The objective of thinking development lesson is to help students change and develop thoughts via classroom teaching. In thinking development lessons, students will reinforce the application scenarios of their thinking skills and learn new thinking skills. For design of classroom teaching of thinking development type, thinking visualization tools are needed for organizing and guiding thinking process. In this study, a teaching design framework of thinking development lesson was developed based on mind mapping, and applied in the teaching design process of the course of Health Fitness Education. It consists of five steps, namely teaching objective setting, question situation establishment, externalization of tacit thinking, formalization of explicit thinking, and automation of efficient thinking. Teaching result check shows that the course teaching design scheme developed in this study is helpful to improve students' learning effect in the course of Health Fitness Education significantly. This study provides a new teaching design method for teaching of Health Fitness Education, which is of important significance to helping students integrate the knowledge they have learned and rationalize thinking.


This study evaluated a multi-catenary spread mooring system design of a mobile ocean test berth for wave energy converters (WECs), the Ocean Sentinel (OS) instrumentation buoy, through dynamic simulation, numerical analysis and comparison with measured field motion data of the OS off the Oregon coast. First, the accuracy of the numerical employed model based on a full coupling method of the OS and its mooring lines was validated by comparing predicted mooring tensions to the field measurements. Then, the anchor movability, fatigue damage and extreme mooring tension of the OS mooring system were analyzed to assess survivability. Field test results show that the numerical model provided accurate predictions of mooring tensions even under environmental conditions of strong wind, current and waves. Factors affecting the accuracy are discussed. One mooring anchor was shown to have moved significantly during the ocean field test. Mooring fatigue damage was calculated for different levels of sea states. Design strengths of the mooring lines were calculated and analyzed.


The conformational behavior of both uncharged and charged hyperbranched polymers (HBPs) in dilute solutions has been studied using Brownian dynamics simulations. A distinction has been made between two types of architectures: type 1, which is characterized by its degree of polymerization (N) and its number of generations (gmax), and type 2, which is characterized by its degree of polymerization (N) and its degree of branching (DB). The radius of gyration (Rg) of both uncharged and charged type 1 HBPs is strongly influenced by variation of g. For uncharged type 2 HBPs Rg is relatively insensitive to variation of DB, whereas for charged type 2 HBPs Rg is a decreasing function of DB. The values of the radii of gyration as determined in the simulations are well reproduced in mean-field calculations. Scaling of Rg with the Wiener index and N has been investigated and compared to data from literature. The radial mass distribution of a charged type 1 HBP exhibits an ordering of the monomers that is highly dependent on g; the radial mass distribution of a charged type 2 HBPs shows an ordering that is only weakly dependent on DB. These orderings manifest themselves via oscillations of the static structure factor.


We present in this paper a low-power bioamplifier suitable for massive integration in dense multichannel recording devices. This bioamplifier achieves reduced-size compared to previous designs by means of active low-frequency suppression. An active integrator located in the feedback path of a low-noise amplifier is employed for placing a highpass cutoff frequency within the transfer function. A very long integrating time constant is achieved using a small integrated capacitor and a MOS-bipolar equivalent resistor. This configuration rejects unwanted low-frequency contents without the need for input RC networks or large feedback capacitors. Therefore, the bioamplifier high-input impedance and small size are preserved. The bioamplifier, implemented in a 0.18-mum CMOS process, has been designed for neural recording of action potentials, and optimised through a transconductance-ef-ficiency design methodology for micropower operation. Measured performance and results obtained from in vivo recordings are presented. The integrated bioamplifier provides a midband gain of 50 dB, and achieves an input-referred noise of 5.6 muVrms. It occupies less than 0.050 mm2 of chip area and dissipates 8.6 muW.


Abstract A small but diverse assemblage of pollen and spores recovered from marine sediments of the Avon Park Formation (middle Eocene) in west central Florida, represents the oldest land flora described from the state. Twenty‐one pollen taxa from terrestrial plants, are identified from the Dolime Minerals and Gulf Hammock quarries. The presence of mangrove pollen associates such as Acrostichum, Nypa, and Pelliciera associated with seagrass macrofossils, combined with evidence from invertebrate fossils and sedimentary structures, suggest that the sediments of the Avon Park Formation, at these quarry sites, were deposited in a shallow marine lagoon, perhaps near the mouth of a river or stream in a protected area that had some tidal influence. This is the earliest report of terrestrial vegetation and near marine vegetation of Florida and documents the presence of a Florida landmass during middle Eocene time.


Humans' decision making process often relies on utilizing visual information from different views or perspectives. However, in machine-learning-based image classification we typically infer an object's class from just a single image showing an object. Especially for challenging classification problems, the visual information conveyed by a single image may be insufficient for an accurate decision. We propose a classification scheme that relies on fusing visual information captured through images depicting the same object from multiple perspectives. Convolutional neural networks are used to extract and encode visual features from the multiple views and we propose strategies for fusing these information. More specifically, we investigate the following three strategies: (1) fusing convolutional feature maps at differing network depths; (2) fusion of bottleneck latent representations prior to classification; and (3) score fusion. We systematically evaluate these strategies on three datasets from different domains. Our findings emphasize the benefit of integrating information fusion into the network rather than performing it by post-processing of classification scores. Furthermore, we demonstrate through a case study that already trained networks can be easily extended by the best fusion strategy, outperforming other approaches by large margin.


Electronic commerce has made unprecedented business transformations. The confluence of new technologies and business models provides significant research opportunities in information systems, enterprise technology, and the economics of information systems. By its very nature electronic commerce research is interdisciplinary, demanding research perspectives that go beyond traditional disciplinary boundaries. What is more, electronic commerce often requires innovative views and business practices to capture its ever changing manifestation.


Creating multi-layered channels for mimicking human blood vessels in thick tissues is the main challenge to overcome in organ biofabrication. Current three-dimensional (3D) printing strategies cannot effectively manufacture hollow channels with multiple layers. This study aims to propose a coaxial nozzle-assisted embedded 3D printing method in which core-shell filaments can be formed in a yield-stress matrix bath by extruding different ink materials through the corresponding channels. The materials selected for the core ink, shell ink, and matrix bath are Pluronic F127 (F127) and calcium chloride (CaCl2), sodium alginate (NaAlg), and poly(ethylene glycol) diacrylate (PEGDA) and nanoclay, respectively. After crosslinking the matrix bath and shell, the core layer made from the sacrificial ink (F127) is removed to generate a hollow channel. In this work, the effects of ink material properties and operating conditions on core-shell filament formation have been systematically studied. The rheological and mechanical properties of the yield-stress matrix bath have been characterized as well. A thick tissue-like structure with embedded single-layered, hollow channels has been successfully printed for demonstration. Since it is feasible to design coaxial nozzles with a core-shell-shell architecture, the proposed method is technically extendable to create double-layered channels within a cellular tissue construct, accurately mimicking human blood vascular networks in thick tissues.


U-section steel sheet piles are used for constructing retaining walls and they are connected together to form continuous walls using sliding joints located along their centerlines. Interpile movement along these joints can, in theory, reduce strength by 55% and stiffness by 70%, in comparison with the performance of piles in which no slip occurs (full composite action). This problem of interlock slippage is known as reduced modulus action (RMA). Despite the potential for this problem, it is common practice in many countries to ignore RMA in design, although the exact conditions governing when it becomes a design issue are not fully understood. This paper presents results from an investigation into this problem using experimental tests carried out using miniature piles. Unlike previous studies these tests were carried out using a similar load arrangement to that found in practice. The investigation indicates that the loading configuration affects the development of RMA and that friction between pile interlocks has the potential to mitigate much of the effect of RMA. A numerical model simulating the tests was developed and it has been used to model full-scale piles. The study indicates that many commonly occurring forms of steel sheet pile walls are unlikely to exhibit significant problems from RMA and this is relevant to pile design using Eurocode 3: Part 5.


Every year, almost 62,000 are diagnosed with a head and neck cancer (HNC) and 13,000 will succumb to their disease. In the primary setting, intraoperative radiation therapy (IORT) can be used as a boost in select patients in order to optimize local control. Addition of external beam radiation to limited volumes results in improved disease control over surgery and IORT alone. In the recurrent setting, IORT can improve outcomes from salvage surgery especially in patients previously treated with external beam radiation. The use of IORT remains limited to select institutions with various modalities being currently employed including orthovoltage, electrons, and high-dose rate brachytherapy. Practically, execution of IORT requires a coordinated effort and careful planning by a multidisciplinary team involving the head and neck surgeon, radiation oncologist, and physicist. The current review summarizes common uses, outcomes, toxicities, and technical aspects of IORT in HNC patients.


[1] Wave, current, acoustic backscatter and suspended sediment concentration measurements (both single-point and vertical profiles estimated by conversion of acoustic backscatter data) are used to investigate wave-current-cohesive sediment interaction on the muddy Atchafalaya inner shelf. During an energetic storm, we propose that bed state follows a cycle of dilation due to fluidization, erosion, deposition with fluid mud formation and consolidation. A one-dimensional-vertical cohesive sediment transport model is calibrated using current and concentration profiles to estimate the physical parameters that could not be measured directly, e.g., bottom stresses. Estimated bed position and computed bottom stresses suggest that the critical erosion threshold is in the range of 0.3 Pa to 0.5 Pa. The study site is impacted by a sediment-laden fresh water plume coming from the Atchafalaya River mouth. Bed density evolution during the storm is estimated from vertical sediment exchange between the water column and the bed excluding the duration of passage of a sediment-carrying water front. The values are in the range of 1,030 kg/m3 to 1,200 kg/m3and indicate that the bed density increases during the erosion phase and decreases during deposition. At the end of the storm, it shows a steady increasing trend during hindered settling and exceeds the space-filling value during consolidation. Both the critical erosion shear stress and bed density values are consistent with the results of laboratory tests on samples from the experimental site.


Background: The speed and magnitude of physical, mental, social, and emotional changes during adolescence result in stress. Improper coping strategies toward stress have a negative impact on the mental health of adolescents that may continue to their adulthood. Objectives: The present study aimed at investigating puberty coping strategies, puberty knowledge, and attitude of early and late adolescent females living in Karaj, Iran. Methods: This was an analytical cross-sectional study conducted on 513 female high school students using the multi-stage random sampling method. The Persian form of Endler and Parker coping inventory for stressful situations, the scale for the assessment of knowledge and attitudes of adolescent females towards puberty, and socio-demographic questionnaire were used to gather data. The SPSS v21 and Chi-square, Kruskal Wallis, and Spearman were used to analyze data at a significance level of 0.05. Results: The average age of participants was 15.40 (± 1.52). Results showed that avoidance was the dominant puberty coping strategy and the least frequent was related to the problem-focused strategy. A significant difference was observed between the frequency of coping strategies (P = 0.001), knowledge status (P ≤ 0.001) and attitude (P = 0.005) towards puberty, and source of information for puberty (P ≤ 0.001) was shown between two age groups of 15 years and under and above 15. Conclusions: The findings of this study showed the significance of educating teen females about physical and psychological changes during puberty. It seems that health educators and health practitioners could help young females cope with puberty through training proper coping strategies. Parents should also be educated to be supportive and should be able to consider puberty as a stressful situation and help adolescents with proper coping.


There is a growing interest by consumers to purchase fresh tomatoes with improved quality traits including lycopene, total soluble solids (TSS), vitamin C, and total titratable acid (TTA) content. As a result, there are considerable efforts by tomato breeders to improve tomato for these traits. However, suitable varieties developed for one location may not perform the same in different locations. This causes a problem for plant breeders because it is too labor-intensive to develop varieties for each specific location. The objective of this study was to determine the extent of genotype · en- vironment (G·E) interaction that influences tomato fruit quality. To achieve this ob- jective, we grew a set of 42 diverse tomato genotypes with different fruit shapes in replicated trials in three locations: North Carolina, New York, and Ohio. Fruits were harvested at the red ripe stage and analyzed for lycopene, TSS, vitamin C, and TTA. Analysis of variance (ANOVA) revealed that there were significant differences (P < 0.05) among tomato genotypes, locations, and their interaction. Further analysis of quality traits from individual locations revealed that there was as much as 211% change in performance of some genotypes in a certain location compared with the average per- formance of a genotype. Lycopene was found to be most influenced by the environment, whereas TTA was the least influenced. This was in agreement with heritability estimates observed in the study for these quality traits, because heritability estimate for lycopene was 16%, whereas that for TTA was 87%. The extent of G·E interaction found for the fruit quality traits in the tomato varieties included in this study may be useful in identifying optimal locations for future field trials by tomato breeders aiming to improve tomato fruit quality.


For continuous composite beams that in normal working stage, due to concrete cracks at negative moment region are restricted by transverse tendon reinforcements at the slab, it would be reasonable to consider concrete contribution to the bending capacity of such composite beams. Based on this, a variable stiffness method is proposed in this paper to calculate the composite beam deflection. Before concrete slab cracks, the flexural stiffness (the maximum value) is calculated according to the reduced transformed beam section, with the consideration of concrete contribution; After concrete cracks, this stiffness value will be decreased as per the increase of the concrete crack, and at final stage, when concrete contribution to the flexural stiffness reach zero, the stiffness value reach it's minimum value. The loads capacity at such maximum and minimum stiffness values could be considered as the beam capacity before concrete cracking as per current code, and the elastic moment capacity after concrete cracking respectively, while the stiffness between these maximum and minimum values could be determined by linear interpolation. The bending stiffness derived from this method has a higher precision than the method presented in current China specification in which the concrete contribution is totally neglected. Especially, this procedure would be more useful for those prestressed concrete composite beams, as they have higher crack- resistance capability.


Scope changes in construction can vary, and among all types of changes, design change by owner is the type that most often threatens a project with failure. Design changes requested by owners include additions, deletions and/or modifications to the original scope of the work. Design changes frequently impact project cost and time and have the potential to increase the possibility of conflicts between owners and contractors. Project time and cost change impact can become severe if owners do not consider the fact that a change in one part of the project may cause a series of changes in other parts of the project, which is known as the "change ripple effect." Therefore, for the well-organized delivery of construction projects, it is essential to have an efficient design change management system. The fundamental objective of any change management system is to eliminate any unnecessary extra costs and time delays to the original contract. Therefore, there are two main factors to effectively manage design change: first, identifying the ripple effect of the design change on other project components, and second, quantifying the ripple effect of a change on project cost and time. Limited work has been conducted in this area and no integrated model has been developed that would be able to visualize, identifies and quantifies the above-mentioned factors. This thesis presents an automated model named BIM-Change for design professionals and owners that make it possible to visualize the ripple effects of owners' design changes. The developed model calculates the impact of design changes and their ripple effect on a project's total duration and updates the project schedule accordingly. It then estimates the impact of design changes, and their ripple effect, on project cost. The cost data provided by the developed model would be the updated project total cost including direct cost, indirect cost and impact cost. As result of the proposed model, the computer program called BIM-Change was developed using the "Visual C#. Net" programming language. This program consists of six add-ins: Check Change, Ripple Effect, Room Grouping, Time Impact, and Cost Impact, Data Filtering. The model has been applied to a case study to demonstrate its usefulness, illustrate its essential features, and facilitate its evaluation. The result validated the advantages of the BIM-Change over the available software such as Vico, Innovaya, Autodesk Navisworks, Synchro and Assemble.


Taking advantage of magneto-elasto-electric interactions, new laminated composites of magnetostrictive and piezoelectric layers have been developed for highly sensitivity magnetoelectric (ME) sensors. The ME sensor design chosen in this study was based on long-type Metglas composites laminated together with piezoelectric fibers. In this paper, we analyze the expected limit of the magnetic noise of ME sensor versus its intrinsic characteristics and electronic setup. Theory calculations and experimental results are compared, and are well supported by noise measurements. Moreover, the presented results show very impressive performances in terms of the equivalent magnetic sensor noise. A 65 pT/√Hz equivalent magnetic noise was achieved at 1 Hz, while reaching values as low as 70 fT/√Hz near the ME resonant frequency.


A new, general ortho/para-selective anodic dehydrogenative cross-coupling of two aryl amines, naphthalen-2-amine derivatives and anilines, is described. This electrochemical protocol assembles a wide range of unsymmetrical biaryls in good to excellent yields under mild, additional-metal-catalyst-free, oxidant-free conditions with excellent selectivity, broad substrate scope, and wide functional group tolerance. This electrochemical technology is highlighted with facile incorporation of important pharmacophores into the resulting biaryls, and is applicable to the homocoupling of anilines for producing symmetrical biaryls.


Background: Numerous strategies have been proposed for the treatment of peanut allergies, but despite the steady advancement in our understanding of atopic immune responses and the increasing number of deaths each year from peanut anaphylaxis, there is still no safe, effective, specific therapy for the peanut-sensitive individual. Immunotherapy would be safer and more effective if the allergens could be altered to reduce their ability to initiate an allergic reaction without altering their ability to desensitize the allergic patient. Methods: The cDNA clones for three major peanut allergens, Ara h 1, Ara h 2, and Ara h 3, have been cloned and characterized. The IgE-binding epitopes of each of these allergens have been determined and amino acids critical to each epitope identified. Site-directed mutagenesis of the allergen cDNA clones, followed by recombinant production of the modified allergen, provided the reagents necessary to test our hypothesis that hypoallergenic proteins are effective immunotherapeutic reagents for treating peanut-sensitive patients. Modified peanut allergens were subjected to immunoblot analysis using peanut-positive patient sera IgE, T cell proliferation assays, and tested in a murine model of peanut anaphylaxis. Results: In general, the modified allergens were poor competitors for binding of peanut-specific IgE when compared to their wild-type counterpart. The modified allergens demonstrated a greatly reduced IgE-binding capacity when individual patient serum IgE was compared to the binding capacity of the wild-type allergens. In addition, while there was considerable variability between patients, the modified allergens retained the ability to stimulate T cell proliferation. Conclusions: These modified allergen genes and proteins should provide a safe immunotherapeutic agent for the treatment of peanut allergy.


Introduction: Medication errors can occur at any step while handling a medication from prescribing, indenting, dispensing to administration. Medication errors have the potential to cause patient harm to the extent of serious morbidity or even mortality and can have a substantial cost impact on the healthcare system. It can also lead to patient dissatisfaction and loss of confidence on the medical care. This study done with the objective of analysis of medication errors in a teaching hospital with an aim towards process improvement is thus justified.

Materials and methods: This were a retrospective study done on the reported inpatient Medication Errors between January 2018 to December 2019 in a 600-bed tertiary care teaching hospital in Bihar. The total number of Medication errors reported during the study period was 1501 and the total number of orders during the said period was 28,472 as retrieved from the pharmacy software. The data from the Incident Report Form was entered in the Excel Spreadsheet and variables analysed using Descriptive Statistics.

Results: The medication error rate per 100 orders was 5.27. Majority of the Medication errors about 96.8% took place in the Wards. Majority of the Medication Errors i.e. 66.42% occurred between 4 PM to 8 PM. Doctors contributed to the maximum percentage of Medication Errors 69.8%. Majority of the medication errors 67.62% (1015) were a combination of prescription and transcription errors. The major reasons for Medication Errors were Dose related errors which constituted the maximum proportion of 70.43% (1058).

Conclusion: The study concluded that medication errors occur even in hospital settings with established policies for Safe Handling and Use of Medications. However, those can be restricted from reaching the patient with well-structured dedicated strategies and multi-level checks ("Swiss-cheese" Model) in place aimed towards increasing the safety of medication handling and use. Further in-depth studies are recommended on medication errors including "Near miss" which can throw more light on lapses in an existing process and identify the effective intervention strategies to help process improvement.


For psychology to truly embrace reconciliation, a greater representation of Indigenous Australian psychology professionals is required. A model for increasing Indigenous participation in psychology degrees is described here. Such an increase has many potential benefits for the discipline and the services that it provides. The model proposed targets the barriers reported by past and potential Indigenous students. Key aspects of this model are as follows: the institutional context that embraces a cultural competence framework, the inclusion of relevant Indigenous curriculum in subjects within the degree, partnership with the local area health service, and involvement of local elders and communities. It also encompasses a system for growing a sustainable mentoring program involving students and staff. Mutually respectful relationships and reciprocal learning are foundational in this approach. The model provides experience of reconciliation in action for all psychology students important in training future professionals. Integral is a process to increase the relevance of the curriculum and pedagogy for serving the needs of Indigenous people, thereby increasing the engagement of Indigenous students.


: The authors describe the installation and application of a computerized management system for clinical information in an intensive care-resuscitation unit. The authors analyze the installation of the hardware and software as well as the professional preparation provided to personnel. They review the different sections which comprise this program, describing the use(s) of each. They conclude by analyzing the advantages and disadvantages detected over the two years during which they have employed this program, highlighting the qualities derived from its daily use which make it a tool that facilitates daily nursing tasks. This report was presented at "Inforenf 2000", "Inforenf 2001" and "Seeiuc 2000".


Leishmaniasis is a neglected tropical disease that continues to pose a serious public health problem. Albeit dogs have long been held as the major reservoirs of Leishmania infantum, the involvement of domestic cats in the zoonotic cycle of visceral leishmaniasis has gained prominence. Here, 240 cats were evaluated by clinical signs and haematological/biochemical changes compatible with leishmaniasis and were diagnosed by serological, molecular, and parasitological techniques. Thus, four cats naturally infected by L. infantum were submitted to xenodiagnosis. A total of 203 females of Lutzomyia longipalpis were subjected to feeding on four cats, with all females completing the blood meal. Parasitological and molecular assays were carried out to evaluate the presence of L. infantum in the sand flies' midgut. Promastigotes were observed in 10 females (6.5%) that fed on one cat, and L. infantum DNA was detected in 17 (8.4%) females which fed on two cats. Our results strengthen the evidence that naturally infected cats are capable of transmitting L. infantum to sand flies. This article is protected by copyright. All rights reserved.


This paper aims at reducing the embedding distortion of prediction error expansion reversible watermarking. Instead of embedding the entire expanded difference into the current pixel, the difference is split between the current pixel and its prediction context. The modification of the context generates an increase of the following prediction errors. Global optimization is obtained by tuning the amount of data embedded into context pixels. Prediction error expansion reversible watermarking schemes based on median edge detector (MED), gradient-adjusted predictor (GAP), and a simplified GAP version, SGAP, are investigated. Improvements are obtained for all the predictors. Notably good results are obtained for SGAP-based schemes. The improved SGAP appears to outperform GAP-based reversible watermarking.


The Learning Church series offers a range of brief and accessible introductions to the key themes of Christian discipleship and theology. What do Christians believe the Bible to be, and what are the consequences of these beliefs? For many people, tackling the Bible is rather like sorting the attic: lots of obscure and long forgotten paraphernalia, a certain amount of untidiness and mess ...but perhaps some hidden gems. Seeking to ask the questions which 'ordinary people' might ask about the relevance of the Bible for today's Church, this book aims to equip those who want to find ways of making it more useful, and to help them explore with openness and honesty the difficulties of trying to use an ancient text as a guide for contemporary faith.


Tropospheric ozone (O3) is probably the air pollutant most damaging to vegetation. Understanding how plants respond to O3 pollution under different climate conditions is of central importance for predicting the interactions between climate change, ozone impact and vegetation. This work analyses the effect of O3 fluxes on net ecosystem productivity (NEP), measured directly at the ecosystem level with the eddy covariance (EC) technique. The relationship was explored with artificial neural networks (ANNs), which were used to model NEP using environmental and phenological variables as inputs in addition to stomatal O3 uptake in Spring and Summer, when O3 pollution is expected to be highest. A sensitivity analysis allowed us to isolate the effect of O3, visualize the shape of the O3-NEP functional relationship and explore how climatic variables affect NEP response to O3. This approach has been applied to eleven ecosystems covering a range of climatic areas. The analysis highlighted that O3 effects over NEP are highly non-linear and site-specific. A significant but small NEP reduction was found during Spring in a Scottish shrubland (−0.67%), in two Italian forests (up to −1.37%) and during Summer in a Californian orange orchard (−1.25%). Although the overall seasonal effect of O3 on NEP was not found to be negative for the other sites, with episodic O3 detrimental effect still identified. These episodes were correlated with meteorological variables showing that O3 damage depends on weather conditions. By identifying O3 damage under field conditions and the environmental factors influencing to that damage, this work provides an insight into O3 pollution, climate and weather conditions.


Download this article from UCL Discovery. Conflicts between regional executive leaders and the executive heads of regional capital cities were a frequent occurrence in El'tsin's Russia, and were consequences of the rapid decentralization of power that occurred in the first half of the 1990s. This article focuses on the political competition that emerged in Sverdlovsk Oblast between the regional governor Eduard Rossel' and his counterpart at the local level, Ekaterinburg Mayor Arkadii Chernetskii. It evaluates the key network relationships held by these two actors during the 1990s, and asks how these networks influenced the balance of regional power prior to the federal recentralisation processes of the 2000s. The article applies the strategy of boundary control, as previously applied by Edward Gibson to the study of subnational regional regimes in Latin America under conditions of national democratization;1 in so doing, it considers Rossel''s hold over regional power as being determined by his approach to representing regional elite interests, both political and economic, which thereby insulated his power from challengers.


The several spectacular congregational sacrifices or yajnas known from early first millennium B.C. South Asia, viz. the rājasūya, vājapeya, gavāmayana or atirātra, included numerous rites, rituals and customs with magical connotations, and also had significant political implications like reasserting a monarch's positions or promoting him through several stages of kingship. One such sacrifice, the aśvamedha, often referred to in the context of empires and metropolises c. 8–7th century B.C., was rather spectacular, involving the letting loose of a horse, its military peregrination for one year, and its subsequent immolation in a rite involving mock necrophilia and bestiality. The many studies of the rites, procedure, and symbolism of aśvamedha are marked by two apparent gaps. The first of these is that most studies, apart from some notable works like of Puhvel or, more recently, Witzel, are preoccupied with the mature form of the aśvamedha and do not adequately consider the evolution of the rites, procedures and symbolisms. The second gap is that most studies, including the ones referred to above, concentrate on the various ritual symbolisms of the sacrifice, usually overlooking its 'military' aspect, i.e. the ritualised military context of the yearlong circuit, that had actually made the sacrifice so spectacular. The aim of this paper is to go beyond the ritual and ceremonial aspects of the aśvamedha as known from its mature form, and seek the roots of its politico–military procedure far back in time in the nomad world of endemic warfare.


Public Health discipline has evolved and currently focuses on addressing social determinants of health and working multi-sectorally to promote health. Public Health Leadershipis the practice of mobilizing people, organizations, and communities to effectively tackle tough public health challenges. Leadership is a core competency of public health.Leaders are people with Vision, Influence, Values and Passion to achieve personal and organizational mission.Leadership is not a personal trait but is learnable skill. Leadership is a journey where one goes from being a member of a single team to lead health sector in working with other sectors. A leader moves from carrying out assigned tasks at the beginning of journey to providing a vision to motivate others to achieve their life goals. A true leader grooms leaders to establish a legacy of leadership. Ten lessons from my life would be: Believe in yourself; Seize the opportunities; present a vision of future; get out of comfort zone; expand capacity rather than define limits; strengthen communication and people to people skills; build a team; consider everyone as a potential collaborator; focus on deliverables and on relationships. We should start Public Health leadership course and develop core modules for teaching of leadership to post graduates in all medical schools.


Explosives are commonly used in terrorist attacks and the craters formed by blast waves can be used as a diagnostic tool. For example, the focus of the explosion and the mass of the explosive used in the attack can be deduced by examining the location, geometry, and dimensions of the crater. However, studies about craters produced by explosions on or above ground level, which would be the case when the explosive charge is situated in a vehicle, are rarely found in the open technical literature. In this paper, a numerical study on craters formed by explosive loads located on the soil surface is presented. The soil parameters used in the numerical model, as well as the analysis procedure, were validated against experimental observations of the crater diameters. Results of numerical tests performed with different amounts of explosive on the soil surface are presented. Moreover, the effect of elevation of the center of energy release of explosive loads located on the soil surface is analyzed and discussed. Simple predictive equations for the crater diameter are presented.


Background: The sustainability of school-based health interventions to improve students' health, wellbeing and behaviour after start-up funding/resources cease has been relatively unexplored compared to health-care. Discontinuing effective interventions prevents new practices from reaching wider student populations and wastes investment in implementation. This thesis examines evidence on whether/how schools sustain health interventions and explores sustainability processes. Method: Empirical studies were systematically reviewed to assess the sustainability of school health interventions. A case-study was conducted of the sustainability of 'Learning Together', a bullying-prevention intervention initiated in English secondary schools through an effectiveness trial. The intervention entailed: restorative practice (RP), a staff-student action group, and a curriculum. Qualitative, longitudinal data were collected from five schools: interviews with multiple staff/school, and with students and external facilitators the first-year post-trial; interviews with one staff member/school two years post-trial; and descriptive data from the trial's process evaluation. Results: Twenty-four studies of eighteen interventions were included in the systematic review. No interventions were sustained entirely; all interventions had some components sustained by some schools/staff, bar one that was discontinued. Key facilitators included commitment from senior leaders, staff observing an improvement in students' engagement/wellbeing, and confidently delivering valued intervention approaches. Important contextual barriers emerged: the norm of prioritising educational outcomes under time/resource constraints, insufficient funding/resources and ongoing training, and staff turnover. Learning Together was not sustainable two years post-trial. RP had been continued by some individuals in all schools and was sustained at school-level in one school; the curriculum and action groups were discontinued in all schools, though actions initiated by the groups were sustained in two schools. Staff's experiences of components' effectiveness compared to existing provision and views of their long-term value affected components' sustainability. Sustainability depended on staff's ability to mainstream desired components across the school, which they had little capacity to do. Conclusion: Intervention developers need to support schools to mainstream evidence-based interventions to sustain them at school-level. Methodologically stronger primary research on sustainability and sustainability strategies is needed.


Tubulointerstitial nephritis (TIN) refers to a group of heterogeneous diseases affecting the interstitial compartment of the kidney. It might be primary or can develop secondary to many urinary systemic diseases. Primary TIN develops mainly following drug usage, exposure to toxins, and also infections and humoral and cell-mediated immune reactions. In some patients, signs of systemic inflammatory reactions can be the first presenting symptoms. Histopathological evaluation reveals mononuclear cells and lymphocytes in the interstitium and tubuli. Acute and chronic TIN can resolve after elimination of the culprit destructive factors, as drugs, toxins and immune reaction. Combination of tubulointerstitial inflammation and uveitis is termed as tubulointerstitial nephritis-uveitis (TINU) syndrome. Uveitis might occur before, after, and also concomitantly with TIN. Herein, two adolescent cases of TIN and TINU, seemingly developed secondary to paracetamol and codeine phosphate use, are presented.


Romania now has one of the best-drafted bankruptcy laws in Central and Eastern Europe. The new Romanian bankruptcy law went into effect on August 26, 1995 and replaced the previous bankruptcy provisions in §695-987 of the Romanian Commercial Code, which was translated from the Italian Commercial Code of 1884 and enacted in 1887. While the commercial code fell into disuse during the Communist era, it was never repealed. After the Romanian revolution and the demise of Nicolae Ceausescu at the end of 1989, the commercial code as well as the civil code remained good law and needed only to be reprinted and applied by the Romanian courts. While these laws needed substantial modernization, at least there was a body of law for the Romanian courts to apply while the legislature was preparing modernization legislation. There are two trial level courts in Romania, the Municipal Court and the Tribunal. In general, the larger and more important cases are filed initially in the Tribunal, and the smaller cases begin in the Municipal Court. All bankruptcy cases begin in the Tribunals. With few exceptions, the Tribunal judges begin their judicial careers in the Municipal Courts and move up after they gain a measure of experience. With these general observations in mind, this article addresses the specific questions raised in the hypothetical posed for this symposium.


Lower urinary tract symptoms (LUTS) are highly prevalent in women, and are expected to impose a growing burden to individuals and society as the population ages. The predominance of research related to LUTS has focused on underlying pathology, disease mechanisms, or the efficacy of treatments for women with LUTS. Although this research has been vital for helping to reduce or ameliorate LUTS conditions, it has done little to prevent the onset of LUTS. Health promotion and prevention require an expansion of scientific inquiry beyond the traditional paradigm of studying disease mechanisms and treatment to the creation of an evidence base to support recommendations for bladder health promotion and, in turn, prevention of LUTS. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) introduced the concept of prevention as an important priority for women's urologic research as a prelude to supporting the formation of the Prevention of Lower Urinary Tract Symptoms (PLUS) research consortium. In this article, we introduce the PLUS research consortium to the scientific community; share the innovative paradigms by which the consortium operates; and describe its unique research mission: to identify factors that promote bladder health across the life course and prevent the onset of LUTS in girls and women.


Program Number: 3359 Poster Board Number: C0052 Presentation Time: 11:00 AM–12:45 PM A comparison of image quality between swept source optical coherence tomography and spectral domain optical coherence tomography according to ocular media opacity Yong Un Shin, Byung Ro Lee, Han Woong Lim. Ophthalmology, Hanyang Medical Center, Seoul, Republic of Korea. Purpose: To compare of image quality between swept source optical coherence tomography (SS-OCT) and spectral domain OCT (SDOCT) according to various ocular media opacity Methods: 20 healthy eyes without media opacity and 40 eyes with media opacity (20 eyes with cataract, 15 eyes with vitreous opacity, 5 eyes with corneal opacity) were included in this study. All subjects performed same scan protocol (6x6 mm macular scan) of both SDOCT and SS-OCT sequentially. For the comparison of image quality, a total of 120 OCT images were subjectively graded by two trained retina specialist using qualitative OCT image grading system (0-9) suggested by previous report. In addition, we measured image quality factor (Q-factor) of all OCT images provided by each OCT device for objective assessment. Results: The image quality of SS-OCT was better than that of SDOCT in both healthy eyes and the eyes with medial opacity, which was statistically significant in both subjective (7.79 vs 2.91) and objective (106.82 vs 32.49) assessment (P<0.05). Regardless of the type of media opacity, SS-OCT showed better image quality than SDOCT. In cases with healthy eyes, there was no statistical difference in subjective interpretation between two OCT devices. In cases with severe media opacity, SD-OCT did not show detailed microstructure of retina such as external limiting membrane and photoreceptor layer, while SS-OCT did clearly. Conclusions: Recently introduced SS-OCT used longer wavelength light source than SD-OCT, which may lead to good image quality in eyes with media opacity. SS-OCT may be useful in the evaluation of retinal disease in cases with severe media opacity.


If you have ever searched for a suitable graduate-level textbook on e-Learning,1 you will appreciate it when I say the process is like hunting for a needle in a haystack. Many available titles on e-Learning have a business practice overtone. Although this is to be expected, for e-Learning is big business, such books often are unsuitable for a graduatelevel course in the field of education. When I finally found and finished reading The SAGE Handbook of E-learning Research, I knew I had the right book. It was not only suitable for graduate-level education classes but clearly valuable for doctoral students interested in research and development, learning models, and historical perspectives on e-Learning. The editors, Richard Andrews and Caroline Haythornthwaite, and 32 other contributors (ranging from graduate student to distinguish professor) took stock of "progress in e-learning research," addressed "a range of issues from student experience to policy," and provided "a foundation for further research and development" (p. 1). One may wonder if a mere 560 pages can do justice to the field of e-Learning. However, I found myself quite satisfied by the breadth and the depth of the topics covered. The editors ensured a long shelf life for the book by covering the latest trends in e-Learning development, such as third-generation (3G) mobile phones, immersive (whole-body) virtual environments, and online games. The 23 chapters are grouped into five parts: "Contexts for Researching E-learning," "Theory," "Policy," "Language and Literacy," and "Design Issues." The reader will find treatises on topics such as e-Learning's history ("Development and Philosophy of the Field of Asynchronous Learning Networks," by Starr Roxanne Hiltz, Murray Turoff, and Linda Harasim), efforts to advance distance education ("From Distance Education to E-learning," by Melody M. Thompson), politics ("Digital Divide and E-learning," by Caroline Haythornthwaite), the development of theory and methodology ("Learning Sciences Theories and Methods for E-learning Researchers," by Christopher Hoadley), and policy and practice ("An International Comparison of the Relationship Between Policy and Practice in E-learning," by Gráinne Conole). Educators in languages, reading, and writing will be delighted to find sections devoted to the discussion of reading, writing, bilingualism, and second-language learning in an e-Learning environment. Also addressed is the fascinating human journey from paper-based to digital reading and writing, as well as the increasingly complex modes of writing and message composition in the Internet Age, from single-mode (text based) to dual-mode (text and image), to multimodal (incorporating multiple media, e.g., text, audio, and video). It is evident from the arguments presented in this book that computing technology and the Internet are not only changing modes of lesson delivery but also reshaping the rhetorical space in which literacy and learning occur. Although a number of research methodologies are mentioned in passing by individual authors, the chapter titled "Learning Sciences Theories and Methods for Elearning Researchers" could give the impression that the handbook is skewed toward learning sciences only. Even though this is a very well-written chapter and particularly helpful for doctoral students interested in looking at e-Learning research through a scientific lens, I would have liked to see other, similarly titled chapters that examined the relevance of other research theories and methodologies that are equally suitable for e-Learning researchers—educational data mining, formative research, and design-based research, to name a few. Similarly, the handbook contains many excellent chapters that cover the historical aspects of e-Learning research (indeed, they read like well-written literature reviews from dissertations). Among the topics covered are the rise of asynchronous learning networks (chap. 2), the use of online games and simulations in e-Learning (chap. 5), the rise of learning sciences in e-Learning research (chap. 6), how writing and literacy evolved through many iterations of technology change (chaps. 3 and 18), computersupported collaborative learning (chap. 11), and the rise in learning-styles research pertaining to personality, age, and gender issues (chap. 15). It is ironic that the handbook does not include a chapter expounding the rise of the term e-Learning itself, from limited commercial application to cult success status in today's society.


Background. Lexical Bundles (LBs) have become the focus of many recent corpus linguistics studies. Research has found variable use of LBs in terms of quality and quantity pertaining to different linguistic groups or registers. Still, there is a paucity of research investigating Arab EFL writers' use and development of such a feature.
Purpose. This study investigates the 4-word LBs use and development by Arab EFL learners and expert writers in a corpus of 250000 words regarding their frequency, functions, and structure.
Methods. Two corpora were compiled for Arab learners and scholars. The LB use of both groups was compared to investigate the development of LB use. Further, the Arab corpus was analysed against a native reference corpus extracted from the British Academic Written English (BAWE) corpus to compare LB use across the two corpora.
Results and Implications. The results imply that there is no noticeable effect of postgraduate education or professional practice on using LBs. The other results, however, are in-line with the previous literature in that native speakers' use of LBs varies in quantity and quality from non-natives'. The findings reveal that stance LBs are more frequent in the native corpus and that they tend to use more VP-based clausal LBs than their non-native counterparts. These findings offer empirical evidence that EFL writing quality is lower despite the current academic writing instruction they receive. They, therefore, indicate the need to foster academic writing instruction programs to include training on using LBs in learners' writing at both Bachelor and postgraduate levels. Also, the results are expected to raise teachers' awareness of how EFL learners use LBs to develop their writing quality and thus to adapt their teaching strategies accordingly. Moreover, Arab scholars are called to reconsider their use of effective writing techniques including LBs for more effective writing.


The Mersin Mélange, located in southern Turkey north-west of the city of Mersin, includes blocks and tectonic slices of different origins. The Kilek section in the Mersin Mélange was sampled for a thorough examination of its lithology, biostratigraphy and fossil content. Two samples from the cherty limestone layers within the Huglu Tuffites at the top of the section yielded a rich silicified ostracod fauna of late Early Carnian (based on a two-fold Carnian subdivision) or middle Middle Carnian age (based on a three-fold Carnian subdivision), deposited in an open marine environment, in the outer platform-upper slope zone. We report 121 ostracod species belonging to 53 genera. Two new genera are described: Edithobairdia Forel gen. nov. and Gencella Forel gen. nov., as well as 16 new species: Acanthoscapha mersinella Forel sp. nov., Bairdia hugluensis Forel sp. nov., Acratia kollmanni Forel sp. nov., Citrella? carniana Forel sp. nov., Cytheropteron? schornikovi Forel sp. nov., Eucytherura lacerata Forel sp. nov., Gencella taurensis Forel sp. nov., Kerocythere dorsidenticulata Forel sp. nov., Kerocythere tricostata Forel sp. nov., Monoceratina praevulsaformis Forel sp. nov., Patellacythere tourkosella Forel sp. nov., Polycope kilekensis Forel sp. nov., Ptychobairdia praekristanae Forel sp. nov., Simeonella daginikella Forel sp. nov., Spinomicrocheilinella reliquiaella Forel sp. nov. and Triassocythere tavuscayiriensis Forel sp. nov. The diagnosis of Acratia goemoeryi Kozur is emended. The Kilek fauna retains primitive characteristics illustrated by the first known occurrence of Palaeocopida and Rectonariidae (typical Palaeozoic forms) in the Late Triassic, associated with typical Triassic–modern elements such as thick-shelled and ornamented Bairdiidae and diverse Cytheroidea known from the Middle and Late Triassic worldwide. The unique composition of Palaeozoic and Mesozoic taxa from the Kilek section illustrates unexpected long-term survival in a deep-sea refuge zone following the end-Permian extinction, and the diachronous character of the ostracod recovery in different environments. http://zoobank.org/urn:lsid:zoobank.org.pub:662C3D5C–2B86–4D7B–BDB5–8F8B6A1AD1E7


The individual's spiritual self-perception of the need to strike out has caused Expressionism to arise. When describing herself, the artist tells about his dead ends, his fears, his loneliness in the world. The despair of the artist, the reflection of the inner troubles and the figures in the works, also constituted the main cause of the unaesthetication in the paintings. The expressionist artist has reflected incidents in his works in an incoherent manner and has treated the figures in his paintings in the way he would like to see them from his point of view. This is seen very concrete in the works of Expressionist artists Kirchner, Nolde, Beckman, Kokoschka. Almost all of the artists fluttered in the mass of grievances, reflecting their fears, sorrows, troubles in their works. It was also the main reason for the unaestheticisation in his paintings. In these pictures, a vague mood is hidden behind rich content, scary and frightening images. With the discovery of the omneness the reality of the outside world is redesigned. Expressionists have no intention of lifting all the usual patterns of art. They only want to discover the most secret world of the subject and reflect it in their works. In expressionist works, unaestheticisation or ugliness in figures were not an admiration for their ugliness, but they necessarily regarded it as a necessity for their natural life..


Frequent losses of chromosome 19p have recently been observed in sporadic lung adenocarcinomas, targeting the location of a critical tumor suppressor gene. Here we performed fine mapping of the short arm of chromosome 19 and found that the LKB1/STK11 gene mapped in the minimal-deleted region. Because germ-line mutations at LKB1/STK11 result in the Peutz-Jeghers syndrome and an increased risk of cancer, we performed a detailed genetic screen of the LKB1/STK11 gene in lung tumors. We detected a high frequency of somatic alterations (mainly nonsense mutations) in primary lung adenocarcinomas and in lung cancer cell lines. Thus, our findings demonstrate for the first time that LKB1/STK11 inactivation is a very common event and may be integrally involved in the development of sporadic lung adenocarcinoma.


Sustainable (also known as environmental, social, and corporate governance [ESG]) investing is currently of intense interest in the investment world. In this article, the authors consider the salient challenges associated with ESG investing and how quantitative approaches may address them. Compared to fundamental methods of sustainable investing, the authors see quantitative methods as having several advantages: These methods can build on and extend the vast analytical toolbox of modern portfolio theory to incorporate investor preference in portfolio construction; they can leverage the recent data explosion to obtain insights on many intangible sustainability metrics; and they do not have the black box label. Instead, subjective judgment applied to building the quantitative system is essential. A thoughtful analytical system can be applied to a large universe of stocks, and quantitative methods may also be leveraged to predict popular ESG vendor ratings. Although these are the early days of quantitative sustainable investing, the authors believe these advantages will prove the quantitative method's worth in sustainable investing. TOPICS: ESG investing, portfolio theory, portfolio construction, statistical methods Key Findings ▪ Quantitative methods have unique advantages for sustainable investing in the areas of portfolio construction, data application, and scaling domain knowledge. ▪ The skillful quantitative practitioner can create the optimal blend of human insight and computing power to extract sustainability insights from data.


Due to continuous development of additive technologies and perspectives for their practical application in many fields of engineering such as architecture and civil engineering, mechanical engineering, etc., the question of new approaches and requirements for design process is becoming a key point. In this framework the search for the rational or optimal shapes seems reasonable. In the paper, the investigation on the design of several types of helical surfaces which can be applied in different fields of mechanical industry is presented, along with the parametric equations for ruled helicoids which can be useful for further application using additive technologies. Different classifications of ruled helical surfaces are presented and compared from technical and mathematical points of view. There are also some recommendations for usage the proper types of helical structures in accordance with geometry investigation and effective material usage. The paper can be interesting for designers from mechanical and civil engineering, architecture and industry design. 


We present a theoretical model of the time-resolved excitonic photoluminescence in quantum wires. We study the role of disorder on the temperature dependence of the photoluminescence lifetime. We find that at low temperature the exciton population is not thermalized in disordered quantum wires and that the lifetime is mainly determined by the localization length of the exciton. However for large localization lengths or high enough temperatures the exciton population thermalizes within its lifetime and the temperature dependence becomes square root like.


Electric stimulation is used for managing osteoarthritic (OA) pain; however, little is known about the development of analgesic tolerance during repeated stimulations and the relation of spinal microglia with OA pain. We investigated the changes in the analgesic effects of repeated electric stimulations and the relation between the development of analgesic tolerance and spinal microglial expression in rats with OA. To induce OA, monosodium iodoacetate was injected into the synovial space of the right knee joint of the rats (n = 185). Repeated high frequency, low frequency, or sham transcutaneous electric nerve stimulation (TENS) was performed to the ipsilateral knee joint for 20 min in rats with OA (n = 45). Minocycline or minocycline plus TENS (HF, LF, or sham) was treated in OA rats with repeated TENS-induced tolerance (n = 135). Immunohistochemistry of the microglia in the L3–L5 spinal segments was performed. Knee joint pain during passive movement of the knee joint were quantified using the knee-bend score and the proportion of activated microglia was calculated as primary variables. Paw withdrawal threshold (hypersensitivity to mechanical stimuli) was assessed and the resting and activated microglia were counted as secondary variables. Repeated applications decreased the analgesic effect of TENS on OA pain and failed to reduce the expression of activated microglia in the spinal cord. However, spinal microglial inhibition by minocycline restored the analgesic effect of TENS on OA pain in TENS-tolerant OA rats. TENS combined with minocycline treatment improved knee joint pain and mechanical hypersensitivity in TENS-tolerant OA rats, and inhibited the expression of activated microglia in the spinal cord. These results suggest a possible relationship between repetitive electric stimulation-induced analgesic tolerance for OA pain control and changes in microglia activation.


The paper is devoted to explore how the increasing availability of spatial micro-data, jointly with the diffusion of GIS software, allows to exploit micro-econometric methods based on stochastic spatial point processes in order to understand the factors that may influence the location decisions of new firms. By using the knowledge of the geographical coordinates of the newborn firms, their spatial distribution is treated as a realization of an inhomogeneous marked point process in the continuous space and the effect of spatial-varying factors on the location decisions is evaluated by parametrically modelling the intensity of the process. The study is motivated by the real issue of analysing the birth process of small and medium manufacturing firms in Tuscany, an Italian region, and it shows that the location choices of the new Tuscan firms is influenced on the one hand by the availability of infrastructures and the level of accessibility, and on the other by the presence and the characteristics of the existing firms. Moreover, the effect of these factors varies with the size and the level of technology of the new firms. Besides the specific Tuscan result, the study shows the potentiality of the described micro-econometric approach for the analysis of the spatial dynamics of firms.


What is the effect of one's religious attitudes and behaviors on the frequency of different emotions? I propose that a stronger religious affiliation and a higher frequency of attending religious services will lead to feeling happy and ashamed more often and feeling sad, anxious, and mad less often. Further, I propose that a higher frequency of prayer will lead to feeling sad, anxious, mad, and ashamed more often and feeling happy less often. I analyze the frequency of these emotions in 892 respondents to the 1996 General Social Survey, a nationally representative dataset obtained via face to face interviews. Regression analysis revealed that more frequent prayer leads to feeling sad and ashamed more often, and more frequent religious service attendance leads to feeling anxious less often. Demographic control variables are also found to have an effect on how frequently one feels sad, mad, and anxious. The results offer partial support for the hypotheses. Further research is necessary to reconcile these differences and to explain the mechanisms by which the relationship between religiosity and emotions operates.


Arcobacter butzleri, the most prevalent species of the genus, has the demonstrated ability to adhere to various surfaces through biofilm production. The biofilm formation capability has been related to the expression of certain genes, which have not been characterized in A. butzleri. In order to increase the knowledge of this foodborne pathogen, the aim of this study was to assess the role of six biofilm-associated genes in campylobacteria (flaA, flaB, fliS, luxS, pta and spoT) in the biofilm formation ability of A. butzleri. Knockout mutants were constructed from different foodborne isolates, and static biofilm assays were conducted on polystyrene (PS), reinforced glass and stainless steel. Additionally, motility and Congo red binding assays were performed. In general, mutants in flaAB, fliS and luxS showed a decrease in the biofilm production irrespective of the surface; mutants in spoT showed an increase on stainless steel, and mutants in pta and spoT showed a decrease on reinforced glass but an increase on PS. Our work sheds light on the biofilm-related pathogenesis of A. butzleri, although future studies are necessary to achieve a satisfactory objective.


ofcommunity care, multidisciplinary evaluation of community based services-are very similar. Health professionals engaged in community care in India, if invited to Britain on a regular basis, can, I believe, meaningfully participate in both the theoretical and practical aspects of the planning and implementation of community care, often to mutual benefit. This would be true of health services in general, but especially so of community based mental health care. Such services as there are in India are negligible and there is a disappointing lack of professional skill in the area. BISWAJIT SEN


Despite recent theoretical advances, the pattern of trust development between coworkers is a topic of dispute and many basic trust processes remain unclear. Increasingly, trust researchers are recognising that trust development is a context specific process that requires more nuanced empirical investigation of trust changes over time and in specific situations. Furthermore, theory suggests that employees attend to an array of independent trust cues but it fails to identify which cues are important when. Using a four wave longitudinal field study with 193 participants, this research demonstrates how new coworker intentions to engage in trust behaviours (reliance and disclosure) evolve during employee socialisation, and examine the trust cues that prime decisions to trust. Drawing on existing theory, it is hypothesised that early trust intentions will be related to individual trust propensity and that intention to engage in trust behaviour will increase over time. It is also hypothesised that early trust will be presumptive, based on information about coworker roles, the rules inherent in the organisation, and identification with the coworker group. In contrast, it is expected that as relationships develop, trust will be based on more personal cues (coworker trustworthiness). Latent growth modelling reveals that both reliance and disclosure intentions develop in a positive, non-linear pattern over time. Furthermore, the findings indicate that propensity to trust has a statistically significant effect on the initial status of intention to rely on and disclose information with coworkers but not on changes in trust behaviour over time. The multi-wave design permits comprehensive assessment of the change in the impact of different trust cues over time on intentions to engage in trust behaviour and finds that the importance of certain cues change as a relationship matures. Based on these findings implications for theory, practice and future research are discussed.


The Gasherbrum Peaks, in the Himalaya of Pakistan, reach elevations of >8000 m. The relief between the peaks and the adjacent valley (Baltoro Glacier) is in excess of 3000 m. Eight samples of the Early Cretaceous Gasherbrum Diorite at elevations between 4880 and 7165 m on Gasherbrum IV were collected for fission-track dating. Zircon fission-track ages from the Gasherbrum Diorite vary from Early Cretaceous to middle Tertiary in age. There is no consistent pattern between age and elevation. The Cretaceous ages indicate that these rocks were never deeply buried, i.e., heated to temperatures in excess of 175 C, to reset the zircons during Cenozoic time. These results also indicate that the uplift of this part of the Himalaya has been either very rapid and recent, or very slow since Early Cretaceous time. This latter possibility is not consistent with the high relief at Gasherbrum and what is known about regional tectonics. Gasherbrum IV zircons, currently at {approximately}4880 m, have never been at depths greater than 6 km, and less than 3 km of material has been removed from the top of the range by erosion since the Early Cretaceous. Rapid uplift has occurred very recently, and erosion rates have notmore » been able to keep pace with this uplift.« less


We show both theoretically and numerically a connection between the smoothed finite element method (SFEM) and the virtual element method and use this approach to derive stable, cheap and optimally convergent polyhedral FEM. We show that the stiffness matrix computed with one subcell SFEM is identical to the consistency term of the virtual element method, irrespective of the topology of the element, as long as the shape functions vary linearly on the boundary. Using this connection, we propose a new stable approach to strain smoothing for polygonal/polyhedral elements where, instead of using sub‐triangulations, we are able to use one single polygonal/polyhedral subcell for each element while maintaining stability. For a similar number of degrees of freedom, the proposed approach is more accurate than the conventional SFEM with triangular subcells. The time to compute the stiffness matrix scales with the O(dofs)1.1 in case of the conventional polygonal FEM, while it scales as O(dofs)0.7 in the proposed approach. The accuracy and the convergence properties of the SFEM are studied with a few benchmark problems in 2D and 3D linear elasticity. Copyright © 2015 John Wiley & Sons, Ltd.


Background—Renarrowing of dilated arterial sites (restenosis) hampers the clinical benefits of coronary angioplasty. Infiltration and activation of monocytes in the arterial wall mediated by monocyte chemoattractant protein-1 (MCP-1) might be a major cause of restenosis after angioplasty. However, there is no direct evidence to support a definite role of MCP-1 in the development of restenosis. Methods and Results—We recently devised a new strategy for anti–MCP-1 gene therapy by transfecting an N-terminal deletion mutant of the MCP-1 gene into skeletal muscles. We used this strategy to investigate the role of MCP-1 in the development of restenotic changes after balloon injury in the carotid artery in hypercholesterolemic rabbits. Intramuscular transfection of the mutant MCP-1 gene suppressed monocyte infiltration/activation in the injured arterial wall and thus attenuated the development of neointimal hyperplasia and negative remodeling. Conclusions—MCP-1–mediated monocyte infiltration is necessary in the development of restenotic changes to balloon injury in hypercholesterolemic rabbits. This strategy may be a useful and practical form of gene therapy against human restenosis.


A new biopolymer has been produced that can satisfy demands to enhance oil recovery for it has a high viscosity of diluted solutions in formation waters. Biopolymer solutions are stable in a wide range of pH values and temperatures, possess pseudoplastic behaviour and steadiness to thermal degradation at temperatures above 100°C. This biopolymer called simusan is an exopolysaccharide (EPS) produced by Acinetobacter species capable to utilize ethanol as a carbon and energy source. An estimation of chemical and rheological properties, its emulsion activity and filterability of simusan solutions as wen as fermentation broth has been performed. A technique to improve filterability of the simusan fermentation broth has been developed. New compositions on the base of simusan possessing thickenning and gelation properties have been produced and tested in the oil fields.


In virtual environments the virtual hand may not always be exactly aligned with the real hand. Such misalignment may cause an adaptation of the users' eye-hand coordination. Further, misalignment may cause a decrease in manipulation performance compared to aligned conditions. This experimental study uses a prism-adaptation paradigm to explore visuomotor adaptation to misaligned virtual hand position. Participants were immersed in an interactive virtual environment with a deliberately misaligned virtual hand position (a lateral shift of 10 cm). We carried out pointing tests with a nonvisible hand in the real world before (pretest) and after (posttest) immersion in the virtual world. A comparison of preand post-tests revealed aftereffects of the adaptation of eye-hand coordination in the opposite direction of the lateral shift (negative aftereffects). The magnitude of the aftereffect was 20 under stereoscopic viewing conditions. However, decreased manipulation performance in VE (speed/accuracy) during the immersion with misaligned hand conditions was not found.


— Virtual Reality techniques are more and more used to validate the design hypotheses during different phases of the product development. In the automotive field, however, there are some types of analyses that are unlikely to be performed by using only a Virtual Prototype (VP) of the vehicle. Therefore, the trend is to develop systems -called seating bucks-that enable engineers to integrate virtual and real objects to provide a tangible interface for the VP of the vehicle. This research aims at defining a new system and an evaluation protocol to improve, simplify and speed up the usual activities carried out for the ergonomic assessment of the driver's seat. In particular, we are interested in evaluating the ergonomics of car's dashboard with its knobs, buttons, display and other control systems. In this paper, we have described the development of this system by providing useful information about the physical issues, related to the seating buck structure, and about the development of the MR environment. The system and the evaluation protocol have been validated by performing several testing sessions with users. The tests confirm the effectiveness of our approach and have enabled us to achieve at interesting considerations.


Oligotyping is a novel, supervised computational method that classifies closely related sequences into "oligotypes" (OTs) based on subtle nucleotide variation (Eren et al., 2013). Its application to microbial datasets has helped reveal ecological patterns which are often hidden by the way sequence data are currently clustered to define operational taxonomic units (OTUs). Here, we implemented the OT entropy decomposition procedure and its unsupervised version, Minimal Entropy Decomposition (MED; Eren et al., 2014c), in the statistical programming language and environment, R. The aim of this implementation is to facilitate the integration of computational routines, interactive statistical analyses, and visualization into a single framework. In addition, two complementary approaches are implemented: (1) An analytical method (the broken stick model) is proposed to help identify OTs of low abundance that could be generated by chance alone and (2) a one-pass profiling (OP) method, to efficiently identify those OTUs whose subsequent oligotyping would be most promising to be undertaken. These enhancements are especially useful for large datasets, where a manual screening of entropy analysis results and the creation of a full set of OTs may not be feasible. The package and procedures are illustrated by several tutorials and examples.


In this paper we discuss how location-based mobile games can be designed for learning in modern technology enhanced public spaces. We start with the description of the design process and we identify the main challenges faced. We elaborate the case of the game Invisible City: Rebels vs. Spies, a game to be played in a city centre using mobile devices. Through this case we highlight the adaptation of an original party game into a mobile form, the issues we faced and the key aspects conductive to learning in a smart city. It is claimed that creating mobile city games for learning is a new challenge, as our city landscapes are augmented with an increasing number of layers of digital information in which a new generation of city games are played.


4H-SiC epilayer channel MOSFETs are fabricated. The MOSFETs have an n- epilayer channel which improves the surface where the MOS channel is formed. By the optimization of the epilayer channel and the MOSFET cell structure, an ON-resistance of 12.9 mcm2 is obtained at VG = 12 V (Eox = 2.9 MV/cm). A normally-OFF operation and stable avalanche breakdown is obtained at the drain voltage larger than 1.2 kV. Both the ON-resistance and the breakdown voltage increase slightly with an increase in temperature. This behavior is favorable for high power operation. By the evaluation of the control MOSFETs with n+ implanted channel, the resistivity of the MOS channel is estimated. The MOS channel resistivity is proportional to the channel length and it corresponds to an effective channel mobility of about 20 cm2/Vs.


OBJECTIVE
The mortality rate among patients with emphysematous pyelonephritis (EPN) is high and the best therapy has long been debated.

MATERIAL AND METHODS
Between January 1993 and December 2004, 26 patients diagnosed with EPN were treated at our hospital. Historical, demographic and laboratory data were obtained from medical records for analysis.

RESULTS
The mean age of the patients was 58.7+/-12.7 years. All patients had diabetes, and women outnumbered men (23:3). The clinical findings were non-specific. A plain abdominal X-ray was diagnostic in only 9/26 patients (36%), ultrasonography was accurate in 13 (50%) and CT was diagnostic in all cases. Eighteen patients survived, including all five treated with open drainage and three out of four treated with percutaneous drainage (although one of these later required nephrectomy), and eight died. Diabetic ketoacidosis or non-ketotic hyperosmolar syndrome, obesity and smoking were significant predictors of death.

CONCLUSIONS
Early diagnosis by means of CT and CT-guided percutaneous drainage (which is better than ultrasonography-guided drainage) or open drainage, along with antibiotic treatment, may be a reasonable alternative to nephrectomy for this high morbidity condition.


The study focuses on the investigation of the impact of gender on translation of literary texts.To be more specific, the article is aimed to explore the distinctive features of translated work by male and female translators. Previous researches and studies in this area of investigation have been gathered and analyzed. The aim of the following paper is to identify gender-specific language and the influence of the translator's gender identity on the translation result, at the morphological, lexical and syntactic levels, on the basis of a comparative analysis of the original and translated texts.Studies of gender differences on the material of the literary texts allow to consider the implementation of gender as a parameter reflecting the gender identity of the author, and affecting the pragmatic potential of translation the work into target languages. The choice of fiction as a research material is not accidental. Since, gender factor in literary translation may act as a structure-forming element of the text, affecting the embodiment of the artistic images and the plot lines.


The European Association for the Study of Obesity (EASO) considers obesity to be a health, research, and societal priority [1]. It promotes the study of obesity. Moreover, the EASO facilitates and engages in actions that reduce the burden of unhealthy excess weight in Europe through prevention as well as management and prevent and combat the epidemic of obesity.


Global routing techniques for an automated analog/digital IC layout compiler are presented. The global router routes in a net-by-net, high-sensitivity-net-first order. Minimum trees are searched for the interconnection of sensitive nets and power nets. For the routing of noise nets, the router provides a net-crossing-free terminal assignment between sensitive nets and noise nets for the routing of channels. Efficient terminal assignment and extraction techniques for the router are also presented.<<ETX>>


We propose an improvement to the electrostatic membrane deformable mirror technique introducing push-pull capability that increases the performance in the correction of optical aberrations. The push-pull effect is achieved by the addition of some transparent electrodes on the top of the device. The transparent electrode is an indium-tin-oxide coated glass. The improvement of the mirror in generating surfaces is demonstrated by the comparison with a pull membrane mirror. The control is carried out in open loop by the knowledge of the response of each single electrode. An effective iterative strategy for the clipping management is presented. The performances are evaluated both in terms of Zernike polynomials generation and in terms of aberrations compensation based on the statistics of human eyes.


The aim of this work is to perform a feasibility study on the power line communication for the development of a new generation of interface devices (IDs) for smart grid applications. More in detail, this paper deals with one of the most important issues on this topic which is the communication system. Among the existing communication technologies, the study is focused on power line communications (PLCs). After a analysis of the state of the art in the field, the main aspects are analyzed, concerning the open issues on the use of PLCs, especially for medium voltage (MV) and low voltage (LV) systems. In this work the use of PLC in MV-LV networks is investigated, by means of simulations and experimental tests. These tests are performed in a test power network, which includes a MV overhead power line and a MV/LV transformer. The two ways communication channel is characterized, by transmitting a signal from the MV bus-bars and receiving it from the LV network and vice-versa. In this way the possibility to cross the power transformer is investigated.


kinase suppressor of Ras (ksr) encodes a putative protein kinase that by genetic criteria appears to function downstream of RAS in multiple receptor tyrosine kinase (RTK) pathways. While biochemical evidence suggests that the role of KSR is closely linked to the signal transduction mechanism of the MAPK cascade, the precise molecular function of KSR remains unresolved. To further elucidate the role of KSR and to identify proteins that may be required for KSR function, we conducted a dominant modifier screen in Drosophila based on a KSR-dependent phenotype. Overexpression of the KSR kinase domain in a subset of cells during Drosophila eye development blocks photoreceptor cell differentiation and results in the external roughening of the adult eye. Therefore, mutations in genes functioning with KSR might modify the KSR-dependent phenotype. We screened approximately 185,000 mutagenized progeny for dominant modifiers of the KSR-dependent rough eye phenotype. A total of 15 complementation groups of Enhancers and four complementation groups of Suppressors were derived. Ten of these complementation groups correspond to mutations in known components of the Ras1 pathway, demonstrating the ability of the screen to specifically identify loci critical for Ras1 signaling and further confirming a role for KSR in Ras1 signaling. In addition, we have identified 4 additional complementation groups. One of them corresponds to the kismet locus, which encodes a putative chromatin remodeling factor. The relevance of these loci with respect to the function of KSR and the Ras1 pathway in general is discussed.


Background—NO produced by the endothelial NO synthase (eNOS) is an important regulator of cardiovascular physiological and pathological features. eNOS is activated by numerous stimuli, and its activity is tightly regulated. Platelet-endothelial cell adhesion molecule-1 (PECAM-1) has been implicated in regulating eNOS activity in response to shear stress. The current study was conducted to determine the role of PECAM-1 in the regulation of basal eNOS activity. Methods and Results—We demonstrate that PECAM-1–knockout ECs have increased basal eNOS activity and NO production. Mechanistically, increased eNOS activity is associated with a decrease in the inhibitory interaction of eNOS with caveolin-1, impaired subcellular localization of eNOS, and decreased eNOS traffic inducer (NOSTRIN) expression in the absence of PECAM-1. Furthermore, we demonstrate that activation of blunted signal transducers and activators of transcription 3 (STAT3) in the absence of PECAM-1 results in decreased NOSTRIN expression via direct binding of the signal transducers and activators of transcription 3 to the NOSTRIN promoter. Conclusion—Our results reveal an elegant mechanism of eNOS regulation by PECAM-1 through signal transducers and activators of transcription 3–mediated transcriptional control of NOSTRIN.


We study how the predicted [$\alpha$/Fe]-[Fe/H] relations in early-type galaxies vary as functions of their stellar masses, ages and stellar velocity dispersions, by making use of cosmological chemodynamical simulations with feedback from active galactic nuclei. Our model includes a detailed treatment for the chemical enrichment from dying stars, core-collapse supernovae (both Type II and hypernovae) and Type Ia supernovae. At redshift $z=0$, we create a catalogue of $526$ galaxies, among which we determine $80$ early-type galaxies. From the analysis of our simulations, we find [$\alpha$/Fe]-[Fe/H] relations similar to the Galactic bulge. We also find that, in the oldest galaxies, Type Ia supernovae start to contribute at higher [Fe/H] than in the youngest ones. On the average, early-type galaxies with larger stellar masses (and, equivalently, higher stellar velocity dispersions) have higher [$\alpha$/Fe] ratios, at fixed [Fe/H]. This is qualitatively consistent with the recent observations of Sybilska et al., but quantitatively there are mismatches, which might require stronger feedback, sub-classes of Type Ia Supernovae, or a variable initial mass function to address.


Tourism is one of the largest economic sectors in the world. It has a positive effect on the economy of many countries, but it can also lead to negative impacts on local ecosystems. Informal environmental education through Citizen Science (CS) projects can be effective in increasing citizen environmental knowledge and awareness in the short-term. A change of awareness could bring to a behavioral change in the long-term, making tourism more sustainable. However, the long-term effects of participating in CS projects are still unknown. This is the first follow-up study concerning the effects of participating in a CS project on cognitive and psychological aspects at the basis of pro-environmental behavior. An environmental education program was developed, between 2012 and 2013, in a resort in Marsa Alam, Egypt. The study directly evaluated, through paper questionnaires, the short-term (after 1 week or 10 days) retention of knowledge and awareness of volunteers that had participated in the activities proposed by the program. After three years, participants were re-contacted via email to fill in the same questionnaire as in the short-term study, plus a new section with psychological variables. 40.5% of the re-contacted participants completed the follow-up questionnaires with a final sample size of fifty-five people for this study. Notwithstanding the limited sample size, positive trends in volunteer awareness, personal satisfaction regarding the CS project, and motivation to engage in pro-environmental behavior in the long-term were observed.


High-resolution molecular programs delineating the cellular foundations of mammalian embryogenesis have emerged recently. Similar analysis of human embryos is limited to pre-implantation stages, since early post-implantation embryos are inaccessible. Notwithstanding, we previously suggested conserved principles of pig and human early development. For further insight on pluripotent states and lineage delineation, we analysed pig embryos at single cell resolution. Here we show progressive segregation of inner cell mass and trophectoderm in early blastocysts, and then of epiblast and hypoblast in late blastocysts. We detected distinct pluripotent states, first as a short 'naïve' state followed by a protracted primed state. Dosage compensation with respect to the X-chromosome in females is attained via X-inactivation in late epiblasts. Detailed human-pig comparison is a basis towards comprehending early human development and a foundation for further studies of human pluripotent stem cell differentiation in pig interspecies chimeras.


The aim of this study was to explore Swedish junior high school students meaning-making of participating in exergaming in school based on their aesthetic judgments during game play. A transactional approach, drawing on the work of John Dewey, was used in the study and the data consisted of video-and audio recordings of ongoing video gaming. A practical epistemology analysis PEA was used in order to explore the students' meaning-making in depth. When analyzing the data, the importance of performing well in relation to the challenges the game offers; developing techniques suitable for the game; and interacting socially with one's peers emerged as main themes in the students' meaning-making and learning. It was clear that the students' taste for gaming played a crucial role in how they proceeded in the activity and that meaningful gaming included an intrinsic combination of pleasure and displeasure.


Structural, magnetic, dielectric properties and Mossbauer effect were investigated on complex perovskite with composition AFe2/3B1/3O3 (A=Ca,Sr,Pb,Ba; B=W,Te). The most striking feature of this type of complex perovskites is the coexistence of magnetic and antiferroelectric types of ordering in a certain temperature interval. It was found that ferrimagnetic Ca and Sr compounds belong to a partially ordered perovskite structure, and antiferromagnetic Pb phase to a disordered one. The possible models for nuclear and magnetic structures were proposed in accordance with the observed dielectric and magnetic properties.


Finding non-linearity is a common application of modal testing but in this way, there is a need to control the input signal. Nowadays, commercial data acquisition software is not enough flexible in controlling the applied signals, whereas MATLAB as general software which supports National Instrument makes it possible to run modal test and control input signal via closed-loop controlling. In this work, using MATLAB commands, a modal test is run with a stepped-sine excitation and the input is controlled to achieve desired pure sinusoidal excitation which commonly is used in finding the non-linearity.


This study describes an investigation into nano-indentation induced deformation twinning in pure magnesium.
The working objectives of this study were to clarify: 1. Whether deformation twinning is a statistical certainty 2. The positive effects of high stress on deformation twinning 3. Whether deformation twins in magnesium are strain-rate sensitive 4. The role of grain and pre-existing twin boundaries on deformation twinning 5. The efficacy of the Schmid criterion (CRSS) in predicting deformation twinning.
Deformation twins induced by nano-indentation using a Berkovich tip on magnesium grains were studied using a combination of optical microscopy, SEM and electron back scattering diffraction (EBSD).
All nano-indents made on the magnesium grains in this study induced twinning, mainly of the {101 2} tension twin type. The twins induced were highly reproducible in terms of twin type, size, shape, amount and orientation with respect to the indent.
Consistent with findings from other studies, deformation twins were found to react positively to increasing contact pressure. The evidence shows that twin nucleation and growth are both higher for indents made with higher stress. Moreover, deformation twins appear to be insensitive to strain-rate. Whilst pre-existing twin boundaries play no apparent role in promoting further twinning, grain boundaries twins were found to promote twinning in neighbouring grains. Finally, the twin variants formed by indenting in different crystal orientation suggested a break-down of the Schmid criterion, hence invalidates of the CRSS evaluation for deformation twinning in magnesium. These results elucidate existing knowledge gaps in this area.


Family violence has been highlighted by the World Health Organization as a major public health concern. Although family violence occurs to all genders, a higher prevalence of victims are female. Estimates report around 30% of all women experience intimate partner violence worldwide. Experiencing assault in the family violence context can lead to an acquired brain injury (ABI); however, the connection between these two phenomena has not been well established. The aim of this qualitative study was to explore the extent of, and factors contributing to, ABI and family violence. We conducted 22 semi-structured interviews and one focus group (n = 4) with practitioners working with family violence victims and/or perpetrators. Thematic data analysis utilised inductive and deductive coding approaches. The Social Determinants of Health Framework was used to guide analysis. Practitioners estimated 30%-40% of the clients on their caseloads had a suspected or diagnosed ABI. They identified that contributing factors were extremely complex. These included acquiring an ABI through assault (past family violence or other criminal act), and transport crashes. Complicating factors of ABI were identified as mental health conditions, alcohol and drug use, and post-traumatic stress disorder. Additional factors contributing to family violence were recognised as biological (age of parent, twin births, pregnancy, premature births, and children with congenital abnormalities), relationships (intimate partner, father, boyfriend, mother and siblings), previous trauma (family violence), and life stressors (unemployment, financial, and lack of housing). Social determinants of health included cultural (ethnicity, societal attitudes, values, and beliefs) and organisational (legislation and policy) factors which influenced behaviours and outcomes across all sectors. A model of Brain injury Family violence Nexus (BFN) was created to understand the interaction between these phenomena. Utilising the BFN model to understand the interaction can enhance the methods used within health and social services for a more efficacious approach.


Different formulations of the field-to-transmission-line coupling equations are reviewed and discussed. An equivalent formulation is derived in which the source terms (or forcing functions) are expressed in terms of the magnetic excitation field. This formulation is particularly useful for evaluating field-to-transmission-line coupling when the exciting field is determined experimentally, since only the measurement of the electric field-generally easier to measure than the electric field-is necessary. >


Abstract Interdisciplinary approaches are required to tackle complex environmental issues as freshwater ecosystems face unprecedented pressures globally. The emerging Ecohydraulics field of research should, therefore, take steps towards developing true interdisciplinarity to adapt to a continuing changing world. This study contributes to the ongoing discussion on interdisciplinarity in Ecohydraulics and shapes its growth by identifying key actions, actors and implementation strategies that can strengthen it. Based on an online questionnaire and a workshop involving over 150 early and established careers, we present a list of 20 prioritised actions that will help engage the research community towards specific goals and will result in increased interdisciplinary outcomes. While early career researchers (ECRs) have taken the lead on creating this roadmap, its implementation should be a joint responsibility of both ECRs, established career scientists, groups, and institutions within Ecohydraulics. The list of identified actions and assigned responsibility should, therefore, be considered a conversation starter. Continued revision of the here-stated approaches will be required in the future as the field of research and its community progresses. With this contribution, we resume a critical reflection on where the Ecohydraulics field of research and community stand today and suggest where resources should be invested in the long-term to consolidate the inherent interdisciplinarity in Ecohydraulics.


This review summarizes and discusses the role and efficacy of moisturizers, particularly the more recently introduced ceramide-based formulations, in the skin care regimen of patients with both active and quiescent atopic dermatitis (AD). It is now well established that a complex interplay of environmental and genetic factors are responsible for disease onset and chronicity. Indeed, several novel genetic mechanisms have been recently discovered to be associated with AD pathogenesis. Moreover, it is increasingly recognized that the epidermal barrier plays a critical role in the initiation, perpetuation, and exacerbation of AD. The skin of patients with AD harbors several defects in epidermal barrier function, including filaggrin and ceramides. An improved understanding of these etiopathogenic factors has led to the development of topical ceramide-dominant moisturizers to replace the deficient molecules and re-establish the integrity of barrier defenses. Some of these products have demonstrated efficacy in the treatment of adult and childhood AD that are similar to mid-potency topical steroids. More importantly, they have been shown to be safe with very few associated side-effects. We recommend the addition of such new agents as both the first step of treatment and in the maintenance of clinically quiescent skin of patients with AD.