BACKGROUND AND PURPOSE: Acidification of the tumor microenvironment from abnormal metabolism along with angiogenesis to meet metabolic demands are both hallmarks of malignant brain tumors; however, the interdependency of tumor acidity and vascularity has not been explored. Therefore, our aim was to investigate the association between pH-sensitive amine chemical exchange saturation transfer echoplanar imaging (CEST-EPI) and relative cerebral blood volume (CBV) measurements obtained from dynamic susceptibility contrast (DSC) perfusion MRI in patients with gliomas. MATERIALS AND METHODS: In this retrospective study, 90 patients with histologically confirmed gliomas were scanned between 2015 and 2018 (median age, 50.3 years; male/female ratio = 59:31). pH-weighting was obtained using chemical exchange saturation transfer echo-planar imaging estimation of the magnetization transfer ratio asymmetry at 3 ppm, and CBV was estimated using DSC-MR imaging. The voxelwise correlation and patient-wise median value correlation between the magnetization transfer ratio asymmetry at 3 ppm and CBV within T2-hyperintense lesions and contrast-enhancing lesions were evaluated using the Pearson correlation analysis. RESULTS: General colocalization of elevated perfusion and high acidity was observed in tumors, with local intratumor heterogeneity. For patient-wise analysis, median CBV and magnetization transfer ratio asymmetry at 3 ppm within T2-hyperintense lesions were significantly correlated (R = 0.3180, P = .002), but not in areas of contrast enhancement (P = .52). The positive correlation in T2-hyperintense lesions remained within high-grade gliomas (R = 0.4128, P = .001) and in isocitrate dehydrogenase wild-type gliomas (R = 0.4300, P = .002), but not in World Health Organization II or in isocitrate dehydrogenase mutant tumors. Both magnetization transfer ratio asymmetry at 3 ppm and the voxelwise correlation between magnetization transfer ratio asymmetry and CBV were higher in high-grade gliomas compared with low-grade gliomas in T2-hyperintense tumors (magnetization transfer ratio asymmetry, P = .02; Pearson correlation, P = .01). The same trend held when comparing isocitrate dehydrogenase wild-type gliomas and isocitrate dehydrogenase mutant gliomas (magnetization transfer ratio asymmetry, P = .04; Pearson correlation, P = .01). CONCLUSIONS: A positive linear correlation between CBV and acidity in areas of T2-hyperintense, nonenhancing tumor, but not enhancing tumor, was observed across patients. Local heterogeneity was observed within individual tumors.


The aim of this study is to describe and to analyze the accountability of Batu City Government's fixed asset management. The objects of this study are concerned with the activities of Batu City Government's fixed asset management centralized in BPKAD (regional institution of finance and asset management). Fixed asset management accountability in this study is concerned with legal and regulatory accountability, process accountability, program accountability, and policy accountability. It is a case study with Stewardship Theory as its analytical instrument. On the Stewardship theory, there are two values: a value of intrinsic and extrinsic. At the Batu City Government, the regional asset management scheme favors to the intrinsic value that are motivated to self-actualization and awards as it is compared with extrinsic values that is motivated to the monetary value. Nevertheless, Stewardship behavior has not underlined that all behaviors and activities are undertaken by the regional government so that the accountability that is achieved has not maximized yet. The results of this study on legal accountability show that 71% of the land assets have not possessed evidences of legal ownership yet. The process accountability, of the majority of the 13 asset management activities, has not possessed a SOP or groove established procedure as regional regulations so that the activities have only been carried out based the existing regulations. On the program and policy accountability that the government produced, Batu City Government has not consistently run the activities in accordance with the program set on RPJMP (government's mid-term development plan), strategic plan and implementation of policies, and working plan. It has not been conducted maximally in accordance with the existing regulations.


For heating T of the die material is valid where the thermal diffusivity of the die material is exercised by deciding method. The stress of the die material by heating from the die casting liquid metal depends mainly on physical properties of the die material when the value of the calculated stress does not exceed the yield point. Also derived with help of dislocations write the die life till the origin of cracks in cycles eventually the share of this die life on total die life in dependence on mechanical and physical properties of the die material and well explain increasing die life at higher thermal diffusivity of the die material as also at heat treatment of the same die material on the lower strength. The derived relation for the spreading cracks length in dependence on number of cycles agrees with the results of the transferred tests.


The aim of the present work was to study exposure to PM in the indoor and outdoor microenvironment of a typical residence in the center of Athens. Simultaneous indoor and outdoor measurements of PM10 and PM2.5 were conducted, by the use of gravimetric and continuous samples, during October and November 2006. Moreover, air exchange rate was monitored continuously during the entire measurement period. The indoor and outdoor concentration levels were significant for both size fractions. Mean daily PM10 outdoor concentrations exceeded the E.U. 24-hr limit value for 84 % of the measured days, while the respective PM2.5 concentrations exceeded the 24-hr limit value set by the C.A.F.E. working group for 69 % of the measured days. PM10 and PM2.5 concentrations exhibited increased short-term variability with high peak concentrations during morning and afternoon/night rush hours. Indoor concentration levels seem to be mainly affected by PM of outdoor origin, since the calculated indoor-to-outdoor concentrations ratios (I/O) were much lower than 1.00 during all days and indoor and outdoor concentrations were highly correlated. This finding was also supported by the pattern of their diurnal cycles, which followed the outdoor ones, with a delay of approximately 1 hr. The results indicate increased PM concentration levels in the center of Athens, even in indoor microenvironments with no significant indoor sources and emphasize the need for a more extensive investigation of the Athens population exposure, for the protection of public health.


This paper studies the use of laser engraving and aluminum foil laminating as an embellishing process to denim fabric. Laser technique is being applied in the textile and fashion industries because it is an ideal surface treatment for design application without usage of chemicals and water. This paper will explore a design method that combines laser engraving technology and metallic foil laminating for a sheening surface effect. Before the application of laser engraving, the aluminum foil is laminated on denim fabric with laminating adhesive. Then, the laminated denim fabric is engraved by the laser with a different DPI (dots per inch) as well as the pixel time (microsecond, μs). The performance of the laser engraved foil laminated denim fabric is investigated, including physical and mechanical properties. The study demonstrates an embellishment application in denim fabric, which developed metallic appearance with patterns on denim fabric combing the aluminum foil laminating and the laser engraving techniques. It carries out new possibilities for textile and fashion designs and reveals the future potential for green textile products.


Stockholm Norvik is a new port which is planned to be built on Norviksudden of Nynashamn. With the construction of a new port it will affect traffic conditions in its vicinity and it is therefore important to investigate any navigational risks that may arise. This study has focused on four different issues that have starting points in geographic risks, placement of buoys in the area, the junction at Finnhallorna and the traffic flow.

The study has been designed in the form of a case study where the primary data collection consists of qualitative semi-structured interviews. There has been much emphasis on the informants' navigational expertise and local knowledge which has limited the choice of informants.

The geographical risks the informant's addresses are mainly cruise traffic and its tender activities affecting traffic in the area as well as the current location of the anchorage.

The informants agreed that placement of buoys must be reviewed in the area and reinforced in some places. That also includes speed limits, but the scope and level of restriction was uncertain.

The crossing occurring outside Finnhallorna is seen as no major navigational risk since the traffic flow to the port will not achieve a greater quantity and the approach is less complicated when compared to other international ports.


A simple photonic approach to implementing an ultra-wideband microwave phase shifter based on an erbium-ytterbium (Er/Yb) co-doped linearly chirped fiber Bragg grating (LCFBG) is proposed and experimentally demonstrated. The LCFBG is designed to have a constant magnitude response over a reflection band, and a phase response that is linear and nonlinear in two sections in the reflection band. When an optical single-sideband with carrier (OSSB+C) signal is sent to the LCFBG, by locating the optical carrier at the section corresponding to the nonlinear phase response and the sideband at the section corresponding to the linear phase response, a phase shift is introduced to the optical carrier, which is then translated to the microwave signal by beating the optical carrier and the sideband at a photodetector. The tuning of the phase shift is realized by optically pumping the Er/Yb co-doped LCFBG by a 980-nm laser diode. The proposed ultra-wideband microwave photonic phase shifter is experimentally demonstrated. A phase shifter with a full 360° phase shift with a bandwidth from 10 to 40 GHz is experimentally demonstrated.


Aristotle said that the goal of the city, the organized expression of man's action, is to make people happy and safe. In the period of crisis through which humanity is now passing, there is a need for working out the goals which have to guide man's action. Today, in the middle of the phase of rapid development, the goal of the city must be defined as being to make people happy and safe for better human development. This is why, in a conference dealing with water, we should not be limited to isolated aspects of the problems, such as water for drinking, or for the production of food, or for industrial and economic development. All these various aspects, and several others, are only parts of the one general goal which should be Water for Human Development.


Research carried out by Dr Jeremy Dixon (University of Bath) examined mentally disordered offenders' views of their risk assessment and management plans. The research took place between March 2009 and September 2011, and involved a combination of interviews with mentally disordered offenders and a review of their health and social care records. These offenders had been given a hospital treatment order at the point of sentencing. They were also subject to restrictions operated by the Ministry of Justice during and after hospital admission, on the grounds that such restrictions were necessary to protect the public. The findings show that although mentally disordered offenders were aware that mental health professionals were assessing their risk, they were generally unaware of the content of these assessments and how decisions were made.


Introduction Telehealth is recognised as a viable way of providing health care over distance, and an effective way to increase access for individuals with transport difficulties or those living in rural and remote areas. While telehealth has many positives for patients, clinicians and the health system, it is important that changes in the delivery of health care (e.g. in-person to telehealth) do not result in inferior or unsafe care. In this review, we collate existing meta-analyses of mortality rates to provide a holistic view of the current evidence regarding telehealth safety. Methods In November 2020, a search of Pretty Darn Quick Evidence portal was conducted in order to locate systematic reviews published between 2010 and 2019, examining and meta-analysing the effect of telehealth interventions on mortality compared to usual care. Results This review summarises evidence from 24 meta-analyses. Five overarching medical disciplines were represented (cardiovascular, neurology, pulmonary, obstetrics and intensive care). Overall, telehealth did not increase mortality rates. Discussion The evidence from this review can be used by decision makers, in conjunction with other disease-specific and health economic evidences, to support and guide telehealth implementation plans.


Contrasting monsoons of 2008 and 2009 provided a test bed to enhance the understanding of the aerosol variability and aerosol-cloud interaction. Vertical aerosol profiles derived from the Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO) are used to delineate the aerosol properties during the two contrasting Indian summer monsoons. We observed a 30–40% increase in the aerosol occurrence frequency (AOF) in lower altitudes (below 6 km) in 2009 and a 5–8% enhancement in AOF at higher altitudes in 2008. The cloud occurrence frequency also showed more deep convective clouds in 2008 (13–15%) than in 2009. Cloud Fraction, Aerosol Optical Depth and TRMM precipitation data sets have been also used to investigate the aerosol-cloud interaction. We define the microphysical effect as the increase in cloud fraction with increase in aerosols (CCN) and the radiative effect as the decrease of cloud fraction with increase in aerosol loading. We observe a stronger microphysical effect than the radiative effect in 2008 as compared to 2009. In 2009, atmospheric brown clouds were observed from March to September, which slowed down the microphysical effect and enhanced the radiative effect. This resulted in a 30% reduction in the total cloud fraction that may have reduced precipitation, and invigorated the drought conditions during 2009. Keyword: Atmospheric aerosols; Aerosol optical depth; Atmospheric chemistry; Air pollution; Cloud aerosol interactions; Remote sensing.


The shortage of staff in hospitals resulted in the overcrowding of outpatients departments (OPDs) and long waiting times. The problems of the current health care system include the lack of access to transportation and high transport fees which cause delays in health seeking behaviours by patients or them resorting to traditional medicine in their neighbourhood. To alleviate the above issues, the new Primary Health Care (PHC) approach provides health care at a ward based and household level through community care giver (CCGs) and outreach teams. The study evaluated the management of rural ward-based primary health care in the UThukela District Municipality (UDM). The study intended to evaluate current performance systems in order to provide effective and efficient PHC; identify the role of the operational manager (OM) in the provision of PHC; and identify the factors affecting the performance of CCGs. A mixed methods approach was used amongst 368 CCGs and 17 OMs. Data was collected from CCGs using questionnaires while an interview schedule was used to collect data from OMs. The study showed that the performance management systems currently being used were not providing the desired performance management outputs. There were no performance bonuses to recognise best performing staff and therefore no increase in performance. The study also showed a significant relationship between the management of referrals and participation in the activities of PHC outreach teams. The clinic was not regularly giving feedback to the respondents and also not consistently conducting performance reviews. The findings indicated that OMs were playing various roles in the provision of PHC, namely policy and strategy implementation; leadership and governance; clinical care; allocation of resources; clinic budget management; supply chain management; and writing clinic reports. The extent of the allocation of resources to the wards varied from 43% for medicines and equipment to 31% for financial resources and only 18% for human resources. More than 95% of the CCGs viewed the availability of transport, resources, training and the provision of a stipend to be strong enabling factors for them to perform their work. Respondents indicated that monitoring and evaluation was done through reporting, performance reviews, feedback and supervision. The findings indicated that ward-based outreach teams are crucial in the delivery of PHC services in rural municipal wards within the Operation Sukuma Sakhe programme. Lack of management and supervisory support contribute to high rates of dissatisfaction amongst CCGs, as well as poor quality of work for community caregivers. There is a need for the Department of Health (DoH) to invest in the ward-based outreach teams (WBOTs) and allocate CCG budgets within the ward-based outreach teams. The study recommended that a review of monitoring and evaluation policy is required to clearly state the tools, activities and benefits of the implementation of the M & E performance management systems. The use of point-of-care technology by the WBOTs should be strengthened especially in deep rural wards. Therefore, biomedical technology will enhance point-of-care diagnosis, for instance, rapid home test kits for HIV diagnosis and pregnancy tests. The KwaZulu-Natal DoH should fast-track development of the sub-districts in order strengthen service delivery at a local level with top management ensuring development of OMs and PHC Supervisors in order to increase the level of competence and thereby improve service delivery at the PHC facilities. Another recommendation was to strengthen implementation of Operation Sukuma Sakhe (OSS) where the war room and the ward committee increase commitment to designing community-specific interventions with the engagement of community structures and government departments and local municipality through social planning, social action and locality development. Therefore, the results of the study should also influence the formulation of policies, programmes, methods and interventions which will enable UThukela District Municipality to improve health outcomes.


There are many accounts of the current strong connection between dogs and some humans. These accounts imply or pre-suppose a strong social-sensual relation between dogs and their humans. In a highly visualised culture how is this social-sensual relation mediated? What role does olfaction play? Autoethnography and 'mystory' are methodologies that can be used to address these questions.


This policy briefing presents cyclone disaster management strategies for effective relief and recovery in affected communities. Recently, in Southern Africa climate change has manifested through cyclones that have devastated and displaced a significant number of individuals and households, shattering their long-term goals and aspirations. African governments and relief agencies are often overwhelmed by the responsibility of ensuring community relief and recovery from climate-related disasters, given the unforeseen demand on resources. Most interventions have a short-term alleviation impact while long-term goals fall away. Based on a mixed methods research design, this briefing argues that predisaster fortification of communities and migration capacitation are effective long-term adaptation strategies after devastating events. It calls for the integration of community resilience building and environmental migration into national frameworks for adaptation and broader development plans. Mitigating the Impact of Cyclone Disasters: Lessons from Cyclone Idai


Optical properties of GaInP/GaAs:Er,O/GaInP double heterostructure (DH) laser diodes (LDs) grown by organometallic vapor phase epitaxy (OMVPE) were investigated. The Er-doped LDs showed laser emission of the GaAs band-edge. The threshold current density (Jth) was 3.6 kA/cm2 on the n-type GaAs substrates and 15.8 kA/cm2 on the p-type at 77 K. The Er-doped LDs on the n-type substrate showed a strong sulfur (S)-related emission in the near-infrared region. Conversely, the S-related emission was strongly suppressed in the LDs on the p-type substrates. This was achieved by preventing the incorporation of S atoms into the GaAs active layer. For the electroluminescence (EL) properties, 1.54 μm-emission from Er3+ ions was clearly observed in the Er-doped LDs on p-type substrates. The dependence of EL intensities on the current density showed that the suppression of an energy transfer from the Er3+ ion to the S-related emission was necessary for efficient Er3+ emission at the stimulated emission region of the GaAs band-edge.


Sucrose dependent translational dynamics Gene expression is regulated at several different levels starting from chromatin remodeling and transcription in the nucleus to translation and post-translational modifications in the cytosol. Depending on the gene and circumstances, different regulatory mechanisms are operational at various levels. mRNA translation is regulated both at the level of specific mRNAs and at the global level, where thousands of mRNA transcripts are affected. In yeast, sugar depletion results in inhibition of ribosome biogenesis and mRNA translation. In A. thaliana similar conditions results in down regulation of many r-protein genes and factors involved in ribosome biogenesis, indicating that general mRNA translation in A. thaliana likely is similarly controlled. In A. thaliana leaves and cell cultures, diurnal sugar levels and sugar starvation regulate gene expression at the transcriptional and at the translation level. In this thesis the effects of high sucrose levels on translational dynamics is investigated both at the gene specific level as well as at the global level. It is concluded that sucrose affects gene expression to a much larger extent than that was previously anticipated. Using an mRNA profiling approach, translational regulation in response to high sucrose levels was studied. Total and polysomal mRNA populations were isolated from A. thaliana leaves incubated in high sucrose levels or control conditions. It is shown that in response to high sucrose levels many genes are translationally controlled. Substantially more genes change their presence in the polysomal mRNA population in response to sucrose compared to sucrose regulated genes in the total mRNA population. Interestingly, many of the translationally controlled genes enriched in the polysomal mRNA population are known sugar regulated genes. These genes encode proteins involved in photosynthesis, ion and lipid metabolism and translation. These results suggest that sucrose-regulated genes are preferentially selected on or excluded from polysomes. mRNA selection is influenced by the ribosome and associated non-ribosomal proteins. Sucrose affects gene expression of many factors involved in mRNA translation, which includes genes that encode ribosomal proteins (r-proteins), but also other RNA binding proteins. This indicates that the general translation machinery is affected by high sucrose levels. Ribosomes are heterogeneous, large protein complexes consisting of 79 different r-proteins. In A. thaliana, each r-protein is encoded by two to six different genes. Using an advanced LC-MSE proteomics approach, the relative abundance of r-proteins in polysome protein extracts was quantified. About 71 % of the 234 expected r-proteins were identified and are present in ribosomal preparations. The abundance of specific r-protein paralogs changes significantly in response to high sucrose levels. This suggests that different r-protein paralogs are incorporated in the ribosome upon high sucrose levels and that, therefore, plants are capable of changing their ribosomal heterogeneity in response to environmental stimuli. Possibly, the differential incorporation of r-protein within the ribosome affects ribosome kinetics, accuracy or cellular localization. Only few reports have appeared on the function of r-protein paralogs, but future studies on the functions of individual r-protein paralogs is required to fully understand their biological roles.


ABSTRACT Pyrazinamide (PZA), an indispensable component of modern tuberculosis treatment, acts as a key sterilizing drug. While the mechanism of activation of this prodrug into pyrazinoic acid (POA) by Mycobacterium tuberculosis has been extensively studied, not all molecular determinants that confer resistance to this mysterious drug have been identified. Here, we report how a new PZA resistance determinant, the Asp67Asn substitution in Rv2783, confers M. tuberculosis resistance to PZA. Expression of the mutant allele but not the wild-type allele in M. tuberculosis recapitulates the PZA resistance observed in clinical isolates. In addition to catalyzing the metabolism of RNA and single-stranded DNA, Rv2783 also metabolized ppGpp, an important signal transducer involved in the stringent response in bacteria. All catalytic activities of the wild-type Rv2783 but not the mutant were significantly inhibited by POA. These results, which indicate that Rv2783 is a target of PZA, provide new insight into the molecular mechanism of the sterilizing activity of this drug and a basis for improving the molecular diagnosis of PZA resistance and developing evolved PZA derivatives to enhance its antituberculosis activity.


This essay considers the representation of pleasure in three "post"-conflict Northern Irish texts: Glenn Patterson's novel The Rest Just Follows (2014), Billy Cowan's play Still Ill (2014) and Lucy Caldwell's short story collection Multitudes (2016). A framework is offered that advocates a turning away from the dominance of trauma theory in Northern Irish cultural criticism towards a recognition of the plurality of experiences which these texts represent. This essay uses theoretical insights from Lauren Berlant, Heather Love, Laura Frost and Eve Kosofsky Sedgwick to consider the unique affective topography in which Northern Irish writers represent their pleasures. In these texts, published in the last few years, we see the representation of queer and non-reproductive sexual encounters set against the backdrop of the social and political policing of morality in Northern Ireland. This essay, however, will argue that these texts are not simple metonyms but rather present complex sensual experiences which enrich our understanding of the emotional landscape of contemporary Northern Ireland.


the former. But the correction of the traditional account remains incomplete in that it is not indicated that the conclusion of a complex dilemma is disjunctive only sensu lato (i.e., only the inclusive disjunction can be inferred from the premisses of the dilemma, although of course the exclusive disjunction might happen to be true in a particular case). And the author makes the mistake of using the same symbol v to render both kinds of disjunction; thus he gives as symbolic notation for the inference ponendo tollens, " p v q ; p ; .'. q ' , " and a t another place gives " p ' v q " as the definition of (material) implication, apparently overlooking that the combination commits him to the fallacy of denial of the antecedent. There is a separate article devoted to "syllogisms of relations," under which head are included certain inferences of non-traditional form which lend themselves to simple verbal expression. There is here a failure to distinguish between inferences valid on the basis of form alone and other which, despite a verbal similarity, require additional premisses or are not valid. The assertion a t the end of the article (p. 159) that all such inferences are reducible to categorical syllogisms is in error; even the one example of such a reduction which the author gives requires analysis of the same proposition into subject-predicate form in two different ways, and this must be classed as a non-traditional step. Erratum. On page 80, the symbolic statement given for the law of contradiction should


Oneirology, the study and interpretation of dream content, has been part of human experience throughout recorded history. In modern times, the interpretation of dreams has been used as a tool in the practice of psychotherapy for the purpose of developing insight into the individual's intrapsychic and interpersonal relationships. Ringel, Jung, and others have noted that the content of dreams may be used to assess the individual's state of mind with regard to suicidal intent. Litman has noted the difference between dreams related to suicide and dreams expressing the presence of a clinical depression. Death dreams of the elderly may be considered expressions of depressive symptoms, although this conclusion should be approached with caution. Taylor, Sanford, and others have noted that death dreams generally may be considered as the need for transformation within the individual's personality. The author's impressions taken from clinical experience as well as his experience in teaching university-level courses both in dream interpretation and suicidology are also included in this paper. Language: en


Numerous α,α-trehalose diesters have been isolated from bacteria such as Mycobacteria and Corynebacteria, and more recently from Caenorhabditis elegans dauer larvae. Although these glycolipids are thought to confer protection to the bacteria and larvae against harsh environmental conditions, it is the biological activities of these compounds, including anti-tumour and adjuvant activities, which have been of major interest to scientists over recent years.  In this thesis, three different aspects relating to the synthesis and testing of defined trehalose glycolipids will be presented. First, the synthesis of a variety of fatty acid trehalose diesters (TDEs) with varying lipid lengths was performed and the ability of these glycolipids to activate macrophages was studied. Two different synthetic strategies were employed to attain the TDEs of interest and it was observed that lipid lengths of more than 18 carbons were required for macrophage activation. Furthermore, the C22 fatty acid trehalose monoester (TME) and the C26 TME were also synthesised and interestingly they both showed macrophage activation abilities, with subsequent studies indicating that like TDEs, the TMEs were also ligands for mincle, a C-type lectin found on macrophages. This is the first time that TMEs have been tested for their ability to activate macrophages via Mincle. The cytotoxicity of these compounds and subsequent anti-tumour activity of a few selected compounds were also studied and although the TDEs and TMEs did not exhibit any significant cytotoxicity, in in vivo models the C10 TDE and C22 TDE both showed anti-tumour activity. This depicts that the mechanism for anti-tumour activity of these compounds is not due to cytotoxicity but due to as yet unidentified pathway.  Methodology that can be applied to the synthesis of more complex trehalose glycolipids, such as trehalose dicorynomycolates (TDCMs, isolated from Corynebacteria) and trehalose dimycolates (TDMs, isolated from Mycobacteria) was also explored. One of the key steps frequently used in the synthesis of these glycolipids is the Fráter-Seebach alkylation. To improve the efficacy of this methodology allylic iodides, rather than alkyl iodides were used for theα-alkylation of β-hydroxy esters. Our results showed that for all substrates studied, the yield of the α-alkylation was greatly improved when the allylic, rather that the alkyl halide was used. The use of this methodology in the synthesis of trehalose monocorynomycolate (TMCM) was also investigated.  The third aspect of this thesis focuses on the use of Affinity Based Proteome Profiling (AƒBPP) for elucidating the receptors that TDMs bind to upon interacting with host cell. AƒBPP focuses on using small molecules which mimic the natural substrate for a particular protein and through the use of 'trap' and 'tag' groups on the molecule the identity of the protein/receptors can be determined. The synthesis of a TDM probe containing a benzophenone 'trap' group and an alkyne 'tag' group will be discussed.


We used a higher-order correlation-based method for signal denoising. In our approach, we determined which wavelet coefficients contained mostly noise, or signal, based on higher-order statistics. Because the higher that second-order moments of the Gaussian probability function are zero, the third-order correlation coefficient will not have a statistical contribution from Gaussian noise. We obtained results for both 1-D signals and images. In all cases, our approach showed improved results when compared to a more popular denoising method.


This paper discusses the adaptation of Demeter and Persephone's myth by two poets Alfred Tennyson and Carolyn Kizer. The poems are approached from a feminist point of view. The paper is divided into three sections, the first reviews the theoretical parts concerning mythology and feminism, the second presents the application of the feminist theories on Tennyson's poem, the third sets forth a similar application of the feminist theories on Kizer's poem. The study aims to provide answers to crucial questions of the differences between the poets' interpretations, portrayals of Demeter and her daughter Persephone, and the myth's reinvented themes, as well as their depictions as heroines. The study has arrived to some outcomes; first, Tennyson's poem describes motherhood in Demeter's actions, while Kizer's poem highlights womanhood in Persephone's individuation. Second, Tennyson's version contemplates on social problems, whereas Kizer's version explores woman's psychological states. Third, both the poets have constructed their poems as dramatic monologue to give the rightful voice to their heroines.


The isozyme of lactate dehydrogenase (LDH) that is specific to testes, designated LDH-C4, is the predominant LDH isozyme in mammalian spermatozoa. Four high-affinity monoclonal antibodies have been developed to murine LDH-C4. These antibodies were tested for crossreactivity with LDH-C4 from rat, hamster, rabbit, and human by competitive binding radioimmunoassays. Monoclonal antibodies RG-1 and RG-2 are specific for adjacent or partially overlapping epitopes. The other two monoclonal antibodies each recognize separate and distinct determinants. One of these, designated RG-4, recognizes a sequential determinant that is contained in the coenzyme binding loop, residues 101-115 of the C subunit. Furthermore, RG-4 shows reduced binding affinity for rat LDH-C4 which differs in amino acid sequence at residue 108 and 111 in this region of the molecule. RG-4 also has reduced affinity for LDH-C4 of other species, which is consistent with substitutions in the amino acid sequences of the coenzyme binding loop. These differences between C4 of closely related species is in contrast to the high degree of conservation of this sequence in the LDH-A4 and LDH-B4 isozymes. These results provide useful information regarding homologies among species of LDH-C4 as well as the evolution of this isozyme.


The so called "Startup Act" (Decree Law 179/2012, converted into Law 221/2012), has introduced in Italy the notion of innovative companies with a high technological value, denoted as the innovative startups. Among them, the Italian government includes the category of SIAVS ("Startup Innovative A Vocazione Sociale"), which represents a relatively new field of interest in both scientific and normative perspective. A social startup must satisfy the same requirement of other innovative startups, usually operating in sectors such as social assistance, education, health, social tourism and culture which can have a direct (social) impact on collective well-being. Furthermore, they must produce specific reporting of the produced social impact, enjoying also some tax benefits. In 2020 more than 200 SIAVS are registered in Italy, more than doubled with respect to 2015. This work is concerned with the empirical analysis of innovative companies focused in funding and implementing solutions to social, cultural, or environmental issues. Specifically, the aim of the paper is to investigate what are the relevant factors for the arise of SIAVS in Italy. The response variable is based on the number of active social startups in Italian provinces while the set of explanatory variables is composed by economic and demographic indicators at the provincial level. Generalized linear models (GLM) for discrete outcomes are applied and compared, even taking into account the zero-inflated issue arising due to the distribution of these particular data.


Background
Pressure ulcers, (also known as pressure damage) are a debilitating, chronic wound condition representing a significant health and treatment burden. Associated with continuous pain (Brigs et al., 2013), distressing symptoms and impaired psychological and social functioning (Gorecki et al., 2013), reducing the quality of life for patients and their carers (Rees et al., 2001). The use of a validated pressure ulcer risk assessment tool for prevention assessment and management of PU is National Institute for Clinical Excellence (NICE) recommendation (NICE, 2015).

Rationale
Review of pressure damage assessment, prevention and management strategies, within an Community Health Services NHS Trust, identified themes requiring transformation to meet ever more complex clinical needs of patients and the elimination of all avoidable pressure damage within its care.

Method
A sequentially staged, service evaluation, implementing a new and innovative approach to pressure damage risk assessment, prevention and management strategies was undertaken. In Stage-One, a purpose designed questionnaire assessed clinician's perspectives surrounding current pressure damage assessment, prevention, and care management strategies. Stage-Two implemented the innovation and the Trust, became early adopters of Pressure Ulcer Risk Primary or Secondary Evaluation Tool (PURPOSE-T; 2013). In Stage-Three, PURPOSE-T was implemented during March 2016 for a four-week pilot period and nurse's perceptions surrounding implementation of PURPOSE-T were obtained via a focus group.

Results
Thematic analysis (TA; Braun & Clarke, 2006) of Stage-One survey identified three key themes in the way clinician's made sense of pressure damage prevention, management and care management strategies; Confidence in Tool Supporting Clinical Decision Making, Defensively Nursing and Usability. The findings suggest, clinicians are dichotomised toward considerations of using Waterlow in their daily practice. Some, considered Waterlow a useful, but flawed tool. A larger group of narratives however, strongly voiced Waterlow inadequacy supporting clinical decision making. Confusion surrounding interpretation of 'grey areas' (Waterlow, 2005) or ambiguously interpretable risk factor identifiers were widely perceived as problematic, these narratives revealed deep frustration, lack of confidence and professional disempowerment, which were perceived as stemming from use of Waterlow. Clinicians also perceived use of Waterlow to have evolved into one of constrained dictation, rather than part of an assessment process. This was strongly voiced surrounding perceptions of a propensity for Waterlow to over predict risk and trigger inappropriate allocation of resources and clinical facing time. This seemingly had influencing a working culture where clinical judgement is (for some) overruled by Waterlow score outcome, resulting in a move toward a 'nursing by numbers' care approach. Suggesting the Trust may be wasting resources on more expensive forms of PU management than necessary. As such, many narratives directly requested Waterlow replacement.

In Stage-Two, PURPOSE-T was successfully integrated into SystmOne and effectively incorporated into clinical routine during the four-week pilot period. In Stage-Three Clinician satisfaction and support for PURPOSE-T, was strongly favourable. Focus group TA (Braun & Clarke, 2006), identified three themes surrounding implementation of PURPOSE-T: Comprehensiveness of Assessment, Improved Clinical Confidence and Acceptability. The screening stage was considered an important feature for improving patient care, improving allocation of resources and potentially saving the Trust costs through an improved PU risk identification. Risk factor descriptors were felt to be clear and unambiguous and improve risk factor interpretation. This resulted in clinicians perceiving there to be potential for greater consistency of risk factor identification between clinicians. PURPOSE-T was also considered as supporting well supporting clinicians to act in accordance with an own professional knowledgebase, rather than as response to an assessment score outcome. Difficulties were however, encountered with the colour coded assessment pathway guidance being functionally limited within SystmOne and usability concerns arose from a changed risk assessment format and process. Usability concerns were subsequently addressed and refined within the educational package developed to support implementation of PURPOSE-T.

Overall, PURPOSE-T was considered as encouraging a more thoughtful, approach to assessment, prevention and management of PU and improving congruency between clinical judgement and care pathway allocation.


The interface between cognition, emotion, and motivation is thought to be of central importance in understanding complex cognitive functions such as decision-making and executive control in humans. Although nonhuman apes have complex repertoires of emotional expression, little is known about the role of affective processes in ape decision-making. To illuminate the evolutionary origins of human-like patterns of choice, we investigated decision-making in humans' closest phylogenetic relatives, chimpanzees (Pan troglodytes) and bonobos (Pan paniscus). In two studies, we examined these species' temporal and risk preferences, and assessed whether apes show emotional and motivational responses in decision-making contexts. We find that (1) chimpanzees are more patient and more risk-prone than are bonobos, (2) both species exhibit affective and motivational responses following the outcomes of their decisions, and (3) some emotional and motivational responses map onto species-level and individual-differences in decision-making. These results indicate that apes do exhibit emotional responses to decision-making, like humans. We explore the hypothesis that affective and motivational biases may underlie the psychological mechanisms supporting value-based preferences in these species.


The thesis describes techniques that can be used to reduce or eliminate artefacts arising due to magnetic field disturbances and/or motion in temperature maps obtained by the Proton Resonance Frequency Shift (PRFS) method of MRI temperature mapping. The first chapter describes a hardware modification, which enables PRFS temperature mapping during percutaneous transluminal angioplasty performed using a hot balloon. It is proposed to separate in time media injection and heating by first inflating a balloon with a media at an initial temperature, and then by heating the media up using laser light. The separation is shown to eliminate flow, motion and susceptibility-redistribution artefacts and to enable real-time MRI temperature mapping using the PRFS technique. The second chapter describes a post-processing technique, which eliminates temperature artefacts caused by breathing. A set of baseline images characterizing Respiratory Induced Resonance Offset (RIRO) at a variety of respiratory cycle instants is acquired before the thermal treatment starts. During the treatment, the temperature evolution is found from two successive images. Then, the calculated temperature changes are corrected for the additional contribution caused by RIRO using the pre-treatment baseline images acquired at the identical instances of the respiratory cycle. The third chapter describes an acquisition and post-processing technique, which utilizes the fat signal to improve the immunity of the PRFS method of MRI temperature mapping against magnetic field disturbances. The described method is based on the utilization of several gradient and spin echoes acquired within one repetition interval with water and fat-selective scans. The fourth chapter describes an approach to post-processing PRFS temperature maps acquired during High Intensity Focused Ultrasound (HIFU) treatments, which allows the user to extract from the maps some additional information that can be used to monitor the treatment in a more safe and reliable way as well as to adjust the treatment in case it deviates from the desired scenario. A set of mathematical operations (including discrete analogues of time derivative, directional derivative, gradient and Laplacian) is applied to temperature maps to reveal the HIFU beam waist, focus, heat deposition site and their evolution during sonications. The location of the maximum temperature spot is identified and traced as well as its displacements are visualized and characterized. The resulting images reveal the information, which is usually hidden on the traditional temperature maps.


Different frequency distributions models were fitted to the monthly data of raw water Turbidity at water treatment plants (WTPs) along Tigris River in Baghdad. Eight water treatment plants in Baghdad were selected, with raw water turbidity data for the period (2008-2014). The frequency distribution models used in this study are the Normal, Log-normal, Weibull, Exponential and two parameters Gamma type. The Kolmogorov-Smirnov test was used to evaluate the goodness of fit.  The data for years (2008-2011) were used for building the models. The best fitted distributions were Log-Normal (LN) for Al-Karkh, Al-Wathbah, Al-Qadisiya, Al-Dawrah and, Al-Rashid WTPs. Gamma distribution fitted well for East Tigris and Al-Karamah WTPs. As for Al-Wehda WTP Weibull distributions, was the best model. The best fitted distributions were used to forecast ten sets of monthly data for each plant that were compared with the observed data for years (2012-2014). The Kolmogorov-Smirnov test results indicated the capability of these models to produce data that has the same frequency distribution of the observed data. Moreover the frequency of occurrence of the observed and generated series in each plant indicated the capability of the model to produce results with frequency occurrence of probabilities of turbidity values > 50, 80, 100, 120, and 150 NTU.


Abstract The COVID-19 pandemic has forced all nations to take an active role in infection control incorporating recommendations and measures to control viral dissemination. The epidemiological impact is very diverse and dynamic, even within the same region. Scientific knowledge regarding SARS-CoV-2 continues to improve every day with protocols needing to be updated and adjusted on a regular basis. Ophthalmology is a medical specialty identified to be at high risk for several reasons: it has very close doctor-patient contact, the virus has been detected in tears, and the ocular surface serves as a gateway to developing the infection. We have reviewed the current information on SARS-CoV-2 in the ophthalmologic field and provide up-to-date recommendations to help create protocols that can adapt to the dynamic situation of ophthalmologic institutions, patient cases, economic situations and access to diagnostic tests. This paper outlines the main recommendations regarding the initial consultation and outpatient clinics, measures to apply in the operating room (OR), and suggestions for post-surgical controls. Triage, according to the patient's conditions and eye pathology, reduction of the time the patient is at the institution, social distancing, correct use of personal protective equipment (PPE), barrier methods, hygiene, as well as other recommendations mentioned in this document, will allow physicians to take care of the visual health of the patients while reducing the impact of the COVID-19 pandemic.


Abstract Given n items and m knapsacks, the Generalized Assignment Problem (GAP) is to find the optimum assignment of each item to exactly one knapsack, without exceeding the capacity of any knapsack. This problem can also be described as the optimal assignment of n jobs to m capacitated agents. During the last three decades, many papers have been published on the GAP. In this survey we mainly concentrate on its real-life applications in scheduling, timetabling, telecommunication, facility location, transportation, production planning, etc. We also mention some of the most recent solution approaches: from state-of-the-art metaheuristics to variable neighborhood search algorithms and from exact solution procedures to simple heuristic algorithms.


The use of a pressure exchanger, or wave rotor, in an air-cycle air conditioner is examined as an alternative to vapor-compression cycles which use chloroflourocarbons (CFC's), hydrochlorofluorocarbons (HCFC's) and hydrofluorocarbons (HFC's). In a pressure exchanger, expansion and normal shock waves are the mechanisms which transfer energy from a high pressure gas, by expanding it, to a low pressure gas, by compressing it. The device consists of a rotor which is divided into cells and a stator end-plate which controls inflow and outflow. A one-dimensional, homentropic unsteady numerical model was developed using the method of characteristics to simulate the flow through one cell. By entering the inlet and outlet pressures, the locations of the high pressure inlet and outlet ports and the low pressure inlet and outlet ports are calculated based on flow conditions. The mass flow rate through the system and the size of the rotor are also determined. Besides the pressure exchanger, an air-to-air heat exchanger and air compressor are necessary to develop an air conditioning cycle. These components can be arranged into six configurations of which two are superior to the rest. One configuration consists of the pressure exchanger and compressor working in parallel to raise room air to a higher pressure and temperature so that the heat can be transferred outside. In the other configuration, room air is compressed in stages, first by the pressure exchanger and then by the compressor with heat exchangers located after each compression stage. Six configurations of these components can provide cooling. Three involve expanding outside air below atmospheric pressure to absorb heat from the cooled space. These are not practical because of variability due to outside ambient humidity, high outlet temperatures for cool air to prevent frosting, and high volumetric flow rates of air. Of the three systems which compress room air to extract energy, the configuration with the pressure exchanger and compressor operating in parallel exhibited slightly better performance than the two configurations where the pressure exchanger and compressor compress the air in series.


The clock is ticking for the G20. Not a new actor on the international stage â?? it met for the first time in 1998, after the Asian and Russian defaults â?? the G20 has dramatically raised its profile recently, as a consequence of the financial crisis and the international recession. In its new format, the G20 summit of heads of state and government, it has taken the lead in coordinating the international response to the crisis, covering both macroeconomic policies and financial regulation, connecting inputs from the IMF and the Financial Stability Board. This enhanced role has generated expectations that must now be met, or its credibility â?? its existence perhaps â?? will be imperilled. As the global economy emerges from the deepestpost-war recession with a reform agenda still largely undefined, the next few months will be crucial.Success will not necessarily mean breaking through on all fronts or resolving all dissents; this would be unrealistic. What the G20 needs to do is to demonstrate its ability to bring home a few key changes in therules governing the international economy and financial system, based on a shared diagnosis of the status quo. Not a small task, admittedly, but in a highly interconnected and multipolar world economy only a formation with the global reach of the G20 can perform this role. While the stakes are global, they are of special relevance for Europe. The turmoil has demonstrated the stabilising influence that certain landmark European achievements, like the euro and the ECB, can have in times of instability. But it has also exposed fragilities in the European single market and more generally in the EU financial and institutional architecture. The crisis can help Europeans tackle important unresolved hurdles. An active presence in the G20 process can and should be part of a strategy to improve the European construction as well. At this defining moment for global cooperation, Bruegel has decided to open a new forum of discussion specifically dedicated to the G20. The G20 Monitor (G20M) will host comments by scholars affiliated withBruegel but will also be open to external contributors. It will accompany the institutional calendar by timing its contributions around the main G20 events, such as summits and ministerial meetings. The most proximate of such events is the meeting of G20 finance ministers and central bank governors scheduled for next Friday in Washington DC. Two issues top the agenda, not only of this meeting but of the whole joint Korean-Canadian G20 presidency. The first is macroeconomic policy coordination. At theirSeptember 2009 meeting in Pittsburgh, G20 leaders decided to launch a â??Framework for Strong, Sustainable and Balanced Growthâ??, a program of regular consultations and peer reviews aimed at making national macroeconomic policies consistent with balanced growth. In the leadersâ?? intentions, the consultations will establish, with technical support from the IMF, â??commonly agreed policies and objectivesâ?? capable of reducing the large and persistent external imbalances among the main economies and currency areas, notably the US and the emerging Asian bloc. Discussions have continued afterPittsburgh, so far without appreciable changes in the negotiating positions. In the meantime, new data and analyses (most recently by the ECB) have made increasingly clear that the narrowing of payment gaps observed during the recession is cyclical in nature; global imbalances willexpand again once global growth resumes its pace. These developments strengthen the conviction that policy action is necessary, but also open a number of questions. What are the chances that a consensus oncommon rules can be found, now that the sense of urgency and pressure to act stemming from the crisis is fading? Will the new framework pass its first test, that of engineering a coordinated exit from the currentextraordinarily accommodative policy stance? Will the rules and enforcement mechanisms in the different areas (fiscal, structural, etc.), be compatible with national objectives and legislatures? What statisticalindicators should the coordination exercise be based on? The second issue likely to feature prominently in the upcoming meetings, especially later this year, is financial reform. At their London and Pittsburgh meetings in 2009, G20 leaders delegated work in this area largely to the Financial Stability Board (FSB), the IMF and the Basel Committee on Bank Supervision (BCBS). Since then, national reform agendas have moved ahead: new structures for conducting systemic supervision are being set up in Europe, the US, and the UK. More technical discussions, on bank capital and other prudential requirements, pro-cyclicality, management incentives and internal controls, credit ratings, OTC derivatives markets, as well as reform of the international financial institutions, are ongoing in the FSB, the BCBS and the IMF; their results will come together later this year or shortly after. In this complex program of work, the challenge of the G20 is to coordinate national and internationalagendas, promoting consistency and speed and ensuring that no important aspects are missed. Importantly, the G20 is also the place where effective coordination among the new systemic supervisors should be ensured; this is an essential element still missing from the picture. As demonstrated by recentIMF analyses, a national or regional focus in setting capital and other prudential charges for systemically relevant institutions would produce biased results for the system as a whole. Systemic financial risk isinherently a global phenomenon, and so should the related policies be conducted. As in earlier years, the upcoming G20 agenda also includes other items, in addition to those directly related to post-crisis reform: climate change financing, energy policies, development goals, to name a few. Whileeach of them is valuable in itself and progress would be desirable, the focus on post-crisis reform should not be lost. In no way should advancement in these more peripheral areas be seen as a substitute for lack of progress on the core tasks. The G20 was brought in, at the peak of the turmoil, to provide a global policy response to the crisis and its consequences. It has unique characteristics to do so. Starting this Friday, ministers and leaders will have an opportunity to tilt the balance of the costs and benefits from the most dramatic post-war crisis more to the good side. It should not be missed.


Over the past decade, cellular immunotherapies such as CAR-T, TCR-T, and NK cell therapies have achieved tremendous success in cancer treatment. However, various challenges and obstacles remain, including antigen escape, immunosuppression in the tumor microenvironment, toxicities, and on-target off-tumor effects. Recent strategies for overcoming these roadblocks have included the use of genome engineering. Multiplexed CRISPR-Cas and synthetic biology approaches facilitate the development of cell therapies with higher potency and sophisticated modular control; they also offer a toolkit for allogeneic therapy development. Engineering approaches have targeted genetic modifications to enhance long-term persistence through cytokine modulation, knockout of genes mediating immunosuppressive signals, and genes such as the endogenous TCR and MHC-I that elicit adverse host-graft interactions in an allogeneic context. Genome engineering approaches for other immune cell types are also being explored, such as CAR macrophages and CAR-NK cells. Future therapeutic development of cellular immunotherapies may also be guided by novel target discovery through unbiased CRISPR genetic screening approaches.


Background . - Few data exist in Algeria on urolithiasis in general, and those of the child in particular. The purpose of this paper was to investigate the epidemiological characteristics of pediatric urolithiasis. Materials and methods . - This descriptive study of the transversal type aimed at 127 children (2 months - 17,5 years) with urolithiasis. Data were collected on sociodemographic parameters, clinical data, background, urinary parameters and stones. Results . - The sex ratio was 1.6 and the mean age was 6.4 years (2 months-17.5 years). 23.6% and 12.6% of children were respectively underweight and overweight. 74.8% came from urban boroughs, 65.4% had a mother with a low educational level. The consanguinity rate and family history of urolithiasis were 26.8% and 43.3% respectively, while 15.7% had recurrences. The main presenting symptoms were abdominal/flank pain (63%) and urinary tract infection (43.3%). 15.3% of stones were located in the bladder. Open surgery involved 36.1% of the stones and modern technics 5.6%. Urinary pH varied from 4.8 to 7.9, urinary density from 1000 to 1070 and urinary volume from 50 to 2000 ml/24h. Crystalluria was positive in 88.9% of the urines. Struvite, urinary infection index, was the most common component of stones with 28.3%, but was present in 47.8%. Calcium oxalate was found in 45.6% of stones (23.9% whewellite, 21.7% weddellite), followed by carbapatite and cystine in 8.7% each, urates in 6.5% and uric acid in 2.2%. Conclusion . - Urinary infection was the main etiology of urolithiasis in children.


Abstract
Balinese arts can be said one of the most important entities in the system of tourism industry in Bali. However, due to the business maximalization of the industry, the Balinese arts are commodified (getting a "commodification" , that is a process of excessive commoditization and commercialization for the sake of economic benefit). This study shows that, in terms if an aesthetic discourse, such a phenomenon is no longer relevant to be analyzed in a modern aesthetics but postmodern one.
It is said so since the modern one can not express unstability , irony, and chaos, which are really facts in the postmodern age. In fact, in the hand of tourism capitalization, the Balinese arts such as Barong Dance and Kecak Dance shown to the tourists semiotic forms of fun and not of meaning. By this, cultural tourism in Bali, including the two most popular dance shows, can be categorized a postmodern industry.


Submodular function maximization (SFM) has attracted much attention thanks to its applicability to various practical problems. Although most studies have considered SFM with size or budget constraints, more complex constraints often appear in practice. In this paper, we consider a very general class of SFM with such complex constraints (e.g., an s-t path constraint on a given graph). We propose a novel algorithm that takes advantage of zero-suppressed binary decision diagrams, which store all feasible solutions efficiently thus enabling us to circumvent the difficulty of determining feasibility. Theoretically, our algorithm is guaranteed to achieve (1-c)-approximations, where c is the curvature of a submodular function. Experiments show that our algorithm runs much faster than exact algorithms and finds better solutions than those obtained by an existing approximation algorithm in many instances. Notably, our algorithm achieves better than a 90%-approximation in all instances for which optimal values are available.


SuperWASP is a wide angle survey for transiting hot-Jupiter exoplanets around bright (V<13) solar-type stars. Lightcurves for millions of stars with a few thousand observations per star are available in the SuperWASP archive. We report the results of a search for periodic variable subdwarf stars in the data from the 2004 observing season. A Fourier transform of the SuperWASP lightcurve for Balloon 090100001 recovers the main pulsation frequency of this star. No new pulsators are found among the stars studied (about 200 objects). The binary sdB star HS 2333+3927 with a large reflection effect was recovered. We find that the hot subdwarf PG 1348+369 is variable with a period of 3.316days and a semi-amplitude of 13%. Follow-up spectroscopy shows that this variation is due to irradiation of a cool companion star in a binary system.


This thesis reviews two methodologies for process improvement; Six Sigma and the Shainin System. A strengthened methodology is developed following the 12-step Six Sigma DMAIC cycle with an added Shainin loop in the Analyse phase to narrow down sources of variation. This Hybrid Six Sigma framework is used to develop a sampling strategy known as the Process Variation Diagnostic Tool (PVDT).
The PVDT allows a Gage R&R and a Provisional Process Capability study to be carried out with just 20 samples. It also allows for an IsoplotSM and a Shainin Multi-Vari study. The method was then reviewed in three different industrial situations to demonstrate its effectiveness. Applying the PVDT allowed the project teams involved to quickly produce Gage R&R and Provisional Process Capability Studies. It reduced samples required from the combined 110 measurements from 60 products typically taken in industry to 60 measurements from 20 products. A significant advantage was the ability to extract a Shainin Multi-Vari Study from measurements taken for the PVDT. This technique allowed the project team the ability to categorise the most significant families of variation. From these case studies it can be seen that at the border of the Measure/Analyse phase in Six Sigma the proposed PVDT offers an efficient method of collecting Six Sigma metrics and steering the course of an improvement project.
A teaching vehicle known as the PIM game is introduced to demonstrate and facilitate the teaching of a number Process improvement Method. These methods are directly related to Six Sigma and Shainin methods developed in this thesis. The historical development and need for a teaching game are discussed.
Finally the thesis proposes a new method of destructive measurement system analysis (MSA). An industrial problem is used to benchmark the method against a traditional approach to destructive MSA. The project highlights when there is a second non-destructive test a conservative estimate of Gage R&R can be determined for destructive test equipment.


Developing writing skills has become a priority for many students in English as a foreign language (EFL) contexts. To this end, classroom practices should be facilitative of opportunities to communicate accurately and fluently in written and oral forms. Drawing on evidence which suggests that task repetition allows students to perform subsequent tasks more efficiently and accurately, the study examines the likely effect of procedural repetition with four narrative tasks (i.e. narrating stories in written form after watching short animated videos) on five EFL students' fluency and accuracy (AF). To do this, the levels of the students' AF were measured during the performance of each task. Moreover, qualitative data from questionnaires administered to the students after each task were also included to better understand the behavior of the AF levels in relation to their perceptions of the task performance and the familiarity with the content of the tasks. The evidence shows that the students' AF tended to progressively increase as weeks went by. The highest AF levels were found in the tasks where the content was familiar to the students. The opposite was observed when the students claimed not to be familiar with the content. The argument that we put forward in this article is that task (procedural) repetition may be beneficial for enhancing students' AF in writing task performance; however, if this practice combines with the students' lack of content familiarity, AF may engage in a dynamic interaction in which trade-off effects can be observed.


Precambrian-Cambrian Hantaishir ophiolite complex locates in the Altai region of the West Mongolia. The complex is approximately 50 km long and 12 km wide, and its entire configuration is elongated from northwest to southeast. The complex consists of two major massifs: they are Naran massif and Taishir massif. Although the massifs are continuous and no boundary is recognized, both consist of altered harzburgite and dunite with cumulated websterite, clinopyroxenite (Taishir massif) and gabbro with volcanic rocks. Pillow lavas are dominant both in the Naran and Taishir massifs. Sheeted dikes are also major rocks in both massifs, but they are apparently subordinate volcanics in the Taishir massif to the pillow lavas. Sheeted dikes of the Taishir massif consist of boninites, tholeiitic andesites and tholeiitic basaltic andesites. A small amount of the sheeted dikes of the Naran massif are solely tholeiitic andesite in composition. Both massifs are sandwiched in the large serpentinite melange.     The dominant ultramafic rock is harzburgite in the ophiolite complex and it is highly altered. Chromian spinel commonly remains as fresh mineral in the harzburgite, and they have similar composition to the chromian spinel in the harzburgite occurring in the other supra-subduction zone (SSZ) ophiolites. The mineral chemistries of rarely found highly magnesian olivine in the harzburgite and dunite are consistent with residual upper mantle origin in combination with the highly chromian spinel chemistry. The ultramafic body of the Hantaishir ophiolite could be formed in the mantle below the zone of plate collision.     The REE patterns of the gabbro and volcanic rocks of the Naran massif seem almost flat and significantly differ from those of the Taishir massif: both the tholeiitic andesites and boninites of the latter are substantially depleted in LREE. The spider diagrams for both massifs show clearly different patterns as well. No significant chemical difference between boninites and tholeiitic andesites from the Taishir massif was noticed as far as trace elements are concerned. The chemical characteristics of the boninite from the ophiolite are common to the modern boninites from the West Pacific island arcs excluding REE patterns: geochronologically recent boninites have U-shaped forms. On the basis of the discrimination diagrams, the gabbros and volcanic rocks from the Hantaishir ophiolite complex can be considered to have originated near plate margin.


We consider the evolutionary dynamics of a cooperative game on an adaptive network, where the strategies of agents (cooperation or defection) feed back on their local interaction topology. While mutual cooperation is the social optimum, unilateral defection yields a higher payoff and undermines the evolution of cooperation. Although no a priori advantage is given to cooperators, an intrinsic dynamical mechanism can lead asymptotically to a state of full cooperation. In finite systems, this state is characterized by long periods of strong cooperation interrupted by sudden episodes of predominant defection, suggesting a possible mechanism for the systemic failure of cooperation in real-world systems.


Discussions of N fertilizer needs for corn (Zea mays L.) usually are based on the assumption that economic optimum rates (EORs) of N provide the best benchmark to indicate the rates most likely to maximize profits for producers. We describe methods for calculating some additional benchmarks and illustrate how efforts to improve N management could be advanced by recognizing several alternative benchmarks simultaneously. We analyzed data from 54 small-plot trials with a new procedure that disaggregates problems associated with systematic model bias and variability in crop yield responses to fertilizer N. We compared the commonly used method for calculating EORs to a method that is described as discrete marginal analysis at near-optimal rates of N fertilization. We described methods for calculating the incremental break-even rate, the incremental rate that gives no crop response, and the incremental rate of N that gives the desired level of profit. Discussions of the relative merits of each benchmark suggest that problems associated with calculating and using the concept of EORs can be avoided by presenting the alternative benchmarks as proposed in this paper.


: Neuronal responses were studied in the nucleus isthmi area of Rana temporaria. The animals were immobilized by diplacine, a curare-like drug. Single neurons in this area had no background activity. After single-pulse electric stimulation of the contralateral optic nerve these neurons discharged as a rule with one action potential only, its minimal latency being 20-110 msc. The latencies decrease significantly when the stimulus intensities were increased from threshold to maximal, indicating development of summation process in the corresponding afferent pathway. Only 14 per cent (7 of 57) of neurons responded to stimuli exciting myelinated optic fibres and not exciting the ummyelinated ones. All the nucleus isthmi neurons discharged with unstable latency; this means that these neurons were excitated not antidromically. The functional role of nucleus isthmi in Anurans is discussed.


The Asian summer Monsoon circulation is driven by differential thermal heating, primarily associated with the localized latent heat release from enhanced precipitation over the India sub-continent. Although this heating is of limited zonal extent, it drives a time-averaged, upper level anticylone which is of global extent, extending from the western edge of the bulge of Africa, to the east of the Asian continent. The current theory (originally proposed by Gill (1980)) for explaining this zonally asymmetric component of the tropical circulation is unsatisfactory because it is based on the linear theory of damped equatorial waves while it is known that, at least for the upper level flow near the tropopause, the dynamics are strongly nonlinear. An alternative explanation, which is consistent with the nonlinear nature of the flows, involves the shedding of vortices from the directly forced monsoon anticyclone. The vortices, or eddies, are capable of drifting to the far field to establish a circulation which extends far beyond the local forcing. This thesis provides a dynamical explanation for the generation of eddies near the center of a divergent anticyclone, which, through their westward drift are responsible for the establishment of the global scale of the Asian summer Monsoon. The thesis consists of two parts, one numerical and one observational. The numerical study systematically investigates localized thermally driven circulations by using a shallow water model. This part of the thesis is theoretical in nature, and seeks to understand how non-axisymmetric elements such as a beta effect, or an external uniform flow, affects the dynamics of a divergent anticyclone for which, in the absence of non-axisymmetric elements, there exists an analytical axisymmetric solution. Control parameters which determine the dynamical regime of the flow are identified and explained. For the midlatitude beta plane experiment, the control parameter, pO, is the ratio between the free drift speed of an axisymmetric vortex on a beta plane, OL, and the strength of the forced localized divergent flow (ux) where L is the size of the axisymmetric circulation. For the uniform flow experiments, the control parameter is the strength of the uniform flow, Urn, and the divergent flow, ux. Each control parameter measures the relative importance of two competing effects, one which tries to displace the anticyclone westward (for the midlatitude beta plane experiments), or downstream (for the uniform flow experiments) and one tries to keep the forced vortex anchored. For each series of experiments, a critical value which separates the different long-time flow behavior is found. When the circulation is below the critical value, the circulation is persistent and localized. When the control parameter is above the critical parameter, a material filament with low potential vorticity is drawn from the divergent center, rolls up due to shear instability and is soon shed away by detaching itself from the main vortex. In the time-mean vorticity budget, the transient eddies have the effect of dissipating the time-mean flow. The dissipation effect by transient eddies can be grossly parameterized as a linear damping term in the linear version of the model. Another series of experiments, extending the midlatitude beta plane to the equatorial beta plane, with an equator within the reach of the forced perturbation, is conducted in which equatorial waves can be generated. The shedding behavior begins when the value of the control parameter is of order unity in the midlatitude beta plane experiments, and continues to exist for values of order 10 in the equatorial beta plane experiments. When the control parameter takes on values of order 100 and larger, the shedding behavior disappears and is replaced by linear wave solutions. In these experiments, another non-dimensional parameter (q), which measures the non-dimensional distance from the thermal forcing center to the equator, is found to affect the stability characteristics of the forced vortex. This series of experiments also allows equatorial waves to co-exist with the nonlinear vortex and to be excited by the broad thermal cooling, whose magnitude and location are determined by the internal dynamics of the nonlinear forced vortex. This linear part of the response is similar to the solution predicted by Gill (1980), but is of opposite sign, since it is the response to the resulting broad thermal cooling part of the thermal forcing, and not the small localized imposed thermal heating as Gill would have it. In the second part of the thesis, the theory is confirmed by discovering eddy shedding from the analysis of observational data. The potential vorticity on the isentropic surfaces are analyzed from 17 isobaric level NCEP-reanalysis data over the region of the Asian summer Monsoon. Two episodes of eddy shedding are found in July of 1990. The shedding events in the potential vorticity field are observed at the levels of isentropic surfaces from 360K to 380K. The induced geopotential perturbation penetrates deeper to 400 mb. The technique of Contour Advection with Surgery, a technique that allows to discriminate between adiabatic and diabatic effects, is used to recapture the shedding events, and confirm that the eddy shedding is indeed due to the essentially inviscid process identified in the idealized shallow water model. Thesis Supervisor: R. Alan Plumb Title: Professor in Atmospheric Sciences Notice Doctoral Dissertation Defense of Thesis entitled: Eddy Shedding from Non-axisymmetric, Divergent Anticyclones with Application to the Asian Monsoon Anticyclone by: C. Juno Hsu N6wJ7a, tL-us wIAr is rlmt souvo A&t ,' .5deD/v6VaRTEX~(


Visible-light-driven water splitting process is highly attractive for alternative energy utilization, while developing efficient, earth-abundant, and environmentally friendly photocatalysts for hydrogen evolution reaction has remained a major challenge. Herein, heterostructured photocatalysts composed of hollow N-doped TiO2 and g-C3N4 (N-TiO2/g-C3N4) were developed by an in situ impregnation calcination method. N-TiO2 and N-TiO2/g-C3N4 heterostructures with different ratios of N-TiO2 and g-C3N4 were synthesized by simply varying the amount of cyanamide (CY) as the g-C3N4 precursor. Using N-TiO2/g-C3N4 as a H2 evolution photocatalyst, the largest rate of 296.4 μmol g−1 h−1 was obtained under visible light irradiation (λ ≥ 420 nm) without any noble metal co-catalyst, which is 25.8 times larger than that of pure g-C3N4 (11.5 μmol g−1 h−1). Femtosecond time-resolved diffuse reflectance spectroscopy was used to evaluate the lifetime of photogenerated electrons and electron transfer dynamics in N-TiO2/g-C3N4. It is suggested that an additional decay pathway exists for the photogenerated electrons in N-TiO2/g-C3N4, in which N-TiO2 acts as an electron trapping site, leading to higher photocatalytic H2 evolution activity than pure g-C3N4. The present work not only provides a facile method for preparing doped materials and heterostructures with efficient photocatalytic activity, but also deepens the understanding of charge transfer dynamics in heterostructured photocatalysts.


The abrupt transformation of one-party Communist regimes into political systems holding competitive elections challenges theories of democracy by evolution. Part One develops an inter-active model of how the supply of parties by political elites shapes the responses of inexperienced electors, and what this means for the institutionalisation of party systems and party identification. The model is then applied to elections since 1990 in ten Central and East European democracies that are now members of the European Union. Part Two provides a definitive and up to date text of election results and the formation and disappearance of parties in these ten countries. In addition, there is a lengthy chapter on elections in Russia.


The process of modernization of European competition policy aims at rendering the action of the Commission more effective. One of the proposals put forward to this aim is to empower the Commission to adopt decisions accepting commitments offered by the undertakings in the course of the proceedings. The adoption of remedies is already provided by merger control law in the European Union and in many national antitrust legislations, notably in the United States. The analysis of the Commission's proposal in a comparative perspective tries to shed light on both its costs and benefits and provides the opportunity to discuss the role of alternative dispute resolution in antitrust matters.


Tip enhanced IR spectra and imaging have been widely used in cutting-edge studies for the in-depth understanding of the composition, structure and function of interfaces at the nanoscale. However, molecular monolayer sensitivity has only been demonstrated on solid/gas interfaces. In aqueous environment, the reduced sensitivity due to strong damping of the cantilever oscillation and background IR absorption extremely limits the practical applications of tip enhanced IR nanospectroscopy. Here, we demonstrate hypersensitive nanoscale IR spectra and imaging in aqueous environment with the combination of photoinduced force (PiF) microscopy and resonant antennas. The highly confined electromagnetic field inbetween the tip end and antenna extremely amplifies the photoinduced force to the detectable level, while the excitation via plasmon internal reflection mode minimizes the environmental absorption. A polydimethylsiloxane (PDMS) layer (~1-2 nm thickness) functionalized on the AFM tip has been successfully identified in water with antennas of different sizes. Sampling volume of ~604 chemical bonds from PDMS was demonstrated with sub-10 nm spatial resolution confirmed by electric (E) field distribution mapping on antennas, which strongly suggests the desired requirements for interfacial spectroscopy. This platform demonstrates for the first time the application of photoinduced force microscopy in aqueous environments, providing a brand-new configuration to achieve highly enhanced nanoscale IR signals, which is extremely promising for future research of interfaces and nanosystems in aqueous environments.


The geometric morphometric analysis of the shell of Caretta caretta hatchlings revealed that morphological variations may be related to incubation duration. Based on the overlapping of anatomical landmarks of the carapace and the plastron, it was possible to discriminate hatchlings from slow and fast developing clutches. Carapace and plastron of hatchlings from nests where incubation lasted less than 55 days are rounder as compared to the hatchlings from nests where incubation took 67 days. The differences observed in shell shape in terms of incubation duration were statistically significant, though carapace and plastron shape overlapping was observed in several individuals. Our results indicate that the incubation duration explains only a small part of the total variation in the shell shape as a whole. Yet, in spite of the low discriminant function coefficient, cross-validation tests indicated that 84.7% and 77.8% of the hatchlings were correctly categorised concerning the carapace and plastron, when the descriptive variable is incubation duration.


This article identifies a series of specific questions that reporters can ask about claims made by developers of automated motor vehicles ("AVs"). Its immediate intent is to facilitate more critical, credible, and ultimately constructive reporting on progress toward automated driving. In turn, reporting of this kind advances three additional goals. First, it encourages AV developers to qualify and support their public claims. Second, it appropriately manages public expectations about these vehicles. Third, it fosters more technical accuracy and technological circumspection in legal and policy scholarship.


Transportation infrastructure is a major source of stormwater runoff that can alter hydrology and contribute significant loading of nutrients, sediment, and other pollutants to surface waters. These increased loads can contribute to impairment of streams in developed areas and ultimately to Lake Champlain. In this study we selected six watersheds that represent a range of road types (gravel and paved) and road densities (rural, suburban, and urban) present in Chittenden County, one of the most developed areas in Vermont. The location and density of road networks were characterized and quantified for each watershed using GIS analysis. Monitoring stations in each watershed were constructed and instrumented to measure discharge and water quality parameters continuously from spring through early winter. Storm event composite samples and monthly water chemistry grab samples were collected and analyzed for total nutrients, chloride, and total suspended sediments. Results from this study show that road type and road density are closely linked with the level of impairment in each watershed. Total phosphorus and total nitrogen from storm event composite samples and monthly grab samples significantly increased along a gradient of increasing road network density. Chloride concentrations increased several orders of magnitude along this same gradient. With the exception of Alder brook where total suspended sediment (TSS) concentrations tended to be high, there were no significant differences in TSS concentrations between rural and developed watersheds. The event TSS concentrations in the rural streams were slightly higher than we expected and the event and base TSS concentrations in the developed streams were somewhat lower than we expected, suggesting that the unpaved roads in the rural watersheds might contribute to stormwater runoff loads and that sediment control, at least, in the developed watersheds might be fairly effective. The overall results from this study show that local roads are significant source of impairment for streams in the Chittenden County area. Most of these roads are municipal roads that are not under to management of the Vermont Agency of Transportation. Thus, local actions


The focus of this paper is to explore the recruitment process for board members, and board member choices in family firms in Sweden. It was found that the board member re- cruitment process is a field with low amount of research. This is the main argument upon the construction of this study. Previous research also argue that most family businesses are small, which increase the likelihood of finding firms without an active board, or with low professionalism in the board.Through a case study, four Swedish family firms were interviewed in order to identify the board composition, board governance and board recruitment process at these firms. The firms represent different sizes, sectors, and stages of growth, being a small company with two employees and SEK 1.7m annual revenue, to a large company with 1200 employees and SEK 8bn annual revenue. These companies were then analysed through both the agency theory, and the stewardship theory, using previous research as foundation and sup- port.The findings show that the most desired board member characteristic are knowledge within the sector the firm is operating in, as well as trustworthiness. All of the interviewed com- panies saw their board as more of a function to advise the family, rather than to monitor the managers, and having extensive knowledge from the sector is of relevance when giving advice. The members of these boards were recruited using the networks of the CEO, or us- ing consultancy firms to help finding potential members. Lack of trust was identified as a potential issue in board member recruitment, as the member will gain access to valuable in- formation. This led to the obstacle of letting external members in on the board. This ob- stacle, however, is recommended to be overseen as all CEO's that were interviewed em- phasized the benefits of recruiting external members to the board, arguing that the benefits of having external members in the board outweighs the potential costs.


Muscle pain is a common symptom associated with, for example, myofascial syndrome, fibromyalgia and polymyalgia rheumatica. Many diseases of the muscle tissue are, how -ever, completely or nearly painless such as polymyositis and inclusion body myositis. Thus, a mere inflammation cannot be the cause of muscle pain. In needle electromyog raphy (EMG), the insertion of a needle electrode causes pain but further advancement is usually painless. However, there are small spots of muscle tissue where sudden pain is elicited with the needle. In EMG, these 'active spots' are observed to produce spontane - ous activity in the form of end plate noise and spikes (EPSs). End plate noise is elicited at the neuromuscular junction of α, β or γ motor neuron. EPSs are action potentials of γ or β motor units. Muscle spindles are the main nociceptors in muscle tissue, both in healthy muscle and in diseases with muscle pain by inflammation of the muscle spindles. Multiple possible mechanisms of muscle pain exist. Polymyalgia rheumatica may have interstitial pain and possibly pain associated with muscle spindle capsules. Delayed onset muscle soreness may reflect both interstitial muscle pain caused by minor injuries and pain generated in mildly inflamed muscle spindles.


Diffuse alveolar damage (DAD), which represents the pathologic changes seen after acute lung injury, is caused by damage to all three layers of the alveolar wall and can ultimately result in alveolar collapse with loss of the normal pulmonary architecture. DAD has an acute phase that predominantly manifests as airspace disease at CT owing to filling of the alveoli with cells, plasma fluids, and hyaline membranes. DAD then evolves into a heterogeneous organizing phase, with mixed airspace and interstitial disease characterized by volume loss, architectural distortion, fibrosis, and parenchymal loss. Patients with DAD have a severe clinical course and typically require prolonged mechanical ventilation, which may result in ventilator-induced lung injury. In those patients who survive DAD, the lungs will remodel over time, but most will have residual findings at chest CT. Organizing pneumonia (OP) is a descriptive term for a histologic pattern characterized by intra-alveolar fibroblast plugs. The significance and pathogenesis of OP are controversial. Some authors regard it as part of a spectrum of acute lung injury, while others consider it a marker of acute or subacute lung injury. At CT, OP manifests with various forms of airspace disease that are most commonly bilateral and relatively homogeneous in appearance at individual time points. Patients with OP most often have a mild clinical course, although some may have residual findings at CT. In patients with DAD and OP, imaging findings can be combined with clinical information to suggest the diagnosis in many cases, with biopsy reserved for difficult cases with atypical findings or clinical manifestations. To best participate in the multidisciplinary approach to patients with lung injury, radiologists must not only recognize these entities but also describe them with consistent and meaningful terminology, examples of which are emphasized in the article. © RSNA, 2023 See the invited commentary by Kligerman et al in this issue. Quiz questions for this article are available in the supplemental material.


Abstract This qualitative case study examined Turkish middle school teachers' subject matter knowledge in terms of alternative solution methods that they propose to calculate the volume of prisms. The data was collected from four middle school teachers through the questionnaire, semi-structured interviews, and classroom observations. The results from the questionnaire revealed that the middle school teachers stated four alternative solution methods; volume formula, systematic counting, layer counting and column/row iteration. However, analyses of classroom observations showed that they only used the volume formula to calculate the volume of prisms in their lessons. Furthermore, it could be concluded that the variety of alternative solution methods changed with respect to the way that the researchers asked the questions even if all the questions were related to calculating the volume of prisms. More specifically, if the question was a little complicated and the teachers were not familiar with it, then the teachers focused on using the volume formula.


This study looks at the effects of silence as compared to two different types of music and one type of irrelevant speech to analyze the effects on an assessment of 4 categories of mathematical questions. The hypothesis tested was that students would perform best when subject to no distraction (silence), followed closely by non-verbal music (dubstep), while verbal music (Rap) and irrelevant self-speech (repeating the word 'za') would result in a decrease in performance. The hypothesis was not found to be statistically significant, but a general trend supporting the hypothesis was present and found to be consistent with similar research.


In this paper, an augmented simplex-lattice mixture design is used to fit a mathematical metamodel for predicting work in process in a flexible manufacturing cell. The average work in process is modeled as a response variable by varying the incoming percentages of different products. Computer simulation is utilized to run different experiments to obtain the required data for fitting the metamodel. The accuracy of the metamodel predictions warrant its use in place of the simulation model, thus eliminating the need for lengthy simulation runs and complicated output analysis. This work provides an example of the utility of mixture experiments in a discrete manufacturing environment.


Distributed applications and middleware services targeted for mobile devices must use device discovery service to provide any kind of service to other devices. Device discovery algorithms developed for wired networks are not suitable for mobile ad-hoc networks of pervasive computing environments. This research proposes a dependable device discovery mechanism for the middleware of the applications consisting of rapidly reconfiguring mobile devices. Our approach offers a comprehensive solution to potential problems that can arise in highly adaptive mobile ad-hoc networks of pervasive computing environments. The approach is robust enough to accommodate the device limitations and rapid changes in the resource strengths of each device in the network. We present three new device discovery algorithms in this paper: a window based broadcasting algorithm, a connectivity based dynamic algorithm, and a policy-based scalable algorithm. The algorithms vary in complexity and efficiency depending upon the pervasive computing applications. We identify the desirable dependability related characteristics of device discovery services and present how our algorithms realize those characteristics. Experimental results are presented to compare and contrast the algorithms.


Introduction As long as syndromic management of sexually transmitted infections (STI) remains the main model of care in low and middle income countries, diagnostic surveillance is essential for STI control, especially in high HIV incidence settings. Here, we present the baseline data from the CAPRISA 083 cohort study that was conducted in a large urban primary health care clinic in KwaZulu-Natal, South Africa. Methods Women aged 18–40 presenting for syndromic STI care at the facility were assessed for participation. HIV positive women (prevalence 39.1%), pregnant women (9.1%) or those engaging in sex work were excluded due to pre-determined eligibility criteria. Women consenting to the study completed a sexual risk questionnaire, were examined by a nurse, and underwent point-of-care testing for chlamydia and gonorrhoea (Xpert CT/NG), trichomonas (OSOM rapid test), and microscopy to assess for bacterial vaginosis (BV) and candida. Gonorrhoea cases were further investigated for antibiotic resistance. Results A total of 267 women, median age 23 (IQR 21–27), were enrolled and 88.4% reported to be symptomatic. All were sexually active and 75.7% stated that they used condoms with their partners, although only 3.7% used them consistently. 125 (46.8%) had abnormal pelvic examinations, including 106 (39.7%) women with vaginal discharge. STI testing revealed an 18.5% prevalence of chlamydia (20.5% in <25 year-olds), 5.2% gonorrhoea and 2.6% trichomonas. Two thirds of women (69.3%) had evidence of abnormal vaginal flora (33.7% BV and 35.6% intermediate flora) based on Nugent Score, and 17.6% were diagnosed with candida infection. A total of 52/267 (19.5%) reported symptoms, but had no STI or abnormal flora found. Of 9 specimen cultured for gonorrhoea resistance, 7 (77.7%) were resistant to penicillin and 4 (44.4%) to ciprofloxacin, but no cephalosporin resistance was identified. Conclusion In this high HIV incidence setting, the burden of chlamydia infection and abnormal vaginal flora was concernedly high, warranting enhanced STI management strategies at population level.
Support:
 This work was NIH-funded (AI116759). Cepheid loaned two 4-module Genexpert machines to the study team free-of-charge, but did not contribute to the preparation of this abstract