Implementation of suitable innovation packages into cropping systems is required to address the issues of food security and improvement of the crop yield in Sub-Saharan Africa. However, quantification of the effects of innovation packages such as increase in fertilizer application rates, introduction of high yielding cultivars or change in farming practices such as sowing date and irrigation, generally requires substantial investments, in particular the quantification at large scales. Crop models are widely employed to estimate the impacts of agronomic decisions on cropping systems and to detect the most suitable areas for their implementation. The main goal of the study is to quantify the effects of a) change in nitrogen fertilization rate, b) adjustment of sowing date, c) implementation of new cultivars, and d) supplementary irrigation on maize cropping systems across six African countries including Ghana, Nigeria, Kenya, Malawi, Ethiopia and Burkina Faso. For this purpose, 30 years (1980-2010) of climate data are used as well as soil and management information obtained from global datasets at 0.5° x 0.5° spatial resolution. The nitrogen and cultivar packages were tested for all six countries whereas the changes in sowing dates (Ghana and Malawi) and the irrigation (Ethiopia) package were used in specific countries only. The crop modelling framework SIMPLACE was used to test the effects of innovation packages at the country level. The model results indicated that the agronomic innovation packages could improve maize yield by 1 t ha-1 to 2.3 t ha-1 in the studied countries. The magnitude of the yield improvement is country and package specific. The largest maize yield improvements across the packages were obtained by increase in nitrogen application rate, assuming that other nutrients like phosphorus and potassium are not limiting crop growth and yield. However, in some cases a combination of the agronomic innovation packages showed the highest maize yield. We conclude that it is vital to combine the agronomic packages to fill the gap between potential and current yields of maize in Africa. This will require appropriate incentives and investments in extension services, fertilizer distribution networks, and farmer capacity building.


We examine "conversational receptiveness" – the use of language to communicate one's willingness to thoughtfully engage with opposing views. We develop an interpretable machine-learning algorithm to identify the linguistic profile of receptiveness (Studies 1A-B). We then show that in contentious policy discussions, government executives who were rated as more receptive according to our algorithm and their partners, but not their own self-evaluations were considered better teammates, advisors, and workplace representatives (Study 2). Furthermore, using field data from a setting where conflict management is endemic to productivity, we show that conversational receptiveness at the beginning of a conversation forestalls conflict escalation at the end. Specifically, Wikipedia editors who write more receptive posts are less prone to receiving personal attacks from disagreeing editors (Study 3). We develop a "receptiveness recipe" intervention based on our algorithm. We find that writers who follow the recipe are seen as more desirable partners for future collaboration and their messages are seen as more persuasive (Study 4). Overall, we find that conversational receptiveness is reliably measurable, has meaningful relational consequences, and can be substantially improved using our intervention (183 words).


Background: Sleep-disordered breathing (SDB), predominantly obstructive sleep apnea (OSA), is a frequent phenomenon in interstitial lung disease (ILD) and may be associated with significant morbidity and mortality. Methodology: A prospective, observational, hospital-based study was conducted in a tertiary care hospital after ethics committee permission. The study group consisted of 100 consecutive ILD patients diagnosed by a multidisciplinary diagnosis. They were evaluated for the prevalence of SDB with a polysomnography after a comprehensive history, detailed clinical examination, calculation of various pretest probability scores, and relevant prerequisite workup. Results: Out of the total 100 ILD patients, 44 were male (44%) and 56 were female (56%). SDB was present in 57 (57%) patients. Of these, 29 (29%) were found to have only nocturnal oxygen desaturation (NOD), while 28 (28%) had OSA. The 28 cases of OSA were distributed as 15 mild OSA (53.57%), 10 moderate OSA (35.71%), and 3 severe OSA (10.71%). The patients were divided into the following four groups: total study Group (A), patients with OSA (Group B), patients with NOD without OSA (Group C), and no SDB (Group D). The mean forced vital capacity values predicted in the four groups were 53.67%, 50%, 45.56%, and 57.87%, respectively. The mean body mass index in the four groups was 24.56, 27, 26.98, and 24.89 kg/m2, respectively. The mean 6-min walk distance in the four groups was 280.7, 250, 256.65, and 311.4 m, respectively. The mean partial pressure of oxygen in the four groups was 65.65, 60, 62.10, and 75.66 mmHg, respectively. The mean apnea–hypopnea index in the study group was 2.98/h, 8.6/h with mild OSA, 21.69/h with moderate OSA, 48.78/h with severe OSA, 3.89/h in patients having NOD without OSA, and 2.54/h in patients with no SDB. Conclusion: SDB in ILD is associated with a significant impact on the cardinal determinants of functional capacity, lung function, and quality of life.


The spectral behavior of regular Hermitian matrix pencils is examined under certain structure-preserving rank-1 and rank-2 perturbations. Since Hermitian pencils have signs attached to real (and infinite) blocks in canonical form, it is not only the Jordan structure but also this so- called sign characteristic that needs to be examined under perturbation. The observed effects are as follows: Under a rank-1 or rank-2 perturbation, generically the largest one or two, respectively, Jordan blocks at each eigenvalueare destroyed, and ifis an eigenvalue of the perturbation, also one new block of size one is created at �. Ifis real (or infinite), additionally all signs atbut one or two, respectively, that correspond to the destroyed blocks, are preserved under perturbation. Also, if the potential new block of size one is real, its sign is in most cases prescribed to be the sign that is attached to the eigenvaluein the perturbation.


BACKGROUND
Seizures and status epilepticus (SE), both clinical and subclinical, are frequent in critically ill patients. The list of available antiseizure medications (ASMs) is expanding and now includes older and widely used drugs as well as more recent medications with a better safety and pharmacokinetics profile.

METHODS
We review a selection of recent publications about the indications and administration of ASMs in critical care for the prophylaxis and treatment of seizures and SE, focusing on recent ASMs available as intravenous formulation and emphasizing pharmacokinetics and safety issues in relation to several aspects of critical illness.

RESULTS
Levetiracetam, lacosamide and more recently brivaracetam, represent interesting alternatives to older ASMs, mostly due to a more favorable safety and pharmacokinetic profile. Low-quality studies suggest that this profile results in better tolerability in treated patients. Ketamine might represent a useful addition in our anesthetic armamentarium for refractory SE, due to its different mechanism of action and cardiovascular properties. Little evidence is available however to support the prophylactic use of ASMs in critically ill patients, except in specific settings (traumatic brain injury and subarachnoid hemorrhage). Head-to-head studies comparing recent and older ASMs in the treatment of acute seizures and SE are ongoing or awaiting publication. Administration of ASMs to critically ill patients needs to be adapted to organ dysfunction, and especially to renal dysfunction for recent drugs.

CONCLUSIONS
Recent ASMs and could represent better treatment choices in critically ill patients than older ones but this needs to be confirmed in randomized controlled studies. In general, further studies are required to clarify the indications and optimal use of ASMs in the critical care setting.


The river is a main source to fulfill the basic needs of drinking water & irrigation. Due to multifarious anthropogenic activities has created havoc to the river health. Therefore, it is imperative to assess the river health to make it suitable for various purposes. In this study, various water quality indices (WQI) used for assessing river health are discussed. The literature reveals that water quality parameters are the most significant tool to assess the river health. In this paper an attempt has been made to assess the river health by using different methods viz. EQI, RPI & OPI. It is found that the RPI method is most effective, less time consuming and cost effective. By using different methods, it is found that the river health of Chambal River comes in average category, gives an indication that river is slightly/moderately polluted


Digitalization drives constantly changes in organizations, whereby disruptive technologies can act as a catalyzer for such adaptions. Specifically, blockchain as an emerging technology establishes data-driven businesses by offering an open and decentralized ecosystem for any kind of transactions. Among others, such blockchain ecosystems can be used by companies for crowd-sourcing to achieve competitive advantages through new access to external knowledge. In addition, new possibilities to integrate business intelligence into public distributed ledgers arise, allowing the investigation and analyses of information created by crowd communities. In our paper, we discuss the foundations of blockchain-based crowd-sourcing by applying the theories of absorptive capacity and knowledge of the firm. We used design science research and derived four general design requirements based on selected literature. The proposed findings serve as a starting point for designing blockchain-based crowd-sourcing applications and resulting business intelligence possibilities, which represent novel ways to transform information into winning business decisions.


The morphology and mechanical properties of PVC/SMA-g-PA6 blends were investigated in this paper. Graft to polymer SMA-g-PA6 was prepared via a solution graft reaction between SMA and PA6. FTIR test evidences the occurrence of the graft reaction between SMA and PA6. DSC analysis shows that SMA-g-PA6 has a lower melting point of 187°C, which may result in a decrease in crystallinity of PA6 and thus enable efficient blending of SMA-g-PA6 and PVC. Compatibilization was evidenced by the dramatic increase in mechanical properties, the smaller particle size and finer dispersion of PA6 in PVC matrix, and, further, a cocontinuous morphology at 16 wt % SMA-g-PA6 content. SMA-g-PA6 from the solution graft reaction can toughen and reinforce PVC material. © 2004 Wiley Periodicals, Inc. J Appl Polym Sci 94: 432–439, 2004


Background: Catheter-associated urinary tract infections (CAUTIs) are associated with urinary catheterization. Up to 25% of hospitalized patients may be catheterized during their stay. Urethral catheters are necessary as part of many urologic procedures, but the removal of unnecessary catheters has become more important to reduce infections, healthcare costs, and patient morbidity. Methods: Open access data from the U.S. Centers for Disease Control and Prevention (CDC), United States Census, and the American Urological Association (AUA) Census was obtained, and a linear correlation used to determine relations. Results: A correlation between the number of urologists per hospital and CAUTIs per hospital was found in both the wards and intensive care units (ICU; p < 0.01). A similar relation was found between the number of urology residencies per hospital and CAUTIs per hospital in the wards (p < 0.01), but this was not significant in the ICU (p = 0.15). The number of urology residencies per state was correlated with the number of urologists per state (p < 0.01). No correlation between state population density and hospital number of CAUTIs, urologists, and urology residencies was found. Conclusions: Increased number of urologic procedures and the need for catheterizations likely drives the correlation with urologists and CAUTIs. Despite this, no urologists are on the CDC committee that created CAUTI guidelines. Urologists should be considered for hospital and national committees particularly because they often care for these patients in the outpatient setting.


Neurodegenerative processes of various types of dementia start years before symptoms, but the presence of a "neural reserve", which continuously feeds and supports neuroplastic mechanisms, helps the aging brain to preserve most of its functions within the "normality" frame. Mild cognitive impairment (MCI) is an intermediate stage between dementia and normal brain aging. About 50% of MCI subjects are already in a stage that is prodromal-to-dementia and during the following 3 to 5 years will develop clinically evident symptoms, while the other 50% remains at MCI or returns to normal. If the risk factors favoring degenerative mechanisms are modified during early stages (i.e., in the prodromal), the degenerative process and the loss of abilities in daily living activities will be delayed. It is therefore extremely important to have biomarkers able to identify—in association with neuropsychological tests—prodromal-to-dementia MCI subjects as early as possible. MCI is a large (i.e., several million in EU) and substantially healthy population; therefore, biomarkers should be financially affordable, largely available and non-invasive, but still accurate in their diagnostic prediction. Neurodegeneration initially affects synaptic transmission and brain connectivity; methods exploring them would represent a 1st line screening. Neurophysiological techniques able to evaluate mechanisms of synaptic function and brain connectivity are attracting general interest and are described here. Results are quite encouraging and suggest that by the application of artificial intelligence (i.e., learning-machine), neurophysiological techniques represent valid biomarkers for screening campaigns of the MCI population.


Ultraviolet detection has advantages of high sensitivity and low false alarm rate. Analysis of ultraviolet characteristics has great significance for space target detection. An accurate modeling method is proposed for the ultraviolet characteristics of space target. Based on the background environment and material properties of space target, region and grid division are generated, and the mathematical model of ultraviolet characteristics of space target is established by introducing bidirectional reflectance distribution function. The position relations of target, detector and background radiation source are determined by coordinate transformation algorithm. The calculation flow for ultraviolet characteristics of space target is derived. Finally, the observed ranges and irradiation distributions of Ziyuan-1 and Fengyun-3 satellite are calculated by the given parameters. The simulation results demonstrate the validity of the modeling method.


Data on chloramphenicol sensitivity of clinical Proteus strains isolated within 1970--1975 and some mechanisms of their resistance to this antibiotic are presented. It was found that most of the Proteus strains (62.82 +/- 2.15 per cent) were resistant to chloramphenicol. 75 per cent of the isolates had resistance of transmissive character. Resistance of the Proteus cultures to chloramphenicol was not a stable feature and was lost during storage under laboratory conditions. Direct correlation between stability of the antibiotic resistance in the Proteus, the resistance level and the period of the culture storage was found. It was shown that the transmissive resistance to chloramphenicol in the Proteus cultures was due to synthesis of a highly active constituitive chloramphenicol-inactivating enzyme. Direct relation between the Proteus resistance level to chloramphenicol and the rate of the enzyme synthesis was noted. A number of the Proteus strains phenotypically sensitive to this antibiotic was capable of its inactivation. Still, the activity of the enzyme was low. The rate of the enzyme synthesis and the level of the acquired resistance in the chloramphenicol resistant mutants depended on the presence or absence of the enzyme in the cells of the initial sensitive strain. The capacity for chloramphenicol accumulation in a number of the chloramphenicol resistant mutants of the Proteus was decreased.


Deep brain stimulation (DBS) is an established treatment option for advanced stages of Parkinson's disease and other movement disorders. It is known that DBS is susceptible to strong electromagnetic fields (EMFs) that can be generated by various electrical devices at work, home, and in medical environments. EMFs can interfere with the proper functioning of implantable pulse generators (IPGs). Very strong EMFs can generate induction currents in implanted electrodes and even damage the brain. Manufacturers of DBS devices have issued a list of warnings on how to avoid this danger.Strong EMFs can result from natural forces as well. The authors present the case of a 66-year-old woman who was being treated with a rechargeable DBS system for neck dystonia when her apartment was struck by lightning. Domestic electronic devices that were operating during the event were burned and destroyed. The woman's IPG switched off but remained undamaged, and she suffered no neurological consequences.


We propose efficient algorithms for simultaneous clustering and completion of incomplete high-dimensional data that lie in a union of low-dimensional subspaces. We cast the problem as finding a completion of the data matrix so that each point can be reconstructed as a linear or affine combination of a few data points. Since the problem is NP-hard, we propose a lifting framework and reformulate the problem as a group-sparse recovery of each incomplete data point in a dictionary built using incomplete data, subject to rank-one constraints. To solve the problem efficiently, we propose a rank pursuit algorithm and a convex relaxation. The solution of our algorithms recover missing entries and provides a similarity matrix for clustering. Our algorithms can deal with both low-rank and high-rank matrices, does not suffer from initialization, does not need to know dimensions of subspaces and can work with a small number of data points. By extensive experiments on synthetic data and real problems of video motion segmentation and completion of motion capture data, we show that when the data matrix is low-rank, our algorithm performs on par with or better than low-rank matrix completion methods, while for high-rank data matrices, our method significantly outperforms existing algorithms.


Decoherence of a central spin coupled to an interacting spin bath via inhomogeneous Heisenberg coupling is studied by two different approaches, namely an exact equations of motion (EOMs) method and a Chebyshev expansion technique (CET). By assuming a wheel topology of the bath spins with uniform nearest-neighbor $XX$-type intrabath coupling, we examine the central spin dynamics with the bath prepared in two different types of bath initial conditions. For fully polarized baths in strong magnetic fields, the polarization dynamics of the central spin exhibits a collapse-revival behavior in the intermediate-time regime. Under an antiferromagnetic bath initial condition, the two methods give excellently consistent central spin decoherence dynamics for finite-size baths of $N\ensuremath{\le}14$ bath spins. The decoherence factor is found to drop off abruptly on a short time scale and approach a finite plateau value which depends on the intrabath coupling strength nonmonotonically. In the ultrastrong intrabath coupling regime, the plateau values show an oscillatory behavior depending on whether $N/2$ is even or odd. The observed results are interpreted qualitatively within the framework of the EOM and perturbation analysis. The effects of anisotropic spin-bath coupling and inhomogeneous intrabath bath couplings are briefly discussed. Possible experimental realization of the model in a modified quantum corral setup is suggested.


Background Several examples have emerged of enzymes where slow conformational changes are of key importance for function and where low populated conformations in the resting enzyme resemble the conformations of intermediate states in the catalytic process. Previous work on the subtilisin protease, Savinase, from Bacillus lentus by NMR spectroscopy suggested that this enzyme undergoes slow conformational dynamics around the substrate binding site. However, the functional importance of such dynamics is unknown. Methods Here we have probed the conformational heterogeneity in Savinase by following the temperature dependent chemical shift changes. In addition, we have measured changes in the local stability of the enzyme when the inhibitor phenylmethylsulfonyl fluoride is bound using hydrogen-deuterium exchange mass spectrometry (HDX-MS). Finally, we have used X-ray crystallography to compare electron densities collected at cryogenic and ambient temperatures and searched for possible low populated alternative conformations in the crystals. Results The NMR temperature titration shows that Savinase is most flexible around the active site, but no distinct alternative states could be identified. The HDX shows that modification of Savinase with inhibitor has very little impact on the stability of hydrogen bonds and solvent accessibility of the backbone. The most pronounced structural heterogeneities detected in the diffraction data are limited to alternative side-chain rotamers and a short peptide segment that has an alternative main-chain conformation in the crystal at cryo conditions. Collectively, our data show that there is very little structural heterogeneity in the resting state of Savinase and hence that Savinase does not rely on conformational selection to drive the catalytic process.


A statewide survey of staff development practices in New York State was completed to: 1) assess the current staff development practices for laboratory personnel in a variety of health care delivery settings; 2) determine the importance of selected laboratory practices to the professional growth of the laboratory staff; 3) make recommendations for staff development practices based on research findings. The study results are based on responses to a 1978 mail survey to laboratory staff employed in New York State. The most significant findings were that in over half of the laboratory settings surveyed three of six general types of laboratory staff development practices were nonexistent. Furthermore, regardless of size and/or type of laboratory setting, there were rare opportunities for staff development. The findings have implications for level of job satisfaction, level of professionalism, and even performance appraisal.


The American criminal justice system falls far short of democratic ideals. In response, democratic communitarian localism proposes a more decentralized system with a greater emphasis on local control. This approach aims to deconcentrate power and remove bureaucracy, arguing local control would reflect informal cultural life better than our current system. This view fails to adequately address localized domination, however, including in the background culture of society. As a result, it underplays the need for transformative, democratizing change. Rejecting communitarian localism, I defend a mass deliberative democratic approach to criminal justice reform that relies on institutions outside localities to democratize local institutions and background cultural patterns. Nonetheless, local institutions must be empowered to exert democratic control, as well as to influence institutions outside the locality. This process of democratic co-development offers greater hope for political equality, non-domination, and inclusive democratic deliberation about criminal law than democratic communitarian localism.


Recently, a novel processing route for fabricating microcellular ceramics has been developed. The strategy for making the microcellular ceramics involves: (i) forming some shapes containing a mixture of preceramic polymer, expandable microspheres and optional fillers by a conventional ceramic forming method, (ii) foaming the compact by heating, (iii) cross-linking the foamed body, and (iv) transforming the foamed body into microcellular ceramics by pyrolysis. The flexural strength and compressive strengths of the microcellular ceramics were investigated; values up to 30 MPa and 100 MPa, respectively, were obtained at room temperature. The superior mechanical properties were attributed to homogeneous distribution of cells in microcellular ceramics.


Research has documented anomalous organization of random events generated by an electronic random events generator (REG) during various group situations that promote group consciousness experiences. A group situation hypothesized to promote an intense group consciousness experience was an international Qigong conference. Over 2500 invited guests, scientists and practitioners from many countries attended the 1997 International Yan Xin Qigong Practice and Research Conference in New York City on August 30-September 1. Three basic REG predictions were evaluated: (1) the null hypothesis, (2) deviations from randomness would be observed during the days and would disappear during the nights, and (3) deviations from randomness would be observed during the days and continue during the nights (predicted by Chinese scientists YX, ZS, and LS to reflect "accumulating Qi over the entire meeting"). Three days and two nights of FieldREG data were collected prior to, during, and following the conference. During the conference, a total of 234,412 trials of 200 samples per second reflecting I's and 0's (100 I's would be expected to occur by chance per second on the average) were collected using a PEAR computerized FieldREG system and stored for later analysis. When the 3 days and 2 nights were analyzed in terms of trials above versus below 100, each of the five segments showed relative increases (p < .023). These patterns were not observed during the pre and post conference control days and nights. The data provide tentative support for the hypothesis that an intense group experience that continues over a three day period may create a consciousness or Qi field that can be discerned using the Fie1dREG paradigm.


kept coming up painfully in my left upper abdomen as if there were a pair of bellows left inside. By the time that I had been readmitted to hospital for Christmas and the surgeon said that I had a subacute obstruction that could be cured by a further operation, my only feeling was relief at what earlier that month would have been unthinkable. After four pints of blood I felt well, and the second operation was not too bad at all. After it, however, I developed a high pyrexia of unknown origin for a week, which did not respond to parenteral antibiotics but disappeared magically with the sudden discharge of 300 cc of bile-stained pus from the abdominal drain. Later I became anaemic again and required several transfusions, but I was told this was temporary bone marrow shut down that happened after intra-abdominal infection, and I was never too worried about this, once sternal puncture had shown nothing malign. The worst part of what stretched to five months off work was the constant pruritus, particularly affecting the back. Local antipruritics and antihistamines were ineffective, but it was cured through what I regard as a brilliant clinical hunch that it might be due to zinc deficiency. The professorial unit of my own hospital turned out to be interested in trace metals, and there was no difficulty in obtaining a serum zinc estimation. This was very low, and the itching was cured after taking simple zinc sulphate capsules twice a day for a fortnight. After three months back at work, the final operative repair of an incisional hernia with three days in hospital was almost an anticlimax. The future


Patients and staff may have difficulty facing the realities of a dangerous situation on an inpatient service. The authors describe how, in response to the presence of a potentially violent patient, distorted patient communications in group settings may be reinforced by staff avoidance patterns. Appropriate therapeutic interventions are often delayed until staff members overcome their resistance to acknowledging the signals that frightened patients send. The authors discuss strategies to circumvent and overcome these problems.


This paper examines the legal tools that may be available to patients with rare diseases seeking to compel Canadian governments to provide funding for required or desired treatments. In making health care coverage decisions, governments must decide whether to extend funding to cover potentially expensive treatments that benefit relatively few people, particularly when those treatments are experimental. If particular treatments are not covered by health insurance, patients
with rare diseases may turn to the courts with claims based in constitutional, human rights, administrative, international or tort law, in an effort to compel the government to provide funding. Strategies that employ the courts in this way are unlikely to be successful, as courts tend to defer to government on these types of policy-driven decisions.


This document specifies an extension of OSPF for IPv6 to support
mobile ad hoc networks (MANETs). The extension, called OSPF-MDR, is
designed as a new OSPF interface type for MANETs. OSPF-MDR is based on
the selection of a subset of MANET routers, consisting of MANET
Designated Routers (MDRs) and Backup MDRs. The MDRs form a connected
dominating set (CDS), and the MDRs and Backup MDRs together form a
biconnected CDS for robustness. This CDS is exploited in two ways.
First, to reduce flooding overhead, an optimized flooding procedure is
used in which only (Backup) MDRs flood new LSAs back out the receiving
interface; reliable flooding is ensured by retransmitting LSAs along
adjacencies. Second, adjacencies are formed only between (Backup) MDRs
and a subset of their neighbors, allowing for much better scaling in
dense networks. The CDS is constructed using 2-hop neighbor
information provided in a Hello protocol extension. The Hello protocol
is further optimized by allowing differential Hellos that report only
changes in neighbor states. Options are specified for originating
router-LSAs that provide full or partial topology information,
allowing overhead to be reduced by advertising less topology
information.


India is poised to use nuclear energy in a big way. The safety of these systems depends upon monitoring various parameters in hazardous environment like high radiation, high temperature exceeding 1000°C, and gas/coolant leakages. In this chapter, we shall dwell on basics of distributed sensing, related instrumentation, device fabrication, and actual advanced field applications. Techniques like Raman scattering, resonance response of fiber gratings, and selective absorption are employed for design, development, and fabrication of distributed sensors and devices. Raman distributed sensors with advanced data processing techniques are finding increasing applications for fire detection, coolant leak detection, and safety of large structures. The systematic investigations related to portable systems developed at the author ' s lab have been described. Wavelength-encoded fiber gratings are the attractive candidate for high gamma radiation dose measurements in environment such as particle accelerators, fission reactors, food processing facilities, and ITER-like installations. The basics of fiber gratings, their operational designs, and devices based on fiber gratings have been described with advanced applications like high temperature sensing, strain measurements at cryogenic temperatures, and strain in nuclear environment. Finally, novel approaches are described for distributed hazardous gas monitoring for large areas such as airports, train stations, and reactor containment buildings.


Data mining has a significant impact in information management in discovering patterns in order to use the gained knowledge to develop strategies and future plans. Employees are one of the determining factors for the success of a firm in a global economy. We use data mining to discover useful patterns from the employee faults in manufacturing to enhance employee efficiency. Employees can understand the "why" behind their jobs with the help of the generated rules to be successful in the job. The acquired decision tree model is different from existing methods that have problems such as difficulty to understand.


The effects of floral morphology and breeding behavior on flower longevity were investigated in Easter cactus (Hatiora ×graeseri (Werderm.) Barthlott)). Four clones were studied: two diploid ( n = 11) clones ('Evita' and 'Purple Pride') that were highly self-incompatible (SI), and two cytochimeras (diploid epidermis and tetraploid subepidermis) that were recovered from the diploid cultivars, both of which were self-compatible (SC). The clones exhibited differences in the stage of floral development in which autogamy commenced. Autogamy commenced on the day of anthesis in the two 'Evita' clones and occurred ≈5 days after anthesis in the 'Purple Pride' cytochimera. In the 'Purple Pride' diploid clone, anthers and stigmatic lobes remained spatially separated during the period from anthesis to senescence. Examination of styles collected from senesced, undisturbed flowers showed that few pollen tubes traversed to the base of the styles for the two SI diploid clones, whereas large numbers of pollen tubes were present at the base of the styles for the two SC cytochimeras. Flower longevity for the 'Evita' cytochimera was significantly less than for 'Evita' diploid, but the diploid and cytochimeral clones of 'Purple Pride' exhibited similar flower longevities. Application of 2 m M silver thiosulfate, an inhibitor of ethylene (C 2H4) action, did not affect flower longevity of 'Evita' cytochimera. Our results show that flower longevity in Easter cactus is influenced by breeding behavior and the stage of floral development at which autogamy commences. and is often associated with an SC breeding system (Ross, 1981). The objectives of the present investigation were to study flower longevity in diploid (SI) and cytochimeral (SC) clones of 'Evita' and 'Purple Pride' Easter cactus, and determine if flower longevity was influenced by floral morphology or breeding be- havior.


This paper studies the existence of "excess" current-account imbalances in Chile in the 1960-1999 period. This phenomenon is modeled using present value tests that allow for variable interest rates and exchange rate fluctuations. Despite its simplicity, most of the observed imbalances in the current account are accounted for by the model. Results suggest that using models where agents behave as forward-looking rational agents, is a valid framework. Moreover, the analysis highlights the relevance of variable interest rates and exchange rates. Results also imply that capital controls, that were widely used in the period under study, were not effective.


Objectives: This paper presents the ultimate load carrying capacity and behaviour of Cold Formed Steel (CFS) starred section with different end conditions and the specimens are subjected to axial compression. Methods: Theoretical study is carried out by using Euler's load equation. Six plain sections of different sizes of 2mm thickness were tested as short columns. The analytical study is carried out using FEM software. The specimen used for testing have different dimensions, 60×60×2mm and 50×50×2mm with welded end condition, balled end condition and bolted end condition. The specimens are also tested experimentally by applying axial compression loading. Findings: The analysis is numerically carried out using FEM software and the results are compared. The experimental investigation of the cold-formed steel column is carried out by testing the column under loading frame with load applied manually and the test results are found match with the theoretical values. Compression tests were carried out on cold-formed steel starred angles under different end connections. As a result, welded end condition provides more strength than balled end condition where balled end condition provides more strength than the bolted end condition. Applications: This results can be further used with different section size or with different end condition under different loading conditions to find the ultimate strength of cold formed steel.


The paper aims to provide a theoretical overview of the nature of the transport system within the context of sustainable development and to study the framework indicators of the development of freight and passenger transport so as to identify opportunities for improving the infrastructure and applying global practices to the Bulgarian transport sector. The paper therefore provides a theoretical overview of the nature of the transport system and the sustainable development of decision making to overcome spatial disparities between freight and passengers. The effects and indicators of sustainable development of the transport of passengers and freight have been systematized. The research focuses on two major areas and has two main objectives: to ensure high mobility of freight and passengers and to reduce the adverse impact of transport on the environment, in line with the 'Energy consumption as a percentage of the GDP' indicator and measured through specific indicators. The study also focuses on two other framework indicators 'Security and safety' and 'Environmental indicators'. The analysis is based on official statistics from Eurostat and the Bulgarian National Statistical Institute. Based on the theoretical overview and the analysis of the empirical data, we have identified local problems as well as opportunities for improving the quality of the transport infrastructure in Bulgaria and adjusting world practices to the situation in Bulgaria in order to contribute to the active implementation of sustainable development ideas to the transport sector in the country.


Many faculty members demonstrate unwavering resistance to adopting research- based instructional strategies. This phenomenon commonly fits with motivated reasoning, whereby a person feels threatened by persuasion to change, leading to overtly defensive and sometimes disruptive behaviors and refusal. Changing away from established practices may challenge one's self- identity and values as an effective teacher and triggers arguments intended to invalidate research- based alternatives. Faculty who are motivated to reject consensus best practices may impede the implementation of these practices across entire departments or institutions. Motivated reasoning and its underlying cognitive processes are explained by self- determination theory, which leads to predictions of faculty behaviors and suggesting more effective persuasion approaches by educational developers. Change conversations need to preserve the basic psychological needs of autonomy, competence, and relatedness (espe-cially within affinity groups) in order to succeed. Importantly, persuasive argumentation with data or authoritative viewpoints, which succeeds with many faculty who electively attend educational- development programs, will predictably have limited success with faculty who respond with motivated reasoning.


Abstract Field studies were conducted from 2004 to 2006 to evaluate the tolerance of three annual medic species (bur, black, and barrel medic) to selected POST herbicides. 2,4-DB at 0.56 and 1.12 kg/ha caused the most stunting across all three species. Imazethapyr at 0.1 kg/ha stunted all three annual medics in 1 of 3 yr whereas flumetsulam at 0.04 kg/ha stunted black and barrel medics in 1 of 3 yr. Clethodim at 0.28 kg/ha did not cause any medic stunting. Imazethapyr, imazamox, and 2,4-DB at 0.56 kg/ha reduced henbit dry matter composition compared to the untreated check whereas clethodim, flumetsulam, and 2,4-DB at 1.12 kg/ha did not. In 2004, 2,4-DB at 1.12 kg/ha reduced dry weight yield of bur and barrel medic but not black medic when compared with the untreated check. Black medic treated with imazethapyr at 0.05 and 0.1 kg/ha and clethodim at 0.28 kg/ha produced higher dry weight yield than the untreated check. In 2006, both rates of 2,4-DB and flumetsulam at 0.04 kg/ha reduced dry weight yield of bur medic compared to the untreated check. Barrel medic dry weight yields were reduced by both rates of 2,4-DB and flumetsulam compared to untreated check. No herbicides reduced dry weight yields of black medic. Nomenclature: Clethodim; 2,4-DB; flumetsulam; imazamox; imazethapyr; henbit, Lamium amplexicaule L. LAMAM; bur medic, Medicago polymorpha L. 'Armadillo'; black medic, Medicago lupulina L. 'BeBlk'; barrel medic, Medicago truncatula L. 'Jemalong'.


Along with the economical development, the automobile enhances unceasingly in our country's inventory. The automobile profession takes the national support the pillar industry, has the very big promoter action to national economy's development. In recent years, the independent road sense's research and the application in domestic and foreign developed rapidly, was honored as the automobile profession the next technological revolution. This topic basis independent road sense's demand, studied one kind to be possible to use in independent driving the range measuring system. This system take the binocular range finder as a principle, may supply around the automobile body the object distance information, the precise periphery object distance information is the independent road sense foundation, thus this topic research results have the broad application space. Carries on regarding the binocular range finder's analysis under the OpenCV environment, OpenCV takes one kind to open the source the machine vision function storehouse, in the last few years along with the edition renewal, the function strengthened gradually, has involved machine vision nearly all domains. The research on two-sided visual in the OpenCV environment, simplified the binocular vision development step, sped up the development progress.


PURPOSE/OBJECTIVES
To describe the mental and emotional impact of treatment for breast cancer with a focus on the ways the body is experienced.

DESIGN
Phenomenologic, descriptive, and interpretive.

SETTING
An outpatient treatment area of a comprehensive cancer center in the southwestern United States.

SAMPLE
20 women, ages 20-68 (mean = 50 years), who had mastectomies (including both modified radical mastectomies and lumpectomies, with some having reconstruction) for breast cancer.

METHODS
Content analysis of verbatim transcriptions of open-ended interviews using hermeneutic phenomenology and descriptive and interpretive presentation of a paradigm case.

MAIN RESEARCH VARIABLES
Reaction to breast cancer and its treatment.

FINDINGS
Informants' descriptions demonstrate that the body can be viewed as having three aspects: (a) the body as symbol or social expression (i.e., how bodies make a social statement and tell others who you are); (b) the body as a way of being in the world, including sensations and symptoms such as nausea, fatigue, and pain; and (c) the existential sense that one needs a body to be in the world (i.e., the body expresses existence), which led to more awareness of the possibility of death.

CONCLUSIONS
Women treated for breast cancer view their bodies in ways that go beyond what is suggested by the literature on body image and breast cancer, encompassing a wide range of responses.

IMPLICATIONS FOR NURSING PRACTICE
The contribution of this study is the documentation of the complexity of the meaning of "body" for women with breast cancer. Appropriate interventions differ for each aspect of the body: for the body as social symbol, programs such as Look Good ... Feel Better or image centers; for the body's sensations and symptoms, information about what to expect and about symptom prevention and management; for the existential body, active listening to fears and concerns and providing assistance as needed.


The present study was performed to observe the significant effect of individuality of dairy buffaloes on the acoustic features of their vocal signals. The mean call duration, pitch, 1st formant, periodicity and degree of voice breaks of adult lactating Murrah buffaloes were observed to be 2.15±0.05 s, 143.48 ± 2.51 Hz, 900.11 ± 4.21 Hz, 95.31% (183.95 periodic pulses out of 192.99 pulses) and 20.78 ± 0.89 % respectively. Analysis of bioacoustics features extracted from 300 voice samples of 10 adult lactating Murrah buffaloes revealed that differences for amplitudes (minimum, maximum and mean), total energy, mean power, pitch (median, minimum, range and mean), intensities (mean, minimum and maximum), formants (F1, F2, F3, F4 and F5), bandwidths (B1, B3 and B4), number of pulse, number of period, mean period, unvoiced frames, degree of voice breaks, jitter, shimmer, mean noise to harmonic ratio (%) and mean harmonic to noise ratio (dB) were highly significant. Out of these only few acoustic features viz. formants (F1, F2, F3, F4 and F5), number of pulse, number of period, degree of voice breaks, mean noise to harmonic ratio (%) and mean harmonic to noise ratio (dB) were observed to have significant difference for each and every individual dairy buffalo, hence only these features could be selected as the best suited acoustic features for discrimination of individual Murrah buffaloes from their herd.


Migraine is a very serious health issue prevailing not only in the old age people but in really small ages as well . Since it is very painful in the head and one cannot perform normally therefore, it's of utter importance to improve the prevailing condition of migraine and manage it properly . Now, when talking about migraine management it includes pharmacological therapies and medications . Pharmacological therapies can be subdivided into two parts acute or symptomatic treatment and preventive treatment called prophylaxis. We here would specifically be talking about the pharmacological prophylaxis. Pharmacological prophylaxis for migraine consists of a long list of drugs. T Beta blockers, antidepressants, antiepileptics, calcium channel blockers, pregabalin, levetiracetam, etc. The main drugs utilized for a long time and a number of studies have been conducted to investigate their efficacy in migraine prophylaxis. To assess the effectiveness of well-known drugs and some newer ones we searched last five year, original research articles on MEDLINE, Google Scholar and EMBASE on 15th February 2019. We selected randomized or quasi-randomized trials of drugs used in migraine prophylaxis. We didn't compare each of them but searched for their effectiveness individually. Percentage reduction in attack frequency was evaluated. We found 41 studies out of which we include 14 studies. We excluded animal studies, abstract with only papers and studies with missing data. Amitriptyline was found to be most effective ranging from 60% to 83%.Thought it has great amount of effectiveness but is has not been approved by the USA food and drug administration (FDA). Therefore it also requires a minimum time period of 4-6 weeks for it to show it's effectiveness. For Sodium valproate was the most studied drug with 60% to 78% reduction in attack frequency after two months.Sodium valporate had been established in for treatment of epilepsy. Hense it was considered to act by mimicking γ-aminobutyric acid. Though an evidence was also gained that valporate could prevent migraine attacks, especially in the adults and unlike pregbalin it is widely used for treating and conducting migraine management in the US and European countries. From sources it was told that, Hering and Kuritzk reported ,that valproate had been really effective in preventing the dreadful migraine or even reducing the frequency, severity, and duration of attacks in 86.2% patients over a period of 8 weeks. Shaygannejad also came reporting for the same and further suggested , about treatment with valproate could significantly decreases the duration, monthly frequency, and intensity of migraine probably after 8 weeks. Takeshima had reported that the efficacy treatment with valproate was 59.7% after 2 months after having the treatment. These all reports together indicate that apart from the majority some patients having migraine did not responded really well to treatment of it with valproate. Therefore if prophylactic treatment with a particular drug is unsuccessful, it can be substituted by a different prophylactic drug.Pregabalin showed 65% reduction in attack frequency after two months treatment. Pregabalin, is an anticonvulsant drug which binds to alpha2-delta subunit of voltage-gated calcium channels and inhibits neurotransmitter release which also haves the glutamate, norepinephrine, serotonin, dopamine, substance P, and calcitonin gene-related peptide . All of these mechanisms are taken from the existing data which includes glutamatergic mechanisms in migraine physiopathology. High plasma and cerebrospinal fluid levels of glutamate has also been seen in patients suffering from migraine. There is no available trial of pregabalin use in the migraine prophylaxis in adults. Levetiracetam found to be effective by 58% to 70% reduction in attack frequency.levetiracetam has excellent bioavailability, linear kinetics, minimal plasma protein binding and quick achievement of steady state concentrations. It has no clinically relevant drug-drug interactions. Its rapid onset of action, lack of drug-drug interactions and availability as an intravenous solution makes it an optimal drug to treat epilepsy associated with other medical conditions. Moreover, no serious idiosyncratic side effects have been reported for levetiracetam.thus making it an interesting option in the treatment of th migraine therapy. Mechanisms of action of this drug are quite very much unknown . Though recently, it has been seen to exert inhibitory effects on neuronal-type calcium channels. calcium channelopathy has also been seen as a factor which may be responsible for neuronal hyperexcitability in migraine. Though it is more likely to be believed that levetiracetam may be working its prophylactic effects via inhibiting these channels. Flunarizine effectiveness ranges from 46% to 76%. Flunarizine is a calcium channel blocker which haves the tendency to reduces smooth muscle spasm. After studying it thoroughly it is hevaily suggested that flunarizine is just the same as effective as propranolol or topiramate for reducing the frequency of migraines in adults. Though having only one drawback and it could be considered most common adverse effect of it is gaining of weight. Erenumab (a human monoclonal antibody which blocks calcitonin gene related receptor) also showed 50% reduction in attack frequency. Fremanezumab (quarterly administration) is moderately effective with 40% reduction in attack frequency. Reduction in attack frequency was 63% by melatonin. Omega 3 polyunsaturated fatty acids showed 66% reduction in attack frequency. Long chains of omega-3 polyunsaturated fatty acids were found to be associated with lower prevaing of many difficult headache in the US. People who have higher levels of long chain omega-3 polyunsaturated fatty acids (PUFAs) in their diet may have lower prevalence of severe headache, according to a recent study We may conclude that in reducing migraine attack frequency, older drugs are more effective though newer one also seems to be promising


Author(s): Luo, Hao | Advisor(s): Abu-Omar, Mahdi M | Abstract: Increasing greenhouse gas emissions as well as a series of environmental issues caused by fossil fuels combustion have motivated the development of renewable energy sources. Nonfood lignocellulosic biomass is a promising renewable source for making liquid fuels and valuable chemicals, due to its high energy content stored by the biosphere. However, the efficient utilization of biomass has been significantly hindered by its recalcitrant nature. Herein, we have investigated the use of Ni/C for the catalytic depolymerization of native lignin in Miscanthus, a grassy biomass. Under optimized conditions, over 69% yield of select aromatic products were obtained from lignin. Carbohydrates remaining after lignin removal were recovered as a solid residue, which upon treatment with iron chloride produced useful platform chemicals (furfurals and levulinic acid). Understanding bond connectivity in biomass (between lignin and carbohydrates) advances the development and commercialization of more efficient catalytic methods for biomass utilization. To achieve this goal, Dynamic Nuclear Polarization (DNP) Enhance Solid State NMR (ssNMR) was used to probe the atomic level structure of biomass pre- and post- lignin treatment. Our results revealed an increase in the relative ratio of crystalline cellulose upon the catalytic depolymerization of lignin (CDL) using Ni/C catalyst. In parallel with direct catalysis of native lignin in raw biomass, organosolv pretreatment was used to produce sulfur-free technical lignin in high purity. Our study investigated the effect of biomass substrate and organosolv pretreatment methods on the isolated lignin towards further upgrading over a Ni/C catalyst. By comparing different solvents (acetic acid/formic acid, acetone and methanol) applied for lignin extraction, methanol was revealed to minimize the undesirable re-condensation of organosolv lignin.


The Development of a Vertical-Axis Wind Turbine Wake Model for Use in Wind Farm Layout Optimization with Noise Level Constraints Eric Blaine Tingey Department of Mechanical Engineering, BYU Master of Science This thesis focuses on providing the means to use vertical-axis wind turbines (VAWTs) in wind farms as an alternative form of harnessing wind energy in offshore and urban environments where both wake and acoustic effects of turbines are important considerations. In order for VAWTs to be used in wind farm layout analysis and optimization, a reduced-order wake model is needed to calculate velocities around a turbine quickly and accurately. However, a VAWT wake model has not been available to accomplish this task. Using vorticity data from computational fluid dynamic (CFD) simulations of VAWTs and cross-validated Gaussian distribution and polynomial surface fitting, a wake model is produced that can estimate a wake velocity deficit of an isolated VAWT at any downstream and lateral position based on nondimensional parameters describing the turbine speed and geometry. When compared to CFD, which takes over a day to run one simulation, the wake model predicts the velocity deficit at any location with a normalized root mean squared error of 0.059 in about 0.02 seconds. The model agrees with two experimental VAWT wake studies with a percent difference of the maximum wake deficit of 6.3% and 14.6%. Using the actuator cylinder model with predicted wake velocities of multiple turbines, aerodynamic loads can be calculated on the turbine blades to estimate the power production of a VAWT wind farm. As VAWTs could be used in urban environments near residential areas, the noise disturbance coming from the turbine blades is an important consideration in the layout of a wind farm. Noise restrictions may be imposed on a wind farm to limit the disturbance, often impacting the wind farm's power producing capability. Two specific horizontal-axis wind turbine farm designs are studied and optimized using the FLORIS wake model and an acoustic model based on semiempirical turbine noise calculations to demonstrate the impact a noise level constraint has on maximizing wind farm power production. When a noise level constraint was not active, the average power production increased, up to 8.01% in one wind farm and 3.63% in the other. Including a noise restriction in the optimization had about a 5% impact on the optimal average power production over a 5 decibel range. By analyzing power and noise together, the multi-modality of the optimization problem can be used to find solutions were noise impact can be improved while still maximizing wind farm power production.


This article presents the results of an ex-ante evaluation exercise on the financial instruments adopted under the rural development policy. Using fad n data, during a ten-year time span, the study estimates the investments and their financial covertures made by a sample of farms in the Abruzzo region.The balance sheets of the farms were analysed in order to quantify the investments made by the farms in one year and the related financial coverage. The main results show that the propensity to invest is, on average, of 0.27 and it varies according to the characteristics of the farms; while on average 90% of farm investment value is self-financed. These results provided some interesting policy implications, highlighting either or both, a latent need for farms for external financial funds and/or an ineffective financial management of the business activity.


Generic event boundary detection (GEBD) is an important yet challenging task in video understanding, which aims at detecting the moments where humans naturally perceive event boundaries. The main challenge of this task is perceiving various temporal variations of diverse event boundaries. To this end, this paper presents an effective and end-to-end learnable framework (DDM-Net). To tackle the diversity and complicated semantics of event boundaries, we make three notable improvements. First, we construct a feature bank to store multi-level features of space and time, prepared for difference calculation at multiple scales. Second, to alleviate inadequate temporal modeling of pre-vious methods, we present dense difference maps (DDM) to comprehensively characterize the motion pattern. Finally, we exploit progressive attention on multi-level DDM to jointly aggregate appearance and motion clues. As a result, DDM-Net respectively achieves a significant boost of 14% and 8% on Kinetics-GEBD and TAPOS benchmark, and outperforms the top-1 winner solution of LOVEU Challenge@CVPR 2021 without bells and whistles. The state-of-the-art result demonstrates the effectiveness of richer motion representation and more sophisticated aggregation, in handling the diversity of GEBD. The code is made available at https://github.com/MCG-NJU/DDM.


Previous health services research has failed to account for the role played by clinical staff in the collection of data. In this paper we use the work of Roth on hired hand research to examine the politics of evidence production within health services research. Sociologies of work predict lack of engagement in the research tasks by subordinated groups of workers. We examine the role of midwives in researching ante-natal screening for sickle cell and thalassaemia in England, and construct three ideal types: repairers, refractors, and resisters to account for the variable engagement of health staff with research. We find some features of the hired hand phenomenon predicted by Roth to be in evidence, and suggest that the context of our project is similar to much health services research. We conclude that without concerted attempts (1) to change the social relations of research production; (2) to mitigate hired hand effects; (3) to assess the impact of the hired hand effect on the validity and reliability of findings, and (4) to report on these limitations, that health services research involving large teams of subordinated clinical staff as data collectors will be prone to produce evidence that is of limited trustworthiness.


Spanish missions were established in the San Francisco Bay Area beginning in A.D. 1776 with the founding of Mission San Francisco de Asis (Mission Dolores). Native American accommodation and resistance to colonial settlements has been studied in a variety of contexts in California, including mission sites, but only recently have scholars challenged preconceptions of culture change to examine the range of sociocultural consequences that resulted from colonial encounters. With the present research I seek to identify the places beyond the mission quadrangles where hunter-gatherers both maintained cultural practices and negotiated the adoption of new ones, as well as the processes of cultural change and persistence.I examine a cluster of three shell mounds--CA-MRN-114, CA-MRN-115, and CA-MRN-328--located on the Marin Peninsula in the hinterland of Mission Dolores for evidence of long-term patterns of hunter-gatherer residence before, during, and after Spanish settlement (1776 -1830s). I critically evaluate whether hunter-gatherers returned on permissible leave from the missions or illicitly to these places of refuge to supplement introduced diets with traditional subsistence pursuits; practice seasonally-defined ceremonies and rituals; and to refashion social identities. I argue that periodic occupation of some shell mounds by runaway Indians over time both mirrors Coast Miwok subsistence routines that predate colonial settlement and would have reaffirmed connections to ancestral territories among mission Indians.My dissertation research contributes to the growing body of scholarship dealing with culture contact and colonialism. I frame my research within theories of landscape, resistance, practice, identity, and materiality, and I employ a combination of archaeological methods--digital mapping, surface collection, geophysical survey, augering, and targeted excavation; specialized analyses, including X-ray fluorescence spectrometry, AMS radiocarbon dating, and obsidian hydration dating; historical documents; and oral interviews with Coast Miwok descendants. My results suggest that, despite missionization efforts, hunter-gatherers continued to occupy shell mounds likely reinforcing connections to ancestral territories throughout subsequent periods of Mexican and American settlement in the San Francisco Bay area.


: This study investigated how teacher education academics embed sustainability education in learning and teaching, using a systematic literature review of peer-reviewed journal articles. A taxonomy of four distinctive approaches was developed: (1) embedding sustainability education widely across curriculum areas, courses, and institution; (2) through a dedicated core/compulsory subject; (3) through a component of a core/compulsory subject; and (4) through a dedicated elective subject. This paper investigates the differing rationales, theoretical frames and pedagogical approaches used and identifies the perceived challenges underpinning each of these approaches. The final section offers an analysis and discussion of the implications of our review findings for teacher education academics and researchers, and others in the broader academic community who are interested in change towards sustainability through education.


China's financial conundrum arises from two sources: (1) its large trade (saving) surplus results in a currency mismatch because it is an immature creditor that cannot lend in its own currency. Instead foreign currency claims (largely dollars) build up within domestic financial institutions. And (2), economists - both American and Chinese - mistakenly attribute the surpluses to an undervalued renminbi. To placate the United States, the result is a gradual appreciation of the renminbi against the dollar of 6 percent or more per year. This predictable appreciation since 2004, and the fall in US interest rates since mid 2007, not only attracts hot money inflows but inhibits private capital outflows from financing (compensating?) China's huge trade surplus. This one-way bet in the foreign exchange markets can no longer be offset by relatively low interest rates in China compared to the United States, as had been the case in 2005-06. Thus, the People's Bank of China (PBC) now must intervene heavily to prevent the renminbi from ratcheting upwards - and so becomes the country's sole international financial intermediary. Despite massive efforts by the PBC to sterilise the monetary consequences of the reserve buildup, inflation in China is increasing, with excess liquidity that spills over into the world economy. China has been transformed from a deflationary force on American and European price levels into an inflationary one. Because of the currency mismatch, floating the RMB is neither feasible nor desirable - and a higher RMB would not reduce China's trade surplus. Instead, monetary control and normal private-sector finance for the trade surplus require a return to a credibly fixed nominal yuan/dollar rate similar to that which existed between 1995 and 2004. But for any newly reset yuan/dollar rate to be credible as a monetary anchor, foreign 'China bashing' to get the RMB up must end. Currency stabilisation would allow the PBC to regain monetary control and quash inflation. Only then can the Chinese government take decisive steps to reduce the trade (saving) surplus by tax cuts, increased social expenditures, and higher dividend payouts. But as long as the economy remains overheated, the government hesitates to take these trade-surplus-reducing measures because of their near-term inflationary consequences. This is part of a series of BIS Working Papers (273 to 278) collecting papers presented at the BIS's Seventh Annual Conference on 'Whither monetary policy? Monetary policy challenges in the decade ahead' in Luzern, Switzerland, on 26-27 June 2008. The event brought together senior representatives of central banks and academic institutions to exchange views on this topic. BIS Paper 45 contains the opening address of William R White (BIS), the contributions of the policy panel on 'Beyond price stability - the challenges ahead' and speeches by Edmund Phelps (Columbia University) and Martin Wolf (Financial Times). The participants in the policy panel discussion chaired by Malcolm D Knight (BIS) were Martin Feldstein (Harvard University), Stanley Fischer (Bank of Israel), Mark Carney (Bank of Canada) and Jean-Pierre Landau (Banque de France). This Working Paper includes comments by Michael Mussa.


Results of sedimentological analyses (grain-size distribution, bulk and day mineralogy, TC/TOC) from ODP Site 987 show that the sedimentary succession off Scoresby Sund fjord complex consists of three dominantly hemipelagic phases ( with varying input from ice rafting) and two de bris flow units. The presence of ice on continental central East Greenland throughout the last -7.5 Ma is indicated by the continuous presence of dasts in the sediments. The debris flow units, with bases at -5 Ma and -2.6 Ma respectively are interpreted to represent major glacial advances across the central East Greenland shelf. It is suggested that the shelf areas were free of any major ice during the hemipelagic phases. Based on mineralogy and dast (>l cm) compositions, a progressive upward shift in the main sediment source area from volcanic regions to the sedimentary Jameson Land is proposed.


The consistent and sometimes exaggerated emphasis on the unpredictability of careers these days has prompted an assertion of the need and the capacity of individuals to take control. In turn, this helpfully exposes a number of tensions and ambiguities in the study of 'career'. These need to be explored rather than bypassed by a new orthodoxy. Exploration can lead to innovative and balanced analyses of how people and their careers develop, how the notion of career success can be construed, how career is an inherently social process, and how career and other arenas of life interact.


Materials, making, and objects are important parts of an ecology of meaningful learning and teaching in art that must accompany the development of concept and social impact. New materialist theory suggests that matter matters to how life is lived, while emphasizing that animacy is inherent not only to what we think of as animate beings but to all types of matter. The author explores what new materialism is and its relationship with making, materials, and objects in her own practices and in visual art education. Through deepened understandings of their material articulations of the world, makers and learners construct new knowledge and thickened experiences, and they develop firsthand sensitivities to making that help them find the "causal structures" (Barad, 2007) underlying what they do. This "knowing in being" (Hickey-Moody & Page, 2016, p. 12) can be transformative with regard to how a maker/student/person interacts with and lives in the world.


'POLTROON. An abject and contemptible coward. From Old Italian poltrone, lazy good-for-nothing, apparently from poltrire, to lie indolently in bed.' In a word, ME. There I was helpless in my hospital bed, an eminent anaesthetist (or anaesthesiologist, if the Americans take over our language as they have our hotel rooms) about to insert a needle for an antibiotic and saline drip into my right arm my writing arm! - and he asks me what I do and I admit to being a member of the University of Sydney's English Department (happily, I don't have time to confess to being a newspaper columnist) and he turns out also to be an aesthetician, when it comes to matters linguistic. One of his sons, he informs me, sounding a note of betrayal of which Oedipus' dad would not have been unproud (pardon me, George Orwell!), recently used 'criteria' as a singular noun! And did I know that journalists had to be given lessons in how to write? The drip inserted, he lent (loaned?) me a copy of Wayne speak to cheer me up.


Knowledge about the reception of architectural structures is crucial for architects and urban planners. Yet obtaining such information has been a challenging and costly activity. However, with the advent of the Web, a vast amount of structured and unstructured data describing architectural structures has become available publicly. This includes information about the perception and use of buildings (for instance, through social media), and structured information about the building's features and characteristics (for instance, through public Linked Data). Hence, first mining (i) the popularity of buildings from the social Web and (ii) then correlating such rankings with certain features of buildings, can provide an efficient method to identify successful architectural patterns. In this paper we propose an approach to rank buildings through the automated mining of Flickr metadata. By further correlating such rankings with building properties described in Linked Data we are able to identify popular patterns for particular building types (airports, bridges, churches, halls, and skyscrapers). Our approach combines crowdsourcing with Web mining techniques to establish influential factors, as well as ground truth to evaluate our rankings. Our extensive experimental results depict that methods tailored to specific structure types allow an accurate measurement of their public perception.


Currently a hydraulic system has been used for changing Continuously Variable Transmission (CVT) ratio of metal pushing V-belt with single acting pulley system. This paper introduces an alternative way of changing CVT ratio using an electro-mechanical dual acting pulley (EMDAP) CVT system. This new system introduces two DC servomotors as actuators and power screw mechanisms as a means of shifting the pulleys axially along the transmission shafts. The primary motor is responsible for changing CVT ratio, while the secondary controls the metal belt from slipping. Since the methods of controlling these two motors are similar, this paper only discusses the primary part. The servomotor regulates the axial movement of two movable pulley sheaves to shift the metal belt placed between the sheaves, and change the belt-pulley contact radius. Changing this contact radius means changing the CVT ratio. Fuzzy PID control scheme is proposed for this pulley position control. Computer simulation results are presented to demonstrate the effectiveness of the proposed fuzzy PID controller as compared to that of the conventional fixed gain PID controller.


The rapid evolution of Internet-of-Things (IoT) technologies has led to an emerging need to make them smarter. A variety of applications now run simultaneously on an ARM-based processor. For example, devices on the edge of the Internet are provided with higher horsepower to be entrusted with storing, processing and analyzing data collected from IoT devices. This significantly improves efficiency and reduces the amount of data that needs to be transported to the cloud for data processing, analysis and storage. However, commodity OSes are prone to compromise. Once they are exploited, attackers can access the data on these devices. Since the data stored and processed on the devices can be sensitive, left untackled, this is particularly disconcerting. In this paper, we propose a new system, TrustShadow that shields legacy applications from untrusted OSes. TrustShadow takes advantage of ARM TrustZone technology and partitions resources into the secure and normal worlds. In the secure world, TrustShadow constructs a trusted execution environment for security-critical applications. This trusted environment is maintained by a lightweight runtime system that coordinates the communication between applications and the ordinary OS running in the normal world. The runtime system does not provide system services itself. Rather, it forwards requests for system services to the ordinary OS, and verifies the correctness of the responses. To demonstrate the efficiency of this design, we prototyped TrustShadow on a real chip board with ARM TrustZone support, and evaluated its performance using both microbenchmarks and real-world applications. We showed TrustShadow introduces only negligible overhead to real-world applications.


Fluoxetine hydrochloride (FLX), Prozac ® , is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed to patients suffering from depression and other psychiatric disorders. FLX is known to enter the aquatic environment through municipal effluent discharge so that the constant release of this drug into aquatic environments exposes all organisms throughout all stages of development. In the current study, we evaluated the role of FLX in aquatic toxicology by modeling the toxicity of maternally-transferred compounds on fish embryo development using Japanese medaka (Oryzias latipes) as a model species. Three different methods: (1) waterborne exposure, (2) nano-injections and (3) topical application were considered and undertaken to measure the embryotoxicity of FLX. Waterborne exposure and nano-injection presented difficulties in mimicking the transfer of contaminated maternal tissue to embryos; thus, topical application was used as the method of choice. Dosing for toxicity tests was performed by topical application of FLX in dimethylsulfoxide (DMSO) onto the exterior of newly fertilized eggs to transport the chemical into the egg. Toxicity was assessed by observing how it affected mortality and adverse fish development, as indicated by the frequency of signs of pathology in fish embryos. From the results, FLX does cause developmental abnormalities as observed from the significant decrease in the percentage of normal fish. This occurrence is mostly contributed from a high prevalence of body hemorrhaging in comparison to the other signs of pathology. Thus, FLX may be maternally-transferred to oocytes during sexual maturation to cause embryotoxicity.


Develop your skills, realise your full potential and make your life work. Whether you want a one-to-one conversation, or to wow during a company presentation, find the right tools to express with success. This work includes practical techniques, effective tips, 5-minute fixes and case studies to equip you to succeed in the real world, plus set your goals and check progress with simple self-assessment exercises. Follow as a complete course, or dip in and out of topics for quick reference. It is pocket-sized - take it wherever life takes you.


Real world network datasets often contain a wealth of complex topological information. In the face of these data, researchers often employ methods to extract reduced networks containing the most important structures or pathways, sometimes known as `skeletons' or `backbones'. Numerous such methods have been developed. Yet data are often noisy or incomplete, with unknown numbers of missing or spurious links. Relatively little effort has gone into understanding how salient network extraction methods perform in the face of noisy or incomplete networks. We study this problem by comparing how the salient features extracted by two popular methods change when networks are perturbed, either by deleting nodes or links, or by randomly rewiring links. Our results indicate that simple, global statistics for skeletons can be accurately inferred even for noisy and incomplete network data, but it is crucial to have complete, reliable data to use the exact topologies of skeletons or backbones. These results also help us understand how skeletons respond to damage to the network itself, as in an attack scenario.


This paper describes the construction and evaluation of a self-help skill training system for assisting student nurses in learning skills involving the transfer of patients from beds to wheelchairs. We have proposed a feedback method that is based on a checklist and video demonstrations. To help trainees efficiently check their performance and correct errors, the checklist was prepared with items specific to the performance of tasks related to individual body parts (e.g., the height of the waist). In this system, two Kinect RGB-D sensors were used for measuring the posture of the trainees and patients. An automatic skill evaluation method was used to designate the trainees' performance against each evaluation item as correct or incorrect. Furthermore, the system's operation interface was designed to enable self-operation by trainees. Control tests were performed to measure the training effectiveness of the system. The results of the tests on a control group (n = 5) that used only a textbook and demonstration video but did not receive feedback were compared with those of the experimental group (n = 5) that used the proposed system. The results of both subjective and objective evaluation demonstrated that the experimental group showed greater improvement in performing patient transfer than the control group (p <; 0:05).


Selective photocatalytic aerobic oxidation, which can be conducted under ambient conditions, is of great importance towards achieving sustainable chemistry. However, its practical applications are undermined by several challenges, such as low selectivity, sluggish reaction rates, and the requirement of UV light irradiation. Herein, we report a new concept of synergistic photocatalytic oxidation, for which two seemingly irrelevant reactions can be achieved in one photocatalytic system through the synergistic interplay of reactants and catalyst. As proof of concept, two challenging reactions, the aerobic oxidation of sulfide and the aerobic oxidative formylation of amine with methanol, were employed to demonstrate such synergistic photocatalytic aerobic oxidation under visible-light irradiation. This work could pave the way for highly selective photoredox catalysis via rational design based on mechanistic insight.


The effect of thermochemical treatment namely carburising on the fatigue behaviour of one carbon and two alloy steels has been studied in rotating and unidirectional bending. The effect of carbon profile on the unidirect¬ional bending fatigue strength of 63SA14 was assessed, and it was found that single stage carburising with a surface carbon content of 0.8% has resulted in a higher fatigue strength than other types of carbon profiles. Residual stresses and other metallurgical variables arising from different carbon profiles, were also considered. The highest compressive stresses h~e resulted from boost-diffuse-carburising. On the other hand surface decarburisation was associated with tensile residual stresses and a reduced fatigue strength. Retained austenite was found to be detrimental in unidirectional bending fatigue; however its presence in carburised 83SAIS did not seem to influence the rotating bending fatigue strength. Carbide particles in globular and/or intergranular form were detrimental to compressive residual stresses; the unidirectional bending fatigue strength is markedly lowered. The highest fatigue strength was accomplished by vacuum carburising. The absence of internal oxidation was the key factor in the increased fatigue strength; the presence of uniformly distributed fine carbide particles did not upset the superior fatigue strength of vacuum carburised pieces. The effect of mean stress on the fatigue strength of carburised 63SA14 was studied. Increasing the mean stress as would be expected resulted in a decreased fatigue strength. Carburisation showed its advantages at low mean stress, but at high mean stress it offers little advantage over the uncarburised hardened conditions. Notch effect was also studied in unidirectional bending of carburised 080MlS. The general trend showed that the fatigue strength decreases with increasing the stress concentration factor. But different carburising conditions have different effect on notch sensitivity.


In 2018 MCAHE commissioned five new site-specific contemporary artworks for heritage sites in North East England. The exhibition 'Out of Place', re-presented these artworks within the new context of the Hatton Gallery, prompting a questioning of how the meaning and experience of art changes when it is relocated from its original site.

The exhibition featured sound works, installation, painting and sculpture by MCAHE artists Susan Philipsz, Matt Stokes, Fiona Curran, Andrew Burton, Marcus Coates and Mark Fairnington. Presented in the Hatton, the MCAHE works are exhibited in relation to Kurt Schwitters' Merzbarn, a key example of a site-specific artwork that is relocated from its original context.

Responding to the Hatton Gallery, Fiona Curran chose to make a new body of work that built on the research undertaken for the original National Trust Gibside project. This research focused on the inspirational network of female botanists in the 18th century whose 'amateur' practices opened a space for women to discuss and share their findings. Preferring not to resituate the original work from its site-specific location next to Mary Eleanor's Orangery to the interior space of the gallery, this new body of work instead focused on decorative depictions of the natural world, women's broader cultural association with flowers and plants and the thresholds between interior and exterior spaces.


Hypotensive and cardioprotective effects of amlodipine (normodipine) were evaluated in 65 patients (35 men and 30 women) with grade II essential arterial hypertension treated with regard for calcium-controlling parathyroid function. 24 hour Holter monitoring, Doppler-cardiography, and blood PTH measurement were performed before and 6 months after the onset of therapy. The patients were divided into 3 groups depending on PTH levels (0-25, 26-50, and over 51 pg/ml). Changes of structural and functional cardiac parameters and AD were most prominent in group 3 in the form of decreased left ventricular hypertrophy, improved ventricular diastolic function, and marked hypotensive effect. The group was significantly different from group 1 in terms of these characteristics. Univariate analysis revealed correlation of PTH levels with left ventricular mass, mean daily systolic and diastolic AD, and left ventricular diastolic function. It is concluded that evaluation of calcium-regulating parathyroid function is necessary for optimization of antihypertensive therapy with calcium antagonists.


This document defines two optional extensions to the Constrained
Application Protocol (CoAP): the Repeat option and the Request-Tag
option. Each of these options when integrity protected, such as with
DTLS or OSCOAP, protects against certain attacks on CoAP message
exchanges. The Repeat option enables a CoAP server to verify the
freshness of a request by requiring the CoAP client to make another
request and include a server-provided challenge. The Request-Tag
option allows the CoAP server to match message fragments belonging to
the same request message, fragmented using the CoAP Block-Wise
Transfer mechanism. This document also specifies additional processing
requirements on Block1 and Block2 options.


Morphodynamic models usually contain empirical parameterisations to estimate sand transport quantities from near-bed characteristics of the wave-orbital motion. While this results in reasonable predictions of the nearshore morphodynamics in deeper water, predictions in shallow water (≲ 3 m) are largely inaccurate. This precludes the use of these models to study, for example, the cross-shore sand transport toward the beach after the implementation of (shoreface) nourishments. Both acceleration skewness and surface-generated turbulence can induce additional sand suspension beneath breaking waves in the surf zone; however, their net effect on short-wave sand transport is not clear. The aim of this thesis is to improve our knowledge on turbulence, sand suspension and short-wave sand transport beneath irregular breaking waves. This aim is fulfilled through the analysis of turbulence and sand concentration measurements, collected beneath irregular waves in a field-scale laboratory flume and in natural surf zones. Detailed measurements of the turbulent kinetic energy, at three elevations above the bed, were collected during the BARDEXII experiment to analyse the importance of surface-generated turbulence as a function of the relative wave height. The vertical turbulence profile shows a transition from being dominated by bed-generated turbulence beneath nonbreaking waves (low relative wave height) above vortex ripples to being dominated by surface-generated turbulence beneath plunging breaking waves (high relative wave height) above subdued bed forms. To analyse the effect of breaking-induced turbulence on sand suspension, the sand concentration was measured at collocated sand concentration sensors. An event-based analyses shows that 50% of the turbulence events beneath plunging breakers can be related to concentration events. Beneath nonbreaking shoaling waves with vortex ripples, the sand concentration close to the bed peaks right after the maximum positive wave-orbital motion and shows a marked lag in the vertical. Beneath plunging waves with subdued bed forms, concentration peaks beneath the wavefront without any notable phase lags in the vertical. Further shoreward beneath bores, the sand concentration remains phase-coupled to the positive wave-orbital motion, but the concentration decreases toward the shoreline. The wave-driven suspended sand transport is thus onshore-directed and largest beneath plunging waves, while it is small and can also be offshore-directed beneath shoaling waves. To explore the generality of these findings and the resulting sand transport in the shallow surf zone, the magnitude, direction and relative importance of the short-wave sand flux in the BARDEXII dataset is compared with measurements collected on two natural sandy beaches. The relative importance of the short-wave sand flux in comparison with the mean flux, for all data combined, scales with (Auurms)/|u|, where Au is the velocity asymmetry, urms is the root-mean-square orbital motion and u is the mean cross-shore current. Contributions are high (~70% ) when this ratio is high (~10) and low and sometimes negative (~0% ) when this ratio is low (~ 1). These field and laboratory measurements under irregular waves thus support the hypothesis that the inclusion of velocity asymmetry in transport formulations would improve the performance of morphodynamic models in the shallow surf zone.


: For the patient who presents with a hair disorder, a host of diagnostic techniques are available in addition to history, physical examination, and laboratory assessment. Microscopic hair shaft examination is presented as a technique for establishing a definitive diagnosis.


Health-related quality of life (HRQOL) is a multi-dimensional concept used to examine the impact of health status on their global well-being. The IMPACT-III is a 35-item questionnaire specifically designed to evaluate the quality of life of patients with paediatric Inflammatory Bowel Disease (pIBD). This questionnaire had its origin in 1999 in Canada (Otley et al.) and, since then, it has been adapted to many languages.
 The objective of this study was to assess the quality of life of pIBD patients using the IMPACT-III questionnaire and to identify specific needs according to the patient's profile.

 An observational, descriptive, and retrospective study was carried out in November 2020, including the pIBD patients undergoing follow-up in a tertiary hospital that have previously completed the IMPACT-III questionnaire. Epidemiological and clinical data were anonymously retrieved from the electronic medical records. We established three blocks of IMPACT-III items according to physical, emotional and social well-being, or to the perception of body image. The results of each block and totals were compared according to gender, age, diagnosis, time of evolution, activity and treatment.
 To make the comparison, the Mann-Whitney U test for independent samples for 2 groups and the Kruskal-Wallis test for 3 or more independent groups were used. The statistical analysis was performed using SPSS software and the results were considered statistically significant when reaching a bilateral critical level (p) ≤ 0.05, with a 95% confidence interval.

 We included a total of 40 patients. There were no significant differences according to gender, type of IBD or type of treatment. The group of adolescents obtained a higher score in the body image block (p = 0.009). Patients with over two years of evolution of the disease obtained statistically significantly higher scores in the physical well-being block (p = 0.027). In patients who filled out the questionnaire during a flare, the scores on questions of physical well-being (p = 0.007), emotional and social (p = 0.037), as well as total (p = 0.012) were significantly higher. Overall, 31 patients (77.5%) answered that IBD had negatively affected their family.

 Our data suggest that patients with a longer evolution time, adolescents and patients suffering an active flare seem to report a worst HRQOL. Patients with the mentioned characteristics constitute a vulnerable population with special care needs that should be addressed from an interdisciplinary point of view. Despite the limitations of the retrospective design and the scarce number of patients, our results indicate that family-centered care should be a priority.


The permeability of junctions between cells of the same type (homologous junctions) is greatly increased by retinoic acid (10(-9)- 10(-8) M), a probable morphogen, and this responsiveness is shared by a variety of normal and transformed cell types (Mehta, P.P., J.S. Bertram, and W.R. Loewenstein. 1989. J. Cell Biol. 108:1053-1065). Here we report that the heterologous junctions between the normal and transformed cells respond in the opposite direction; their permeability is reduced by retinoic acid (greater than or equal to 10(-9) M) and its benzoic acid derivative tetrahydrotetramethylnaphthalenylpropenylbenzoic acid (greater than or equal to 10(-11) M). The opposite responses of the two classes of junction are shown to be concurrent; in cocultures of normal 10T1/2 cells and their methylcholanthrene-transformed counterparts, the permeability of the heterologous junctions, which is lower than that of the homologous junctions to start with, falls (within 20 h of retinoid application), at the same time that the permeability of the homologous junctions rises in both cell types. Such a counter-regulation requires a minimum of three degrees of cellular differentiation. A model is proposed in which the differentiations reside in a trio of junctional channel protein. The principle of the model may have wide applications in the regulation of intercellular communication at tissue boundaries, including embryonic ones.


A significant limitation of one-class classification anomaly detection methods is their reliance on the assumption that unlabeled training data only contains normal instances. To overcome this impractical assumption, we propose two novel classification-based anomaly detection methods. Firstly, we introduce a semi-supervised shallow anomaly detection method based on an unbiased risk estimator. Secondly, we present a semi-supervised deep anomaly detection method utilizing a nonnegative (biased) risk estimator. We establish estimation error bounds and excess risk bounds for both risk minimizers. Additionally, we propose techniques to select appropriate regularization parameters that ensure the nonnegativity of the empirical risk in the shallow model under specific loss functions. Our extensive experiments provide strong evidence of the effectiveness of the risk-based anomaly detection methods.


Connexins (Cxs) are a family of proteins that form two different types of ion channels: hemichannels and gap junction channels. These channels participate in cellular communication, enabling them to share information and act as a synchronized syncytium. This cellular communication has been considered a strong tumor suppressor, but it is now recognized that some type of Cxs can be pro-tumorigenic. For example, Cx46 expression is increased in human breast cancer samples and correlates with cancer stem cell (CSC) characteristics in human glioma. Thus, we explored whether Cx46 and glioma cells, can set up CSC and epithelial-to-mesenchymal transition (EMT) properties in a breast cancer cell line. To this end, we transfected MCF-7 cells with Cx46 attached to a green fluorescent protein (Cx46GFP), and we determined how its expression orchestrates both the gene-expression and functional changes associated with CSC and EMT. We observed that Cx46GFP increased Sox2, Nanog, and OCT4 mRNA levels associated with a high capacity to form monoclonal colonies and tumorspheres. Similarly, Cx46GFP increased the mRNA levels of n-cadherin, Vimentin, Snail and Zeb1 to a higher migratory and invasive capacity. Furthermore, Cx46GFP transfected in MCF-7 cells induced the release of higher amounts of VEGF, which promoted angiogenesis in HUVEC cells. We demonstrated for the first time that Cx46 modulates CSC and EMT properties in breast cancer cells and thus could be relevant in the design of future cancer therapies.


According to a widespread interpretation, in Gorgias' philosophy of language there is no room for truth at all. The only aim of logos for him would be effective persuasion and speech would be constrained by nothing but persuasiveness itself. Referring to Encomium of Helen, I try to point out, however, that in Gorgias there is an attempt to investigate the complex relationship between truth and efficacy in the functioning of language. I also suggest that, seen from this perspective, Gorgias' conception of truth shows significant points of contact with Rorty's and, above all, Foucault's thinking.


OBJECTIVE
To assess the impact of state Medicaid wage pass-through policy on direct-care staffing levels in U.S. nursing homes.

DATA SOURCES
Online Survey Certification and Reporting (OSCAR) data, and state Medicaid nursing home reimbursement policies over the period 1996-2004.

STUDY DESIGN
A fixed-effects panel model with two-step feasible-generalized least squares estimates is used to examine the effect of pass-through adoption on direct-care staff hours per resident day (HPRD) in nursing homes.

DATA COLLECTION/EXTRACTION METHODS
A panel data file tracking annual OSCAR surveys per facility over the study period is linked with annual information on state Medicaid wage pass-through and related policies.

PRINCIPAL FINDINGS
Among the states introducing wage pass-through over the study period, the policy is associated with between 3.0 and 4.0 percent net increases in certified nurse aide (CNA) HPRD in the years following adoption. No discernable pass-through effect is observed on either registered nurse or licensed practical nurse HPRD.

CONCLUSIONS
State Medicaid wage pass-through programs offer a potentially effective policy tool to boost direct-care CNA staffing in nursing homes, at least in the short term.


Background Cutaneous leishmaniasis (CL) caused by Leishmania braziliensis remains an important public health problem in Brazil. The goal of this study was to identify genetic risk factors for CL. Methods Genome-wide analysis was undertaken using DNAs from 956 CL cases and 868 controls (phase 1) and 1110 CL cases and 1178 controls (phase 2) genotyped using Illumina HumanCoreExome BeadChips. Imputation against 1000G data provided 4,498,586 quality-controlled single nucleotide variants (SNVs) common across phase 1 and phase 2 samples. Linear mixed models in FastLMM were used to take account of genetic diversity/ethnicity/admixture. Cellular cytokines were measured using flow cytometry. Results Combined analysis across cohorts found no associations that achieved genome-wide significance, commonly accepted as P<5×10-8. Support for variants at wound-healing genes previously studied as candidate genes for CL included SMAD2 (rs115582038/rs75753347; Pimputed_1000G=1.47×10-4). Top novel GWAS hits at P<5×10-5 in plausible candidate genes for CL included SERPINB10 (rs62097497;Pimputed_1000G=2.67×10-6), CRLF3 (rs75270613; Pimputed_1000G=5.12×10-6), STX7 (rs144488134;Pimputed_1000G=6.06×10-6), KRT80 (rs10783496 Pimputed_1000G=6.58×10-6), LAMP3 (rs74285558;Pimputed_1000G=6.54×10-6) and IFNG-AS1 (rs4913269;Pimputed_1000G=1.32×10-5). Of these, LAMP3 (Padjusted=9.25×10-12; +6-fold), STX7 (Padjusted=7.62×10-3; +1.3-fold) and CRLF3 (Padjusted=9.19×10-9; +1.97-fold) were all expressed more highly in CL biopsies compared to normal skin, whereas expression of KRT80 (Padjusted=3.07×10-8; −3-fold) was lower. Notably, the percent peripheral blood CD3+ T cells making interferon-γ in response to Leishmania antigen differed significantly by IFNG-AS1 genotype. Conclusions In addition to supporting variants in wound-healing genes as genetic risk factors for CL, our GWAS results provide important novel leads to understanding pathogenesis of CL including through the regulation of interferon-γ responses.