for applications where signers must maintain a large, secure, and current cache of public keys in order to verify messages. We report a technical analysis of our scheme (which is provably secure in the random oracle model), a detailed implementation-level specification, and implementation results based on RSA and OpenSSL. To evaluate the performance of our scheme, we focus on the target application of BGPsec (formerly known as Secure BGP), a protocol designed for securing the global Internet routing system. There is a particular need for lazy verification with BGPsec, since it is run on routers that must process signatures extremely quickly, while maintaining a large cache of over 36, 000 public keys. We compare our scheme to the algorithms currently proposed for use in BGPsec, and find that our signatures are considerably shorter nonaggregate RSA (with the same sign and verify times) and have an order of magnitude faster verification than nonaggregate ECDSA, although ECDSA has shorter signatures when the number of signers is small.


Individual tasks carried out within benchmarking initiatives, or campaigns, enable direct comparison of alternative approaches to tackling shared research challenges and ideally promote new research ideas and foster communities of researchers interested in common or related scientific topics. When a task has a clear predefined use case, it might straightforwardly adopt a well established framework and methodology. For example, an ad hoc information retrieval task adopting the standard Cranfield paradigm. On the other hand, in cases of new and emerging tasks which pose more complex challenges in terms of use scenarios or dataset design, the development of a new task is far from a straightforward process. This letter summarises our reections on our experiences as task organisers of the Search and Hyperlinking task from its origins as a Brave New Task at the MediaEval benchmarking campaign (2011-2014) to its current instantiation as a task at the NIST TRECVid benchmark (since 2015). We highlight the challenges encountered in the development of the task over a number of annual iterations, the solutions found so far, and our process for maintaining a vision for the ongoing advancement of the task's ambition.


In this paper, common colour models for background subtraction and problems related to their utilisation are discussed. A novel approach to represent chrominance information more suitable for robust background modelling and shadow suppression is proposed. Our method relies on the ability to represent colours in terms of a 3D-polar coordinate system having saturation independent of the brightness function; specifically, we build upon an Improved Hue, Luminance, and Saturation space (IHLS). The additional peculiarity of the approach is that we deal with the problem of unstable hue values at low saturation by modelling the hue-saturation relationship using saturation-weighted hue statistics. The effectiveness of the proposed method is shown in an experimental comparison with approaches based on RGB, Normalised RGB and HSV.


In summary, cancer programs across the country have been developing since 1975. A more formal organizational structure has been adopted to program activities since 1980. The full-time Cancer Program Administrator position exists in about one-third of the programs reporting. Persons occupying the position are at least bachelors degreed with many also having a masters degree. Strengths, weaknesses, and obstacles to program development are basically the same items across the country. It appears that programs that have one problem resolved are still working towards the solution of another problem and vice versa among programs. All programs are struggling for identity within the hospital and are in developmental stages with a lot of activity focused on clarifying the position of an organized cancer program within the hospital organization.


ABSTRACT Background: A burn event can elicit symptoms of posttraumatic stress disorder (PTSD) in survivors and their partners and may impact the way these couple members interact with each other. They may try to protect each other from further emotional distress by avoiding talking about the burn event, but they may also show concern towards each other. Objective: The aim of this study was to investigate bidirectional relationships between survivor's and partner's PTSD symptoms and two interpersonal processes: partner-oriented 'self-regulation', which is avoidance-oriented, and 'expressed concern', which is approach-oriented. Method: In this longitudinal multi-centre study, 119 burn survivors and their partners participated. Measures of PTSD symptoms, self-regulation, and expressed concern were administered in the acute phase following the burns, and follow-ups took place up to 18 months postburn. Intra- and interpersonal effects were examined in a random intercept cross-lagged panel model. Exploratory effects of burn severity were also investigated. Results: Within individuals, survivor's expressed concern predicted later higher levels of survivor's PTSD symptoms. In their partners, self-regulation and PTSD symptoms reinforced each other in the early phase postburn. Between the two couple members, partner's expressed concern predicted later lower levels of survivor's PTSD symptoms. Exploratory regression analyses showed that burn severity moderated the effect of survivor's self-regulation on survivor's PTSD symptoms, indicating that self-regulation was continuously related to higher levels of PTSD symptoms over time within more severely burned survivors, but not in less severely burned survivors. Conclusion: PTSD symptoms and self-regulation reinforced each other in partners and possibly also in more severely burned survivors. Partner's expressed concern was related to lower levels of survivor's PTSD symptoms, whereas survivor's expressed concern was related to higher levels of survivor's PTSD symptoms. These findings emphasize the importance of screening for and monitoring PTSD symptoms in burn survivors and their partner and of encouraging couple's self-disclosure. HIGHLIGHTS PTSD symptoms in burn survivors and their partners are related to both avoidance- and approach-oriented interpersonal processes. In partners, higher levels of self-regulation were bidirectionally related to higher levels of posttraumatic stress symptoms. Concern expressed by partners may mitigate posttraumatic stress symptoms in burn survivors.


The article contains an analytical overview of the causes of local washouts on hydraulic installations of Don highway networks. One of the major outlet structures of the main canal is the terminal resets in Sadkovskaya gully (Veselovsky reservoir 1115+79), with a maximum flow rate of 50 m3/sec, designed for irrigation and desalination of Veselovsky reservoir. To analyze the effect of the liquid on the bottom of the outlet structures we need to know the kinematic parameters of the liquid in the channel. Until now there are no universal correlations, which would allow calculating these parameters. The mathematical dependences allow analyzing the impact of water flow on the bottom of the spillway constructions of melioration canals. Modeling of local scour of channels is based on a thorough analysis of the causes of this phenomenon. The main ones are the kinematic parameters of the liquid, the speed and the propagation direction of fluid flow, structural features of the channel. The mathematical dependences allowed us to identify the following parameters that influence the degree of local scour at end spillway structures on melioration channels: the rate of flow, the degree of compression of the stream size, flow, shape, and movement of sediment, depth and shape of the supports in the plan and cross section, the shape of the hydrograph, the angle of the jet, duration of standing high water levels in Sadkovskaya balka, etc.


AbstractThe objective of this study was to determine the cost-effectiveness of eplerenone compared with usual care in patients with chronic heart failure and New York Heart Association (NYHA) Class II symptoms.A Markov model was constructed with 5 health states to reflect NYHA symptom status (Classes I–IV) and death. All subjects began in the "Class II" health state and then moved to other symptom health states or died. Subjects could also be hospitalized for HF in any cycle. Transition probabilities were derived from the Eplerenone in Mild Patients Hospitalization And Survival Study in Heart Failure (EMPHASIS-HF) study. Decision analysis was applied to compare an Eplerenone Group with a Usual Care Group (UCG). In the UCG, 47.3% of subjects in Class II and 93.7% of subjects in Classes III and IV were assumed to be taking spironolactone (as per published data). In the Eplerenone Group, all subjects in Classes II, III, and IV were assumed to be taking eplerenone. The efficacy of spironolactone was assumed to be the same as eplerenone. Cost and utility data were derived from published sources. A discount rate of 5.0% was applied to future costs and benefits. The outcome of interest was incremental cost-effectiveness ratio (ICER) (cost per year of live saved (YoLS) and quality-adjusted life years (QALY) gained).Over 10 years the model predicted that for each patient compared with usual care, eplerenone would lead to 0.26 YoLS (discounted) and 0.19 QALYs gained (discounted), at a net cost of AUD $6961 (discounted). These equate to ICERs of AUD 28,001 per YoLS and AUD 37,452 per QALY gained. Sensitivity analyses indicated a 99.0% likelihood of eplerenone being cost-effective compared with usual care at a willingness to pay threshold of AUD 50,000 per QALY gained.From an Australian healthcare perspective, the addition of eplerenone in management of patients with chronic heart failure and NYHA Class II symptoms represents a cost-effective strategy compared with usual care.


The strength and latitudinal position of the North Atlantic Current, NAC, determines the position of the Arctic front and heat transport to the high northern latitudes with potentially important consequences for Northern Hemisphere glaciation. A southward shift in the NAC and reduced poleward heat transport is hypothesized to have triggered the last major climate transition in Earth's history—late Pliocene intensification of Northern Hemisphere glaciation (iNHG). In turn, iNHG is hypothesized to have led to the amplification of climate variability on suborbital time scales. To date, however, only a handful of adequately resolved records are available to test these two hypotheses. Here we present a new late Pliocene to earliest Pleistocene record from Integrated Ocean Drilling Program Site U1313 (North Atlantic, 41°N; 2.9 to 2.4?Ma). We use Mg/Ca-derived paleotemperature records in planktic foraminiferal calcite to investigate changes in summer sea-surface temperatures (SST) on orbital and suborbital time scales. Our results call into question the suggestion that significant weakening and/or southward shift of the NAC served as a trigger for Northern Hemisphere cooling and intensified continental ice sheet growth across iNHG. In contrast to the late Pleistocene, during iNHG, we find that the position of the NAC and Arctic Front probably lay well to the north of Site U1313 and that the amplitude of suborbital SST variability did not change on glacial-interglacial time scales. Conservative estimates of Late Pliocene to earliest Pleistocene interglacial summer SSTs in our record are up to 3°C warmer than present, while glacial summer SSTs are only 2°C to 3°C cooler. In fact, our interglacial summer SSTs are remarkably similar to those of the mid-Pliocene. Our findings indicate that iNHG must have involved amplifying feedback mechanisms that are tightly coupled to ice sheet growth but that these processes were insufficiently developed by the late Pliocene/earliest Pleistocene to have triggered large amplitude changes in suborbital climate in the midlatitude North Atlantic.


Traffic data, such as travel speed and travel time, is by nature stochastic. In order to deploy Intelligent Transportation Systems successfully, efficient, accurate, and sufficient collection of traffic data in a timely manner without interrupting the traffic flows is one of the imperative first steps. It is evident that travel speed estimates by gathering traffic data with moving vehicles is more representative of highway performance than the point estimates of speed from fixed detectors. Recently, GPS and cellular probe techniques have been researched and practiced in academic and industrial areas all around the world. The use of GPS and cellular probes for obtaining traffic data appears to be technically feasible. Still, there is little evidence to demonstrate that either system can be practically implemented. The comparative study conducted in this paper has integrated the possible real attributes of GPS and cellular probe systems, such as location accuracy, probe penetration rate and update frequency, into simulation on a real transportation network, and has developed methods for freeway travel speed estimation. The findings from simulation show that either of these two techniques has its own pros and cons. Cellular probe has wider probe penetration rate than GPS, which relieves the dependency on location accuracy, but the low update frequency reduces the coverage and accuracy of link travel speed estimation in the network. The GPS probe has a high update frequency, but the low probe penetration rate and the subsequent strong dependency on location accuracy are big obstacles to obtaining enough samples for link travel speed estimation. Thus, combining these two technologies of wide cellular probe rate and high GPS update frequency should provide better estimation of traffic conditions.


Pregnancy causes large physiologic changes in most body systems and these changes may lead to ease or harden examining some events. The purpose of this study is to define the rate of risk in pregnant women and the results in mother and fetus and also to define the risk rate of pregnancy in pregnant women and its effect on parameters after birth in patients of Educational and Medical center of Gorgan, Dezyani. This case - control study was performed in Educational and Medical Center Dezyany, of Golestan University of Medical Sciences in 1390. In this study, 1266 pregnant women were enrolled of which 804 cases (63.5%) according to the criteria for scoring in the questionnaire with a score greater than or equal to 7 were considered as high risk pregnancies (case group), 462 patients (36.5%) were considered as low-risk pregnancies (control group). Parameters after the birth and pregnancy results such as delivery type, infant difficulties, mother health after labor were compared and analyzed by T-test and ANOVA in both groups. About the history of infertility almost 80% of the people who had a 2-year history of infertility were in high-risk group and the difference was significant. (P = 0.02) About the history of abortion also almost 90% of the people who had a 2-year history of abortion were in highrisk group and the difference was significant. (P<0.05) Post-term infant was found in 77 cases that were entirely in high-risk group. This difference was statistically significant (P<0.05). According to results and comparing them to other studies we can conclude that pregnant mothers who have pregnancy difficulties history such as history of abortion or infertility, visits during pregnancy should be paid attention and warn them about the risk of not being visited and timely pursuits.


Purpose The main aim was to evaluate the changes in beliefs about immunosuppressants over a 3-year period in patients after kidney transplantation. The second aim was to investigate the relationship between beliefs, medication adherence, and selected clinical outcomes such as graft functioning. Patients and Methods This observational follow-up study was conducted in the outpatient post-transplant clinic at the University Hospital Hradec Kralove in the Czech Republic. Adult patients, at least 4 weeks after kidney transplantation, were invited for the structured interview, which was followed by a self-administered questionnaire survey during their regularly scheduled visits at the clinic. Appropriate paired tests were used to compare two measurements of beliefs about immunosuppressants by BMQ-CZ© in 2016 (baseline) and in 2019 (follow-up). Self-reported adherence was measured by two validated tools (MARS-CZ© and BAASIS©) capturing implementation and discontinuation phases. A generalized linear model was used to investigate the relation between beliefs and the consecutive estimated glomerular filtration rate. Results The study involved 134 patients. Over time, their perceived treatment necessity beliefs of immunosuppressants decreased, while their treatment-related concerns increased. Overall self-reported non-adherence (ie, taking, dosing and discontinuation of immunosuppressants) was reported by 12% of the patients in both observation periods. In the follow-up period, timing non-adherence was reported by 52 (38.8%) patients. Higher baseline treatment concerns were associated with poor adherence whereas higher baseline treatment necessity beliefs corresponded with better kidney functioning, even after adjusting for age. Conclusion Higher treatment necessity beliefs corresponded with better kidney functioning, whereas higher treatment concerns were related to non-adherence to immunosuppressants at the beginning of the observed period. Still, most patients accepted their medicines that do not come without risk. Nevertheless, decreasing treatment necessity beliefs on one hand, and increasing treatment concerns on the other, should be considered in clinical practice.


Abstract In the coming decades, the countries of the South will be facing the aging of the population faster than the countries of the North. This will have long-term economic consequences for the South but also for the North through the changing of international capital flows. To study the latter, we build a simple two-region two-period overlapping generations (OLG) model, assuming fully integrated financial markets. This allows us to determine the analytical expression of the world interest rate dynamics at general equilibrium and the resulting capital flows accruing to each of the two regions (the North and the South). From there, we analyze how a reduction in either fertility or mortality alters the magnitude of the international capital flows. Contradictory effects are evidenced. To clear-up any ambiguity and to study the South's demographic transition, which involves a succession of shocks, we propose numerical simulations. Even if the results stress that the institutional context and technological catching-up may matter, they suggest in a rather general way that the declines in both fertility and mortality tend to reduce the relative capital needs of the Southern economies and consequently their capital inflows. This, in turn, would be beneficial to the North's productive capacity, which should then hold more capital.


The paper introduces the concept of wicked intelligence to public relations. This idea associates practice in the field with progressive strategic thinking, social responsibility and democracy. Wicked intelligence is itself positioned in the paper as an example of counterintelligence linked to a process of radical unlearning in the PR discipline. This call for cognitive decommissioning is based on the notion that learning is a recurring theme in conceptualisations of intelligence and positioned as a desirable aspect of individual and collective development. Nevertheless, discourse around learning often underpins a managerial paradigm which is preoccupied with the promotion of organisational competitiveness rather than the resolution of societal problems (Shih-wei Hsu, 2013).
The idea of wicked intelligence confronts this issue and focuses particularly on the key competencies required to tackle wicked problems. These are intractable issues that cannot be resolved through traditional problem solving techniques because they defy neat definition, linear analysis and are unable to be solved in sequential steps (Conklin, 2006). These types of challenges are embedded at every level of social life and include climate change, childhood obesity, as well as many aspects of organisational leadership. It is argued this landscape is fertile ground for PR and can help the field to address its own image problem through a focus on participatory problem solving. Indeed, wicked intelligence generates collaborative and transparent strategies in which relevant stakeholders are engaged to find the best proposal for all stakeholders. This leads to the formulation of a common, agreed approach in which those people who are affected also become participants (Roberts, 2000). In this context stakeholders are not merely consulted but actively involved in the planning process. This further complements an emerging theoretical perspective in PR that conceptualises stakeholder relationships as a social commons characterised by consensus, equity, moral legitimacy and transparency (Willis, 2012).


Statistical Cases exposed Controls exposed Odds significance of Reference Year Location to Debendox to Debendox ratio odds ratio Goldings 1983 Oxfordshire & 196(6.1%) 407 (2.2%) 2.88 0.02 et al.> W. Berkshire (UK) Elbourne 1985 Cardiff (UK) 93(4.3%) 144 (9.0%) 0.43 NS et al.> Aberdeen (UK) 31(6.5%) 17 609(15.7%) 0.37 NS AIDS and mosquitoes To the Editor: I would like to reply to Professor D.G. Penington's response to Dr David Iles' letter (MJA, November 11, 1985). Very little is known about the epidemiology of AIDS in Africa. That the disease afflicts women and men in nearly equal numbers suggests a different epidemiology there than, for example, here in New York City. It is apparent that the agent, or agents, that cause AIDS may be spread in a number of ways apart from sexual encounters between men. The circumstances that are listed by Professor Penington represent a combination of factors that are related to the susceptibility of the host as well as to the transmission of the putative agent (or agents). Ifan agent that is causally associated with AIDS were to be transmitted by mosquitoes, in addition to other ways, it could be added to a long list of agents of infectious diseases with multiple modes of transmission. Having worked in Uganda, I am aware of the danger of believing estimates that are based on urban-biased incidence rates of disease. The true rates of African AIDS are not known. Even if AIDS in Africa really is an urban phenomenon, it does not rule out the mosquito as a possible vector. Mosquitoes transmit disease agents within relatively short distances in the environment. The transmission of disease is a function of the concentration of susceptible humans as well as of the availability of pathogens, and relates mainly to defects in sanitation. Sanitary problems, as well as population densities, are often greatest in the urban areas of the Third World. Transmission mechanisms as well as host susceptibility may be quite different in Africa from in the United States or in Australia. As possible vectors of disease agents, mosquitoes or other insects could be vehicles for the expression of the unique epidemiology of AIDS in Africa. Factors that are related to' host susceptibility would play an important part in this. Given our obviously poor understanding of the epidemiology of AIDS, especially in Africa, it is counter-productive to reject any plausible explanation out of hand. James R. Hebert, SeD Division of Epidemiology American Heart Foundation East 43rd Street New York. NY 10017. USA


The North East Greenland Ice Stream (NEGIS) is delineated by well-defined shear margins, which are evident in the gradient of surface velocity field as well as in the surface topography, where they form troughs up to ten meters deep. In the upper part of the ice stream the margins appear not to be linked to bedrock topography. To understand this efficient system of mass transport towards the ocean it is essential to investigate the nature of the shear margins, as here very localized deformation decouples the inner ice stream from the slower flowing surrounding ice sheet. This process is influenced by several factors and feedback mechanisms, including the crystal fabric orientation, strain heating and localization of meltwater. In summary, the shear margins are area-wise a small part of the ice stream itself, but the processes leading to the localization of deformation are of similar importance for ice discharge as the processes enabling fast flow of the main trunk over the bed.

We present results from an airborne radar survey with the AWI Ultra-Wide Band Radar system, covering an area 150 km upstream and 100 km downstream of the deep drilling site on the ice stream (EGRIP). Over the survey area the ice stream accelerates from 12 m/a to 75 m/a. We focus on the signatures of the shear margins in the radar data. In the regions of localized shear, the internal reflections in the radargrams show disturbances in the form of steep undulations, or chevron folds, which are intensified with ongoing shear. As the ice stream has been covered with 36 flow-perpendicular radar sections we are able to show the evolution of these characteristic signatures over the survey area, and thus, as an analog, over time. 3D-representations of the folded stratigraphic layers reveal how new folds are formed when the ice stream widens and how older structures are preserved in the outer part of the main trunk, where they are no longer subject to shear. Furthermore, we link the change of the shape of the internal reflections in the shear zones to a strain rate field calculated from high resolution flow velocities derived by TerraSAR-X data.


Carotid bruits need to be investigated without delay. The best imaging procedure available is color-coded duplex ultrasonography in the hands of an experienced examiner. Intra-arterial digital subtraction angiography should be used only when a surgical option appears indicated and the surgeon requests it prior to the operation. Determination of the intima/media thickness with the aid of the B scan provides good prognostic information. In the case of higher-grade stenoses with corresponding symptomatology, carotid surgery is indicated. Before carrying out such operations, however, the patient's risk and the surgery-related risk of a stroke or some other event occurring must be carefully weighed, one against the other, with the results achieved by the surgeon in this area being a major factor.


The main aim of this paper is to analyze the consequences in foreign trade, transportation and the credit system of a nation because of the strengthening of the economic organism, through the economic and political reformation. The paper refers to the case of the Romanian Economy for the period 1859-1918. Romania's modernization and development are the result of the contribution brought by the thinkers of that time, especially by the radical liberal thinkers. At the same time, we should not neglect the participation, more modest however, of the conservative thinkers and their contribution in the economic development of the country.


We consider the high-energy astrophysics of the inner ∼200 pc of the Galaxy. Our modelling of this region shows that the supernovae exploding here every few thousand years inject enough power to (i) sustain the steady-state, in situ population of cosmic rays (CRs) required to generate the region's non-thermal radio and TeV γ-ray emission; (ii) drive a powerful wind that advects non-thermal particles out of the inner Galactic Centre; (iii) supply the low-energy CRs whose Coulombic collisions sustain the temperature and ionization rate of the anomalously warm envelope H 2 detected throughout the Central Molecular Zone; (iv) accelerate the primary electrons which provide the extended, non-thermal radio emission seen over ∼150 pc scales above and below the plane (the Galactic Centre lobe); and (v) accelerate the primary protons and heavier ions which, advected to very large scales (up to ∼ 10 kpc), generate the recently identified Wilkinson Microwave Anisotropy Probe (WMAP) haze and corresponding Fermi haze/bubbles. Our modelling bounds the average magnetic field amplitude in the inner few degrees of the Galaxy to the range 60 < B/μG < 400 (at 2σ confidence) and shows that even TeV CRs likely do not have time to penetrate into the cores of the region's dense molecular clouds before the wind removes them from the region. This latter finding apparently disfavours scenarios in which CRs - in this starburst-like environment - act to substantially modify the conditions of star formation. We speculate that the wind we identify plays a crucial role in advecting low-energy positrons from the Galactic nucleus into the bulge, thereby explaining the extended morphology of the 511 keV line emission. We present extensive appendices reviewing the environmental conditions in the Galactic Centre, deriving the star formation and supernova rates there, and setting out the extensive prior evidence that exists, supporting the notion of a fast outflow from the region.


ABSTRACT Bacteria belonging to the Burkholderia cepacia complex (BCC) are important opportunistic pathogens that lead to respiratory infections in patients with cystic fibrosis (CF). The clinical outcome following colonization with BCC bacteria is highly variable, and so far, unpredictable. A large percentage (80 to 90%) of BCC isolates from CF patients produce the exopolysaccharide (EPS) cepacian, which has been hypothesized to play a role in the colonization and persistence of these bacteria in the CF lung. In this work, we demonstrate that although it is not required for the initiation of biofilm formation, cepacian plays a role in the establishment of thick biofilms. This conclusion was based on a comparison of the abilities of EPS-defective mutants derived from a B. cepacia mucoid CF isolate by random plasposon insertion mutagenesis and the ability of the parental strain to form biofilms. However, the systematic characterization of 108 CF isolates, corresponding to 15 distinct strains, indicated that other strain-dependent factors are also involved in the development of thick, mature biofilms. The isolates examined belonged to the species B. cepacia, B. multivorans, B. cenocepacia, and B. stabilis and were obtained during a 7-year period of surveillance from 21 CF patients receiving care at the major Portuguese CF center. Most of them (90%) were serial isolates from 12 persistently infected patients. In spite of the concept that bacteria growing in biofilms display more resistance to antibiotics and to host phagocyte killing than do planktonically growing cells, no clear correlation could be established between the ability of the various strains examined to produce EPS and/or to form biofilms in vitro and the persistence or virulence of the respiratory infections they caused in different patients.


Abstract - This paper presents a carbon nanotube (CNT) triode-structure field emitter as an ion source in a micro time-of-flight mass spectrometer(TOF-MS). In the ion source by field emission, the electrons emitted from cathodes under an electric field accelerated to the anode and ionize gas molecules by impact before arriving the anode. The generated positive ions are to be accelerated to the ion collector. Whereas most of ions are drawn to the cathodes in diode field emitters, a grid in the triode field emitter prevents the ions from being drawn to the cathodes. The triode field emitter is fabricated by micromachining. The cathode is composed of six CNT cylinders. The total size of the fabricated device is 8.0 × 7.3 × 1.9 mm 3 . The anode and the grid current of the fabricated CNT field emitter were measured for various anode and grid voltages. When the anode and the grid voltages are 1000 V and 990 V, respectively, the emission current passing through the ionization region is 8.6 ㎂, which is a sufficient emission current for ionization and mass spectrometry.Key Words : Micro mass spectrometer, Electron emitter, Carbon nanotube, Triode, Micromachining*준 회 원 : 아주대학교 전자공학과 석사과정** 정 회 원 : 아주대학교 전자공학과 박사과정***비 회 원 : 아주대학교 물리학과 박사후과정§비 회 원 : 아주대학교 물리학과 교수․공학박사† 교신저자, 정회원 : 아주대학교 전자공학과 교수․공학박사E-mail : firstname.lastname@example.com 접수일자 : 2012년 2월 17일 최종완료 : 2012년 5월 9일


The threat of lower limb loss is seen commonly in severe crush injury, cancer ablation, diabetes, peripheral vascular disease and neuropathy. The primary goal of limb salvage is to restore and maintain stability and ambulation. Reconstructive strategies differ in each condition such as: Meticulous debridement and early coverage in trauma, replacing lost functional units in cancer ablation, improving vascularity in ischaemic leg and providing stable walking surface for trophic ulcer. The decision to salvage the critically injured limb is multifactorial and should be individualised along with laid down definitive indications. Early cover remains the standard of care, delayed wound coverage not necessarily affect the final outcome. Limb salvage is more cost-effective than amputations in a long run. Limb salvage is the choice of procedure over amputation in 95% of limb sarcoma without affecting the survival. Compound flaps with different tissue components, skeletal reconstruction; tendon transfer/reconstruction helps to restore function. Adjuvant radiation alters tissue characters and calls for modification in reconstructive plan. Neuropathic ulcers are wide and deep often complicated by osteomyelitis. Free flap reconstruction aids in faster healing and provides superior surface for offloading. Diabetic wounds are primarily due to neuropathy and leads to six-fold increase in ulcerations. Control of infections, aggressive debridement and vascular cover are the mainstay of management. Endovascular procedures are gaining importance and have reduced extent of surgery and increased amputation free survival period. Though the standard approach remains utilising best option in the reconstruction ladder, the recent trend shows running down the ladder of reconstruction with newer reliable local flaps and negative wound pressure therapy.


Gingival recession leading to exposure of crown margins or extensive areas of the tooth root can cause significant aesthetic difficulties. Surgical innovations over the last decade have enabled the periodontist to correct such problems with greater predictability and improved aesthetics. The current surgical procedures for treatment of gingival recession are described and illustrated, and criteria for selection of the appropriate procedure are presented. The learning objective of this article is a review of the surgical procedures and an increased predictability in implementation.


Focussing on narratives collected during a two year participant observation research project in the children's services department of an urban local authority, this article addresses the intersection between incidents of permanent exclusion from school and assumptions made on the basis of a young person's gender. The article considers gendered class reproduction through the choice of GCSEs; gender normativity in single sex schools; and the relationship between domestic violence and sexual aggression in incidents of school exclusion. It finishes with an account of some of the work being done to develop the professionals' support strategies and young people's self-management skills necessary to tackle these effects.


Background : Diagnosis of separation anxiety disorder (SAD) in childhood is a critical risk factor of mental health in adulthood. Etiology studies have indicated the significant role of parental psychological factors in children with SAD phenomena. The purpose of present study was to investigate the effectiveness of parental reflective functioning -based psycho-educational program on improvement of children with separation anxiety disorder. Methods : A single-case experimental design with multiple baselines has been utilized to conduct present study. Subjects of the study included 4 parents (two mothers and two fathers) with children suffering from separation anxiety disorder who referred to psychiatric counseling center and clinic of child and adolescent psychiatrist in Mashhad during May and June of 2010. These parents were selected through convenience purposeful sampling method based on inclusion and exclusion criteria and participated in 12 sessions (two sessions per week) of a parental reflective functioning-based psycho-educational program. The participants completed the parent-separation anxiety questionnaire in three stages of baseline during the implementation of the program (in sessions 5, 9 and 12) as well as one month after follow-up. The obtained data were analyzed using indicators of Percentage recovery / PR, Effect size and Reliable Change Index (RCI). Results : At the end of the psycho-educational program, the results indicated a significant clinical decrease in the severity of separation anxiety in all four parents. at the end of psycho-educational program, the total score of recovery percentage for the first, second, third and fourth subjects was equal to 70.86, 71.30, 72.21 and 70.96, respectively. The RCI indicator of subjects was -9.93, -10.97, -11.59 and -11.26, respectively. Also, the effect size for the first, second, third and fourth subjects were equal to 7.43, 8.21, 8.67 and 8.43, respectively. Moreover, the overall improvement of all four subjects in subscales of fear of being left alone, fear of abandonment, fear of physical illness and fear of dangerous events was 66.75%, 71.10%, 70.39% and 71.73%, respectively which the values were significant in the clinical term. This improvement process continued throughout the follow-up period. Conclusions : according to research findings, the parental reflective functioning-based psycho-educational program has a positive effect on improving the symptoms of separation anxiety disorder in children. Therefore, it is recommended to utilize from this program in treatment interventions for separation anxiety disorder. Keywords: separation Anxiety Disorder, Psycho-Educational Program, Parental Reflective Functioning.


Purpose

The inclusion of modern slavery in the Care Act 2014 as a form of abuse means that the subject of modern slavery is now included in the remit of adult safeguarding in England. The purpose of this paper is to discuss the background to the Modern Slavery Act 2015 and its provisions.

Design/methodology/approach

A policy analysis was undertaken in 2016 drawing on research and commentary related to the interface between modern slavery and adult safeguarding.

Findings

There is little material as yet focussing on adult safeguarding and modern slavery but the inclusion of modern slavery in this area of practice and organisations will require practitioner responses, organisational collaboration and revisions of data collection and analysis. Newspaper accounts of criminal charges under the Modern Slavery Act 2015 may be important first evidence of the interface potentially between modern slavery and adults at risk of abuse and neglect that are the focus of adult safeguarding concern.

Practical implications

Information about modern slavery may provide relevant background and contextual detail for adult safeguarding communities, furnishing links and resources for this new area of their work.

Originality/value

This paper is likely to be of interest to policymakers, researchers and practitioners in examining their new duties under the Care Act 2014 and the Modern Slavery Act 2015, and to wider public and private bodies considering their responsibilities in responses to modern slavery more broadly.


Ninety-three postoperative patients 1 day to 13 years of age had blood cultures, limulus lysate assay, determination of fibrin degradation products, white blood cell and platelet counts. Seven groups were studied. The limulus lysate assay, was often positive (64%) in the presence of gram negative septicemia but there were false positives and negatives. The tests for fibrin degradation products were inconsistent. The white blood cell count was low in habites with gram negative septicemia. One hundred per cent of the infants with gram negative septicemia had a platelet count below 150,000; 71% below 100,000 (average 67,000 septic babies, 257,000 non-septic babies). The drop in platelet count with gram negative septicemia was abrupt-as much as 222,000 in 24 hours. Platelets increased when therapy was effective. Two children with gram negative septicemia had platelet counts of 50,000 and 20,000. The platelet count for patients with gram positive septicemia was 299,000, and above 150,000 in all children with ruptured and non-ruptured appendicitis and major surgery without gram negative septicemia. It was concluded that serial measurements of platelet count in the postoperative infant and child was a rapid and reliable method for early detection of gram negative septicemia and changes in platelet count in response to treatment was an indicator of the effectiveness of therapy.


— A global search optimization system is applied for design of a horizontal axis tidal current turbine with shroud. 11 design parameters of the turbine blade and 4 design parameters of the shroud casing are considered for the optimization search by a genetic algorithm. For reducing the simulation cost, a neural network is applied as the meta-model of the RANS solver. Multi-objectives of a power coefficient at different tip speed ratio are applied for giving a function of wide operating range of the turbine. A proposed optimized design of the turbine shows a high output shaft power under a low tip speed ratio. Internal flow of the optimized horizontal axis tidal current turbine is discussed in detail. It is found that the optimized blade generates swirling flow and suppress flow separation at the diffuser wall. The wide angle of the diffuser successfully achieves higher pressure recovery ratio and results in a high suction power at the inlet of the turbine. It is found that the high performance tidal turbine is possible to design if both the blade and the shroud diffuser are optimized in same time.


Introduction Chronic, non-cancer pain impacts approximately 50 million adults in the USA (20%), approximately 25% of whom receive chronic prescription opioids for pain despite limited empirical efficacy data and strong dose-related risk for opioid use disorder and opioid overdose. Also despite lack of efficacy data, there are many reports of people using cannabis products to manage chronic pain and replace or reduce chronic opioids. Here we describe the protocol for a randomised trial of the effect of cannabis, when added to a behavioural pain management and prescription opioid taper support programme, on opioid utilisation, pain intensity and pain interference. Methods This is a pragmatic, single-blind, randomised, wait-list controlled trial that aims to enrol 250 adults taking prescription opioids at stable doses of ≥25 morphine milligram equivalents per day for chronic non-cancer pain who express interest in using cannabis to reduce their pain, their opioid dose or both. All participants will be offered a weekly, 24-session Prescription Opioid Taper Support group behavioural pain management intervention. Participants will be randomly assigned in 1:1 ratio to use cannabis products, primarily from commercial cannabis dispensaries or to abstain from cannabis use for 6 months. Coprimary outcomes are change in prescription monitoring programme-verified opioid dose and change in Pain, Enjoyment, General Activity scale scores. Secondary outcomes include quality of life, depression, anxiety, self-reported opioid dose and opioid and cannabis use disorder symptoms. All other outcomes will be exploratory. We will record adverse events. Ethics and dissemination This study has ethical approval by the Massachusetts General Brigham Institutional Review Board (#2021P000871). Results will be published in peer-reviewed journals and presented at national conferences. Trial registration number NCT04827992.


In the present state of Posttertiary geology it is of very great importance (as may be inferred from the Presidential address just published, May 1875) that some one should attempt to correlate the deposits in caves with the glacial drifts of the neighbourhood. I therefore venture to bring before the Society a brief statement of the results of observations lately made in and around the Cefn and Pont-newydd Caves, Denbighshire. These caves are situated near to each other in the face of a limestone escarpment, on the north bank of the river Elwy. The Pont-newydd cave has been described by Professor M'Kenny Hughes and the Rev. D. E. Thomas, in the Journal of the Anthropological Institute (vol. iii. p. 387), and by Mr. W. Boyd Dawkins, F.R.S., in his work on Cave Hunting. By these writers the cave-deposits are regarded as Postglacial. The best account of Cefn Cave, as it existed before the deposits were nearly all cleared out, is perhaps to be found in Mr. Joshua Trimmer's 'Practical Geology,' published in 1841, the following being the order of succession therein stated or implied:— 1. Sand, silt, and marl, with sea-shells in one or more places (uppermost). 2. Loam, with angular fragments of limestone and bones, filling the cavern nearly to the roof (diluvium of old authors). 3. Crust of stalagmite. 4. Loam, with smooth pebbles, bones, teeth, and fragments of wood (lowest). Mr. Trimmer believed that the lowest of these deposits was introduced, before the glacial submergence, by the adjacent river while flowing


A major impediment to the development of spiny lobster aquaculture has been the inability to rear lobsters from eggs, through the delicate larval stages, to the settling puerulus stage. An alternative is to harvest pueruli from the wild for commercial on-growing. However, wild harvest of pueruli can potentially have a deleterious effect on the adult lobster fishery. Research presented here investigates both the feasibility and sustainability of an industry based on the harvest of southern rock lobster (Jasus edwardsii) pueruli.
Pueruli were found to settle on a diverse range of substrata. Cheap, lightweight puerulus collectors constructed from readily available materials, such as trawl netting and shade cloth, proved to be significantly more cost-effective for large-scale harvest than collectors currently in use for scientific monitoring of puerulus settlement.
A system of 'reseeding' wild habitat with hatchery-reared juveniles was evaluated as a method of ensuring sustainability of wild populations. Reseeding involves the release of a portion of ongrown ( na'ive) juveniles after one year to compensate for those that would have survived in the wild, and its success is predicated on high survival among released juveniles.
Naive juvenile lobsters tracked acoustically behaved in a similar manner to wild animals, sheltering in appropriate hides during the day, often co-habiting with wild conspecifics, and then moving at night. The highest levels of activity occurred in the 12 h following release, while the distances moved by individual lobsters declined rapidly after this initial period. Stomach contents of tracked lobsters recaptured after 11 days revealed that na'ive lobsters adapted well to wild food sources, although their diet differed from that of wild lobsters.
Mortality rates of tethered juvenile lobsters varied substantially between sites in southeastern Tasmania. However, these differences were not significant once results were corrected for experimental artefacts associated with differences in the predator assemblages among sites. Video footage of tethering trials showed that large wrasse and small octopus were the major predators of juvenile lobsters. Crabs and large lobsters also captured tethered juveniles, however experiments in a mesocosm showed that these captures were artefacts of tethering.
Survival of naive lobsters estimated from mark-recapture trials was generally equivalent to that of tagged wild lobsters. An exception was where lobsters were released onto a small area of isolated patch-reef. Here, naive lobsters tended to ignore reef boundaries, moving away from shelter and onto sand. These results suggest that by following simple criteria in the selection of release sites, mortality among released naive lobsters is minimal, and equivalent to that of wild juveniles at the same stage. The overall conclusion is that reseeding is an effective method of compensating for puerulus harvest.


Background: Explanatory models represent patient understanding of etiology, pathophysiology, illness, symptoms, and treatments, but little attention has been paid to how they are used by patients "at risk" for future disease. Objective: The aims of this study were to elucidate what constitutes an explanatory model of risk and to describe explanatory models of risk related to developing breast cancer. Methods: Thirty qualitative interviews with women identified as at an increased risk for breast cancer were conducted. Interviews were coded to identify domains of explanatory models of risk using a priori codes derived from the explanatory model of illness framework. Within each domain, a grounded thematic analysis described participants' explanatory models related to breast cancer risk. Results: The domains of treatment and etiology remained similar in a risk context compared with illness, whereas course of illness, symptoms, and pathophysiology differed. We identified a new, integrative concept relative to other domains within explanatory models of risk: social comparisons, which was dominant in risk perhaps due to the lack of physical experiences associated with being "at risk." Conclusions: Developing inclusive understandings of risk and its treatment is key to developing a framework for the care of high-risk patients that is both evidence based and sensitive to patient preferences. Implications for Practice: The concept of "social comparisons" can assist healthcare providers in understanding women's decision making under conditions of risk. Ensuring that healthcare providers understand patient perceptions of risk is important because it relates to patient decision making, particularly due to an increasing focus on risk assessment in cancer.


Taguchi experimental design (TED) is applied to find the optimum effectiveness of aqueous Red Pomegranate Peel (RPP) extract as a green inhibitor for the corrosion of mild steel in 2M H3PO4 solution. The Taguchi methodology has been used to study the effects of changing, temperature, RPP concentration and contact period, at three levels. Weight-loss measurements were designed by construction a L9 orthogonal arrangement of experiments.   Results of the efficiencies of inhibition were embraced for the signal to noise proportion & investigation of variance (ANOVA).  The results were further processed with a MINITAB-17 software package to find the optimal conditions for inhibitor usage. Second order polynomial model was used for experimental data fitting. Optimum conditions for achieving the maximum corrosion inhibition efficiency are obtained from optimizing the above model and are found as follow: 39.66 °C temperature of acidic media, 38.29 ml/L inhibitor concentration and 2.95 h contact period. Results demonstrated that rate of corrosion was increased with temperature increasing & decreasing inhibitor concentration.  It was concluded that the Taguchi design was adequately useful in the optimization of operating parameters and that RPP sufficiently inhibited the corrosion of steel at the range of variables studied.


We propose a two-stage tectonic evolution of SE Afar in Djibouti leading to the complex development of highly asymmetric conjugate margins. From c. 8.5 to c. 2 Ma, an early mafic crust developed, associated in the upper crust with synmagmatic growth faults dipping dominantly to the SW. After an erosional stage, a new detachment fault system developed from c. 2 Ma with an opposite sense of motion (i.e. to the NE), during an amagmatic extensional event. In the Asal area, break-up occurred after c. 0.8 Ma along the footwall of an active secondary detachment fault rooted at depth above the lithospheric necking zone. This evolution suggests that flip-flop detachment tectonics is developed during extension at passive margins, in connection with the dynamics of the melting mantle and the associated magma plumbing of the crust.


Background/aims Closure is more difficult to achieve in macular holes that remain open following a previous unsuccessful pars plana vitrectomy (PPV). We present our results with the internal limiting membrane (ILM) translocation technique that is used to optimise outcomes in refractory macular holes. Methods A prospective, interventional, case series was conducted. 12 eyes of 12 consecutive patients with incomplete sealing of the macular hole (open and type 2 closure) after a previous PPV with ILM peeling were included. Measured baseline parameters included best-corrected visual acuity (BCVA) and macular hole smallest diameter, base diameter and height. Surgeries were performed by harvesting a fragment of the ILM near the vascular arcades and subsequently placing it inside the hole. Postoperative measured outcomes included macular hole status, foveal contour, outer retina integrity, BCVA and surgery-related complications. Results Anatomic closure occurred in 11 of 12 eyes (91%). This technique elicited a statistically significant improvement in BCVA (p=0.008). Mean BCVA was 20/400 at study baseline and 20/160 at final follow-up. However, less than 16.7% of cases had a final BCVA of ≥20/63. Conclusion The ILM translocation technique seems to facilitate persistent idiopathic macular hole closure, where primary surgery with PPV and ILM peeling failed.


There are difficulties in the use of the available media comparatively and contrastively with elements that may impact positively or negatively on consumers as the media carries the messages to the target audience for decisions on choice of products. The products in the market place do not get adequate media exposure and consumers lack sufficient knowledge of what the market can offer. The use of survey was adopted and the population of study was the media, the agency, advertisers and selected consumers as judgemental sampling was used. The data collection was by questionnaire and interview and presented in percentages while analysis was by deductive reasoning. The findings were that the media in Nigeria – Electronic, print, out of home and other media lacked digital equipment, accessibility and availability for modern advertising that support mass marketing of products. The maximisation of the media has no substitute for success in advertising and has to provide sufficient information about products and markets to consumers in the target market. Keywords: Media, Advertising, Nigeria