Among 1,118 admissions for acute ischemic heart disease to St. Luke's Hospital in Malta during 1963-72, there were 945 (84.5%) cases of acute myocardial infarction (AMI) and 173 (15.5%) cases of acute coronary insufficiency (ACI). The ratio of AMI to ACI was higher among diabetic than among nondiabetic patients, especially among women. In comparison with the nondiabetic AMI patients, the diabetics, especially women, had a significantly longer interval between onset of symptoms and hospitalization and more often had painless infarcts, both of which resulted in delay of adequate treatment; the diabetics with AMI han more complications and a significantly higher case fatality rate (20.8vs. 14.3% for nondiabetics; in diabetic women the rate was 24.1%). in fatal cases of AMI the mean age at death was lower among diabetics than among nondiabetics. In fatal cases among diabetics death was more often associated with an anteroseptal AMI site, and was the result of one or more of the following: left heart failure (61.6%), shock (38.3%), sudden death from ventricular fibrillation (13.3%), atrioventricular block (8.3%), or systemic or pulmonary arterial thromboembolism (6.5%); it was very rarely the result of diabetic ketosis.


Abstract Silicification of higher plants associated with active, alkali-chloride hot springs in Yellowstone National Park, Wyoming, USA, occurs dominantly in areas of geothermally influenced wetlands. Plants grow in an environment with many of the characteristics of an oligosaline marsh and are subjected to brackish salinity and high pH, temperature, silica, and heavy metal concentrations. As such, the plants undergoing silicification at Yellowstone are predominantly those more typically found colonizing widespread evaporation-driven inland waters and coastal salt marshes (e.g., Eleocharis rostellata, Triglochin maritimum) and are in some ways preadapted to hot-spring settings. This paper documents hydrochemistry and physical parameters in a typical geothermally influenced wetland at Big Blue Hot Spring, Elk Park in Yellowstone and records the taphonomic processes involved in silicification of the most common wetland plant Eleocharis rostellata. Silicification of plants in situ results in the three-dimensional preservation of tissues and cells characteristic of plants preserved around the Lower Devonian Rhynie chert hot-spring system. Sinter deposition at active and fossil hot-spring areas is typically associated with alkali-chloride springs above low-sulfidation epithermal systems. As mineralogical and geological evidence indicates that such a system was responsible for preservation of the Rhynie plants, it is hypothesized that they too, at least periodically, withstood comparable physiological stresses to the modern analogs.


This essay examines two historical documents—David Walker's Appeal to the Coloured Citizens of the World and Martin R. Delany's The Condition, Elevation, and Destiny of the Colored People published in 1929 and 1952, respectively—to stress the rhetorical astuteness of African-Americans writing from the margins in hostile antebellum America. The essay argues that, rhetorically these documents expose America's weaknesses and contradictions between the principles of freedom that motivated the country's founding fathers and the compromises that recognised and permitted the continuation of slavery. Specifically, these rhetoricians exploit and subvert Thomas Jefferson's paradoxical, if not conflicting, thesis on the status of African-Americans in America to advance their argument. We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights that among these are Life, Liberty, and the Pursuit of Happiness.


In this letter, we analyze the effects of electrical parasitics and drive impedance on the laser modulation response. It is found that for lasers with small active-region volume, e.g., vertical-cavity surface-emitting lasers, the finite drive impedance and/or the laser parasitic capacitance can significantly enhance the damping of the laser resonance peak at low bias. This is due to the voltage fluctuations across the laser diode active layer during modulation. It is also shown that the real pole of the small-signal response transfer function corresponding to the laser parasitic cutoff frequency is not fixed but decreases with the increased bias level.


Continuously variable transmissions (CVT) can be used to operate a combustion engine in a more optimal working point. Unfortunately, due to the relatively low efficiency of modern production CVT's the total efficiency of the driveline is not increased significantly. This low efficiency is mainly caused by losses in the hydraulic actuation system and the variator. Decreasing the clamping forces in the variator greatly improves the efficiency of the CVT. However, lower clamping forces increase the risk of excessive belt slip, which can damage the system. In this paper a method is presented to measure and control slip in a CVT in order to minimize the clamping forces while preventing destructive belt slip. To ensure robustness of the system against torque peaks, a controller is designed with optimal load disturbance response. A synthesis method for robust PI(D)-controller design is used to maximize the integral gain while making sure that the closed loop system remains stable. Experimental results prove the validity of the approach.


Developing countries are facing sever productivity problems in their construction sectors. Lean Construction has proven to be an effective solution for such situations. However, when it comes to lean implementation, the operational attributes of the countries can cause significant impacts on the priorities, tools and techniques. This paper took Iranian construction as a sample and sought to identify and prioritise the factors that could significantly contribute to the success of the lean implementation in its context. A comprehensive literature review identified 44 critical success factors (CSFs) in a global setting. The factors were classified into four groups and were presented to industry and/ or academic professionals in the form of semi-structured open-ended interviews that enabled collecting experts' opinion about the priorities to be given. A thematic analysis of the results indicated that lack of awareness and knowledge of lean construction is the main obstacle for the Implementation. It was also established that more priority should be given to Organisational and Project Management Factors when creating Lean Construction implementation roadmap of the country. This is the first study of its type in Iran and is expected to shed light on the factors that can turn the implementation of Lean Construction a successful story, even in this unfavourable context.


A parametric study of cold-formed steel sections with web openings subjected to web crippling was undertaken using finite element analysis, to investigate the effects of web holes and cross-section sizes on the web crippling strengths of channel sections subjected to web crippling under both interior-two-flange (ITF) and end-two-flange (ETF) loading conditions. In both loading conditions, the openings were located at the mid-depth of the webs. It was demonstrated that the main factors influencing the web crippling strength are the ratio of the hole depth to the flat depth of the web, the ratio of the distance of the hole from the edge of the bearing plates to the flat depth of the web and the ratio of the length of bearing plates to the flat depth of the web. In this paper, design recommendations in the form of web crippling strength reduction factors are proposed; these are shown to be conservative to both the experimental and finite element results.


Canterbury Christ Church University (CCCU) have been involved in police education with serving police officers for over twenty years. The College of Policing (COP) are currently considering a range of options to develop learning within the police organisation and this involves a drive for more officers to be degree educated. The responses to a recent public consultation on this proposal involved some differing views on its introduction.

Some of the criticism coming from officers themselves about the proposal argues that there is a limited evidence base for degree level entry and this small study provides some insight into this world.

This paper will discuss the findings from interviews conducted with police graduates from CCCU following their completion of either a BSc or MSc degree programme in Policing. It will discuss police officers' perceptions of their ability to utilise the learning they have gleaned in the classroom and how it is received from their supervisors and peers.

The aim of the drive to increase education in policing focuses on the need for students to develop critical thinking skills, to further apply knowledge and their problem solving abilities.

The research found that police officer graduates felt these skills were enhanced as a result of undertaking a degree, and felt empowered to apply their knowledge. However, findings indicated inconsistencies as to whether this knowledge was applied in practice. This often depended on whether an officer's immediate and senior management were receptive to embrace learning, more often than not there was a lack of willingness from management to 'hear' the learning from the police graduates interviewed in this study. Therefore, this research found that in order to embed knowledge systematically, a wider infrastructure is required to facilitate this at every rank of the police organisation.


An important role for melatonin in bone formation and restructuring has emerged, and studies demonstrate the multiple mechanisms for these beneficial actions. Statistical analysis shows that even with existing osteoporotic therapies, bone‐related disease, and mortality are on the rise, creating a huge financial burden for societies worldwide. These findings suggest that novel alternatives need to be developed to either prevent or reverse bone loss to combat osteoporosis‐related fractures. The focus of this review describes melatonin's role in bone physiology and discusses how disruption of melatonin rhythms by light exposure at night, shift work, and disease can adversely impact on bone. The signal transduction mechanisms underlying osteoblast and osteoclast differentiation and coupling with one another are discussed with a focus on how melatonin, through the regulation of RANKL and osteoprotegerin synthesis and release from osteoblasts, can induce osteoblastogenesis while inhibiting osteoclastogenesis. Also, melatonin's free‐radical scavenging and antioxidant properties of this indoleamine are discussed as yet an additional mechanism by which melatonin can maintain one's bone health, especially oral health. The clinical use for melatonin in bone‐grafting procedures, in reversing bone loss due to osteopenia and osteoporosis, and in managing periodontal disease is discussed.


: Combi laser therapy was evaluated in 50 cases of established post herpetic neuralgia (PHN). Established PHN term was used when neuralgia persisted after 3 months of disappearance of herpes zoster (HZ) vesicles. Twenty exposures were given and affected areas were irradiated from a distance of 2 cm at a frequency of 5000 Hz each area being exposed for a period of 1.23 minutes ie, 8J/cm2 of beam was given. Therapeutic evaluation was done on 4th, 8th, 12th, 16th, and 20th day. All 17 cases of established PHN of duration upto 3 months healed after 16 exposures and in the end 44/50 had cure, 5/50 had partial relief and one patient left trial after 2nd exposure.


In this paper, we deal with the influence of the spatial structure, which limits the communication of agents, on the characteristics of individual agents. We investigate the population characteristics and the behavior of the agents playing iterated prisoner's dilemma (IPD) games on the spatial structure. We first propose a new agent model that plays the IPD game, which contains the gene of the coded parameters of reinforcement learning. The agents evolve and learn while playing the games. Second, we report an empirical study. In our simulation, we observe that the spatial structure affects learning and evolution. Learning is generally not conducive to the mutual cooperation between agents, except in some special conditions. Then, we try to control the population characteristics. We find that they are controllable to some extent when we fix the strategies of several agents.


Authorities often lack information for efficient regulation of the commons. This paper derives a criterion comparing prices versus tradable quantities in terms of expected welfare, given uncertainty, optimal policy and endogenous cost structure. I show that one cannot determine which regulatory instrument that induces the highest expected welfare based on the relative curvatures of the cost and benefit functions alone. Furthermore, optimal policy involves different production (or price) targets across the regulatory instruments, and does not equalize marginal costs and expected marginal benefits under prices. The reason is that firms choose a cost structure which induces exaggerate fluctuations in consumption of the public good under prices, and the regulator has to compensate for this when determining optimal policy. Because no such negative externality arises under quantities, the relative performance of prices is deteriorated. A numerical illustration suggests significant impact. Finally, either regulatory instrument may induce the highest technology investment levels.


Abstract In a variety of ecosystems, interactions between soil microbiota and weedy plants can strongly affect population and community dynamics of these plants. However, weed–soil microbe interactions are not well characterized in field-crop agroecosystems. In Minnesota (USA), we repeatedly applied a fungicide (benomyl) to field plots in a corn–soybean crop rotation in each of 3 years, and sowed experimental weed communities containing host species for arbuscular-mycorrhizal fungi (AMF) and non-host species. Benomyl typically suppresses formation of mycorrhizal symbiosis in AMF-host plant species, and may also affect other soil fungi. We assessed weed density and biomass production, and monitored AMF colonization rates in each of 3 years. We found that weed density, biomass, community composition and the relative performance of AMF-host and non-host weed species were all significantly responsive to fungicide applications, although for all attributes responsiveness was variable. Fungicide application increased total weed density and biomass production in nearly all cases; most effects were modest but reached a maximum of 49%. Fungicide application also increased the relative performance of non-host species in most cases, although most effects were again modest. Our findings are the first assessment of responses by field-crop weeds to direct manipulation of soil microbial communities in a field setting, and suggest that the population and community ecology of these weeds can be strongly affected by the fungal component of soil microbiota.


Abstract Okayasu, R., Okada, M., Okabe, A., Noguchi, M., Takakura, K. and Takahashi, S. Repair of DNA Damage Induced by Accelerated Heavy Ions in Mammalian Cells Proficient and Deficient in the Non-homologous End-Joining Pathway. Radiat. Res. 165, 59–67 (2006). Human and rodent cells proficient and deficient in non-homologous end joining (NHEJ) were irradiated with X rays, 70 keV/μm carbon ions, and 200 keV/μm iron ions, and the biological effects on these cells were compared. For wild-type CHO and normal human fibroblast (HFL III) cells, exposure to iron ions yielded the lowest cell survival, followed by carbon ions and then X rays. NHEJ-deficient xrs6 (a Ku80 mutant of CHO) and 180BR human fibroblast (DNA ligase IV mutant) cells showed similar cell survival for X and carbon-ion irradiation (RBE = ∼1.0). This phenotype is likely to result from a defective NHEJ protein because xrs6-hamKu80 cells (xrs6 cells corrected with the wild-type KU80 gene) exhibited the wild-type response. At doses higher than 1 Gy, NHEJ-defective cells showed a lower level of survival with iron ions than with carbon ions or X rays, possibly due to inactivation of a radioresistant subpopulation. The G1 premature chromosome condensation (PCC) assay with HFL III cells revealed LET-dependent impairment of repair of chromosome breaks. Additionally, iron-ion radiation induced non-repairable chromosome breaks not observed with carbon ions or X rays. PCC studies with 180BR cells indicated that the repair kinetics after exposure to carbon and iron ions behaved similarly for the first 6 h, but after 24 h the curve for carbon ions approached that for X rays, while the curve for iron ions remained high. These chromosome data reflect the existence of a slow NHEJ repair phase and severe biological damage induced by iron ions. The auto-phosphorylation of DNA-dependent protein kinase catalytic subunits (DNA-PKcs), an essential NHEJ step, was delayed significantly by high-LET carbon- and iron-ion radiation compared to X rays. This delay was further emphasized in NHEJ-defective 180BR cells. Our results indicate that high-LET radiation induces complex DNA damage that is not easily repaired or is not repaired by NHEJ even at low radiation doses such as 2 Gy.


Nanostructured materials have shown extraordinary promise for high surface area applications. Here we report the design of polystyrene (PS)-silicone nanofilaments (SNFs) composites, which can be flexibly grown on various substrates. The high surface area achieved by the SNFs is further extended by grafting with polystyrene. By changing the polymerization conditions and post treatment methods, the morphology of grafted PS is easily tuned into three types: leaf-shaped, bead-shaped and well-wrapped. The tuneable morphology of PS is optimized for oil-water separation and photocatalytic reactions and exhibited improved performances.


In the present framework, the q‐homotopy analysis transform method (q‐HATM) we find the solution for the equation describing the interaction between Langmuir waves and the ion‐acoustic waves in the plasma, called Klein–Gordon–Zakharov equations. The projected solution procedure is elegant unification of q‐homotopy analysis technique with Laplace transform. The considered coupled nonlinear system analyzed with the different fractional‐order to ensure the efficiency and applicability of the hired solution procedure. For distinct values of the parameters offered by the considered method and for different fractional‐order, the physical behaviors of achieved solutions are captured in terms of surface and contour plots. To illustrate the accuracy and reliability of the considered method, we conducted the numerical simulation for different fractional order with the change in variables. The obtained results show that, the projected scheme is highly methodical, very effective, easy to implement and accurate to investigate the nature of fractional nonlinear coupled system exemplifying the real‐world problems.


Background: Mobile phone is an integral part of the society used by almost all. Youth in Nigerians are recognized as the most active users of mobile phones. There are about 1.1 billion youth people globally at risk of noise-induced hearing loss from unsafe listening. The awareness and adherence to hearing conservation measures against the hearing-related hazards of mobile phones have not been evaluated in our environment. Aims: To determine the knowledge and adherence to protective measures against the hearing-related hazards of mobile phones among university students. Materials and Methods: The study was a cross-sectional descriptive type, conducted among university students. Ethical clearance was obtained from the institutional review committee, a multistage random sampling technique was used to recruit the participants, and a specially designed and validated questionnaire was used to collect the data. The data were analyzed using Statistical Product and Service Solutions (SPSS) version 20.0. Results: The age of the respondents ranged from 16 to 40 years with a mean age of 23.6 ± 5.3 years. Very few of the participants (19.1%) adhere to protective measures to mitigate hearing-related hazards of mobile phones, although about half (52.1%) had good knowledge of hearing conservation measures. There was a statistically significant association between knowledge of hearing-related hazard of mobile phone (P = 0.038) and knowledge of protective measures (P = 0.000) with the adherence to protective measures, respectively. Conclusions: The knowledge and adherence to protective measures against the hearing-related hazards of mobile phones were poor among the respondents.


Amyotrophic lateral sclerosis refers to a neurodegenerative disease involving the motor system, the cause of which remains unexplained despite several years of research. Thus, the journey to understanding or treating amyotrophic lateral sclerosis is still a long one. According to current research, amyotrophic lateral sclerosis is likely not due to a single factor but rather to a combination of mechanisms mediated by complex interactions between molecular and genetic pathways. The progression of the disease involves multiple cellular processes and the interaction between different complex mechanisms makes it difficult to identify the causative factors of amyotrophic lateral sclerosis. Here, we review the most common amyotrophic lateral sclerosis-associated pathogenic genes and the pathways involved in amyotrophic lateral sclerosis, as well as summarize currently proposed potential mechanisms responsible for amyotrophic lateral sclerosis disease and their evidence for involvement in amyotrophic lateral sclerosis. In addition, we discuss current emerging strategies for the treatment of amyotrophic lateral sclerosis. Studying the emergence of these new therapies may help to further our understanding of the pathogenic mechanisms of the disease.


Abstract Efficacy of conventional opioids can be limited by adverse events (AEs). TRV130 is a structurally novel biased ligand of the &mgr;-opioid receptor that activates G protein signaling with little &bgr;-arrestin recruitment. In this phase 2, randomized, placebo- and active-controlled study, we investigated the efficacy and tolerability of TRV130 in acute pain after bunionectomy. We used an adaptive study design in which 144 patients experiencing moderate-to-severe acute pain after bunionectomy were randomized to receive double-blind TRV130, placebo, or morphine in a pilot phase. After pilot phase analysis, 195 patients were randomized to receive double-dummy TRV130 0.5, 1, 2, or 3 mg every 3 hours (q3h); placebo; or morphine 4 mg q4h intravenously. The primary end point was the time-weighted average change in numeric rating scale pain intensity over the 48-hour treatment period. Secondary end points included stopwatch and categorical assessments of pain relief. Safety and tolerability were also assessed. TRV130 2 and 3 mg q3h, and morphine 4 mg q4h produced statistically greater mean reductions in pain intensity than placebo over 48 hours (P < 0.005). TRV130 at 2 and 3 mg produced significantly greater categorical pain relief than morphine (P < 0.005) after the first dose, with meaningful pain relief occurring in under 5 minutes. TRV130 produced no serious AEs, with tolerability similar to morphine. These results demonstrate that TRV130 rapidly produces profound analgesia in moderate-to-severe acute pain, suggesting that G-protein-biased &mgr;-opioid receptor activation is a promising target for development of novel analgesics.


INTRODUCTION :
Light activated composite resin introduced in 1970 has revolutionized
clinical dentistry by maximizing working time and minimizing the setting
time.62 Thus the clinician has sufficient working time to sculpt the material to
achieve the desired contour to mimic the morphology of the tooth structure.
In the recent years the popularity of esthetic tooth colored restoration
has led to a rapid increase in use of composite resins. The initially introduced
dental composites were chemically cured through amine / peroxide chemistry.
The limitation with the above technique has led to the development of single
component resin composite activated by visible light.
Visible light curing units are an integral part of modern adhesive
dentistry. Visible light activated resin system use a diketone absorber to create
free radical that initiate polymerization. Most dental photo initiator systems
use camphoroquinone as the di-ketone absorber with the absorption maximum
in the blue region of the visible light spectrum at a wave length of 450 –
490nm58. Any source of light that operates in the blue spectrum of visible
light can be employed as a curing source.
The aim and objective of this study is
The aim of this study
1) To test the influence of pulse activation system and conventional
light curing system on the marginal adaptation of polyacid
modified composite resin (compomer) in class V cavity
preparation.
2) To find the degree of cure and depth of cure while using two
different curing modes by measuring VHN at three different
heights (2mm, 3mm, 4mm) and three different loads (50g,
80,110g).
The objective of the study :
To recommend the best curing method that could result in adequate
resin polymerization with improved mechanical properties of the
set material.
MATERIALS AND METHODS ;
This study was done in the Department of Pedodontics and Preventive Dentistry, Ragas Dental and Hospital, Chennai and in collaboration with Central Leather Research Institute and Nuclear Physics Department (Anna University) Chennai, India.
MATERIALS USED :
• COMPOMER (DYRACT AP B2 SHADE)
UDMA resin,
TCB resin,
Strontium flouorosilicate glass,
Strontium fluoride,
Photoinitiators,
Stabilisers.
• PRIME AND BOND NT (Bonding agent)
Di- and trimethacrylate resin.
Amorphous silica,
PENTA,
Photoinitiators,
Stabilisers,
Cetylamine hydrofluoride,
Acetone.
RESULTS ;
The present study was carried out to evaluate the marginal adaptation
of compomer and also the depth of cure of compomers using two different
curing protocols- conventional (group I) and pulse activation system (group
II)
I. For evaluating the influence of light activation system
(conventional and pulse activation) on the marginal adaptation of compomers
Here group I used conventional system i.e. using constant light
intensity of 400mw/cm2 for 40 sec
Group II used pulse activation system i.e. using initial low intensity of
100 mw/cm2 for 4 sec followed by final cure at 400 mw/cm2 for 36 sec.
Comparison was made between the groups (I and II) with heights
2mm, 3mm and 4mm.
CONCLUSION :
This in-vitro study was done in the Department of Pedodontics and Preventive
Dentistry, Ragas Dental College and Hospital, Chennai and in collaboration with
Central Leather Research Institute and Nuclear Physics department (Anna
University) Chennai, India.
The following conclusions were drawn from this study
1) Pulse activation group, grp II showed comparatively better marginal
adaptation than conventional group, grp I.
2) There was no significant difference between the two groups for loads of 50
and 80 gm. But the top surface hardness was higher for conventional system than
pulse activation system for all the groups
3) When subjected to higher loads (110 g) pulse activation group showed better
hardness ratio than conventional for all heights. In other words pulse activation
group could withstand or take up higher loads than conventional. Thus pulse
activation can be a better choice than conventional for curing compomers (light
activated resins) and could be used for restoration in stress bearing areas of cavities
as well. Hence a few manufacturers' instructions of using Dyract AP in stress
bearing areas when cured with pulse activation holds good from the inference of this
study.
4) The practice of curing light activated resins in increments of not more than
2mm still holds good
Since this is an in-vitro study, an in-vivo study should be carried out to
ascertain the longevity of restorative resins cured with different light curing
protocols.


Stratospheric aerosols play an important role in the climate system by affecting the Earth's radiative budget as well as atmospheric chemistry, and the capabilities to simulate them interactively within global models are continuously improving. It is important to represent accurately both aerosol microphysical and atmospheric dynamical processes because together they affect the size distribution and the residence time of the aerosol particles in the stratosphere. The newly developed LMDZ-S3A model presented in this article uses a sectional approach for sulfate particles in the stratosphere and includes the relevant microphysical processes. It allows full interaction between aerosol radiative effects (e.g. radiative heating) and atmospheric dynamics, including e.g. an internally generated quasi-biennial oscillation (QBO) in the stratosphere. Sulfur chemistry is semi-prescribed via climatological lifetimes. LMDZ-S3A reasonably reproduces aerosol observations in periods of low (background) and high (volcanic) stratospheric sulfate loading, but tends to overestimate the number of small particles and to underestimate the number of large particles. Thus, it may serve as a tool to study the climate impacts of volcanic eruptions, as well as the deliberate anthropogenic injection of aerosols into the stratosphere, which has been proposed as a method of geoengineering to abate global warming.


This paper will discuss the use of Integrated Logic analysers (ILAs) and Virtual I/Os (VIOs) to verify the behavior of soft core protocol implementations. In particular, a soft core implementation of the Controller Area Network (CAN) protocol will be used as a representative example to discuss the use of the proposed scheme. The paper will describe a procedure such that VIO and ILA may be employed to conduct low-cost conformance testing against specific test plans, both for the generation of test patterns and the verification of the resulting implementation behavior. As will be shown, VIOs are particularly helpful in generating high-frequency bit patterns, and may be used to great effect as a flexible bench pattern generator; the generated patterns make use the same system clock as the unit under test, and thus allow for tighter control of timing and more precise pattern generation. When coupled with suitable ILAs, such as the simple analysis tool Chipscope, it will be argued that such a scheme allows for a highly flexible and low-cost approach to protocol verification. Finally, we describe the use of a test bed in the verification of an open-source CAN soft core implementation against the relevant ISO testing


Abstract. Changes in the phenology of physical and ecological variables associated with climate change are likely to have significant effect on many aspects of the Baltic ecosystem. We apply a set of phenological indicators to multiple environmental variables measured by satellite sensors for 17–36 years to detect possible changes in the seasonality in the Baltic Sea environment. We detect significant temporal changes, such as earlier start of the summer season and prolongation of the productive season, in several variables ranging from basic physical drivers to ecological status indicators. While increasing trends in the absolute values of variables like sea-surface temperature (SST), diffuse attenuation of light (Ked490) and satellite-detected chlorophyll concentration (CHL) are detectable, the corresponding changes in their seasonal cycles are more dramatic. For example, the cumulative sum of 30 000 W m−2 of surface incoming shortwave irradiance (SIS) was reached 23 days earlier in 2014 compared to the beginning of the time series in 1983. The period of the year with SST of at least 17 °C has almost doubled (from 29 days in 1982 to 56 days in 2014), and the period with Ked490 over 0.4 m−1 has increased from about 60 days in 1998 to 240 days in 2013 – i.e., quadrupled. The period with satellite-estimated CHL of at least 3 mg m−3 has doubled from approximately 110 days in 1998 to 220 days in 2013. While the timing of both the phytoplankton spring and summer blooms have advanced, the annual CHL maximum that in the 1980s corresponded to the spring diatom bloom in May has now shifted to the summer cyanobacteria bloom in July.


In the Atlas-Meseta basins of Morocco, early Carboniferous clastics comprise wave-dominated shelf sediments, turbidites, and mass-flow deposits. Crustal extension controlled the formation of troughs, continental uplift, and general marine subsidence; sedimentation passed from turbidites into storm deposits. The Moroccan Meseta formed a complex marine basin composed of deep troughs, shallow shelves, and islands. The late Visean marine transgression advanced from the north and reached as far south in the High Atlas domain as the Tizi n'Test fault zone. The Variscan compressive phase ended the early Carboniferous sedimentation.


Episodic memory was proposed to be a memory system unique to human (Tulving, 1972, 2002), until Clayton and Dickinson (1998) presented evidence form their study of the scrub jays that animals were capable of recalling episodic-like past events. To date the evidence of episodic-like memory was demonstrated in avian behaviour but not in the non- human mammals. Therefore, this thesis set out to establish a similar "what" "where" "which" episodic-like memory model in rats. Research findings showed that rats can learn a behavioural task encompassing information about specific objects, placed in a given location at a particular time in the recent past, which is evidence of episodic-like recall. Furthermore, rats were capable of retaining the newly attained episodes for at least 15 minutes and performed the episodic-like test with a decreased degree of accuracy subsequent to sustaining bilateral fornix section. Hence these tests of episodic-like memory in the rat provided evidence that the capability of the non-human memory has potential for further research, proving useful in the general understanding of the episodic memory system.


The replication origin of Marek's disease virus (MDV) type 1 was analysed by using a transient replication assay with plasmids containing various fragments of MDV strain Md5 genomic DNA. Plasmid pMBH, containing the BamHI-H fragment, showed replication activity in MDV-infected chicken embryonic fibroblasts (CEF). By deletion analysis of pMBH, two regions, the promoter-enhancer region of the MDV pp38 gene and the 132 bp tandem direct repeat, were shown to be required for replication activity. Replication of pMBH was not observed in uninfected CEF, suggesting that a trans-acting factor(s) encoded by the MDV genome was necessary for replication.


Cyclic AMP response element-binding protein-binding protein (CBP) functions as a transcriptional coactivator through interactions with a number of cellular and viral transcription factors. It has been suggested to play a central integrative role in gene regulation. However, little is known about signal cascades that can regulate CBP activity. Here we show that either nerve growth factor (NGF) or cAMP treatment led to enhanced activity of CBP in PC12 cells. The C-terminal glutamine-rich activation domain of CBP was shown to be responsible for induction by NGF and cAMP. NGF-induced enhancement of CBP activity was also observed in protein kinase A (PKA)-deficient PC12 cells, whereas cAMP failed to increase the transcriptional activity of CBP in these cells. Moreover, the specific PKA inhibitor H-89 blocked cAMP-induced but not NGF-induced up-regulation of CBP activity. The up-regulation of CBP transcriptional activity in response to NGF was, however, prevented by the specific inhibitor of mitogen-activated protein kinase (p42/44MAPK) activation, PD98059, which had no effect on the up-regulation induced by cyclic AMP, indicating that activation of the mitogen-activated protein kinase signal pathway is specifically involved in the NGF-induced activation of CBP. In addition, expression of a dominant-negative interfering mutant of p42/44MAPK can prevent the NGF-mediated induction of the CBP activity, whereas expression of a p42/44MAPK constitutively active mutant can enhance the transcriptional activity of CBP. These data indicate that activation of the p42/p44MAPK cascade mediates the up-regulation of the transcriptional activity of CBP by NGF, whereas the similar up-regulation induced by cyclic AMP is mediated by PKA activation.


I consider several variants of dictator and ultimatum games in which the proposer not only offers an allocation of funds but also selects the rules that will govern that distribution. In the dictator/ultimatum choice game, the proposer first selects whether or not the receiver will have the power to reject the offer. Effectively, the proposer decides between playing a dictator and an ultimatum game. Whether a player is self-regarding or motivated by distributive concerns, the player should elect the dictator game as it enables full control over the allocation. Yet, a majority of subjects select the ultimatum game. Further, even those selecting the dictator game make substantially higher offers than those in a control dictator experiment. Additional experiments and surveys explore various explanations for these results. The additional experiments suggest that players' willingness to share decision-making power with other players is quite robust. I conclude that subjects have an innate preference for "voice," a key component of procedural justice.


Many text generation tasks naturally contain two steps: content selection and surface realization. Current neural encoder-decoder models conflate both steps into a black-box architecture. As a result, the content to be described in the text cannot be explicitly controlled. This paper tackles this problem by decoupling content selection from the decoder. The decoupled content selection is human interpretable, whose value can be manually manipulated to control the content of generated text. The model can be trained end-to-end without human annotations by maximizing a lower bound of the marginal likelihood. We further propose an effective way to trade-off between performance and controllability with a single adjustable hyperparameter. In both data-to-text and headline generation tasks, our model achieves promising results, paving the way for controllable content selection in text generation.


We investigate the extent of the segregation of Roma students in the Hungarian primary school system and discuss its consequences for actual inter-ethnic relationships within schools. Drawing on results from our previous research, we show that more exposure to members of the other ethnic group (less segregation) leads to more inter-ethnic friendships but also to more inter-ethnic hostility. Importantly, we show that Roma students with above-average academic achievement experience a lot more inter-ethnic friendship relationships than hostility without losing friends from their own ethnic group, and thus the positive effects of more exposure to non-Roma peers far outweighs its negative effects. We conclude that policies that aim at improving the academic performance of Roma students can bring additional benefits by improving their relationships in school.


Introduction Loss-of-function TLR7 variants have been recently reported in a small number of males to underlie strong predisposition to severe COVID-19. We aimed to determine the presence of these rare variants in young men with severe COVID-19. Methods We prospectively studied males between 18 and 50 years-old without predisposing comorbidities that required at least high-flow nasal oxygen to treat COVID-19. The coding region of TLR7 was sequenced to assess the presence of potentially deleterious variants. Results TLR7 missense variants were identified in two out of 14 patients (14.3%). Overall, the median age was 38 (IQR 30-45) years. Both variants were not previously reported in population control databases and were predicted to be damaging by in silico predictors. In a 30-year-old patient a maternally inherited variant [c.644A>G; p.(Asn215Ser)] was identified, co-segregating in his 27-year-old brother who also contracted severe COVID-19. A second variant [c.2797T>C; p.(Trp933Arg)] was found in a 28-year-old patient, co-segregating in his 24-year-old brother who developed mild COVID-19. Functional testing of this variant revealed decreased type I and II interferon responses in peripheral mononuclear blood cells upon stimulation with the TLR7 agonist imiquimod, confirming a loss-of-function effect. Conclusions This study supports a rationale for the genetic screening for TLR7 variants in young men with severe COVID-19 in the absence of other relevant risk factors. A diagnosis of TLR7 deficiency could not only inform on treatment options for the patient, but also enables pre-symptomatic testing of at-risk male relatives with the possibility of instituting early preventive and therapeutic interventions.


This study evaluated the effect of a simple shielding method using a thin lead sheet on the imaging dose caused by cone-beam computed tomography (CBCT) in image-guided radiation therapy (IGRT). Reduction of secondary doses from CBCT was measured using a radio-photoluminescence glass dosimeter (RPLGD) placed inside an anthropomorphic phantom. The entire body, except for the region scanned by using CBCT, was shielded by wrapping it with a 2-mm lead sheet. Changes in secondary cancer risk due to shielding were calculated using BEIR VII models. Doses to out-of-field organs for head-and-neck, chest, and pelvis scans were decreased 15 ~ 100%, 23 ~ 90%, and 23 ~ 98%, respectively, and the average reductions in lifetime secondary cancer risk due to the 2-mm lead shielding were 1.6, 11.5, and 12.7 persons per 100,000, respectively. These findings suggest that a simple, thin-lead-sheet-based shielding method can effectively decrease secondary doses to out-of-field regions for CBCT, which reduces the lifetime cancer risk on average by 9 per 100,000 patients.


Film distribution has undoubtedly changed during this contemporary era of media convergence, with a range of innovative practices and methods being adopted across US film and the arrival of new organisations to the industry and distribution sector. This should not suggest that conventional distribution and marketing methods are extinct, or that the traditional gatekeepers of these fields are obsolete. Rather it should indicate a merging of old and new strategies, practices, methods, and organisations, and it is through this fusion of tradition and novelty that today's complex distribution landscape has emerged. At the forefront of many of these changes has been American independent cinema and as such, the central question posed by this thesis is: how has media convergence impacted on the distribution and marketing of American independent cinema, and how can this impact be understood in terms of wider technological, industrial and sociocultural contexts relevant to the current media landscape? In answering this, this thesis provides a comprehensive re-mapping of the distribution sector of American independent cinema, in terms of the distributors involved and methods and strategies through which films are being released, within this contemporary era of media convergence.

This thesis uses the concept of media convergence as a complex and multifaceted lens that has dimensions in the technological, industrial and sociocultural realms, through which recent innovations in film distribution and marketing can be examined. Underpinning this framework is the adoption of an approach informed by the emergent media industry studies agenda (Holt and Perren, 2009; Hilmes, 2013; and McDonald, 2013). The implementation of this converged method to understanding media industries has allowed for a fluid, diverse and multi-layered assessment of the area under examination. Specifically, the thesis uses Thomas Schatz's (2009) macro and micro level framework to examining film industries in order to identify key trends and industrial practices within American independent cinema (and, to a degree, US film at large), exploring how they relate to specific films, filmmakers and companies, within a distribution context.

From this a number of key findings have emerged, including:
• The identification of a new industrial structure that has facilitated a form of re-conglomeration of parts of the American independent cinema that is similar to the co-option of American independent cinema in the late 1980s and early 1990s.
• The identification of new, collaborative distribution and marketing strategies being used within American independent cinema that not only seek to connect films with consumers, but also involve them, to varying degrees, in related processes.
• An outline and discussion on how changes within the distribution sector have impacted on film form and consumption practices evident in this era of convergence.

The thesis provides original contributions to knowledge in the fields of American independent cinema and distribution studies at large by: reconceptualising what independent film is within this contemporary period of media convergence; reframing discussions on film distribution to be more inclusive and less elitist in their scope; providing new methodological approaches to understanding the wider workings of film distribution and marketing; and demonstrating how distribution studies can be utilised to understand innovations within the fields of film production and exhibition.


This paper takes up the question of whether the consequences of a person's volitional actions can contribute to their blameworthiness.  On the one hand it is intuitively plausible to hold that if D1 volitionally shoots V with the intention of killing V then D1 is blameworthy for V's death.  On the other hand, if the only difference between D1 and D2 is resultant luck, many find it counter-intuitive to hold that D1 is more blameworthy than D2.  There are three broad (non-skeptical) strategies for resolving this tension: accept resultant moral luck, deny that one can be morally responsible for outcomes, or accept that outcomes can be within the scope of things one is morally responsible for while denying that they can affect the degree of blameworthiness.  This paper aims to defend resultant moral luck against both the scoping and the internalist strategies by drawing on an "inclusive conception" of blameworthiness, according to which how much blame one deserves is a function of two independent variables: the wrongfulness of the offense and the offender's degree of moral responsibility.  The view defended here holds that consequences affect degree of blameworthiness by affecting the wrongfulness of that for which one is being blamed.


Aim: This study's aim is to define the clinicopathological and surgical outcomes, clinical courses, and results of long-term follow-up of cases that underwent surgical treatment for solitary fibrous tumors of the pleura (SFTp). Subjects and Methods: Clinical and long-term follow-up records of 16 consecutive patients who had surgery for SFTp between 2006 and 2016 were reviewed in the retrospective chart review. There were nine males (56%) and seven (44%) females with an average age of 60.5 ± 17.1 (range 30—87 years). Etiological factors, diagnostic procedures, clinical and surgical outcomes, 5-year overall survival (OS), and disease-free survival (DFS) in these patients were researched. Results: There was no remarkable common etiological factor. Nine of the cases were asymptomatic. Other symptoms were chest pain, dyspnea, cough and hypertrophic osteoarthropathy, respectively. Thoracotomy for the removal of pleural mass was carried out in 15 (94%) cases. Additional resection procedures included the chest wall resection in two cases and lobectomy in two. Video-assisted thoracoscopic surgery (VATS) resection was performed in one (6%) case. Complete surgical excision was performed in 74% of cases. Nineteen percent of cases were malignant SFTp (mSFTp). One of the mSFTp cases died in the 19th month after the diagnosis. The mean follow-up time was 50.6 ± 34.2 months (2--114 months). Mean survival of mSFTp patients was 40.6 ± 19.08 months (19--55 months) and that for benign SFTp (bSFTp) was 52.9 ± 37.05 months (2--114 months). Five-year OS--DFS were 93.5% and 74%, respectively. Conclusion: SFTp is an uncommon benign neoplasm but it can have malignant features. Even in the case of recurrence, the main treatment is total surgical excision. Oncologic treatments can be tried in unresectable and metastatic cases. VATS can be used in surgical total excision for small diameter and appropriate tumors. Understanding the nature of these tumors, immunohistochemical, and genetic studies may be a guide in future.


Growth response of pre-nursery oil palm seedungs in an ultisol amended with oil palm mill by -products
This study was conducted to evaluate the effect of oil palm mill by-products on growth of oil palm seedlings in a sandy soil. There were 3 treatments including the control,
each replicated 6 times in randomized complete block design (RCBD). The treatments were: (i) dried decanter cake (T1); (ii) empty fruit bunch with palm oil mill effluent
biochar (T2); and (iii) palm oil mill effluent (T3). T1 was the control as it is the standard practice of IJM Plantations Berhad (IJMP) where this experiment was conducted. Plant height, stem girth, dry weight of shoots and roots, total nitrogen of leaves and roots, total leaf phosphorus, soil pH, soil organic matter content, soil total
nitrogen, soil available phosphorus and cation exchange capacity were recorded and all data analyzed using one way analysis of variance (ANOVA) at 5% Significance level. T2
resulted in significantly higher plant height (22.99 cm) compared to T1 (19.17 cm) and T3 (21.95 cm) at 3 months after planting. There were no significant differences in
stem girth where the highest mean stem girth was for T2 (4.51 mm), followed by T3 (4.34 mm) and T1 resulted in the lowest stem girth (4.24 mm). There were no significant effects on the dry weight of shoots and roots. The highest mean shoot dry weight was for T2 (1.47 g), followed by T3 (0.98 g) and T1 resulted in the lowest dry weight of shoots (0.93 g). The highest mean dry weight of roots was for T1 and T2 (0.42 g) and T3 resulted in the lowest dry weight of roots (0.34 g). T1 resulted in higher leaf total nitrogen, which was 1.99% as compared to T2 (1.72%) and T3(1.87%). Root total nitrogen was significantly higher in Tl (2.11%) compared to T2 (0.03%) and T3 (1.12%). T1 resulted in significantly higher total P of leaves (13.32 mg
kg-I) compared to T2 (9.38 mg kg-I) and T3 (10.38 mg kg-1). Soil pH was significantly higher in T2 (6.61) compared to T1 and T3 (5.35). There were significant differences
in effects between T1, T2 and T3 on soil organic matter and total organic carbon. T2 resulted in the highest soil organic matter (1.88%) compared to T1 (1.32%) and T3
(0.84%). T2 resulted in higher soil total nitrogen (0.13%) compared to T1 (0.12%) and T1 (0.08%). Soil available phosphorus was significantly higher for T1 (373.64 mg kg-l) compared to T2 (225.41 mg kg-I) and T1 (224.22 mg kg-l). There was no Significant difference between Tl, T2 and T3 for soil cation exchange capacity. T1 decreased the soil cation exchange capacity at 3 months after planting by 70.73% whereas T2 and T3 increased the soil cation exchange capacity by 59.09% and 46.15% respectively. The results indicate that the sandy soil treated with EFB-POME biochar improved the growth rate of the pre-nursery oil palm seedlings. However, sandy soil amended with POME enhanced the soil fertility.


mTOR is a highly conserved serine/threonine protein kinase that serves as a central regulator of cell growth, survival, and autophagy. Deregulation of the PI3K/Akt/mTOR signaling pathway occurs commonly in cancer and numerous inhibitors targeting the ATP-binding site of these kinases are currently undergoing clinical evaluation. Here, we report the characterization of Torin2, a second-generation ATP-competitive inhibitor that is potent and selective for mTOR with a superior pharmacokinetic profile to previous inhibitors. Torin2 inhibited mTORC1-dependent T389 phosphorylation on S6K (RPS6KB1) with an EC(50) of 250 pmol/L with approximately 800-fold selectivity for cellular mTOR versus phosphoinositide 3-kinase (PI3K). Torin2 also exhibited potent biochemical and cellular activity against phosphatidylinositol-3 kinase-like kinase (PIKK) family kinases including ATM (EC(50), 28 nmol/L), ATR (EC(50), 35 nmol/L), and DNA-PK (EC(50), 118 nmol/L; PRKDC), the inhibition of which sensitized cells to Irradiation. Similar to the earlier generation compound Torin1 and in contrast to other reported mTOR inhibitors, Torin2 inhibited mTOR kinase and mTORC1 signaling activities in a sustained manner suggestive of a slow dissociation from the kinase. Cancer cell treatment with Torin2 for 24 hours resulted in a prolonged block in negative feedback and consequent T308 phosphorylation on Akt. These effects were associated with strong growth inhibition in vitro. Single-agent treatment with Torin2 in vivo did not yield significant efficacy against KRAS-driven lung tumors, but the combination of Torin2 with mitogen-activated protein/extracellular signal-regulated kinase (MEK) inhibitor AZD6244 yielded a significant growth inhibition. Taken together, our findings establish Torin2 as a strong candidate for clinical evaluation in a broad number of oncologic settings where mTOR signaling has a pathogenic role.


This thesis focuses on the terminal aspects of massive MIMO systems. Based on the degree of freedom a terminal have in a MaMi, different antenna configurations, transceiver topologies with associated transmission schemes, and the underlying algorithms are researched.The first studied topic concerns multiple-antenna terminals in a massive MIMO system for sub-6 GHz, operated at the center frequency of 3.7 GHz. Simulation environments based on fully-stochastic as well as geometric-stochastic approaches are developed and the results are compared to measured. For the measurements the Lund University Massive MIMO (LuMaMi) testbed has been used. To enable evaluation of multi-antenna terminals, modifications to the LuMaMi framework have been necessary. Real-time diversity schemes for dual antenna terminals as well as a channel capturing feature have been implemented. The latter, to enable analysis and post processing of measured channels from the multi-antenna terminals. Multi-antenna terminal prototypes with integrated antennas, based on real Sony Xperia smartphone chassis where designed for the evaluation. The three-dimensional antenna gain-patterns have been characterized in an anechoic chamber to ensure that simulations and measurements have a common ground. The second topic in this thesis relates to mm-wave massive MIMO systems. As a first step toward evaluation of handsets, a 28 GHz channel sounder has been developed for the measurement of dynamic, highly resolved, in both temporal and spatial domains, propagation channels. To enable measurements, a 256$\times$128 antenna-element system was designed together with a control program to handle the switching and the enormous amount of data. (Less)


Abstract Illegitimate G-protein coupled receptors are known to control cortisol secretion in adrenal adenomas and bilateral macronodular adrenal hyperplasias (BMAHs) causing Cushing's syndrome. In the present study, we have evaluated the role of glucagon in the regulation of cortisol secretion in 13 patients with BMAH or adrenocortical adenoma causing subclinical or overt Cushing's syndrome. Injection of glucagon provoked an increase in plasma cortisol in 2 patients. After surgery, immunohistochemical studies showed the presence of glucagon receptor-like immunoreactivity in clusters of spongiocytic cells in adrenal tissues from patients who were sensitive in vivo to glucagon. We also observed an in vitro cortisol response to vasoactive intestinal peptide from an adenoma, which was insensitive to glucagon and pituitary adenylate cyclase-activating peptide. Altogether, our data show that ectopic glucagon receptors are expressed in some adrenal cortisol-producing benign lesions. Our results also indicate that circulating glucagon may influence cortisol release under fasting conditions.


Underground mining has occurred in the Illawarra region for more than 150 years. Over time, community expectations about the environmental effects of mining and other developments have changed dramatically. It is in this context that community, government, and environmental groups have raised concerns about the effects that mining can have on rivers and other natural features, residential property, and infrastructure, such as transmission lines, roads, and bridges. On natural features, these effects can include fracturing of the rock bedding in the river, water loss to the shallow sub-strata, gas release, rock falls, and vegetation dieback. In the past, mine planning has considered potential effects on engineered structures, however, the same attention has not been paid to the effects of mining on natural features. Through a Stakeholder Involvement Programme conducted by Illawarra Coal, it was identified that government and community stakeholders were seeking a more sensitive approach be taken to mine planning, particularly in significant and high risks areas. As a result, mine planning processes are being reviewed to take into account the effects of mining on the surface features. The focus of this paper is the programme undertaken by BHP Billiton - Illawarra Coal to integrate environmental assessments into mine planning. This has involved internal workshops and projects, together with external consultation. The process that the company is utilising to fully incorporate environmental assessments into the mine planning process is described. The purpose of this process is to identify surface features, determine their sensitivity, develop mitigation and remediation options, and potentially avoidance measures early in the mine planning process. Another key aspect of the process is to incorporate internal and external stakeholder feedback as part of the mine planning process. In implementing this process, it is anticipated that it will provide a more secure outcome for the business. This is expected to occur through understanding and addressing environmental issues and incorporating stakeholder feedback early in the mine planning process, therefore minimizing the risk of costly changes to mine plans being required within short time frames. The rigorous Integrated Mine Planning Process (IMPP) will give the business confidence that the mine plan submitted through the Subsidence Management Plan (SMP) application to government has the highest probability of approval and will provide the most sustainable outcome - for the environment, community, and Illawarra Coal.


This study attempts to measure the financial performance of the food industry taking the top three JSE listed companies Pioneer Foods, Tiger Brands and RCI for the period of 2013-2014. In order to achieve the objectives of this research, ratios such as return on equity (ROE), return on assets (ROA) have been calculated by applying the DuPont analysis. The DuPont analysis is an important tool to measure the operating performance of a firm (Sheela and Karthikeyan, 2012). The volatility of the stock market makes investment decisions a controversial issue for most investors. Investments of huge amounts of money need proper analysis in order to make an informed decision. Financial statements are indicators of the profitability and financial sustainability of the business. Ratios are tools used to quantify the risk element before making any strategic decisions, more especially, investment decisions. It has been reported to be one of the most important financial ratios, because it provides investors with a more comprehensive measure of performance (Demmer, 2015). A detailed financial analysis of all three companies using the DuPont system shows that investing in Tiger Brands would generate a higher return to shareholders than Pioneer Foods or RCI.


The absence of organic compounds from Precambrian iron formations (IF) challenges the hypothesis of the biogenic origin of IF. Here we address the fate of adsorbed organic compounds during transformation from ferrihydrite to hematite. We determined the binding energy between hematite and common molecular terminations found in extracellular polymeric substances and biofilms: carboxylic, hydroxyl and phosphate functional groups. We found that the bond between hematite and hydroxyl groups is approximately 2 times stronger than the bond between hematite-carboxyl and -phosphate groups. We transformed synthetic ferrihydrite to hematite at 90 oC in presence of glycerol, which has a high density of hydroxyl groups and measured the amount of mineral associated glycerol before and after the transformation. We show that the transformation releases glycerol highlighting that organic compounds adsorbed at precursor ferrihydrite could be desorbed during the process of IF sedimentation and diagenesis. Our results suggest that the absence of organic compounds in IF should not be used as evidence against their biogenic origin.


Abstract The neural mechanisms of drug cue‐reactivity regarding the temporal fluctuations of functional connectivity, namely the dynamic connectivity, are sparsely studied. Quantifying the task‐modulated variability in dynamic functional connectivity at cue exposure can aid the understanding. We analyzed changes in dynamic connectivity in 54 adult cannabis users and 90 controls during a cannabis cue exposure task. The variability was measured as standard deviation in the (a) connectivity weights of the default mode, the central executive, and the salience networks and two reward loci (amygdalae and nuclei accumbens); and (b) topological indexes of the whole brain (global efficiency, modularity and network resilience). These were compared for the main effects of task conditions and the group (users vs. controls), and correlated with pre‐ and during‐scan subjective craving. The variability of connectivity weights between the central executive network and nuclei accumbens was increased in users throughout the cue exposure task, and, was positively correlated with during‐scan craving for cannabis. The variability of modularity was not different by groups, but positively correlated with prescan craving. The variability of dynamic connectivity during cannabis cue exposure task between the central executive network and the nuclei accumbens, and, the level of modularity, seem to relate to the neural underpinning of cannabis use and the subjective craving.


In this paper, we generalize a permutation model for free random variables which was first proposed by Biane. We also construct its classical probability analogue, by replacing the group of permutations with the group of subsets of a finite set endowed with the symmetric difference operation. These constructions provide new discrete approximations of the respective free and classical Wiener chaos. As a consequence, we obtain explicit examples of nonrandom matrices which are asymptotically free or independent. The moments and the free (respectively classical) cumulants of the limiting distributions are expressed in terms of a special subset of (noncrossing) pairings. At the end of the paper we present some combinatorial applications of our results.


In May 2008, the Japanese government launched the 'Emergency Project for Improvement of Medical Care and Quality of Life for People with Dementia' under the idea that it is necessary to build a society, without delay, where people can live life safely without anxiety even after being affected by dementia, where they can be supported by appropriate and integrated services of medical care, long‐term care and community care. We would like to introduce our future dementia policy standing on the outcome of this project, which was published as a report on 10 July 2008. The measures for people with dementia in Japan have gradually achieved good results. For example, public understanding and awareness of dementia has increased through renaming the term for dementia in Japanese from 'Chiho' to 'Ninchi‐sho' in 2004, and the comprehensive care system was founded focusing on the importance of providing community based long‐term care while maintaining the person's familiar human relationships and residential circumstances. However, case reports show that there are yet some cases that fail to deliver appropriate treatment or long‐term care service as a result of a lack of timely definite diagnosis in an early stage or a lack of coordination between medical care and long‐term care. Therefore, the future dementia policy should be designed by envisaging the flow of the measures that would support the life of the person and his/her family, and improve their quality of life; starting with measures that link early notice of the patient, his/her family or neighbor to early diagnosis, and then measures to develop well‐designed comprehensive care planning that provides appropriate medical and long‐term care services through good coordination, while promoting research and development of diagnosis/treatment technology. In addition, in regard to early‐onset dementia, comprehensive self‐support measures including employment assistance should be promoted.


Intravital video microscopy is widely used for observing mammalian vasculature in vivo. In microcirculation research, the effect of various stimuli on vasculature is often studied using intravital microscopy. The vessel diameter is a commonly reported indicator for such an effect and needs to be accurately measured. Image sequences acquired using intravital microscopy span several minutes in length, and the current practice of manual measurement using electronic calipers or image shearing is time-consuming and prone to measurement error. Automation of vessel measurement would provide an alternative that is faster and more reliable. The goal of this work was to develop and evaluate an algorithm for automatically measuring the diameter of a vessel from intravital video microscopy data. The proposed method tracks the vessel diameter throughout the entire image sequence once the diameter is marked in the first video frame. Two seed points, indicating the vessel diameter, are placed on the vessel walls and tracked throughout the entire image sequence using feature tracking algorithm. The algorithm parameters were optimized using intravital microscopy image sequences. The ground truth was established manually for each case, and the optimal parameters were found by minimizing deviation from the ground truth. The accuracy of the method was validated using both synthetic and real intravital image sequences. On synthetic dataset, The automated measurements deviated from the ground truth by an average of 0.0 pixels, while the manual measurement had the average mean squared error of 1.74 pixels. When the accuracy was further evaluated on fluorescence-confocal and non-confocal transmission microscopy image sequences, it was found that the automated method can measure the diameter accurately based on expert visual assessment. Furthermore, the repeatability of the automated measurements was evaluated based on Bland-Altman analysis and compared to that of the manual measurements. The 95% limits of agreement were found to be [-1.36 μm, 1.52 μm] for the automated method and [-3.08 μm, 2.17 μm] for the manual measurements. The automated method resulted in narrower limits of agreement, indicating that it has a better repeatability than human raters. The presented algorithm performs well in terms of measurement accuracy and reproducibility. The automated vessel measurement, with the validated performance, will be highly useful for many biological studies that require vessel diameter measurements over time.


A moderately retarded girl had a 47,XX,+der(1 8),t(9; 1 8)(p24;q2l)mat abnormality that was inherited from her mother, who had a 46,XX,t(9;18)(p24;q21) karyotype in most cells, and a minor cell line of 47,XX,+der(18),t(9;1 8)(p24;q21). Her dysmorphic featuresbilateral epicanthic folds, low-set, abnormal ears, low posterior hairline, clinodactyly of the 5th fingers, and broad great toes-were similar to those of other patients with an additional number 18 chromosome in which all or most of the long arm was missing, thus raising the possibility of a distinct syndrome.


The level dependent Choquet integral has been proposed to handle decision making problems in which the importance and the interaction of criteria may depend on the level of the alternatives' evaluations. This integral is based on a level dependent capacity, which is a family of single capacities associated to each level of evaluation for the considered criteria. We present two possible formulations of the level dependent capacity where importance and interaction of criteria are constant inside each one of the subintervals in which the interval of evaluations for considered criteria is split or vary with continuity inside the whole interval of evaluations. Since, in general, there is not only one but many level dependent capacities compatible with the preference information provided by the Decision Maker, we propose to take into account all of them by using the Robust Ordinal Regression (ROR) and the Stochastic Multicriteria Acceptability Analysis (SMAA). On one hand, ROR defines a necessary preference relation (if an alternative a is at least as good as an alternative b for all compatible level dependent capacities), and a possible preference relation (if a is at least as good as b for at least one compatible level dependent capacity). On the other hand, considering a random sampling of compatible level dependent capacities, SMAA gives the probability that each alternative reaches a certain ranking position as well as the probability that an alternative is preferred to another. A real-world decision problem on rankings of universities is provided to illustrate the proposed methodology.


Background and Purpose—Dizziness, vertigo, and imbalance are common presenting symptoms in the emergency department. Stroke is a leading concern even when these symptoms occur in isolation. The objective of the present study was to determine the "real-world" proportion of stroke among patients presenting to the emergency department with these dizziness symptoms (DS). Methods—From a population-based study, patients 44 years of age presenting with DS to the emergency department, or directly admitted to the hospital, were identified. Demographics, the frequency of new cerebrovascular events, and the frequency of isolated DS (ie DS with no other stroke screening term or accompanying neurologic signs or symptoms) were assessed. Multivariable logistic regression was used to evaluate the association of age, gender, ethnicity, and isolated DS with stroke/transient ischemic attack (TIA). The association of the presenting symptoms with stroke/TIA was also assessed. Results—Stroke/TIA was diagnosed in 3.2% (53 of 1666) of all patients with DS. Only 0.7% (9 of 1297) of those with isolated DS had a stroke/TIA. Patients with stroke/TIA were slightly older than those without stroke/TIA (69.3 11.7 vs 65.3 12.9, P 0.02). Male gender was associated with stroke/TIA, whereas isolated DS was negatively associated with stroke/TIA. Patients with imbalance (dizziness as referent) were more likely to have stroke/TIA. Conclusions—The proportion of cerebrovascular events in patients presenting with dizziness, vertigo, or imbalance is very low. Isolated dizziness, vertigo, or imbalance strongly predicts a noncerebrovascular cause. The symptom of imbalance is a predictor of stroke/TIA. (Stroke. 2006;37:2484-2487.)


Medical administrative and diagnosis procedures require the retrieval of patient diagnosis history
before treatments and drug administration. This involves careful checking of the patient past record which might be stored electronically or in paper files. This process is tedious, time consuming and often prone to error. The need to reduce error in patient administrative and diagnosis process has result in wide-ranging research work to integrate latest technology into health care system. Hence, the need for an automated system, that can display patient diagnosis record from a storage location to a
care giver without any human intervention. This paper describes the design of a wireless patient
diagnosis system (WPDS) for retrieving patient medical diagnosis history. A DLP-RFID1 Read/Writer
with ISO 15960 tags were linked together in a novel way using LabVIEW solution that integrates MS Access database for storage and retrieval of information.


In this paper, methods to achieve low-power and high-speed VLSI's are described with the emphasis on cooperation between levels. To suppress the leakage current in a standby mode, Boosted Gate MOS (BGMOS) is effective, which is based on cooperation between technology level and circuit level. To reduce the power in an active mode, VDD-hopping and VTHhopping are promising, which are cooperative approaches between circuit and software. Power consumed in interconnect system is another issue in low-voltage deep-submicron designs. A cooperative approach between VLSI and assembly to the interconnect power problem is also discussed.


In this issue of The Journal of General Physiology we begin a new initiative: Perspectives in General Physiology. The purpose of these Perspectives is to provide a forum where scientific uncertainties or controversies can be discussed in an authoritative yet open manner.

The Perspectives will be solicited by the editors—often based on recommendations by the advisory editors or members of the editorial board, who may be asked to coordinate the process. To frame the issue, two or more experts will be invited to present a brief point of view on the problem, which will be published back-to-back in The Journal. These Perspectives will be preceded by one or two editorial paragraphs that introduce the problem and invite the submission of comments in the form of letters to the editor, which will be published together in a single, predetermined issue (usually four months after publication of the Perspective). These letters may be no longer than two printed pages (approximately six double-spaced pages) and will be subject to editorial review. They may contain no more than one figure, and may not contain significant references to unpublished work. After the letters to the editor have been published, further responses will be limited to full manuscripts.

In the present issue of The Journal, we asked Kevin Strange and David E. Clapham to discuss the uncertainties surrounding the molecular identity of the outwardly rectifying, volume-sensitive chloride channel (or channels) that play a central role in the regulatory volume decrease that occurs in response to cell swelling induced by an osmotic perturbation. The functional characteristics of these channels have been studied extensively by many investigators, and a large number of possible candidate proteins have been proposed. As emphasized by Drs. Strange and Clapham, the list has undergone remarkable evolution: some early promising candidates should be stricken from the list, there is insufficient evidence about others, and there remains uncertainty about the current favorites, which are members of the CLC family of chloride channels. These questions are far from settled, but the present perspectives serve to narrow the scope of the problems that need to be resolved.

Letters to the editor related to this topic will be published in the September 1998 issue of The Journal of General Physiology. The letters should be received no later than June 15, 1998, to allow for editorial review. Letters can be submitted electronically, by sending a formatted text file as an attachment in an e-mail to the editorial office (ude.rellefekcor.xavkcor@pgj). Figures must be submitted in hard copy (they can be faxed so that they are received in the editorial office by the June 15 deadline).


Rebellious youth, the Cold War, New Left radicalism, Pierre Trudeau, Red Power, Quebec's call for Revolution, Marshall McLuhan: these are just some of the major forces and figures that come to mind at the slightest mention of the 1960s in Canada. Focusing on the major movements and personalities of the time, as well as the lasting influence of the period, Canada's 1960s examines the legacy of this rebellious decade's impact on contemporary notions of Canadian identity. Bryan D. Palmer demonstrates how after massive postwar immigration, new political movements, and at times violent protest, Canada could no longer be viewed in the old ways. National identity, long rooted in notions of Canada as a white settler Dominion of the North, marked profoundly by its origins as part of the British Empire, had become unsettled. Concerned with how Canadians entered the Sixties relatively secure in their national identities, Palmer explores the forces that contributed to the post-1970 uncertainty about what it is to be Canadian. Tracing the significance of dissent and upheaval among youth, trade unionists, university students, Native peoples, and Quebecois, Palmer shows how the Sixties ended the entrenched, nineteenth-century notions of Canada. The irony of this rebellious era, however, was that while it promised so much in the way of change, it failed to provide a new understanding of Canadian national identity. A compelling and highly accessible work of interpretive history, Canada's 1960s is the book of the decade about an era many regard as the most turbulent and significant since the years of the Great Depression and World War II.


Changes in the number of bacteria recovered from the skin of processed broilers after each of five consecutive washings in salicylic acid (SA) solutions was examined. Skin samples from commercially processed broiler carcasses were divided into 3 groups and washed in distilled water (control), 10% SA, or 20% SA by agitating skin in wash solutions in a Stomacher laboratory blender. After each wash, skin was transferred to fresh solutions and washing was repeated to provide samples washed 1 to 5 times in each solution. Washed skin was stomached in Butter field's Phosphate Buffer to recover bacteria on the skin. Bacterial flora of the rinsates was enumerated on Plate Count (PC) Agar, Staphylococcus (STA) Agar, Levine Eosin Methylene Blue (EMB) Agar, Lactic Acid Bacteria (LAB) Agar, and Perfringens (PER) Agar with TSC supplement; and then bacterial isolates from each medium were identified. Results indicated that after each of 5 consecutive washes in water, there was no significant difference in the number of bacteria recovered from skin on any of the agar media. Significantly fewer bacteria were recovered on LAB Agar from skin after 5 washes in 10% SA than after 1 wash, but there was no significant decrease in the number of bacteria recovered on any other media after skin was washed in this solution. However, washing skin 4 or 5 times in 20% SA significantly reduced the number of bacteria recovered on PC and STA Agar, while no bacteria were recovered on EMB or LAB Agars from rinsates of skin washed 4 or 5 times in 20% SA or on PER Agar from skin washed 3 or more in the 20% solution. In vitro studies indicated that SA is bactericidal towards bacterial isolates recovered from skin and that resistance to the bactericidal activity of SA in descending order is Staphylococcus simulans > Lactobacillus > Escherichia coli > Clostridium perfringens. Findings indicate that successive washing of skin in SA may significantly reduce the number of bacteria recovered from the poultry skin and that the bactericidal activity SA can kill bacteria in vitro.


This study aimed to elucidate seasonal dynamics of ryegrass root systems in field swards. Established field swards of perennial ryegrass with white clover removed by herbicide and fertilised with nitrogen (N) to replace clover N fixation were subjected to lax and hard grazing management and root biomass deposition monitored using a root ingrowth core technique over a 13 month period. A previously published phytomer-based model of plant morphology that assumes continuous turnover of the root system was used to estimate mean individual root weight (mg) not previously available for field swards. The predicted root weights compared credibly with root data from hydroponic culture and the model output explained much of the seasonal variation in the field data. In particular, root deposition showed a seasonality consistent with influence of an architectural signal ( AS ) determined by plant morphology. This AS arises because it is theoretically expected that with rising temperatures and decreasing phyllochron in early summer, more than one leaf on average would feed each root bearing node. Conversely, in autumn the reverse would apply and root deposition is expected to be suppressed. The phytomer-based model was also able to explain deeper root penetration in summer dry conditions, as seen in the field data. A prediction of the model is that even though total root deposition is reduced by less than 10% under hard grazing, individual root weight is reduced proportionately more because the available substrate is being shared between a higher population of tillers. Two features of the field data not explained by the phytomer based model, and therefore suggestive of hormonal signaling, were peaks of root production after summer drought and in late winter that preceded associated herbage mass rises by about one month. In summary, this research supports a view that the root system of ryegrass is turning over on a continuous basis, like the leaves above ground. The phytomer based model was able to explain much of the seasonal variation in root deposition in field swards, and also predicts a shift of root deposition activity, deeper in summer and shallower in winter.


This paper focuses on creating guidelines for the design of products for persons with disabilities that are applicable during early stages of design. The research uses the International Classification of Functioning, Disability, and Health (ICF) to formally describe user activity, the Functional Basis to describe product function, and the actionfunction diagram as a framework to create a detailed understanding of the interaction between a user and a product. The main objective of this paper is to explore the transferability of the knowledge contained in the Americans with Disabilities Act (ADA) to universal product design. The design information contained in the ADA guidelines is abstracted using a function based approach; association rules are mined from this design information. The association rules obtained are statistically significant guidelines for universal design (UD). The existing examples of universal design are compared to their typical version to observe the design elements that improve the accessibility of a product. Association rules are also mined from the existing examples of universal design using the same methodology. Further, the applicability of ADA guidelines to universal product design is investigated based on the commonality between the association rules obtained from both the datasets. The results show that rules can be translated to a product having a degree of similarity based on the size and space relationship between the user and product without direct translation from an ADA based design guideline to a product design guideline.


RLWI is an important part of Statoil's goal of increasing the recovery factor from subsea wells from 42% to 55%. Subsea well intervention has traditionally been performed by expensive workover rigs which have made intervention for subsea wells less desirable than for platform wells. The introduction of RLWI has made subsea well intervention more desirable. To make it even more desirable, limitation and problems needs to be identified and improved. After investigating 68 RLWI operation performed for Statoil by the Island Offshore Alliance, the three problems with the highest frequency were identify to be; scale related, difficulties pulling the THCP and fish left in the hole. A HXT vs. VXT time analysis showed that RLWI operations takes about two days longer to perform on wells with HXT. The main reason for this difference is because a THCP needs to be pulled, which runs into difficulties 40% of the time. A RLWI will always take longer time for HXT because the THCP needs to be pulled, but the time difference could be reduced by applying a proper THCP pulling procedure. An important part of improving the THCP pulling procedure is to improve the jarring operation. Drag force acting on the wireline by the sea current have the potential to reduce the sensitiveness of the jarring operation. The drag force can reached 1 380 N on the 7/32" braided line during worst case scenario, which creates a deflection of 23m at 300m water depth and a TS weight of 2 000 N. The drag force can be reduced by developing a wireline with higher specific weight, smoother surface and smaller diameter. Or the drag force can be eliminated by placing the wireline winch on the sea bottom. Oil field scale deposit is a big problem for many fields world wide as many fields are getting older. Scale deposit in the well is the reason for many intervention complications such as; high friction in the well, unable to install/RIH downhole equipment and stuck downhole valves and chokes. The introduction of the rotating PTA tractor has provided a cost efficient scale removal technique from electrical wireline. The technique has however two major disadvantages compared to CT and snubbing; the power available downhole is very limited and fluid circulation is impossible. Because of these limitations the technique can only remove relative short soft scale bridges due to the limitation in available downhole power, and the scale bridge cannot completely block the fluid because that makes it impossible to remove the debris. A new wireline called CC can however dramatically increase the available downhole power, but fluid circulation will be impossible to achieve with wireline. Whenever a fish is left in the well it must be investigated what went wrong to avoid the similar incidents in the future. Three cases have been looked into in this report where a fish was left in the hole: o Fish left in hole due too to small ID in the TFL completion solution, the TFL is not a very intervention friendly completion o Fish left in hole because of perforating in too high overbalance. If high overbalance is suspected the TS could be anchored in place to avoid it from being flushed up the well, or the well could be shut in prior to perforating. o Fish likely left in hole because of wrongly installed muleshoe in the tailpipe. The self aligned muleshoe has a spring loaded inner part which has a cushioning effect on the jarring operations, which makes it difficult to jar the TS free. Whenever a muleshoe is installed a caliper run should be run to see if it is properly installed. RLWI has limitations and disadvantages compared to CT and snubbing, but with the development of new techniques and equipment the RLWI clearly has a huge potential to increase the recovery factor for subsea wells. New equipment and techniques will also be needed to perform intervention in constantly deeper and more complex wells.


The article presents reasonably organizational and pedagogical conditions of professional self-development of primary school teachers, namely: support of positive motivation of achievement as meeting internal needs of the individual in professional self-development; the use of cognitive and informative opportunities of the content psychological and pedagogical and methodical disciplines for the formation of didactic complex and technological knowledge and skills, abilities to integrate spatial and substantive, informative and motivational, psychological, social and communication components of the educational environment of teachers' training college; creating rich social and communicative space in the course of interactive cooperation of learning subjects to create students' "success situations" and demonstrating positive experience of the professional success. The result of these organizational and pedagogical conditions of the professional self-development of primary school teachers have reflexive-value treatment to the personality as a future teacher and professional considering his or her strengths and weaknesses, formed a high level of readiness for professional self-development in his or her chosen profession.


To operate efficiently and effectively revenue authorities require discretion, but processes must be in place to keep discretion in check. This delicate balancing act takes place against the background of a more general constitutional framework. This working paper starts by outlining the unique features of the UK constitution that form the background to the way in which the discretion of the UK revenue authorities (HMRC) is assessed and controlled. It then discusses a limited, yet crucial, set of discretions vested in HMRC. The paper focuses particularly on the use of non-statutory guidance. It discusses the operation of judicial review, and in particular, the doctrine of legitimate expectations, in the context of such guidance. It then presents two case studies, which reveal a distinct uncertainty over the limits of non- statutory guidance. This is currently of considerable concern to the UK tax community. As the role of guidance appears to be increasing in the UK system, the case for addressing some of these causes of uncertainty strengthens. The paper concludes by offering some preliminary suggestions on how the problems may be addressed.


The apparent and true digestibilities of the same preparations of six proteins (spray dried whole egg, cottage cheese, canned tuna, peanut flour, soy isolate, and wheat gluten) were estimated in four to five men and in rats and compared to estimates of digestibility from three different in vitro enzymic digestion procedures. For all six proteins, the correlation coefficient was 0.46 between true digestibility in humans and in rats; with values for tuna excluded, r = 0.96. With all six proteins, none of the in vitro values was significantly correlated with values from humans or rats. However, with either the three animal proteins alone or the three plant proteins alone, correlations were high (r greater than 0.90) between one or more of the in vitro estimates and the observed true or apparent human and rat digestibilities. The differences in the relationship between enzymic digestion estimates and the human digestibility estimates for plant or animal proteins suggest that for accurate prediction of protein digestibility in humans by these enzymic methods, different equations would have to be used for plant and animal proteins. For protein sources containing both plant and animal protein, use of the in vitro enzymic procedures would give only an approximate estimate of digestibility in humans.


In order to do research at CNSE, funding is required. Funding is achieved by submitting a grant proposal stating the background of the problem one hopes to address, a proposed solution, and sufficient information to prove success is achievable. These grant proposals follow a very particular format, which is extremely valuable to be familiar with in the scientific field of study. Therefore, learning to write a grant proposal for some of the work I have done during my undergraduate studies was proved a valuable learning experience. The following grant proposal is based on the work I have done during the threesemester sequence of Capstone undergraduate research in the College of Nanoscale Science and Engineering. The data presented throughout the body of the proposal was obtained by Graham Potter, a graduate student on the project, and myself. Dr. James Castracane oversaw the project, which was funded through SEMATECH. The grant proposal format follows standard NIH guidelines. In short, It outlines our findings in the time I was on the project, and includes my ideas for a future research plan to continue investigating surface acoustic wave devices for nanoscale particle removal. The proposal also includes a detailed description of required funding based on the materials needed to continue research as per the proposed research outlined in the body of the proposal. Honors College Thesis – Grant Proposal Page iii


Bolted joints are one of the most common fastening methods in engineering applications. To meet the requirements of structural parts, the torque method is often used for controlling the bolted joint performance. However, only a few investigations have been carried out on the conversion efficiency of bolt torque to the tensile force, leading to uncertainty and potential safety hazards during the bolt tightening. In order to study the input torque distribution and overcome problems caused by the Motosh method and experimental investigations, a new energy-based torque distribution model is established in the present study. In the proposed model, numerous affecting parameters, including the effective bearing radius, effective thread contact radius, spiral angle, and connector deformation are considered. Then a parameterized thread mesh model using finite element technology is proposed to analyze the influence of different bolt friction coefficients on the bolt tightening process. Based on 16 types of tightening analyses, it is concluded that as bolt friction coefficient increases, the corresponding torque conversion rate decreases from 14.45% to 7.89%. Compared with the Motosh method, the torque conversion rate obtained by the proposed method is relatively large, which makes the actual pre-tightening force larger than the design value. However, there is still a possibility of bolt failure.


Objective To explore the effect of the bidirectional Glenn procedure on complex cardiac malformations with anomalies of systemic venous drainage (ASVD), pulmonary venous drainage (APVD), or both. Methods Between March 2010 and December 2013, 29 patients with anomalous systemic or pulmonary venous drainage underwent bidirectional cavopulmonary shunt. The man age of these patients was (60.8 ± 49.6) months and the mean weight was weight (17.6 ± 10.4) kg. A combination of anomalous systemic and pulmonary venous drainage was present in 3 patients, whereas 20 patients had anomalous drainage only from the systemic circulation and 6 patients had isolated anomalies of pulmonary venous return. Results All the patients underwent unilateral or bilateral bidirectional Glenn operation, and the associated procedures included ligation of small left superior vena cava in 3 patients, modified BT shunt to left pulmonary artery in 1 patient, correction of anomalous pulmonary venous drainage in 3 patients, atrioventricular valvuloplasty in 4 patients, pulmonary banding in 3 patients. There were 1 (3.4%) early death due to malignant arrhythmias. Two patients required for reoperation for bleeding, 2 patients developed pericardial effusion, 1 patient developed cerebral embolism and 1 patient developed wound dehiscence. At a mean follow-up of (17.4 ± 10.9) months, no death occurred, the mean blood oxygen saturation was (84 ± 6)%, and 2 patients have undergone total cavopulmonary connexion. One patient received radiofrequency ablation for WPW syndrome, and two patients need medication for decreasing pulmonary artery pressure. Conclusion Bidirectional cavopulmonary shunt can be performed in patients with anomalous systemic or/and pulmonary venous drainage with satisfactory early and mid-term outcomes. The combination of multiple surgical procedures may be an important way to improve outcomes.


In studying affect within the realm of student-teacher relationships my thesis project use the concept of "affect" as composed by Baruch Spinoza (1992, 2007). I focus specifically on how Deleuze (1988) interprets and implements the term within his own philosophy, as well as on Antonio Negri's (2011, 1991) work on Spinoza including his and Michael Hardt's (2000, 2004, 2009) more recent works. This thesis will explore Spinoza's affect within the discourse of Affective Pedagogy and Critical Pedagogy while remaining committed to a Spinoizist ontology as outlined by Deleuze (1988). I used artefacts from my past experiences as a student and teacher to produce evocative writing pieces which act as affective continuances of my past experiences as a student, studentteacher, and teacher, and the relationships of affect that composed them. This project used these artefacts and the writings they produced as sites of intensity that are carried through from traces, to evocative thresholds, to concepts, and finally into analysis.


CONTEXT
Kaiser Permanente's Care Management Institute created a screening tool, Your Current Life Situation (YCLS), which primarily is used to identify social needs for populations at risk of high health care utilization.

OBJECTIVE
This frontline improvement project was designed to address key stakeholder concerns about implementing universal screening for social needs using the YCLS in a primary care clinic.

METHODS
I conducted a rapid stakeholder analysis through informal conversations to identify the most important concerns. Four Plan-Do-Study-Act cycles were conducted to answer stakeholder questions and address concerns.

RESULTS
Stakeholders expressed concerns including YCLS length and low screening acceptability and the possibility that too few or too many patients may have social needs. Throughout the project's duration, 125 office visits occurred and 111 patients were screened. Among the patients for whom findings were positive, 27% requested help. Of the 14 patients who were not screened, only 1 patient opted out of screening. Practitioners and medical assistants stated that administration of the YCLS screening tool did not disrupt clinic workflow.

CONCLUSION
By using a frontline improvement approach, these investigators could answer questions and address concerns most important to local operational stakeholders when implementing screening for social needs. When practitioners conduct universal social needs screening and more fully understand social needs prevalence in a primary care clinic, resources can be tailored more effectively to accommodate patient needs.