This study investigates the effect of the value of financial flexibility on bidder's merger and acquisition (M&A) performance, including the differences between domestic and cross-border M&As and the effect of the financial crisis. Using data gathered between 2005-2012 of 3,882 M&As with the bidder from developed Europe or the U.S., OLS regressions are used to predict the effect of value of financial flexibility on the bidder's cumulative abnormal returns (CARs). Findings reveal partial evidence to support a positive effect of the value of financial flexibility and the cross-border effect on bidder's M&A performance. Collectively, these findings increase understanding of the interdependence of financial flexibility and investments.


The aim of this paper is to conceptualize co-marketing capability (CMC) and to explore its relationship to marketing alliance performance. Drawing on a literature review, in-depth interviews with marketing alliance managers and consulting experience concerning co-marketing alliances, we established a multidimensional model of CMC. Using data from 287 chief marketing officers, we empirically show that the identified CMC is an important source of competitive advantage in terms of marketing alliance success. Further, we were able to identify two important moderators of this relationship, the age of the co-marketing alliance and the complexity of tasks within the alliance.


This study investigated the effectiveness of the integrative perceptual approach (IPA) to enhancing Hong Kong kindergarten children's Chinese character learning. The study applied the IPA to an experimental group of 29 lower form (K2) children. A group of 30 upper form children taught via traditional methods the year before, served as the control group. Quantitative data consisted of pre‐ and post‐test scores, analysed using dependent and independent t‐testing. It was found that the pupils in the experimental group had significantly improved their ability between pre‐ and post‐testing in three aspects of Chinese character mastery: shape, sound and meaning recognition. The progress made was significantly superior to that made by control group counterparts. Qualitative data gathered through teacher and parent interviews indicated that the pupils in the experimental group displayed increased awareness of the composition of several components and structures of Chinese characters.


There remains a conventional wisdom amongst economists that the UK suffers from a seriously under-skilled workforce and that an effective increase in the provision of training is key to economic regeneration. This article, while accepting the link between an underskilled workforce and economic performance, questions the reporting of skill shortages by personnel departments. This is based upon the notion that employees can spend considerable time attempting to influence decision-makers over and above their actual worth. We investigate whether personnel departments use concerns, and the ambiguous nature of, skill shortages to manipulate the reporting of skills at the organizational level.


OBJECTIVE
To examine various clinical factors for their ability to predict mortality in geriatric patients following blunt trauma.

DESIGN
In this retrospective study, trauma registries and medical records from three trauma centers were reviewed for patients 65 years and older who had sustained blunt trauma. The following variables were extracted and examined independently and in combination for their ability to predict death: age, gender, mechanism of injury, admission blood pressure, and Glasgow Coma Scale score, respiratory status, Trauma Score, Revised Trauma Score, and Injury Severity Score.

SETTING
Three urban trauma centers.

PATIENTS
Geriatric trauma patients entering three trauma centers (Stanford [Calif] University Hospital, Vanderbilt University Medical Center, Nashville, Tenn, and Maryland Institute for Emergency Medical Services Systems, Baltimore) following blunt trauma during a 7-year period (1982 to 1989).

RESULTS
The Injury Severity Score was the single variable that correlated most significantly with mortality. Mortality rates were higher for men than for women and were significantly higher in patients 75 years and older. Admission variables associated with the highest relative risks of death included a Trauma Score less than 7; hypotension (systolic blood pressure, < 90 mm Hg); hypoventilation (respiratory rate, < 10 breaths per minute); or a Glasgow Coma Scale score equal to 3.

CONCLUSIONS
Admission variables in geriatric trauma patients can be used to predict outcome and may also be useful in making decisions about triage, quality assurance, and use of intensive care unit beds.


Objectives and Backgrounds The current focus on development of specialist centres in the UK to improve outcomes is based on evidence from overseas care models. While care in a specialist neurosurgical centre will improve outcomes for head injured patients, does transferring them directly have any clinical benefit compared with delivery to a local hospital for initial stabilisation and subsequent transfer to the specialist centre? We performed a systematic review to identify the clinical effectiveness of bypassing local hospital care in moderate or severely head injured patients. Methods Relevant studies were identified by an electronic search of key databases. Papers in English were included if they compared the outcomes of moderate or severely head injured patients (GCS<13, AIS≥3) directly transferred and treated at a specialist centre (SC) vs those who received their initial resuscitation at a local hospital (LH) with some or all patients later transferred to a SC. Outcomes were assessed using available mortality and morbidity data. Results We identified 6 studies involving 2580 patients. One further study was found that did not report the number of subjects. Most studies used SC registry data and adjusted their outcomes for age, pupil dilatation and injury severity. No studies included results for, or adjusted for, patients not transferred after delivery to the LH. For mortality, the adjusted OR was taken from three studies. For those taken to their LH first the OR of death was higher than for the direct transfer group (SC). The level of significance was marginal and undergoing formal meta-analysis at the time of submission. The adjustment of data tended to favour direct transfer over local hospital delivery. No significant difference was reported for morbidity outcomes (Glasgow Outcome Scale) in the three studies that looked at these. Conclusions The reviewed literature comparing direct transfer of head injured patients to specialist neurosurgical centres vs initial local hospital delivery is sparse. What evidence there is supports direct transfer to improve mortality although, at present, this is only marginally significant.


Abstract. Currently, the National Oceanic and Atmospheric Administration (NOAA) National Weather Service (NWS) runs the HYSPLIT dispersion model with a unit mass release rate to predict the transport and dispersion of volcanic ash. The model predictions provide information for the Volcanic Ash Advisory Centers (VAAC) to issue advisories to meteorological watch offices, area control centers, flight information centers, and others. This research aims to provide quantitative forecasts of ash distributions generated by objectively and optimally estimating the volcanic ash source strengths, vertical distribution, and temporal variations using an observation-modeling inversion technique. In this top-down approach, a cost functional is defined to quantify the differences between the model predictions and the satellite measurements of column-integrated ash concentrations weighted by the model and observation uncertainties. Minimizing this cost functional by adjusting the sources provides the volcanic ash emission estimates. As an example, MODIS (Moderate Resolution Imaging Spectroradiometer) satellite retrievals of the 2008 Kasatochi volcanic ash clouds are used to test the HYSPLIT volcanic ash inverse system. Because the satellite retrievals include the ash cloud top height but not the bottom height, there are different model diagnostic choices for comparing the model results with the observed mass loadings. Three options are presented and tested. Although the emission estimates vary significantly with different options, the subsequent model predictions with the different release estimates all show decent skill when evaluated against the unassimilated satellite observations at later times. Among the three options, integrating over three model layers yields slightly better results than integrating from the surface up to the observed volcanic ash cloud top or using a single model layer. Inverse tests also show that including the ash-free region to constrain the model is not beneficial for the current case. In addition, extra constraints on the source terms can be given by explicitly enforcing no-ash for the atmosphere columns above or below the observed ash cloud top height. However, in this case such extra constraints are not helpful for the inverse modeling. It is also found that simultaneously assimilating observations at different times produces better hindcasts than only assimilating the most recent observations.


In this paper, we propose a preference-aware cooperative video streaming system for videos encoded using scalable video coding (SVC). In the proposed system, the collaborating users are interested in watching a video together on a shared screen. However, the willingness of each user to cooperate is subject to her own constraints such as user data plans. Using SVC, videos are segmented into chunks and each chunk is encoded using layers, where each layer can be fetched through any of the collaborating users. We formulate the problem of finding the optimal quality decisions and fetching policy of the SVC layers of video chunks subject to the available bandwidth, chunk deadlines, and cooperation willingness of the different users as an optimization problem. The objective is to optimize a QoE metric that maintains a trade-off between maximizing the playback rate of every chunk and ensuring fairness among all chunks to achieve the minimum skip (stall) duration without violating any of the imposed constraints. We propose an offline algorithm to solve the non-convex optimization problem when the bandwidth prediction is non-causally known. This algorithm has a run-time complexity that is polynomial in the video length and the number of collaborating users. Furthermore, we propose an online version of the algorithm for practical scenarios, where erroneous bandwidth prediction for a short window is used. Real implementation with android devices using SVC encoded video and a public dataset of bandwidth traces reveals the robustness and performance of the proposed algorithm and shows that the algorithm significantly outperforms round robin-based mechanisms in terms of avoiding skips/stalls and fetching video chunks at their highest quality possible.


The promyelocytic leukaemia (PML) body is a phase-separated nuclear structure involved in various biological processes, including senescence, and tumour suppression1. PML bodies consist of various proteins, including PML proteins and several chromatin regulators2,3 and physically associate with chromatin4,5, implying their crucial roles in particular genome functions. However, their roles in transcriptional regulation are largely unknown. Here, we developed APEX-mediated chromatin labelling and purification (ALaP), to identify the genomic regions associated with PML bodies. We find that PML bodies associate with active regulatory regions across the genome and prominently with a ∼300 kb of the short arm of the Y chromosome (YS300) in mouse embryonic stem cells (mESCs). The association with YS300 is essential for the transcriptional activities of neighbouring Y-linked cluster genes. Mechanistically, we show that PML bodies play a novel role in 3D nuclear organization by providing specific nuclear spaces that the de novo DNA methyltransferase DNMT3A cannot access, which results in the robust maintenance of the hypo-methylated states at the Y-linked gene promoters. Our study underscores a new mechanism for gene regulation in the 3D-nuclear space and provides insights into the functional properties of nuclear structures for genome functions.


—The exposures, structure, mineralogy, and composition of unusual sulfide-bearing troctolites from the Yoko-Dovyren layered intrusion in the northern Baikal area (Russia) are described in detail for the first time. The troctolite succession (referred to as the Konnikov Zone) is characterized by the presence of pegmatoid poikilite sulfides and sulfide dissemination with diverse PGE mineralization. The former are dominated by pyrrhotite–troilite products of exsolution of monosulfide solid solution (mss), and the latter is composed mostly of cubanite–chalcopyrite assemblages produced from an intermediate Ni–Cu–Fe solid solution (iss). The positive covariations between the contents of sulfur and chalcogens (Se, Te) along with the sublinear dependence of the Pd, Pt, Au, and Cu contents on the Te contents indicate a sulfide control of the distribution of these elements in troctolite cumulates. According to the sulfide-normalized contents of these elements in rocks, the average "100% sulfides" in the samples are subdivided into two groups: (1) strongly depleted in PGE, Au, Cu, and Te and (2) with 10–50-fold enrichment in them. This division is consistent with the morphological and mineralogical differences between the groups. Of genetic significance is the fact that the mss assemblages are somewhat poorer in PGE and Te than the primitive sulfides from the Dovyren basal zone, whereas the assemblages with predominant copper sulfides are significantly richer in these elements. This fact is confirmed by LA-ICP-MS data on the trace-element composition of the sulfide phases. The established specific features indicate a limited scale of fractionation of immiscible sulfides during the solidification of the troctolite cumulates. The formation of PGE- and Te-rich assemblages can be related to the course of crystallization of a sulfide precursor similar to the most primitive sulfide liquid. This is consistent with the known laws of crystallization of sulfide systems and explains the abnormally high S/Te ratios in pegmatoid troctolites enriched in mss products. Thus, sulfide melts act as an agent that transports precious metals and chalcogens in the troctolite cumulate area. This conclusion requires specification of the physical mechanisms and parameters (rheology, permeability, wettability by sulfides of different phases, etc.) of the cumulus medium favoring the spatial separation of a monosulfide solution and Cu-containing PGE-rich fractions with their subsequent infiltration and deposition at the boundaries of critical low permeability.


Abstract Social organization is an important component of the population biology of a species that influences gene flow, the spatial pattern and scale of movements, and the effects of predation or exploitation by humans. An important element of social structure in mammals is group fidelity, which can be quantified through association indices. To describe the social organization of marine tucuxi dolphins (Sotalia guianensis) found in the Cananéia estuary, southeastern Brazil, association indices were applied to photo-identification data to characterize the temporal stability of relationships among members of this population. Eighty-seven days of fieldwork were conducted from May 2000 to July 2003, resulting in direct observations of 374 distinct groups. A total of 138 dolphins were identified on 1–38 distinct field days. Lone dolphins were rarely seen, whereas groups were composed of up to 60 individuals (mean ± 1 SD = 12.4 ± 11.4 individuals per group). A total of 29,327 photographs were analyzed, of which 6,312 (21.5%) were considered useful for identifying individuals. Half-weight and simple ratio indices were used to investigate associations among S. guianensis as revealed by the entire data set, data from the core study site, and data from groups composed of ≤10 individuals. Monte Carlo methods indicated that only 3 (9.3%) of 32 association matrices differed significantly from expectations based on random association. Thus, our study suggests that stable associations are not characteristic of S. guianensis in the Cananéia estuary.


On integrating the techniques of direct methods and SIRAS: the probabilistic theory of doublets and its applications The mathematical formalism of direct methods is here applied to the SIRAS (single-isomorphous replacement combined with anomalous scattering) case. Speci®cally, the joint probability distribution of three structure factors, which plays the central role in the probabilistic theory of the two-phase structure invariants (doublets), is derived. This distribution leads directly to the conditional probability distribution of the two-phase structure invariants, given the values of selected sets of magnitudes. Furthermore, a probabilistic formula for estimating individual phases of the derivative structure is derived, provided that the heavy-atom substructure is assumed to be known. The formulas were tested for experimental SIRAS data and results are reported.


Financial Literacy has become a priority area across the world in recent years. In a complex and globalized marketplace, a myriad of products is offered in the financial market, and the accessibility of products has also increased. This has made it imperative for individuals to be well equipped with the necessary financial knowledge and awareness to use their financial resources in an optimum way. The study examines the financial literacy of the people by using a questionnaire developed by the Organisation for Economic Cooperation and Development (OECD). The data were collected from 500 respondents from the state of Haryana. The findings reveal that only one-third of the total sample exhibit higher financial literacy. Although the majority of the people possess basic financial knowledge and exhibit positive financial behaviour, 57 per cent of the respondents lack a positive financial attitude. This suggests the need for the introduction of initiatives on the part of policymakers, which may be beneficial in changing the attitudes of the respondents. However, analysis of the socio-demographics suggests that certain factors may prevent persons from being more financially literate. In particular, low levels of income, income instability, and low age are associated with lower levels of financial literacy. The present study offers the first ever comprehensive insight into the financial literacy of the Haryana region.
Keywords: Financial Attitude, Financial Behaviour, Financial Knowledge, Financial Literacy, Socio-demographic Factors
JEL Classification: D14, I22


The Covid-19 pandemic lays bare several problems of livability in our cities. Most of the largest cities are losing the people-oriented characteristic in order to pursue growth and attract investments. Conversely, the emergency reminds us that the essence of cities is to enhance the quality of life of its inhabitants, and build local resilience and sustainability, also through well-planned urbanization. The question we raise in this policy brief is whether this period of emergency could be a springboard to rethink city renewal, allowing the capacity of tackling future challenges – as novel epidemics or climate change effects. Trying to answer this question we provide some historical examples of how sanitary crises have changed the urban environment in the past. Furthermore, we highlight policy suggestions for policymakers and urban planners to foster a sized and liveable city. Multifunctionality, polycentrism, and slow mobility must be key targets to achieve the urban trends of resilience, circularity and sustainability. The tool to realize this bold improvement could be the recent concept of "15 minutes neighbourhood".


The need for reliable detection of head movement artefacts in an ambulatory EEG system has been demonstrated in previous work. In this paper we propose the use of gyroscopes in detecting artefacts in EEG. A collection of features are extracted from the gyroscope signals and ranked using Mutual Information Evaluation Function. Linear Discriminant Analysis is subsequently used as a means of seperating between normal EEG and artefacts. A Support Vector Machine classifier is also applied to the gyroscope feature signals. Results indicate good separation between gyroscope features extracted from normal EEG and those extracted from artefacts arising from head movement, providing a strong argument for including gyroscope signals as features in the classification of head movement artefacts.


This paper studies the distributional effect of a sharp rice price increase on welfare and poverty in Bangladesh. We employ household consumption data and include the indirect effect of price responses to estimate the welfare loss. Our findings suggest that the estimated welfare effect can be misleading if household responses to rice consumption and production are ignored. This study further supports the hypothesis that the poor are the main victims of such a shock. Our examination also indicates that a higher rice price may increase or decrease the poverty head‐count ratio, depending on the choice of the poverty line, but worsens the country's poverty situation when it is measured by the per capita consumption gap. Our analysis reveals that the government can play a central role to prevent and mitigate such shocks, particularly in the medium to long run. On the methodological side, we observe that consumption provides a more consistent outcome across different methods of analysis than household income.


The Al-40Si alloy was modified by 0.5 wt% Sr addition and heat treated using the solution treatment and aging treatment. Its deforming capacity and hardness variance were investigated. The microstructures of the deformed samples were analyzed using optical microscope. The results show that the hardness increases with increasing of the deformation degree. When the deformation ratio exceeds 10.1 %, the hardness sharply increases. When the deformation ratio exceeds 20.4 %, the hardness maintains almost unchanged. In addition, although the cracks are not observed on the surface when the deformation ratio is less than 14.6 %, the primary Si phase is cracked. Thus the critical deformation ratio of the studied Al-40Si alloy is 10.1 %.


Research was designed to reduce herbicide use by replacing POST herbicides with readily available ocean water to control weeds in turfgrasses. Sensitivity to salt stress was evaluated for large crabgrass, goosegrass, mimosa-vine, alyceclover, and yellow nutsedge, as well as the turfgrasses such as seashore paspalum, bermudagrass, St. Augustinegrass, and centipedegrass. Three different salinity levels, (55, 37, and 19 dS/m) and two salt-stress durations (3 and 6 d) were tested. Mimosa-vine was fully controlled at 55 and 37 dS/m. Alyceclover showed maximum injury at 95% when treated at 55 dS/m for 6 d and 90% when treated for 3 d. Large crabgrass was controlled at 55 dS/m. Goosegrass injury was up to 90% at 55 dS/m, but injured plants recovered to 48% at 30 d. Yellow nutsedge showed a maximum of 38% injury but showed 0% injury at 30 d. Among tested turfgrasses, seashore paspalum showed tolerance to pure ocean water at 55 dS/m, with maximum injury at 18%. At the same level of stress, maximum injury for bermudagrass was 30%, for St. Augustinegrass 60%, and for centipedegrass 100%. Lower levels of salt stress resulted in less injury but were still excessive for St. Augustinegrass and centipedegrass. Ocean water was shown to be an effective method to control mimosa-vine, and large crabgrass in seashore paspalum and bermudagrass turfs. Nomenclature: Alyceclover, Alysicarpus vaginalis (L.) DC. #3 ALZVA; bermudagrass, Cynodon dactylon (L.) Pers. # CYNDA; centipedegrass, Eremochloa ophiuroides (Munro) Hack. # ERLOP; goosegrass, Eleusine indica (L.) Gaertn. # ELEIN; large crabgrass, Digitaria sanguinalis (L.) Scop. # DIGSA; mimosa-vine, Mimosa strigillosa Torr. & Gray # MIMST; seashore paspalum, Paspalum vaginatum Swartz. # PASVA 'Adalayd'; St. Augustinegrass, Stenotaphrum secundatum (Walt.) Ktze. STPSE 'Raleigh'; yellow nutsedge, Cyperus esculentus L. # CYPES. Additional index words: Alternative weed control, salt stress, turfgrass salt tolerance. Abbreviation: POST, postemergence.


The story circulated in the fall of 2001: Dino Ignacio, a Filipino-American high school student created a Photoshop collage of Sesame Street's (1970) Bert interacting with terrorist leader Osama Bin Laden as part of a series of "Bert is Evil" images he posted on his homepage (fig. I.1). Others depicted Bert as a Klansman, cavorting with Adolph Hitler, dressed as the Unabomber, or having sex with Pamela Anderson. It was all in good fun. In the wake of September 11, a Bangladesh-based publisher scanned the Web for Bin Laden images to print on anti-American signs, posters, and T-shirts. Sesame Street is available in Pakistan in a localized format; the Arab world, thus, had no exposure to Bert and Ernie. The publisher may not have recognized Bert, but he must have thought the image was a good likeness of the alQaeda leader. The image ended up in a collage of similar images that was printed on thousands of posters and distributed across the Middle East. CNN reporters recorded the unlikely sight of a mob of angry protestors marching through the streets chanting anti-American slogans and waving signs


The aim of the study was to identify predictors of mortality and to propose a new severity scoring system in dogs with acute abdominal syndrome. A retrospective study was carried out on 58 dogs presented with acute abdominal syndrome with American Society of Anesthesiologists grades III-IV and treated surgically by exploratory laparotomy. Medical records were reviewed and information regarding dog signalment, history, clinical, and laboratory data; surgical findings; and outcome was collected. Multiple easily measurable variables were found to be mortality predictors in dogs with acute abdominal syndrome, but the most relevant were the presence of neoplastic process, organ rupture, abdominal distention, and solid organ involvement. Based on the acute abdomen scoring system, animals that received 14 points had a 50% chance of survival, with a sensitivity of 90.48%, specificity of 97.3%, and positive and negative predictive values of 95% and 94.7%, respectively, at this cut-point. According to the receiver operator curve (ROC) analysis, this scoring system classified 94.83% of the cases correctly with the area under the ROC curve (AUC) = 0.965 (P = 0.0001). The presented severity scoring system could reliably assess the severity and probability of death in dogs with acute abdomen and could be used in small animal clinical practice.


A conference paper presented at Networks of Design, 3-6 September 2008, University College Falmouth. The design of textual databases to act as archives or information repositories is dependant on a number of contributory factors which this paper aims to address. The primary consideration is how the information is to be viewed and interrogated by the end user, as this affects both the information collation and the structure of the archive. In order to plan this successfully there are a number of different agencies; and issues arising from how these agencies interact, to be taken into consideration.

The agencies involved include both human and non-human factors which interact forming a single network. The two main non-human factors are the information content, primarily text and images, and the software used in the construction. The methods used in designing and constructing the database will decide the number of human agencies involved, whether the different stages are undertaken by the same individual / group or whether each stage is the responsibility of a different agency. Design in this sense refers to both the aesthetic or visual representation of the user interface and the architecture of the database.

This paper will look at the design and construction of a digital archive using the collotype database, designed by the Centre for Fine Print Research, U.W.E. as a case study. This archive holds a variety of technical and contextual historical data relating to the 19th Century photo-mechanical collotype printing process.

Strategies of interaction are built into the architecture of the database to enable the end user to retrieve information. In order for this to occur successfully the data has to be collated and broken down into various sets. Relationships between these sets then have to be mapped to allow access to this content from various routes as different narrative paths are followed.


The amount of electricity used in individual UK homes varies considerably. Previous UK energy research has identified that high electricity consuming homes not only use more electricity, compared with others, but appear to be consuming even more electricity over time. Furthermore, there is additional evidence which shows that high consuming dwellings also have a greater potential to make energy savings than those who consume less. It has been suggested that future UK energy policy might focus on reducing the demand of high electricity consumers in order to reduce overall CO2 emissions. Therefore, understanding what drives high usage in domestic buildings is essential to support informed decisions.

This thesis asserts that to improve knowledge and understanding of the factors affecting high electrical energy consumption in UK domestic buildings, it is necessary to combine an analysis of the occupants socio-economic characteristics, dwelling technical characteristics and appliance related aspects, with detailed monitoring of the ownership, power demand and occupants use of electrical appliances. Using a sample of 315 UK homes, the influence of socio-economic, technical and appliance related characteristics on the probability of a household being a high electrical energy consumer was investigated (Odds ratio analysis). Detailed appliance monitoring data was collected from 27 UK homes to establish the contributions of appliance ownership, power demand and use to high electrical energy demand (Appliance Electricity Use Survey).

The current research found similar skewed electricity distributions towards high electricity consumers for both the 315 and 27 home cohorts. Conflicting results were however obtained from the two household samples with regard to whether high electricity consumers are increasing electrical energy demand over time. The results of the odds ratio analysis and Appliance Electricity Use Survey suggest that high electricity consumption in domestic buildings is related to a combination of the socio-economic characteristics of the building occupants, technical characteristics of the dwelling and the ownership, power demand and use of electrical appliances.


While the actual risk associated with occupational exposure to inhaled anesthetics has not precisely been defined, a growing body of data has accumulated so that we may begin to make certain valid inferences. Published studies of the teratogenic, mutagenic and carcinogenic effects of exposure to nitrous oxide and isoflurane suggest that a causal role of these inhaled agents appears to be very low or nonexistent.


Abstract : The first International Research Workshop for Process Improvement in Small Settings was held October 19-20, 2005 at the Software Engineering Institute in Pittsburgh, Pennsylvania. Attendees from Australia, Canada, Chile, China, Germany, Ireland, India, Japan, Malaysia, Mexico, Spain, and the United States discussed the challenges of process improvement in small and medium size enterprises, small organizations within large companies, and small projects. The presentations addressed starting and sustaining process improvement, qualitative and quantitative studies, and using Capability Maturity Model Integration (CMMI), Agile, Modelo de Procesos para la Industria de Software (MoProSoft), International Organization for Standardization (ISO), Quality Function Deployment (QFD), and Team Software Process (TSP) in small settings. The workshop also had working groups that discussed issues unique to small settings, such as regional support centers and process improvement on a shoestring. This report includes the papers from this workshop and presents conclusions and next steps for process improvement in small settings. This report also contains the workshop breakout session results.


The Jogjakarta economy is largely dependent on education and tourism industry. The emerging dominance of private transport has reached to a degrading traffic conditions. Severe traffic congestions and high level of air pollution have been affecting the attractiveness of Jogjakarta, a popular tourism city in Indonesia. Unless a new approach of urban transport system development, it is feared that the amount of visitors will keep declining and hence affecting the city economy. From the awareness of the increasingly complex issues, the Ministry of Transportation of Indonesia enacted a decree No 51 of 2007 promoting pilot cities for land transport improvement. This paper originally examines the existing transport policy framework before and after new transit, TransJogja, implementation. The impact of service quality policies on visitor's willingness to take trip by transit is then investigated by using SEM model. From organizational structure point of view, there are only two institutions in terms of urban public transport management at city level, i.e. the city government as the regulator and operators as the service provider. There is no direct relation between the two institutions that can be used to develop the system and to encourage the number of passengers. More than two years after TransJogja was launched, the Cities Development Initiative for Asia (CDIA) was appointed to undertake a review of the urban transport plans for Jogjakarta and the surrounding urban area, however, over three years later the provincial, city and regency governments are in complete support of the strategy of the conducted research and in particular the improvements proposed. According to SEM results, rather than TranJogja service quality, , the information and English guidance factor is the main consideration for the foreign users to travel by the transit.


Two tripodal ligands, bis(2-benzimidazolylmethyl)(2-pyridylmethyl)amine (L(1)) and bis(2-pyridylmethyl)(2-benzimidazolylmethyl)amine (L(2)), were synthesized. With the third chromophoric ligand antipyrine (Antipy), three series of lanthanide(III) complexes were prepared: [LnL(1)(Antipy)(3)](ClO(4))(3) (series A), [LnL(1)(Antipy)Cl(H(2)O)(2)]Cl(2)(H(2)O)(2) (series B), and [LnL(2)(NO(3))(3)] (series C). The nitrate salt of the free ligand H(2)L(1).(NO(3))(2) and six complexes were structurally characterized: Pr(3+)A, Y(3+)A, Eu(3+)B, Eu(3+)C, Gd(3+)C and Tb(3+)C, in which the two A and three C complexes are isomorphous. Crystallographic studies showed that tripodal ligands L(1) and L(2) exhibited a tripodal coordination mode and formed 1:1 complexes with all lanthanide metal ions. The coordination numbers of the lanthanide metal ions for the A, B, and C complexes were 7, 8, and 10, respectively. Conductivity studies on the B and C complexes in methanol showed that, in the former, the coordinated Cl(-) dissociated to give 3:1 electrolytes and, in the latter, two coordinated NO(3)(-) ions dissociated to give 2:1 electrolytes. Detailed photophysical studies have been performed on the free ligands and their Gd(III), Eu(III), and Tb(III) complexes in several solvents. The results show a wide range in the emission properties of the complexes, which could be rationalized in terms of the coordination situation, the (3)LC level of the complexes, and the subtle variations in the steric properties of the ligands. In particular the Eu(3+)A and Tb(3+)A complexes, in which the central metal ions were wholly coordinated by chromophoric ligands of one L(1) and three antipyrine molecules, had relatively higher emission quantum yields than their corresponding B and C complexes.


BACKGROUND
The aim of the study was to investigate the impact of parental socioeconomic status (SES) on subjects' well-being and health behaviour in adolescence, early adulthood and adulthood, and whether these impacts remained after controlling for the person's own SES.

METHODS
All 16-year-old ninth-grade school pupils of one Finnish city completed questionnaires at school. Subjects were followed up using postal questionnaires when aged 22 and 32 years.

RESULTS
Females of manual class origin had lower self-esteem and more distress symptoms from adolescence to adulthood than those from a non-manual background. Lower self-esteem was found among males from manual class families in adolescence and early adulthood. In both genders, no significant class differences were found in depression, health status or prevalence of chronic illness. Unhealthier behaviours regarding smoking and physical activity were more prevalent among both genders of manual class origin, and females of this group had higher rates of overweight and higher body mass index scores. After controlling for the person's own SES, the effect of parental SES diminished but remained significant for smoking in both genders and for physical activity in males up to 22 years, and for self-esteem and BMI in females up to 32.

CONCLUSIONS
This follow-up study contributes to the health inequality debate investigating parental SES differences in health behaviour and somatic health, and particularly in psychological health, which is relatively rarely investigated. The results indicate that parental SES has effects on early adult and adult well-being and health behaviour other than those mediated by current SES.


A generalized version of the multireference coupled‐cluster method using a single‐reference formalism, which we presented in an earlier paper, has been implemented. Any number of determinants, that differ from the formal reference determinant by single or double excitations, can now be included in the reference space. In the present implementation, the single and double excitations from the secondary reference determinants have been truncated to include only those that correspond to triple excitations from the formal reference determinant. Calculations are done on a few model systems, LiH, BH, and H2O, at equilibrium and stretched geometries. Comparisons are made with full configuration interaction (CI) treatment for the single bond stretch in LiH and BH, and the results are quite promising. For the water molecule, comparisons are made with the results obtained with the coupled cluster method truncated at triple excitations (CCSDT), as well as with the full CI results. While the multireference method did not do as well for the simultaneous two‐bond stretch in H2O as it did for the single bond cases, it did at least as well as the CCSDT at representing the points on the full CI potential curve.


We present a method to delens the acoustic peaks of the CMB temperature and polarization power spectra internally, using lensing maps reconstructed from the CMB itself. We find that when delensing CMB acoustic peaks with a lensing potential map derived from the same CMB sky, a large bias arises in the delensed power spectrum. The cause of this bias is that the noise in the reconstructed potential map is derived from, and hence correlated with, the CMB map when delensing. This bias is more significant relative to the signal than an analogous bias found when delensing CMB B modes. We calculate the leading term of this bias, which is present even in the absence of lensing. We also demonstrate one method to remove this bias, using reconstructions from CMB angular scales within given ranges to delens CMB scales outside of those ranges. Some details relevant for a realistic analysis are also discussed, such as the importance of removing mask-induced effects for successful delensing, and a useful null test, obtained from randomizing the phases of the reconstructed potential. Our findings should help current and next-generation CMB experiments obtain tighter parameter constraints via the internal removal of lensing-induced smoothing from temperature and E-mode acoustic peaks.


Abstract An essential component of conservation science is repeated surveys over time to monitor species that might be responding to local factors, such as land management, or more broadly to global change. A systematic survey of the avifauna of Cape York Peninsula was conducted in the late 1990s and early 2000s providing an ideal basal dataset for measuring change in the avifauna. A subset (n > 600) of these sites, primarily within savanna landscapes, was selected for re-survey in 2008 to investigate changes in bird communities on Cape York Peninsula. Changes in mean species richness varied across the study area (decreases in 59 grid cells and increases in 43) with no apparent pattern. Significant change in reporting rates was recorded in 30 species. Four sedentary and highly detectable species declined (Bar-shouldered Dove, Brown Treecreeper, Sulphur-crested Cockatoo and Pale-headed Rosella) and five increased (Peaceful Dove, Pheasant Coucal, Weebill, White-throated Honeyeater and Yellow Oriole). Habitat preference for the species that showed change remained relatively stable between the two survey periods. Some species that were recorded in very low numbers in the original survey and are considered to be threatened (Brown Treecreeper, Black-faced Woodswallow) remained in very low numbers or decreased in our survey suggesting that there has been no regional recovery of these species. Long-term monitoring can describe important patterns of species change over time, though in the case of large, highly seasonal environments like the tropical savannas, signals of change may manifest over decades rather than annually.


Eco-visualizations (EVs) are any kind of interactive device targeted at revealing energy use in order to promote sustainable behaviours or foster positive attitudes towards sustainable practices. There are some interesting, informative, highly creative, and delightful EVs now available. This paper provides a critical survey of several noteworthy EVs and classifies them in terms of scale and contexts of use. The paper attempts to provide a foundation for practitioners to design new EVs in more varied scales and contexts and for researchers to continue to refine understandings of how effective EVs can be and how EVs can be made to be more effective. The paper describes (i) feedback types and use-contexts for classifying EVs and (ii) strategies for designing effective EVs.


Abstract The theme presented is aimed at attempting to perceive the fundamental qualities of the man's personality (body, soul and spirit) from the philosophical, anthropological and theological point of view and, at the same time, to establish the value reflections towards its (current and universal) existential orientations. Namely, today's experience shows us that tendencies with notable prevailing of corporality over the other constitutive properties of the human being are constantly getting stronger. The body cult is vigorously stressed: body building and fitness clubs, as well as special gyms and wellness facilities (saunas, hydro massage baths, tepidariums are advertised, which should satisfy the increased corporal‐hedonistic and corporal‐aesthetic motives. This disturbing of the essential and human structure established by God demands the return to the original settings of Christian trichotomy (not serving the body but serving of the body), whereby a balanced and harmonious relationship between the body, the soul, and the spirit is developed by equally bearing in mind all three areas on which all three "gymnastics" are tuned and effectively performed, which leads to overall development and fulfilment of a human being.


A case of 25- years-old female with NET deriving from Meckel's diverticulum is described. The patient had one year history of dermatological skin problems. Ultrasound examination of abdomen performed because of arterial hypertension, revealed multiple hepatic lesions, which was confirmed in contrast enhanced CT. The typical contrast enhanced metastatic lesions in CT and elevated levels of chromogranin A suggested NET of unknown origin. SRS with 99mTc-HYNICTOC was perform for primary tumor localization, and revealed liver and paraaortic lymph nodes metastases, but no sign of primary tumor location. As a next step for primary tumor localization 68Ga-DOTATATE PET/CT was done, which revealed focus of increased uptake in small intestine considered to be the primary tumor site. The imaging and clinical history of patient was discussed on ENETS Tumor Board. Due to location of primary tumor in the small intestine with no anatomical changes in CT, laparotomy guided with gamma probe after 68Ga-DOTATATE injection was performed. During surgery procedure, the primary tumor was hardly palpable in the tip of Meckel's diverticulum, confirmed by gamma probe. After surgery, tandem peptide receptor radionuclide therapy (PRRT) was started. Patient received 4 doses of 90Y/177Lu-DOTATATE with total activity of 360 mCi (13.32 GBq). The three months follow up 68Ga-DOTATATE PET/CT had shown stable disease of patient. The presented case showed importance role of multidisciplinary team cooperation in patient management. Use of RGS is essential in cases like presented, when the tumor cannot be localized only by surgical palpation.


Dr Lesley Young, BVSc DVA DVC Dip ECEIM PhD MRCVS Introduction Although cardiovascular causes of poor performance are fairly infrequent, many horses have cardiovascular dysfunction, including resting arrhythmias and cardiac murmurs and consequently the significance of these abnormalities can be difficult to determine. As a result cardiac disease can be blamed for loss of performance when it is completely innocent and conversely, on the rare occasion cardiac disease is performance limiting, it is not uncommon for it to be totally overlooked.


This paper addresses some of the challenges of teaching literary history in undergraduate courses and sketches the central dilemma of coverage versus depth. It gives a background to how and why traditional historical survey courses became standard for teaching literature in England, from the early 19th century. With reference to literary history as a research field, we go on to discuss pedagogical goals in terms of inspiring historical inquiry and understanding. We discuss the critical reading skills required for such understanding and compare them to skills involved in cultural understanding. We find that two methods compete for attention: teaching from the past (with the aim to make students recognize the strangeness of past periods), and teaching from the present (with the aim to make students see the relevance of older literary works). In order to open the discussion, but also to focus it on doable pedagogical practices, we present a few cases of historicized literary works.


The genomes of spotted fever group rickettsiae isolated in different geographical areas of Israel (two from ticks and four from humans, obtained over a span of 20 years) were studied by polymerase chain reaction (PCR) and restriction endonuclease fragment length polymorphism (RFLP) analysis. The human isolates were obtained from patients suffering from rickettsial disease of different degrees of severity. The PCR products obtained with five pairs of oligonucleotide primers (two primer sets derived from the 190-kDa polypeptide gene and three from the 120-kDa polypeptide gene) and cleaved with restriction endonucleases were used to study the Israeli isolates and reference Rickettsia conorii isolates. Subtle differences between the PCR-RFLP patterns of Israeli isolates and the two R. conorii reference strains (Moroccan and no. 7) were seen when the PCR products derived from the 190-kDa gene-derived primer sets were digested. All of the Israeli isolates were identical by RFLP analysis using all of the primer sets. This study showed that the Israeli spotted fever group isolates (from both ticks and humans) were genetically homogeneous by the criteria used in this study, despite the time and location differences in their original isolation, and different as a group from R. conorii.


Abstract:Many macro- and micro-level factors affect the spread of an infectious disease. Among them are sociodemographic, socioeconomic, sociocultural, health care system infrastructure, use of alcohol or substances, level of life disruptions because of chronic illnesses. Because of accuracy and timeliness issues, officials are often forced to make one-size-fits-all decisions across all regions. This paper offers a framework to analyze and quantify the interrelationships between a wide set of sociodemographic factors and the transmission speed of the pandemic to facilitate custom-fitted regional containment measures. The purpose of this paper is to investigate the role of a comprehensive set of sociodemographic factors in the diffusion of COVID-19 analytically. Our findings suggest that diverse sets of sociodemographic factors drive the transmission during different stages of the pandemic. In specific, we show that variables such as gender, age groups, daily commuting distances, modes of employment, poverty and transportation means are found to be statistically significant in the transmission speed of COVID-19. Our results do not suggest a statistically significant relationship between transmission speed and migration-related variables. We also find that the importance levels for the statistically significant variables vary across different stages of the pandemic. Our results point out a variety of public policy insights and implications.


In a previous report we presented a novel ART technique with the projections arranged and accessed in a multilevel scheme (MLS) for efficient algebraic image reconstruction, but whether the scheme is still superior in real situations where the data are noisy is unknown. In this paper, we make a detailed comparison between MLS and the other two conventional projection access orderings in ART: the random permutation scheme (RPS) and the sequential access scheme (SAS). By simulating reconstructions of a human head using different sizes of detector, taking different numbers of projections, each measurement under a different number of photons, a full mapping of the reconstruction accuracy measured by correlation coefficient for the three schemes has been made. Test results demonstrate that one-iteration MLS produces the best reconstruction in many situations. It outperforms one-iteration RPS when the noise level is low. SAS in many cases can never attain the image quality of one-iteration MLS, even with many more iterations. A convergence test using different initial guesses also demonstrates that MLS has less initial dependence. In the Fourier domain, it also represents an efficient and fast implementation of the Fourier slice theorem.


Extension in Death Valley is usually interpreted as a combination of low-angle Basin and Range–style extension and strike slip associated with the developing Pacific-North America plate boundary in western North America, with these two tectonic regimes operating synchronously in Death Valley. Examination of structural, stratigraphic, and timing relationships in the region suggests that this interpretation needs revision. Evolution of Death Valley is best described as a two-stage process. In the first stage, lasting from ca. 18 to 5 Ma, low-angle Basin and Range extension transported allochthons consisting of Late Proterozoic through Early Paleozoic miogeoclinal section along detachment surfaces that, as extension continued, were exhumed from mid-lower crustal levels to the surface. Near the end of this extensional phase and lasting until ca. 3 Ma, deposition of a thick sequence of volcanics, clastics, and some lacustrine carbonates signaled a period of relative tectonic quiescence, with sediments in some areas covering the exhumed detachment surfaces. At ca. 3 Ma, initiation of the East California Shear Zone started development of the present-day topographic depression of Death Valley, formed as a pull-apart basin associated with this strike slip. Faulting broke the older, inactive, Basin and Range detachment surfaces, with high-angle transtensional faulting along the Black Mountains front. The Black Mountains were elevated as a result of footwall uplift, with the well-known turtleback structures being megamullions along these bounding faults. These megamullions are similar to those seen at oceanic spreading centers. The Panamint Range has previously been interpreted as an extensional allochthon, with the entire range transported from on top of or east of the Black Mountains. A new interpretation presented here is that the range is a large core complex similar to the core complex at Tucki Mountain, at the northern end of the range. The Basin and Range extensional detachment tracks over the top of the range, with extensional allochthons perched on the eastern flanks of the range. This modified model for evolution of Death Valley suggests a strong link between timing and style of deformation in the basin with the developing Pacific-North America plate boundary, particularly eastward propagation of this boundary.


Social entrepreneurship has always been acontested concept, both within the academic discourse and in practce. A lot of scholarly effort has been put into analyzing the different defnitons of social entrepreneurship and the negatve consequences that the defnitonal debate has on the opportunity to advance social entrepreneurship as a research feld. Very litle is known about what the consequences of the multple meanings of social entrepreneurship are for people working in the sector. This paper advances knowledge on this topic by looking at the social entrepreneurship sector in England and by investgatng through qualitatve research methods what sector members think about social entrepreneurship and its unclear boundaries. The results show that there are three different conceptons of social entrepreneurship within the sector in England. However, while everyone agrees on the presence of a defnitonal debate, opinions on what this means for the sector are several. Some members think it is something positve; some others think it is causing different issues, and a third group considers it as irrelevant.


Physiology being an important subject among basic medical sciences is taught during initial years of undergraduate degree programs throughout the world. Experimental Physiology is an integral component and has its role in comprehension of the physiological concepts and development of conceptual knowledge. With influx of enormous amount of new information in recent past, contents in the theory component are tremendously increased while practical part is relatively lagging behind. Use of live animals in undergraduate laboratories is being discouraged and introduction of basic clinical skills and use of manikins is promoted. At the same time, many important systems of the subject are not covered in the experiments being conducted in majority of institutions; even they do not exist in the list of experiments included by Pakistan Medical & Dental Council (PM&DC) in the revised curriculum. To keep a balance between theory and practical components and to address the growing global needs, a serious revisit of the experimental part of the subject is needed. Use of modern equipment, introduction of new experiments in the neglected areas, strengthening skill labs and adopting measures for development of professionalism is need of the hour. Physiologists need to address this challenge. Meanwhile, there is a growing trend by many medical institutions to adopt integrated curriculum and assessment. It is responsibility of educationists to revisit the subject in such a manner that without compromising the essentials, the subject is incorporated in the curriculum.
Pak J Physiol 2018;14(4):3–4


The Cicerone Project included a study of three 53-ha farmlets, each subjected to a different management system. The systems varied first in their input of fertilisers and sown pastures and second in their grazing management. Farmlet A undertook a high level of pasture renovation and had soil fertility targets of 60 mg/kg Colwell phosphorus (P) and 10 mg/kg KCl-40 sulfur (S), while farmlets B and C both had a low rate of pasture renovation and targets of 20 mg/kg P and 6.5 mg/kg S. In addition, both farmlets A and B adopted a flexible rotational grazing regime over the eight paddocks of each farmlet, whereas farmlet C, which had 37 paddocks, adopted intensive rotational grazing. This paper first reviews the literature relating to soil fertility research in the summer-dominant rainfall region of the Northern Tablelands of New South Wales, Australia. It then examines whether the soil fertility targets set for the farmlets were attained and how the consequences of fertiliser management measured in this trial related to earlier research findings. Fertiliser applications, comprising both capital and maintenance rates, were based on soil test results but at times were constrained by the availability of finance. Soil tests over 5 years indicated that only nitrogen (N), P and S varied with time within the farmlets while the other indices of soil fertility remained similar. Phosphorus and S levels increased in response to fertiliser applications whereas N levels responded to increases in legume composition, which was stimulated by the higher P and S levels. Multivariate statistical analyses demonstrated that farmlet productivity was driven by P and S fertility and thus the two farmlets with lower P and S fertility (farmlets B and C) had similar but lower levels of farmlet productivity compared with farmlet A. Significant increases in several measured pasture productivity parameters were observed in response to the higher P and S fertility on farmlet A, especially when climatic conditions were favourable. The results of the Cicerone farmlet experiment confirm the findings of earlier research on the Northern Tablelands, and elsewhere in the high rainfall zone, that has demonstrated that higher soil fertility levels and pasture renovation enhance the productivity of grazing enterprises more than grazing management, without imposing significant risks to the environment.


Pharmacoepidemiology is a discipline that studies the use of drugs and evaluation of their beneficial or adverse effects on large populations. It requires compliance with laws and maintaining a regulatory approach in order to ensure confidentiality and protection of personal data. It also requires good knowledge of drugs and diseases and the use of the different available data sources. Pharmacoepidemiology incorporates epidemiological methods (cohort, case-control and cross-sectional studies) where the exposure is drug intake. These methods must be applied at the conception of the pharmacoepidemiological study in order to minimize the effect of bias hich can lead to false conclusions. This paper reviews the regulatory basis, methodological approaches and scope of pharmacoepidemiology. EMHJ • Vol. 18 No.1 • 2012 Eastern Mediterranean Health Journal La Revue de Sante de la Mediterranee orientale


Sociologist Erik Love reviews the books Islamophobia and the Politics of Empire and Terrifying Muslims. Each move beyond "post 9/11" explanations for anti-Muslim sentiment, showing how Islamophobia is best understood not as a temporary backlash, but rather as stemming from longstanding and durable forms of racial bigotry and colonialism.


A total of 583 bacterial isolates was tested for susceptibility to cefixime by broth microdilution and by disk agar diffusion with 5-, 10-, and 30-microgram disks. At MIC breakpoints of less than or equal to 1.0 and greater than or equal to 4 micrograms/ml for susceptible and resistant, respectively, the 5-microgram disk showed slightly better discrimination. The 5-microgram cefixime disk is recommended with proposed interpretive breakpoint criteria of: less than or equal to 17 mm, resistant; 18 to 20 mm, intermediate; and greater than or equal to 21 mm, susceptible.


Abstract Although some experimental biological studies have indicated that citrus may have preventive effects against cognitive impairment, no cohort study has yet examined the relationship between citrus consumption and incident dementia. In a baseline survey, we collected data on daily citrus intake (categorised as ≤2, 3–4 times/week or almost every day) and consumption of other foods using a FFQ, and used a self-reported questionnaire to collect data on other covariates. Data on incident dementia were retrieved from the Japanese Long-term Care Insurance database. A multivariate-adjusted Cox model was used to estimate the hazard ratios (HR) and 95 % CI for incident dementia according to citrus consumption. Among 13 373 participants, the 5·7-year incidence of dementia was 8·6 %. In comparison with participants who consumed citrus ≤2 times/week, the multivariate-adjusted HR for incident dementia among those did so 3–4 times/week and almost every day was 0·92 (95 % CI 0·80, 1·07) and 0·86 (95 % CI 0·73, 1·01), respectively (P trend=0·065). The inverse association persisted after excluding participants whose dementia events had occurred in the first 2 years of follow-up. The multivariate HR was 1·00 (reference) for ≤2 times/week, 0·82 (95 % CI 0·69, 0·98) for 3–4 times/week and 0·77 (95 % CI 0·64, 0·93) for almost every day (P trend=0·006). The present findings suggest that frequent citrus consumption was associated with a lower risk of incident dementia, even after adjustment for possible confounding factors.


In a book chapter containing the first checklist and distribution of Turkish rotifers, published in 1999, were listed 167 taxa. The second checklist, published in 2004, reported 229 rotifer taxa in Turkey. During the 7 years since this checklist process, many studies have been carried out and we have prepared a new checklist of Turkish rotifers in the present study. In all, 341 rotifer taxa have been recorded to date.


Back ground: The study aims to explore the impact of premenstrual syndrome on psychological and physical problem among students nursing college at Babylon city. The association between premenstrual syndrome and some of reproductive 'characteristics. Methodology: A descriptive analytic design was used on purposive (non probability) sample of 76 students the period between March – November, 2013. were enrolled in this study from Self administrative questionnaire was used by the investigators for the present study. The validity and reliability of the instrument was determined by using through the panel of experts, and internal consistency through the computation of Alpha Correlation Coefficient. The data have been collected through the utilization of the self-administrated questionnaire as a mean of data collection. Data analysis was employed by applying the Statistical Package for Social Science version 21.0 (SPSS). Results: The finding of the study showed that the current age of female ranged between (21-23) years and represented 53,9%, the age of female menarche ranged between (11-13) years recorded high percentage at 57,9% duration of menstrual cycle represented 51.3% ranged between 3-5 days ,amount of cycle 71% was normal ,frequency of menstrual cycle 94,7 were 10 days , regularity of cycle represented 72.4% were regular.the students experience a moderate level of premenstrual syndrome . The correlation analysis indicated that there is significant association between amount of cycle and psychological and physical problems but there is no association with remaining variables. Conclusion: The study concluded that there is significant association between the amount of menstrual cycle and psychological, physical problem at p-value 0.01. Recommendations: Future studies may be required to assess the whole premenstrual physical and emotional changes as well as the relationship between premenstrual syndromes and depression through pregnancy and the postpartum phase.


Transformational Initiative for Graduate Education and Research (TIGER) program at UPRM; supported by the U.S. Department of Education, Title V, Part B, Promoting Post-Baccalaureate Opportunities for Hispanic Americans (PPOHA) Program (#P031M140035).


Recent studies showed that elevated concentration of plasma homocysteine can be one of the risk factors for cardiovascular disease. The aim of this investigation was to study the effect of 8 weeks incremental aerobic exercise on homocysteine. Twenty-eight sedentary young males (mean ± SD; age: 19±1.2 years and percentage of body fat: 25±1.5) participated in this study, divided into control and experimental groups. The experimental group participated in a regular 8 weeks incremental aerobic exercise while the control group was prevented from any sport activity and just participated in pre- and post-testing. All participants were healthy and free of any medication and they did not have any sport activities during the last 6 months before entering study. However, at least one of their relatives suffered from cardiovascular risk factors. Maximal consumption oxygen (VO2max) was assessed by Bruce incremental treadmill. The blood samples were taken at 07:00 to 8:00 in the morning after an overnight fast for plasma homocysteine. The results showed significant difference in maximum oxygen consumption between experimental and control group in post-test (F=31, p<0.05). No significant effect was found for 8 weeks incremental aerobic exercise on homocysteine concentration (p>0.05). There was no significant difference in homocysteine level in post-test between experimental (X=17.9±8.2 mm/mol/l) and control group (X=15.7±4.8 mm/mol/l) (p>0.05). In conclusion, 8 weeks incremental aerobic exercise cannot reduce plasma homocysteine as risk factors for cardiovascular disease in sedentary young males.


The study of interfacial charge-transfer processes (sensitization) of a dye bound to large-bandgap nanostructured metal oxide semiconductors, including TiO(2), ZnO, and SnO(2), is continuing to attract interest in various areas of renewable energy, especially for the development of dye-sensitized solar cells (DSSCs). The scope of this Review is to describe how selected model sensitizers prepared from organic polyaromatic hydrocarbons have been used over the past 15 years to elucidate, through a variety of techniques, fundamental aspects of heterogeneous charge transfer at the surface of a semiconductor. This Review does not focus on the most recent or efficient dyes, but rather on how model dyes prepared from aromatic hydrocarbons have been used, over time, in key fundamental studies of heterogeneous charge transfer. In particular, we describe model chromophores prepared from anthracene, pyrene, perylene, and azulene. As the level of complexity of the model dye-bridge-anchor group compounds has increased, the understanding of some aspects of very complex charge transfer events has improved. The knowledge acquired from the study of the described model dyes is of importance not only for DSSC development but also to other fields of science for which electronic processes at the molecule/semiconductor interface are relevant.


The article reviews the limited existing social policy literature on taxation and sets out a case for the incorporation of the study of taxation into the accepted remit of social policy. Social policy has historically been concerned with the services and benefits which flow from public expenditure, and people's experiences of them, rather than with taxation, and the contributions by individual researchers have tended to remain marginal to the main focus of social policy. The article offers a speculative account as to why taxation has remained peripheral to social policy and presents three arguments for the mainstreaming of tax in social policy's domain of study. These concern the role of taxation in shaping the distribution of resources, a fundamental pre-occupation of social policy; the contribution social policy scholars can make to shaping a new discourse surrounding taxation, foregrounding issues of equity and need; and how social policy's engagement with taxation can influence the politics of the welfare state.


Abstract. Pattern scaling is a well-established method for approximating modeled spatial distributions of changes in temperature by assuming a time-invariant pattern that scales with changes in global mean temperature. We compare two methods of pattern scaling for annual mean precipitation (regression and epoch difference) and evaluate which method is better in particular circumstances by quantifying their robustness to interpolation/extrapolation in time, inter-model variations, and inter-scenario variations. Both the regression and epoch-difference methods (the two most commonly used methods of pattern scaling) have good absolute performance in reconstructing the climate model output, measured as an area-weighted root mean square error. We decompose the precipitation response in the RCP8.5 scenario into a CO2 portion and a non-CO2 portion. Extrapolating RCP8.5 patterns to reconstruct precipitation change in the RCP2.6 scenario results in large errors due to violations of pattern scaling assumptions when this CO2-/non-CO2-forcing decomposition is applied. The methodologies discussed in this paper can help provide precipitation fields to be utilized in other models (including integrated assessment models or impacts assessment models) for a wide variety of scenarios of future climate change.


Objective. To compare the performance of multiparametric resonance imaging/ultrasound fusion targeted biopsy (MRI/US-TBx) to a combined biopsy strategy (MRI/US-TBx plus 24-core transperineal template saturation mapping biopsy (TTMB)). Methods. Between May 2012 and October 2015, all patients undergoing MRI/US-TBx at our institution were included for analysis. Patients underwent MRI/US-TBx of suspicious lesions detected on multiparametric MRI +/− simultaneous TTMB. Subgroup analysis was performed on patients undergoing simultaneous MRI/US-TBx + TTMB. Primary outcome was PCa detection. Significant PCa was defined as ≥Gleason score (GS) 3 + 4 = 7 PCa. McNemar's test was used to compare detection rates between MRI/US-TBx and the combined biopsy strategy. Results. 148 patients underwent MRI/US-TBx and 80 patients underwent MRI/US-TBx + TTMB. In the MRI/US-TBx versus combined biopsy strategy subgroup analysis (n = 80), there were 55 PCa and 38 significant PCa. The detection rate for the combined biopsy strategy versus MRI/US-TBx for significant PCa was 49% versus 40% (p = 0.02) and for insignificant PCa was 20% versus 10% (p = 0.04), respectively. Eleven cases (14%) of significant PCa were detected exclusively on MRI/US-TBx and 7 cases (8.7%) of significant PCa were detected exclusively on TTMB. Conclusions. A combined biopsy approach (MRI/US-TBx + TTMB) detects more significant PCa than MRI/US-TBx alone; however, it will double the detection rate of insignificant PCa.


Meteorological radar is an important tool capable of providing high resolution measurements of precipitation. In this article, we suggest the use of polarisation diversity, using the knowledge of scattering properties of the targets, as a method of obtaining a good discrimination between clutter and precipitation. Although, this requires a more sophisticated radar than the conventional incoherent one, it provides more information on targets and their identification/quantification as well. Basically, most (linear) polarisation diversity systems work on switching polarisation at each transmission of the microwave pulses and receiving a backscattering signal in both polarisation channels. Also, some systems include the phase information, making Doppler computations also possible.


Abstract. The mid-Pliocene Warm Period (3.29 to 2.97 Ma BP) has been identified as an analogue for the future, with the potential to help understand climate processes in a warmer than modern world. Sets of climate proxies, combined to provide boundary conditions for Global Climate Model (GCM) simulations of the mid-Pliocene, form the basis for the international, data-driven Pliocene Model Intercomparison Project (PlioMIP). Here, we outline the strategy for implementing pre-industrial (modern) and mid-Pliocene forcings and boundary conditions into the GENESIS version 3 GCM, as part of PlioMIP. We describe the prescription of greenhouse gas concentrations and orbital parameters and the implementation of geographic boundary conditions such as land-ice-sea distribution, topography, sea surface temperatures, sea ice extent, vegetation, soils, and ice sheets. We further describe model-specific details including spin-up and integration times. In addition, the global climatology of the mid-Pliocene as simulated by the GENESIS v3 GCM is analyzed and compared to the pre-industrial control simulation. The simulated climate of the mid-Pliocene warm interval is found to differ considerably from pre-industrial. We identify model sensitivity to imposed forcings, and internal feedbacks that collectively affect both local and far-field responses. Our analysis points out the need to assess both the direct impacts of external forcings and the combined effects of indirect, internal feedbacks. This paper provides the basis for assessing model biases within the PlioMIP framework, and will be useful for comparisons with other studies of mid-Pliocene climates.


Homogeneous and inhomogeneous powder beds subjected to low-magnitude vibration are compared in terms of the dynamic response. The inhomogeneous samples were segregated into two phases: loose and dense phases, layering the two phases horizontally or vertically. An apparent mass, defined as a ratio of the base force to base acceleration, was measured. Comparison of homogeneous and segregated data demonstrated a significant density gradient dependence on the apparent mass data. First, homogeneous systems showed a resonant peak, which gave the longitudinal elastic modulus of the bed via the velocity of longitudinal stress wave propagation. Second, vertically segregated systems exhibited two significant peaks at low frequencies, corresponding to the resonance of each phase. In addition, the apparent mass values at the two peaks were related to the quantity of each phase. Third, horizontally segregated systems exhibited a resonant peak, whose frequency was approximately equal to homogeneous data, but the apparent mass value at the peak differed from homogeneous data. A model based on the fourth-power scaling law, two-phase theory and Rayleigh's energy method gave an interpretation for the insensitivity of the peak frequency to the density gradient in the vertical direction.


Antifertility effects of an aqueous leaf extract of Oldenlandia affinis on male rats were investigated. The extract was administered intraperitoneally in sexually mature male rats at a dose of 24 mg/rat (n=8) for a total of eight injections over a 4 week period. There was a decrease in testis weights but all other accessory sex organs and vital organ weights were not affected by treatment with O. affinis extract. Testis histology revealed fewer spermatozoa or azoospermic seminiferous tubules in treated animals compared to controls with no change in neither tubule thickness nor Sertoli cell structure. O. affinis treatment caused a 17% decrease in sperm motility but there was no change in cauda epididymal sperm counts. However, serum testosterone levels decreased significantly (P<0.05) in the experimental group (602.4  57 ng/dL) compared to controls (808.9  55 ng/dL). These preliminary results show that the aqueous leaf extract of O. affinis suppresses fertility parameters in male rats.


Protein oxidation may play a role in the balance between anabolism and catabolism. We assessed the effect of a protein restricted diet on protein oxidation as a possible reflection of whole body protein metabolism. Sixteen healthy males (23 ± 3 years) were instructed to use a 4-day isocaloric protein restricted diet (0.25 g protein/kg body weight/day). Their habitual dietary intake was assessed by a 4-day food diary. After an overnight fast, a 30 g 13C-milk protein test drink was administered, followed by 330 min breath sample collection. Protein oxidation was measured by Isotope Ratio Mass Spectrometry. To assess actual change in protein intake from 24-h urea excretion, 24-h urine was collected. During the 4-day protein restricted diet, the urinary urea:creatinine ratio decreased by 56 ± 9%, which is comparable to a protein intake of ~0.65 g protein/kg body weight/day. After the protein restricted diet, 30.5 ± 7.3% of the 30 g 13C-milk protein was oxidized over 330 min, compared to 31.5 ± 6.4% (NS) after the subject's habitual diet (1.3 ± 0.3 g protein/kg body weight/day). A large range in the effect of the diet on protein oxidation (−43.2% vs. +44.0%) was observed. The residual standard deviation of the measurements was very small (0.601 ± 0.167). This suggests that in healthy males, protein oxidation is unaffected after a protein restricted diet. It is uncertain how important the role of fluctuations in short-term protein oxidation is within whole body protein metabolism.


This Letter introduces a novel finite-difference time-domain (FDTD) formulation for solving transverse electromagnetic systems in dispersive media. Based on the auxiliary differential equation approach, the Debye dispersion model is coupled with Maxwell's equations to derive a supplementary ordinary differential equation for describing the regularity changes in electromagnetic fields at the dispersive interface. The resulting time-dependent jump conditions are rigorously enforced in the FDTD discretization by means of the matched interface and boundary scheme. High-order convergences are numerically achieved for the first time in the literature in the FDTD simulations of dispersive inhomogeneous media.


Serum cortisol level was measured by an enzyme immunoassay (EIA) using the enzyme penicillinase as a label without prior extraction and purification. Polyclonal antibodies were raised against cortisol-3-ortho-carboxymethyl-oxime (cortisol-3-0-CMO) conjugated to bovine serum albumin (BSA). This antibody showed a very low cross-reactivity with structurally related steroids (3.7% for corticosterone and 4% for II-deoxycorticosterone). Standard doses were prepared in a serum sample stripped from endogenous cortisol. Danazol, 8-anilinonaphtalosulphonic acid (8-ANS) and salicylic acid were used as blocking reagents. However these reagents were not suitable in this assay. Samples were heat treated (60° C for 30 min) in order to denature the binding proteins. The assay was sensitive from 250 pg per tube covering up to 50 ng with each point having a coefficient of variation (CV) of less then 15% throughout ten successive assays. CortisoI3-0-CM 0 was conjugated to the penicillinase following a carbodiimide procedure. The formed conjugate retained almost 90% of the enzyme activity. Recoveries of exogenously added cortisol from charcoal-stripped plasma in three different ranges varied between 90-100%. Inter and intra-assay variations showed a CV of less than 12 %. The correlation coefficient was calculated as r=0.99 using our method and the results reported by a local hospital for 20 samples.


Theories concerning the entrepreneur's attitudes towards IT are important because studies show that the entrepreneur's positive attitude towards IT is a key factor in achieving a high quality IT implementation in his/her business. Our study, based on data from multiple cases, supports this contention. Surprisingly, the data shows that those with negative attitudes towards IT also achieve high quality IT implementations. Those with uncertain attitudes towards IT had low quality IT implementations in their businesses. The results of this study yield some useful propositions: the most interesting is the importance of entrepreneurs with negative attitudes to rely on modern management policies in order to achieve a higher quality implementation.


Because of the deficiency of fixed kernel in bilinear time-frequency distribution (TFD), i.e. for each mapping, the resulting time-frequency representation is satisfactory only for a limited class of signals, a new adaptive kernel function named the radial parabola kernel (RPK), is proposed. The RPK can adopt the optimizing method to filter cross-terms adaptively according to the signal distribution, obtain good time-frequency resolution, and offer improved TFD for a large class of signals. Compared with traditional fixed -kernel functions, such as Wigner-Ville distribution, Choi-Willams distribution and Cone-kernel distribution, the superiority of the RPK function is obvious. At last, the RPK function is applied to the analysis of vibration signals of bearing, and the result proves the RPK function an effective method in analyzing signals.


Methyl cellulose (MC) was partially depolymerised and the oligomers thus obtained were studied by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOFMS). The depolymerisation was either enzymatic or acidic. Fractions of enzymatically depolymerised MC were collected from size-exclusion chromatography and subjected to a sample preparation investigation. Several MALDI matrices and solvents were evaluated. The results showed that the solvent choice had a significant effect on the measured degree of substitution (DS). Aprotic solvents produced higher DS values, which was most likely due to poor solubility of species with low DS. The obtained signal intensity, however, did not correlate with the solubility but seemed to be more dependent on certain matrix/solvent combinations. All the matrices attempted produced mass spectra with sufficient signal intensity for accurate peak area calculation. The choice of matrix did not have any significant effect on the measured DS. Sample spots obtained from organic solvents had a more homogeneous distribution of the analyte and smaller crystals than those obtained from water. This increased both the reproducibility and peak resolution and in addition the analysis time was shorter. DS measurements were performed on two acidically depolymerised MCs with different nominal DS values. It was easy to distinguish between the two MCs, and the measured DS values agreed well with the values supplied by the manufacturers.


The shrimp Rimicaris exoculata from hydrothermal vents on the Mid-Atlantic Ridge (MAR) harbours bacterial epibionts on specialized appendages and the inner surfaces of its gill chamber. Using comparative 16S rRNA sequence analysis and fluorescence in situ hybridization (FISH), we examined the R. exoculata epibiosis from four vents sites along the known distribution range of the shrimp on the MAR. Our results show that R. exoculata lives in symbiosis with two types of filamentous epibionts. One belongs to the Epsilonproteobacteria, and was previously identified as the dominant symbiont of R. exoculata. The second is a novel gammaproteobacterial symbiont that belongs to a clade consisting exclusively of sequences from epibiotic bacteria of hydrothermal vent animals, with the filamentous sulfur oxidizer Leucothrix mucor as the closest free-living relative. Both the epsilon- and the gammaproteobacterial symbionts dominated the R. exoculata epibiosis at all four MAR vent sites despite striking differences between vent fluid chemistry and distances between sites of up to 8500 km, indicating that the symbiosis is highly stable and specific. Phylogenetic analyses of two mitochondrial host genes showed little to no differences between hosts from the four vent sites. In contrast, there was significant spatial structuring of both the gamma- and the epsilonproteobacterial symbiont populations based on their 16S rRNA gene sequences that was correlated with geographic distance along the MAR. We hypothesize that biogeography and host-symbiont selectivity play a role in structuring the epibiosis of R. exoculata.


Objectives Vaccine hesitancy remains a major barrier to immunisation coverage worldwide. We explored influence of hesitancy on coverage and factors contributing to vaccine uptake during a national measles–rubella (MR) campaign in Indonesia. Design Secondary analyses of qualitative and quantitative data sets from existing cross-sectional studies conducted during and around the campaign. Methods Quantitative data used in this assessment included daily coverage reports generated by health workers, district risk profiles that indicate precampaign immunisation programme performance, and reports of campaign cessation due to vaccine hesitancy. We used t-test and χ2 tests for associations. The qualitative assessment employed three parallel national and regional studies. Deductive thematic analysis examined factors for acceptance among caregivers, health providers and programme managers. Results Coverage data were reported from 6462 health facilities across 395 districts from 1 August to 31 December 2018. The average district coverage was 73%, with wide variation between districts (2%–100%). One-third of districts fell below 70% coverage thresholds. Sixty-two of 395 (16%) districts paused the campaign due to hesitancy. Coverage among districts that never paused campaign activities due to hesitancy was significantly higher than rates for districts ever-pausing the campaign (81% vs 42%; p<0.001). Precampaign adequacy of district immunisation programmes did not explain coverage gaps (p=0.210). Qualitative analysis identified acceptance enablers including using digital health monitoring and feedback systems, increasing caregiver knowledge and awareness, making immunisation social norm, effective cross-sectoral collaboration, conducive service environment and positive experiences for mothers and children. Barriers included misinformation diffusion on social media, halal–haram issues, lack of healthcare provider knowledge, negative family influences and traditions, previous poor experiences and misinformation on adverse events. Conclusion Barriers to vaccine uptake contributed to coverage gaps during national MR campaign in Indonesia. A range of supply-related and demand-related strategies were identified to address hesitancy contributors. Advancing a portfolio of tailored multilevel interventions will be critical to enhance vaccine acceptance.


In nanometer MOSFETs, because of the small channel size, mesoscopic and even quantum effects can come into play. We have fabricated l6 nm NMOS devices featuring I/sub on/=400 /spl mu/A//spl mu/m and I/sub off/=0.8 /spl mu/A//spl mu/m and demonstrate that the FET principle is still confirmed at room temperature. We have deliberately used a non-overlapped SD/gate architecture, showing that, with adapted channel doping, it not only performs equally as well as the overlapped one, but also shows 1000/spl times/ reduced dispersion and is easily manufacturable. Finally, we show that quantization of energy in the channel motivates a study of performance at low temperature, and that the leading effect at low temperature and low voltage is Coulomb blockade.


While there are numerous studies on how the media cover election campaigns, there is still a lack of longitudinal studies of the dynamics of election news over time and within election campaigns. At the same time, partisan dealignment and increasing electoral volatility suggest that people's need for orientation – and hence their need for news media providing them with the information they need to cast informed votes – has increasing over time. Against this background, the purpose of this study is to investigate the information value of Swedish election news, both across and within the nine last parliamentary elections, held between 1979 and 2006. Based on a quantitative content analysis of more than 36,000 news stories, the general conclusion of this study is that the information value of Swedish election news has decreased, over time as well as within election campaigns and as Election Day approaches.


Quinoxalines derivatives were reported with wide range of biological activities. Hence it was planned to synthesize some novel series of quinoxalines derivatives. Orthopheneylene diamine was reacted with oxalic acid to form quinoxaline 2, 3 Dione. Quinoxaline-2, 3 (1H, 4H)-dione was chlorinated by using Phosphorousoxytrichloride in dimethyl formamide, to form 2, 3- dichloroquinoxaline. This dichloro compound subjected to reaction with 4 amino acetophenone in DMF, refluxed for 5 hours to form 1-(4-(3-chloroquinoxalin-2-ylamino) phenyl) ethanone. Similarly 1-(4-(3-chloroquinoxalin-2-ylamino) phenyl) ethanone then reacted with corresponding aromatic aldehydes to form quinoxaline derived chalcone by claisen Schmidt reaction. All the compounds were characterized by IR, 1H NMR and Mass spectroscopic data and the newly synthesized compounds were screened for anti bacterial, anti oxidant activities.


Aerospace applications have an increasing demand for strong and reliable adhesives, able to withstand large temperature gradients. The variation of the adhesive's mechanical properties with temperature is therefore one of the factors that must be well understood before safe and reliable adhesive joints can be designed for these applications. The stress–strain curve and the toughness properties of an adhesive show strong dependency with temperature for most adhesives, especially near the glass transition temperature (Tg). In this work, an experimental procedure is undertaken to evaluate the effect of low temperatures on the adhesive strength and mode I fracture toughness of a room temperature vulcanizing silicone (RTV) adhesive. Firstly, the temperature at which the glass transition of the RTV occurs was obtained by means of an in-house developed measurement apparatus. Bulk specimens were manufactured and tested at temperatures above and below the Tg in order to obtain a strength envelope of the adhesive over this large temperature range. Single lap joints were also manufactured with this adhesive to assess the behaviour of the adhesive when assembled in a complete joint. For the determination of pure mode I fracture toughness, double cantilever beam specimens were also tested at negative temperatures near Tg. The results showed that the failure loads of all the tests performed have strong temperature dependence and this must be taken into account during adhesive joint design using this type of adhesives.


In the article "Endocannabinoid-Specific Impairment in Synaptic Plasticity in Striatum of Huntington's Disease Mouse Model" by Marja D. Sepers, Amy Smith-Dijak, Jeff LeDue, Karolina Kolodziejczyk, Ken Mackie, and Lynn A. Raymond, which appeared on pages 544 –554 of the January 17, 2018 issue, the following information was omitted from the Acknowledgments: "We thank Dr. Amber Southwell and Dr. Michael Hayden, Centre for Molecular Medicine and Therapeutics, University of British Columbia, for providing the Q175FDN mice used in this study. Additional funding support for this study was provided by the Huntington Society of Canada." This error does not affect the conclusions of the paper. The article has been corrected online.


Csf1R blockade in a model of pancreatic ductal adenocarcinoma negatively impacted the function of infused engineered T cells. Addition of a CD40 agonist increased the persistence of the infused T cells but ultimately, did not rescue their function. Pancreatic ductal adenocarcinoma (PDA) is a lethal malignancy resistant to therapies, including immune-checkpoint blockade. We investigated two distinct strategies to modulate tumor-associated macrophages (TAM) to enhance cellular therapy targeting mesothelin in an autochthonous PDA mouse model. Administration of an antibody to colony-stimulating factor (anti-Csf1R) depleted Ly6Clow protumorigenic TAMs and significantly enhanced endogenous T-cell intratumoral accumulation. Despite increasing the number of endogenous T cells at the tumor site, as previously reported, TAM depletion had only minimal impact on intratumoral accumulation and persistence of T cells engineered to express a murine mesothelin-specific T-cell receptor (TCR). TAM depletion interfered with the antitumor activity of the infused T cells in PDA, evidenced by reduced tumor cell apoptosis. In contrast, TAM programming with agonistic anti-CD40 increased both Ly6Chigh TAMs and the intratumoral accumulation and longevity of TCR-engineered T cells. Anti-CD40 significantly increased the frequency and number of proliferating and granzyme B+ engineered T cells, and increased tumor cell apoptosis. However, anti-CD40 failed to rescue intratumoral engineered T-cell IFNγ production. Thus, although functional modulation, rather than TAM depletion, enhanced the longevity of engineered T cells and increased tumor cell apoptosis, ultimately, anti-CD40 modulation was insufficient to rescue key effector defects in tumor-reactive T cells. This study highlights critical distinctions between how endogenous T cells that evolve in vivo, and engineered T cells with previously acquired effector activity, respond to modifications of the tumor microenvironment.


We have observed gain at 26.2 nm in a laser-produced, recombining boron plasma. We conservatively estimate the gain for the B v 3d−2p transition to be 3.7 ± 0.2 cm−1, yielding a gain–length product of 3.0. The highest value of gain was measured 400 μm from the solid target surface and was obtained with the use of a steel blade. The pump-laser power was 1.1 J in 60 ps.


Increasing use of the Internet has heightened awareness among the information community of the need to provide user friendly searching and navigation tools that lead to quality information. An essential part of gaining effective access to Internet resources is to provide an index of available items in order to save users time and network overload. Discussions on metadata are focused on the format of the record used as the basis for the index. Control of the vast number of resources of the Internet requires an appropriate record format (or formats) which will enable the resource to be adequately described and easily located ; records must be compatible with an appropriate search engine which in turn would ideally be compatible with a search and retrieval Internet protocol and all components should conform to international standards. At present there are a number of formats which meet at least some of these criteria, each of which has its own strengths.


SIR,-As a geriatrician who looks after several elderly people with visual disability I was interested in the paper from the International Glaucoma Association. ' Though the current system seems to be functioning better than expected, the authors state that improvements could be made with closer cooperation among ophthalmologists, general practitioners, and optometrists. Unfortunately, no mention is made of any future role for other medical specialists: with the high prevalence of glaucoma in elderly people geriatricians seem to have an unrivalled opportunity to detect this insidious disease. The competence of geriatricians in performing eye examination, including tonometry and field screening, has been shown.2' In Messrs Maurice W Tuck and Ronald P Crick's study there was a non-attendance rate of 15% among those referred for further assessment.' The profile of these non-attenders is not given, but the reasons given for non-attendance lead me to suspect that they were elderly. Poor attendance at eye departments of people suspected of having glaucoma has been one problem of screening in geriatric medical practice.3 Closer cooperation of geriatric medical and ophthalmological departments seems to be necessary. Establishing mini eye clinics at day hospitals or using day hospitals' existing transport facilities to ensure that elderly patients attend their follow up appointments is worth considering.


Clinical ethics services are increasingly receiving case referrals regarding requests for access to experimental therapies. Sometimes, patients or families seek access to an experimental therapy that has not been subsidised by any government scheme, and for which no local clinical trial is underway. All else being equal, a patient may benefit from receiving an experimental therapy without making any other patient worse off. However, within public healthcare systems, treating only one patient with an experimental therapy, when others might also benefit from it, evokes a troubling sense of inequity. In this paper, I examine the relevance of Pareto principles and the 'levelling down' objection to ethical deliberation about patient or family-initiated requests for experimental therapies. While facilitating access to an experimental therapy may benefit a patient without making any other patients worse off, this does not dispel ethically relevant considerations concerning equity. When deliberating about cases involving inequity, clinicians and hospitals must balance directly improving the position of individual patients with avoiding contributing to or tolerating avoidable inequities. I argue that inequity in access to experimental therapies can be ethically permissible, but only if satisfies two conditions: firstly, the decision to provide one patient and not others with a promising experimental therapy must have a strong likelihood of contributing to future equity; and secondly, the inequity must be exercised in a way that shows respect for other patients who are not equally able to access the therapy in question.