Abstract Previous work (Knee & Zuckerman, 1996) found that the combination of high autonomy and low control was associated with fewer self-enhancing attributions after success and fewer self-protective attributions after failure. The present research again found strong support for a synergistic effect of causality orientations on defensive behavior through a prospective examination of defensive coping strategies (e.g., denial, behavioral disengagement, and mental disengagement) and self-handicapping tendencies. Individuals who were high in autonomy and low in control engaged in less defensive coping strategies (particularly denial) and exhibited less self-handicapping compared to all other individuals. The present findings support the proposition that self-determined individuals are less defensive in their behavior compared to others. Implications for self-determination theory as well as the controversy over the relation between positive illusions and well-being are discussed.


We apply a new technique, multiseed stimulated rotational Raman scattering, to the wave-front control of Raman-converted light when the Raman gain–length product is large enough to produce significant conversion beyond the first-Stokes order. For rotational Raman scattering, such as that which dominates in atmospheric propagation, the polarizations of adjacent Stokes orders may be made circular and opposite in order to eliminate Stokes–anti-Stokes coupling and thereby minimize losses that are due to amplified noise. A parametric process that couples four distinct waves recursively generates a fourth wave when any three waves are incident. Thus at least two seeds (e.g., first and second Stokes) are necessary to start the process. Computer simulations then show that, within limitations imposed by diffraction and competition from noise, the wave fronts of higher-order Stokes fields are determined by those of the incident fields. Starting from a 250-nm laser and using subatmospheric H2 as a Raman medium, we generate multiple seeds with alternate polarization helicities on the S(1) rotational transition. Multiseed experiments showed that a good-beam-quality core was converted and amplified but that a poor-quality background beam was amplified as well. With the aid of computer simulations, we interpret this effect as resulting from the competition between seeded light and noise, the noise being favored by its buildup during the delay until the arrival of the leading edges of the seed pulses. The beam's additional loss of quality is attributable to the growth of aberrations from smaller aberrations and intensity variations that are present in the incident beams.


Background. Chronic systemic inflammation (CSI) is linked with pathogen-esis of chronic disease risk including type 2 diabetes, obesity, cardiovascular diseases and cancer. However, there is dearth of evidence to inform the stake-holders about the pooled effect of excessive sedentary behaviour or its interruptions, which may alter the CSI in adults. Our systematic review will aim to find the evidence behind the sedentary behaviour interventions on CSI. Methods. Five databases (Scopus, PubMed, Web of Science, Cochrane Central Register of Controlled Trials, Ovid Medline and CINAHL) will be searched for studies examining the influence of excessive sitting or its interruptions on CSI markers (Inter-leukin; C-Reactive Protein, Cytokines), its dose, gender differences and context specific settings. Studies that included healthy working, adult population will be examined by two independent reviewers. Results. The study quality will be assessed by QualSyst tool and Cochrane Risk of Bias tools using Revman 5.4. The mean effect size of the sitting interventions on CSI markers will be presented after exploring for potential publication bias. Appropriate visualisation of the effects of the outcome measures of interest will be assessed through Forrest plots to assess the direction, consistency and size of the intervention. Conclusions. Potential associations between excessive sitting and the effects of inter-ruption interventions on CSI will be explored after assessing the quality of the studies.


This thesis addresses an under-studied aspect of the stereoscopic photograph industry: the business and sales practices employed by American stereograph publishers at the dawn of the twentieth century, as exemplified by Keystone View Company. Stereographic sales practices are an essential element in understanding stereoscopy's ubiquity and place in American culture, but have been too frequently oversimplified or wholly overlooked in existing scholarship. Using concepts from business history, this thesis addresses the ways in which Keystone's structure and scale allowed it to function as a national and international entity, and examines the role of communication in the sale of photographs. Keystone's success hinged on the corporate communications between the company and its direct-selling sales agents, communication between sales agents and prospective consumers, and the communication between consumers and the company (both tacitly through purchase and directly through written praise of the products). Furthermore, this thesis considers the affective qualities and social claims of stereoscopy by proposing the role of aspiration as a motivating factor in the images' consumption. Aspiration was woven into the company's prescribed sales pitch, the character of the sales agents employed by Keystone, and in recommendations and testimonials from Keystone users. Consumers' emotional response to stereography, and especially the way that stereography was sold, served as a significant influence in the sales process. Successful sales were Keystone's motivation, and its business practices propelled the company's success, especially through corporate communication and framing stereographs aspirationally. This thesis concludes that the role of business practices in stereoscopic production contributes to the understanding of the cultural phenomenon of stereoscopy, and permits a more complete sense of the market in which these photographs circulated.


This research is performed for Royal Grolsch, the second largest brewery in the Netherlands. The beer market in the Netherlands is becoming more competitive with only 4 large breweries and a lot of small breweries. In this research we will focus on the competitors of Grolsch which are Heineken, AB Inbev and Bavaria. Because of increasing competitiveness, it is necessary for Grolsch to know with which products (and volumes) competitors earn the most money to better understand why the competition is focusing on specific products with their marketing strategies.
The main questions in this research are:
On which products and consumer segments does the competition of Grolsch focus and earn most profit?
How will this (the focus of competition on products and consumer segments) change in the future?
How does this impact Grolsch?
Revenue management is applicable in the beer industry, especially price based revenue management. Discounts are a tool for breweries to influence their prices. Discounts thus need to be taken into account in the profit and loss account and can be seen as the main instrument of breweries to influence their prices and thus profitability. For every brewery a profit and loss account (P&L) is constructed based on information of Grolsch and assumptions to adjust the information. The total brewery P&Ls are compared together and with Grolsch. Besides the total brewery P&L, product P&Ls are constructed for the four most important products per brand: returnable bottle 25/30 cl, can 33 cl, can 50 cl and the non returnable bottle 25 cl. Also the product P&Ls are compared with Grolsch. Then the marketing strategy of the competitors is examined by using a segmentation model based on the consumption moment of each brand.


High performance circuit design is becoming increasingly important in VLSI design. The most important problem faced in the design of these circuits is to meet a certain performance level. In the past few years CAD algorithms and tools have been well developed that improve the performance of logic circuits in the sense that the worst case delay is minimized. However, manufacturers recognize that worst case delay models are typically pessimistic and the manufactured ICs will have a range of performances reflecting the manufacturing variations. Thus, the real problem that needs to be solved in the performance optimization of these circuits is to maximize the percentage of fabricated circuits that will achieve a certain performance level, as opposed to minimizing the worst case delay which has been the focus thus far. We develop methods to improve the statistical timing behavior of a combinational logic circuit, given probability distributions for the gate and wire delays. This work uses a statistical timing analysis technique developed earlier to drive timing optimization in the right direction to achieve a prescribed goal with the least area overhead.<<ETX>>


The effect of heat treatment conditions such as atmosphere, temperature, annealing time and alloying elements on the hydrogen content in Al-Mg based alloys was investigated. The hydrogen content after annealing depends on the annealing atmospheres and alloying elements. When annealed in a wet atmosphere, the release of the hydrogen in the Al-Mg alloys to outside and the absorption of hydrogen from atmosphere into Al-Mg alloys are presumed to occur at the same time. The oxide layer on the surface is revealed to prevent the hydrogen from being released to outside. The spheroidal MgO particles can be seen on the surface of Al-Mg alloys after annealing at 550°C. The number of the MgO particles increases with increasing impurity elements such as Si and Fe, reducing the shielding effect against hydrogen permeration. Therefore, the condensation of hydrogen near the surface after annealing occurs more easily in an Al-Mg alloy of a high-purity than that of an ordinary purity.


In this paper we consider the rearrangeable multi-plane banyan-type switching fabrics, called also log2(N, 0, p) switching networks, with even number of stages. For such networks different rearranging algorithms have been proposed for both: one-at-a-time and simultaneous connection models. In this paper we consider the one-at-a-time connection model, where connections arrive to the system one-by-one, and in case of blocking rearrangements are realized. To our knowledge, known algorithms require several rearrangements, and the number of such rearrangements have not been considered in the literature. We propose the new rearranging algorithm for the multi-plane banyan-type switching fabric composed of even number of stages. This algorithm leads to success using only one rearrangement. We also introduce the modified version of this new algorithm, in which rearrangement of an existing connecting path can be realized without its interruption.


Small practices face unique challenges to improving quality of care. We conducted a pre-post-test of a quality improvement intervention provided by the Center for Practice Innovation (CPI) to 34 small internal medicine practices featuring two site visits, a practice assessment, self-selection of focus areas for improvement and ongoing 'directed guidance' of the practices. In bivariate analyses, the intervention was associated with statistical improvement in percent of patients with: controlled blood pressure for diabetic patients (68% vs. 77%); assessment of fall risk (78% vs. 93%); asthma patients on inhaled corticosteroid (91% vs. 100%); flu vaccine (86% vs. 97%); and pneumococcal vaccine (83% vs. 99%). Additionally, statistically significant improvements were noted in selected practice processes and patient satisfaction measures. However, clinician and staff assessments showed some negative changes. Quality improvement initiatives focused on small practices can improve clinical and patient satisfaction measures but may have risks for clinician and staff satisfaction.


Since chronic obstructive pulmonary disease (COPD) is becoming the 3rd death cause worldwide, modern approaches are expected; Precision medicine is seen as the right approach in COPD management. An interesting paradox can be seen in COPD, overweight and mild obesity being associated with improved survival rate and a slower decline in lung function, lowest mortality risk is seen at BMI ~ 30 kg/m2. Then, shall we treat obesity or not ? this is the dilemma. But these protective effects seems to be valide only under BMI < 32 kg/m2, not above. Further guidelines are expected for obesity and COPD approach. Prospective medical nutrition therapy in COPD should prioritize : adapted caloric intake for long term maintainance of a BMI below 30 kg/m2, muscle mass maintainance by proteic intake at 1,2 g/ kgb/day and right macronutrient percentage : proteins 15-20%, lipids 30-45 %, carbohydrates 40-55%. Mediteranean Diet, physical activity in line with body training performances and smoking cessation will accompany long term healthy lifestyle recommended for these patients. In conclusion, healthy lifestyle recommendations as part of a  pulmonary rehabilitation multidisciplinary intervention will lead to a healthy weight and better pulmonary outcomes.


This paper investigates the dependence of parameters of a stationary point process model on seasonal and spatial variability of rainfall. Twenty-four years of hourly rainfall data for two stations from the Arno River basin in central Italy have been used to estimate parameters for each month, assuming local stationarity within the month. The estimated model parameters are physically reasonable, vouching for the model's ability to capture the general temporal and spatial structure of rainfall events. Parameter sensitivity analysis provide useful guidelines for understanding the model structure and devising effective parameter estimation strategies.


Supplemental Digital Content is available in the text Objectives: Excessive alcohol use is a serious and growing public health problem. Alcoholic beverage sales in the United States increased greatly immediately after the stay-at-home orders and relaxing of alcohol restrictions associated with the COVID-19 pandemic. However, it is not known to what degree alcohol consumption changed. This study assesses differences in alcohol drinking patterns before and after the enactment of stay-at-home orders. Methods: In May 2020, a cross-sectional online survey of 993 individuals using a probability-based panel designed to be representative of the US population aged 21 and older was used to assess alcohol drinking patterns before (February, 2020) and after (April, 2020) the enactment of stay-at-home orders among those who consumed alcohol in February, 2020 (n = 555). Reported differences in alcohol consumption were computed, and associations between differences in consumption patterns and individual characteristics were examined. Results: Compared to February, respondents reported consuming more drinks per day in April (+29%, P < 0.001), and a greater proportion reported exceeding recommended drinking limits (+20%, P < 0.001) and binge drinking (+21%, P = 0.001) in April. These differences were found for all sociodemographic subgroups assessed. February to April differences in the proportion exceeding drinking limits were larger for women than men (P = 0.026) and for Black, non-Hispanic people than White, non-Hispanic people (P = 0.028). Conclusions: There is an association among the COVID-19 pandemic, the public health response to it, changes in alcohol policy, and alcohol consumption. Public health monitoring of alcohol consumption during the pandemic is warranted.


Recent advancements in data intensive computing for science discovery are fueling a dramatic growth in use of data-intensive iterative computations. The utility computing model introduced by cloud computing combined with the rich set of cloud infrastructure services offers a very attractive environment for scientists to perform such data intensive computations. The challenges to large scale distributed computations on clouds demand new computation frameworks that are specifically tailored for cloud characteristics in order to easily and effectively harness the power of clouds. Twister4Azure is a distributed decentralized iterative MapReduce runtime for Windows Azure Cloud. It extends the familiar, easy-to-use MapReduce programming model with iterative extensions, enabling a wide array of large-scale iterative data analysis for scientific applications on Azure cloud. This paper presents the applicability of Twister4Azure with highlighted features of fault-tolerance, efficiency and simplicity. We study three data-intensive applications - two iterative scientific applications, Multi-Dimensional Scaling and KMeans Clustering, one data - intensive pleasingly parallel scientific application, BLAST+ sequence searching. Performance measurements show comparable or a factor of 2 to 4 better results than the traditional MapReduce runtimes deployed on up to 256 instances and for jobs with tens of thousands of tasks.


This article reports upon research on vegan transition, which I bring into dialogue with Sara Ahmed's figure of the killjoy. Ahmed's work on affect and the feminist killjoy is found to be apt for considering contemporary vegans and their transgression of normative scripts of happiness and commensality in a dominant meat and dairy consuming culture. The decentring of joy and happiness is also found to be integral to the critical deconstructive work of the vegan killjoy. Ahmed's ideas further complement the frame of practice theory that I draw upon to understand the process of transition especially in the sense of opposing the meanings of dominant practices. Although food and veganism are not commented upon by Ahmed, the vegan subject constitutes, I argue, a potent further example of what she terms an "affect alien" who must willfully struggle against a dominant affective order and community. Drawing upon interviews with 40 vegans based in the UK, I illustrate examples of contestation and negotiation by vegans and those close to them. The article finds in the figure of the killjoy not only a frame by which to partly understand the negotiation of relationships between vegans and non-vegans but also an opportunity for further intersectional labour between veganism and feminism.


When the United States sought an order forcing Apple to write code that would break the iPhone password protection of one of the San Bernardino shooters, long-simmering questions of statutory interpretation, constitutional limitations, the privacy-security debate, and the architecture of the Internet were brought into relief. The government has found a way to break the phone without Apple's help, but this has only delayed answers to these persistent, wide-ranging questions.The short-term resolution of cases such as Apple's will likely depend upon courts' interpretation of the scope of the All Writs Act (AWA) in light of the Communications Assistance for Law Enforcement Act (CALEA). We believe that CALEA does not permit a court to issue the government's requested order against Apple.But law enforcement has legitimate investigatory needs that the AWA and CALEA hinder. Should, therefore, CALEA be amended? This is an important question because it goes to the very structure of both the Internet and the Internet of Things. For decades, society and the government have been debating the extent to which the government ought to shape and control digital activity. From the Clipper Chip in the 1990s and CARNIVORE in the early 2000s, to the questions of online surveillance and net neutrality today, the structure of the Internet and the Internet of Things has democratic, constitutional, public safety, public security, and business contours. On one level, the Apple case was about a few digits entered into one iPhone. But it also implicates multifaceted, large-scale structural questions.Our paper takes the following route. In Part One, we brief the Apple case, including amici's arguments, and place the case in the relevant context. In Part Two, we review the current reach and limitations of CALEA and consider how CALEA could be amended in light of law enforcement needs in the Apple case. In Part Three, we weigh the protection of personal privacy against the needs of law enforcement, as well as the diverging national security goals of fighting terrorism and protecting our digital infrastructure. We will also address the question whether it is too late anyway, as terrorists and other malfeasants increasingly use apps that leave no trace of earlier communications. Although a great deal of information is evanescent, the issue remains important for two reasons: people will still store valuable data on their smartphones, and they will use their phones as access points to cloud-stored data and Internet-equipped physical objects, such as home locks.Finally, in Part Four, we consider the impact of any CALEA amendment upon the structure of the Internet. If the government can compel Apple to build code to access an iPhone, then it is only a small step to requiring that Internet backbone providers build code to defeat encryption on a wide variety of communicative platforms. This would gradually bring about a restructuring of the Internet as we know it, and compromise the business plans of many companies. Whether this is a price worth paying is hard to say.


Prasugrel, a third generation P2Y12 receptor inhibitor, is more powerful than clopidogrel. TRITON-TIMI 38 trial compared the effectiveness of prasugrel with clopidogrel in patients with STEMI and NSTEMI. This paper examined the main TRITON-TIMI 38 trial and subgroup analyses of the trial to determine patient subgroups in which prasugrel is superior to clopidogrel in preventing clinical events without an additional increase in bleeding risk. In such patients, one might expect to derive optimal benefit from prasugrel without a significant increase in bleeding.


Live streaming is becoming increasingly popular. In a study published in January 2008, Cisco predicted that Internet-to-TV video will account for 30% of all Internet traffic. If all kinds of video traffic are considered, then it will be 90% of consumer traffic by 2012. We distinguish live streams from on demand streams. Live streams are sent as the data is being generated, is typically of long duration, requires high bandwidth and associated with flash crowd behavior. As such, live streams place tremendous demand on network resources.
In this thesis, we proposed network techniques to improve packet latencies of live streams in wired networks. In particular, we made the following contributions. First, we proposed a technique that allows multicasting at the access network, the proverbial last mile which presents tremendous bandwidth limitations. Second, we reduced nodal processing by a tunneling scheme based on source routing. Essentially, using routing computed at source and a novel network encoding scheme, we eliminated intermediate processing. Third, we presented a queueing algorithm that schedules packets based on application deadlines, reduces the number of sorting iterations, thereby improving performance, has low complexity, exhibits good fairness and provides a bounded delay for a single packet that is independent of the number of flows. Finally, we proposed a variation of QoS routing that works with only partial network state information.


: Localization of bacteria in mammalian gastrointestinal tracts by electron microscopy has yielded much information on our understanding of intimate host-microbial interactions, but because of difficulties in obtaining human tissue, the human host-microbial interactions have not been well studied. In this report, an attempt was made to ascertain the feasibility of using gastrointestinal tissues obtained at autopsy. A rat model was used to produce samples that would simulate conditions that autopsy samples might undergo. Rats, left at room temperature for 1 hr and then refrigerated at 2C for time intervals up to 24 hours after death were autopsied and samples from the stomach, ileum and cecum were removed and processed for light and scanning microscopy. Tissues were fixed in buffered glutaraldehyde, postfixed in buffered osmium tetroxide, dehydrated in an ethanol series, critical point dried, coated with gold-palladium and examined. Keratinized murine stomachs showed little or no changes in the localization of the gram-positive layer of bacteria over 24 hours. However, major changes were noted in the ileum and colon with the ileum showing the most dislocation of the flora. Colonic tissues were altered by invading bacteria although some regions had a relatively normal appearing host-flora relationship. Slow cooling rates of the gastrointestinal tracts were implicated as a major cause for alterations in bacterial localization. The data predict that studies of normal microbial location with human autopsy samples will be best pursued on keratinized tissue.


The inclusive top quark pair ($t\bar{t}$) production cross-section $\sigma_{t\bar{t}}$ has been measured in proton-proton collisions at $\sqrt{s}=13$ TeV, using $36.1$ fb$^{-1}$ of data collected in 2015-16 by the ATLAS experiment at the LHC. Using events with an opposite-charge $e\mu$ pair and $b$-tagged jets, the cross-section is measured to be: \begin{equation}\nonumber \sigma_{t\bar{t}} = 826.4 \pm 3.6\,\mathrm{(stat)}\ \pm 11.5\,\mathrm{(syst)}\ \pm 15.7\,\mathrm{(lumi)}\ \pm 1.9\,\mathrm{(beam)}\,\mathrm{pb}, \end{equation} where the uncertainties are due to data statistics, experimental and theoretical systematic effects, the integrated luminosity, and the LHC beam energy, giving a total uncertainty of 2.4%. The result is consistent with theoretical QCD calculations. It is used to determine the top quark pole mass via the dependence of the predicted cross-section on $m_t^{\mathrm{pole}}$, giving $m_t^{\mathrm{pole}}=173.1^{+2.0}_{-2.1}$ GeV. It is also combined with measurements at $\sqrt{s}=7$ TeV and $\sqrt{s}=8$ TeV to derive ratios and double ratios of $t\bar{t}$ and $Z$ cross-sections at different energies. The same event sample is used to measure absolute and normalised differential cross-sections as functions of single-lepton and dilepton kinematic variables, and the results compared with predictions from various Monte Carlo event generators.


Previous work has demonstrated that, in single, paced left ventricular (LV) myocytes isolated from rats with hypertension, the extent of myocyte shortening and the amplitude of the cytosolic Ca2+ concentration transient are decreased relative to normal myocytes. These findings suggest that reduced sarcoplasmic reticular (SR) Ca2+ release could be responsible for hypertension-induced attenuation of the myocyte contractile response. Hypertension-induced reductions in SR Ca2+ release could be due to 1) a decrease in releasable SR Ca2+ content relative to the sarcoplasmic volume into which it is released or 2) alterations in the SR Ca2+ release mechanism such that the fractional release of SR Ca2+ is reduced. Using rapid cooling contractures (RCCs) to provide an index of SR Ca2+ content, we conducted a series of experiments designed to test the former hypothesis. Single LV myocytes were isolated from normotensive control rats and from rats with hypertension, which was induced by abdominal aortic banding (for approximately 4 mo). The extent of myocyte shortening during an RCC is taken to be directly proportional to SR Ca2+ content. As expected, the amplitudes of both twitches and RCCs decreased as pacing frequency increased from 0.2 to 1.0 Hz across both control and hypertensive groups, although the effect was greatest in control myocytes. A significant finding of this study was that, at both pacing frequencies, RCC magnitude was attenuated in hypertensive relative to control myocytes. These results suggest that in hypertension cellular Ca2+ homeostasis is altered and there is a mismatch between releasable SR Ca2+ content and the sarcoplasmic volume into which it is released.


Open Access has become a major mechanism whereby the returns to public investment in research are maximized. Initially, the information technology revolution resulted in new dysfunctions and inequalities of scholarly communication, such as large price differences among publishers and journals; widespread usage limitations and re-use restrictions based on copyright; or systemic manipulation based on unmerited co-authorship, undue delays in peer review, and even outright fraud. Open Access mitigates or resolves these dysfunction and inequalities because a it provides fair returns to all stakeholders; b offers unlimited access and efficient usage; c enhances quality safeguards i.e. transparent processes including easier detection of plagiarism and fraud; and d enables free sharing and re-use e.g. CC-BY license.


In the past few years, higher-order community detection has drawn an increasing amount of attention. Compared with the lower-order approaches that rely on the connectivity pattern of individual nodes and edges, the higher-order approaches discover communities by leveraging the higher-order connectivity pattern via constructing a motif-based hypergraph. Despite success in capturing the building blocks of complex networks, recent study has shown that the higher-order approaches unavoidably suffer from the hypergraph fragmentation issue. Although an edge enhancement strategy has been designed previously to address this issue, adding additional edges may corrupt the original lower-order connectivity pattern. To this end, this paper defines a new problem of community detection, namely hybrid-order community detection, which aims to discover communities by simultaneously leveraging the lower-order connectivity pattern and the higherorder connectivity pattern. For addressing this new problem, a new Micro-unit Modularity (MuMod) approach is designed. The basic idea lies in constructing a micro-unit connection network, where both of the lower-order connectivity pattern and the higher-order connectivity pattern are utilized. And then a new micro-unit modularity model is proposed for generating the micro-unit groups, from which the overlapping community structure of the original network can be derived. Extensive experiments are conducted on five real-world networks. Comparison results with twelve existing approaches confirm the effectiveness of the proposed method.


ABSTRACT From the Trump administration's attempts to narrow down the definition of gender to biologically determined sex at birth to the everyday life gendered performances in digital platforms, from increasing representations of LGBTQI+ in TV programmes to the popularity of PornHub, the relations between gender, sexuality and media are ubiquitous and deeply embedded in everyday life. This Special Issue of Information, Communication and Society draws together cutting-edge contributions on the themes of Gender and Sexuality and Media. Showcasing the work of experienced and internationally renowned scholars and some less experienced but no less relevant voices of emerging scholars. The research upon which the contributions are based analyse media both in terms of representation and agency exploring media texts and the practices of media production and consumption. The special issue provides an accessible and enjoyable, discussion of many of the major themes pertinent to differing uses of digital and other media related to the field of Gender and Sexuality. Investigating nuances of contemporary sex and gender scripts as they are played out in popular media and challenging the heteronormative and sexist performances often encountered. It offers insights upon both 'traditional' and digital media and in some cases illustrates how those two have morphed making it sometimes difficult to clearly define boundaries between the traditional and the digital.


: The ability of apiosomes for the formation of non-contractile stems (such as epistylids) and colonies suggests to refer them to the family Epistylidae rather than to Scyphididae. On the other hand, the atrophy of the stem in the majority of the species, changes in the structure of the foot, in the form and position of the nuclei under the effect of parasitism on fishes suggest their separation into a distinct subfamily, Apiosomatinae subfam. n.


Background: Human immunodeficiency virus (HIV) infection remains a major health problem since discovery of the virus in 1981 Globally, since the introduction of antiretroviral therapy in 1996, acquired immunodeficiency syndrome (AIDS) related deaths fell by more than 25% between 2005 and 2011. HIV related opportunistic illnesses (OIs) are less common, especially with the use of prophylaxis. This study aims to assess the incidence of HIV infection and related OIs in Qatar over a 17-year period. Methods: This is a retrospective cohort study of all HIV infected patients registered in Qatar from 2000-2016. Incidence of HIV infection and related OIs were calculated per 100,000 population. Demographic and clinical characteristics were compared between two groups of patients with and without OIs. Results: In 167 cases with HIV infection, 54 (32.3%) had OIs. The average incidence rate of HIV infection over 16 years is 0.69 per 100,000 population, and the incidence rate for OIs is 0.27 per 100,000 population (Figure 1). The most common OIs is pneumocystis jirovecii pneumonia (PCP), seen in 25% of cases, followed by cytomegalovirus (CMV) retinitis with 7.2%, tuberculosis 5.4%, toxoplasmosis 4.2%, and less than 2% for Kaposi sarcoma and cryptococcal infection. The treatment outcome of cases with OIs was: cure in 59.3%, failure in 3.7%. Mortality within 3 months of OIs was 3.7%, whereas 33.4% accounted for loss to follow up after starting the treatment due to patients leaving the country. Most patients in both groups were young males. The CD4 lymphocyte count and percentage (CD4%), CD4/CD8 ratio and viral load were statistically significant risk factors in cases with OIs (p < 0.05). Presence of comorbidities was lower in patients with OIs (p = 0.032). Conclusion: Qatar has a low prevalence rate for HIV infection and related opportunistic illness. Early diagnosis and use of antiretroviral therapy are important measures to decrease the rate of opportunistic illness.


The purpose of this study was to determine the sensitivity, specificity, and positive predictive value of non-contrast-enhanced helical CT as the primary imaging modality for the evaluation of patients with acute flank pain at the University of Wisconsin. A retrospective review of 163 computed tomography (CT) examinations, dating from 3/4/97 to 3/25/98, was performed. Statistical calculations were performed using only clinically-confirmed data. Sixty-five true positives, 3 false positives, 64 true negatives, and 1 false negative yield a sensitivity of 98.5%, a specificity of 95.5%, and a positive predictive value of 95.6%. A timely diagnosis of non-genitourinary system pathology occurred in 7% of cases, improving the overall efficacy of this modality for the evaluation of flank pain. The University of Wisconsin experience confirms the accuracy and efficacy of using non-contrast-enhanced helical CT in the diagnosis of a suspected obstructing ureteral calculus. The highly accurate and timely diagnosis of an obstructing ureteral calculus, or of extraurinary tract pathology, establishes non-contrast-enhanced helical CT as the diagnostic study of choice for the evaluation of the patient with acute flank pain.


A thermally fusible softwood lignin was directly isolated by a solvolysis of cedar wood chips with a mixture of polyethylene glycol 400 (PEG 400) and sulfuric acid. Its fusibility was found to be due to a PEG moiety introduced into the lignin by the solvolysis. The lignin was easily formed into fibers by melt-spinning at temperatures ranging from 145 to 172 °C without any modification. The lignin fibers could be converted into infusible fibers as a precursor for carbon fibers (CFs) by conventional oxidative thermal stabilization processing in air or a stream of oxygen for 2 days. We found that the infusible fibers resulted from the partial cleavage of the PEG moiety from the lignin fibers after treatment with 6 M hydrochloric acid at 100 °C for 2 h. The infusible fibers were converted into CFs with a tensile strength of 450 MPa by carbonization at 1000 °C under a N2 stream.


The paper investigates the impact of the Common Agricultural Policy (CAP) subsidies on farm total factor productivity (TFP) in the European Union (EU). We employ a structural semi-parametric estimation algorithm directly incorporating the effect of subsidies into a model of unobserved productivity. We empirically study the effects using the Farm Accountancy Data Network (FADN) samples for the EU-15 countries. Our main findings are clear: subsidies impact negatively on farm productivity in the period before the decoupling reform was implemented; after decoupling the effect of subsidies on productivity is more nuanced and in several countries it turned positive.


We use a data set of Football Bowl Subdivision (Division-IA) universities to investigate the hypothesis that higher coach pay leads to improved team performance. Our analysis finds that pay and team performance are positively correlated and that, when schools change coaches, higher pay is associated with improved performance. The evidence suggests that additional rating points are increasingly valuable, perhaps over US$1 million for top teams. Our descriptive analysis reveals the median 2011 head coach pay of US$1.2 million, significant increases over our 2006-2011 study period, and large disparities among schools and conferences. We conclude that administrators perceive highly ranked football teams have significant value.


Three hundred and fifty second trimester amniocenteses performed for prenatal diagnosis of genetic disorders are reported. One hundred and ninety-three of these were performed because maternal age was greater than 35 years, and 6 fetuses with unbalanced chromosomal abnormalities (3%) were identified. Thirteen procedures were performed because a previous child had had a neural tube defect; 1 anencephalic fetus was identified. Ninety-six percent of the initial taps were cultured successfully; we failed to obtain amniotic fluid in 3% of patients. The risk of a spontaneous abortion occurring at some time after the amniocentesis was 0.85%, and no cases of fetal injury were identified.


A firm's business model is critical to gain and maintain a competitive advantage, which means that it is critical to the firm's profitability. The success of a firm's business model depends on the type of value that it offers customers, the type of customers to which it offers, the range of products or services, how it prices products or services, the types of revenue sources, the connected activities that create customer value, the capabilities, and the strategies used to maintain firm's competitive advantage. In designing and implementing a business model, a firm's competitive advantage depends on how it utilizes factors that make the internet impact on the industry. A business model includes values provided, a segmented market, a product or service provided in the segmented market, activities for providing values and capability of performing business activities. This research reviews components of a business model that affect performance of a firm. In this research we present a practical method for building and practicing a business model by analyzing how these elements of a business model are affected by the internet.


Turtles are species that lived on earth since millions of years ago, and are capable of annual migration, within thousands of kilometres between feeding areas and laying places. The current condition of turtles in Indonesia is threatened with extinction due to the uncontrollable exploitation of turtles and eggs. It is caused by greedy human behaviour. Turtles are protected by the Law of the Republic of Indonesia number 31 of 2004, although sea turtle conservation programme have been encouraged by the recent discovery of important new nestling beaches. The method used for future turtle management opportunities for habitat restoration governance is to use descriptive analysis. The current turtle management analysis was conducted with a literature review of various field and laboratory studies at the representative sites assessed for Indonesia. The results showed that turtle populations experienced a decline caused by turtle slaughter and harvesting of turtle eggs that led to turtle extinction. Therefore, it is necessary to manage the habitat of turtle habitat restoration which not only covers the technical aspect of captive breeding, but also covers the aspect of perfection of laws and regulations, economic and institutional aspects and community participation.


Background. The aim of our study was to evaluate Vilnius and Vilnius Region women's knowledge about sexual intercourse during pregnancy.
Materials and methods. The study included 94 women who were in the Center Affiliate of VUH Santariskiu Clinics after delivery. The women were interviewed using a questionnaire. They were divided in three groups by levels of education.
Results. The study showed that 83% of pregnant women had sexual intercourse during pregnancy. 55.1% had coitus several times a month. The first trimester was the most frequent period of sexual intercourse (52.6%). 22.6% of pregnant women were at high risk of miscarriage and 61.9% of them have had sexual intercourse. The frequency of miscarriage in the sexually active group was 17.9% and in the non-active group it was 50% (p < 0.05). All women who reported frequent sexual intercourse were not at threat for miscarriage compared to incidence of miscarriage of those 13 (22%) women who reported infrequent intercourse (p = 0.019). 79.8% of pregnant women were concerned about the adverse effects of sexual intercourse on pregnancy outcomes. 20.2% of the women thought that intercourse during pregnancy was safe. 63.8% of pregnant women were not asked by doctors during pregnancy about their sexual life.
Conclusions. The majority (79.8%) of pregnant women were concerned about the adverse effects of sexual intercourse on pregnancy outcomes but even 83% of pregnant women had sexual intercourse during pregnancy. There were no statistical differences between women with different education level. Pregnant women were rarely asked by doctors about their sexual life.


The world's energy demand is continuously increasing. Non-renewable energy sources, such as petroleum and coal, are extremely limited. On the other hand, conversion efficiency of renewable energy sources into useful forms is insufficient. In our study, we pursued methods to make more efficient solar cells – in particular, photo-electrochemical (PEC) solar cells. We selected the Molybdenum diselenide (MoSe2) based PEC solar cell because of its high resistance to corrosion. First, we explored the relationship between light intensity and efficiency of PEC solar cells. We expected that corrosion of the PEC solar cell would increase with increase in intensity of incident light. Thus, we hypothesized that the efficiency of the solar cell would decrease with increased intensity of incident light. Further, we investigated the relationship between solar cell efficiency and electrolyte volume. We hypothesized that efficiency of PEC solar cell would increase as the electrolyte volume increased. We analyzed several parameters— such as light intensity, fill factor, efficiency, etc.—to draw conclusions. First, we found that percentage efficiency of PEC solar cell was proportional to (light intensity)-0.9. Further analysis showed that PEC solar cell performance was positively influenced by increasing the electrolyte volume. Data revealed that this increase in solar cell performance was more consequential at low intensities of light (around 10 mW/cm2). Our study could contribute to improving the quality of PEC solar cells and might help in the development of carbon-free hydrogen economy.


Transformations process in the agriculture of the West Balkans countries implied land reform and reconstruction of the agricultural holdings, rather privatization of the agricultural land and transformation of the agricultural structure. That process has had considerable influence on development performances of the agriculture – trend of production and labor and land productivity. Characteristics of the transition period in those countries are decrease of agricultural production and land productivity, and stagnation labor productivity, similarly in the other central and eastern European countries in transition.


Two known and two new ortho-phenyl phosphonium-sulfonate compounds have been synthesized and analyzed in solution and in the solid state. When the phosphonium moiety bears alkyl substituents, two rotamers are in equilibrium in solution. These two rotamers have been entirely characterized and are shown to differ by the spatial arrangement of the phosphonium proton relative to the sulfonate moiety. The phosphonium proton chemical shift and the 1JPH coupling constant are characteristic values for each rotamer. The kinetic and thermodynamic constants have been determined by means of NMR and DFT studies.


Efficient and effective text retrieval techniques are critical in managing the increasing amount of textual information available in electronic form. Yet text retrieval is a daunting task because it is difficult to extract the semantics of natural language texts. Many problems must be resolved before natural language processing techniques can be effectively applied to a large collection of texts. Most existing text retrieval techniques rely on indexing keywords. Unfortunately, keywords or index terms alone cannot adequately capture the document contents, resulting in poor retrieval performance. Yet keyword indexing is widely used in commercial systems because it is still the most viable way by far to process large amounts of text. Using several simplifications of the vector-space model for text retrieval queries, the authors seek the optimal balance between processing efficiency and retrieval effectiveness as expressed in relevant document rankings.


Public administrators' perceptions of public engagement in local government
This article is an empirical study of the attitudes of public administrators toward public engagement. Currently there is a gap in the research on the attitudes of senior public servants who are important gate-keepers for the implementation of public engagement policies. This article contributes to filling this gap in the research by using interviews with senior public servants in a Finnish municipality. The study reveals that the administrators positively value citizens and their participation. However, there are differing views concerning the relationships between the new models of civic participation and the traditional models of planning and decision-making. The results indicate that there is an ongoing cultural change within the administration. The main factors that undermine the realization of public engagement policy can be divided into legislative, organizational, individual and cultural capacities.


Impure public goods, like environmentally-friendly and socially-responsible products, have garnered sustained interest. However, existing research on impure public goods focuses on individual consumer decision-making and Nash equilibrium outcomes; little has been done to analyze how policy can improve e ciency in such markets. We develop a cost sharing mechanism to implement a Pareto optimal allocation in impure public good markets. We prove the existence of the cost sharing solution and conditions for uniqueness. We also elucidate the e ciency and comparative static properties of the resulting equilibrium. Our analysis has many applications, ranging from renewable energy to international environmental protection.


Drought events cause changes in ecosystem function and structure by reducing the shrub abundance and expanding the biological soil crusts (biocrusts). This change increases the leakage of nutrient resources and water into the river streams in semi-arid areas. A common management solution for decreasing this loss of resources is to create a runoff-harvesting system (RHS). The objective of the current research is to apply geo-information techniques, including remote sensing and geographic information systems (GIS), on the watershed scale, to monitor and analyze the spatial and temporal changes in response to drought of two source-sink systems, the natural shrubland and the human-made RHSs in the semi-arid area of the northern Negev Desert, Israel. This was done by evaluating the changes in soil, vegetation and landscape cover. The spatial changes were evaluated by three spectral indices: Normalized Difference Vegetation Index (NDVI), Crust Index (CI) and landscape classification change between 2003 and 2010. In addition, we examined the effects of environmental factors on NDVI, CI and their clustering after successive drought years. The results show that vegetation cover indicates a negative ∆NDVI change due to a reduction in the abundance of woody vegetation. On the other hand, the soil cover change data indicate a positive ∆CI change due to the expansion of the biocrusts. These two trends are evidence for degradation processes in terms of resource conservation and bio-production. A considerable part of the changed area (39%) represents transitions between redistribution processes of resources, such as water, sediments, nutrients and seeds, on the watershed scale. In the pre-drought period, resource redistribution mainly occurred on the slope scale, while in the post-drought period, resource redistribution occurred on the whole watershed scale. However, the RHS management is effective in reducing leakage, since these systems are located on the slopes where the magnitude of runoff pulses is low.


hypertension. Studies using different antihypertensive regimens after renal ablation in rats have shown that comparable reductions in systemic blood pressure provide similar protection against glomerulosclerosis irrespective of the effect on glomerular pressure and hyperfiltration.3 Considerable protection against glomerulosclerosis is also provided by inhibition of thromboxane synthesis4 or treatment with heparin,5 in each case without affecting hyperfiltration or glomerular hypertension. The effect of heparin is independent of its anticoagulant properties as similar protection can be achieved with a low molecular weight nonanticoagulant form of the molecule.9 Increases in mesangial cell number and mesangial matrix production are prominent features in progressive glomerulosclerosis: heparin is a potent inhibitor of mesangial cell proliferation and matrix production in vitro, and again this effect can be reproduced with the non-anticoagulant form of the molecule.7 A further area of recent research is the role of peptide growth factors in the adaptation to loss of renal mass. Intrarenal production of insulin-like growth factor type 1 increases after contralateral nephrectomy,5 and this growth factor has mitogenic effects on renal cells in vitro.9 Other growth factors, such as platelet derived growth factor, have potent mitogenic effects on mesangial cells in vitro,"' but their role in vivo has yet to be characterised. Current attempts at intervention in progressive chronic renal failure have been designed on the basis of the hyperfiltration hypothesis. The deficiencies of the hypothesis may partly explain the relative lack of success of such attempts. It is to be hoped that recent advances in understanding the cellular mechanisms underlying progressive glomerulosclerosis may lead to the development of more rational and therefore more effective treatments.


Introduction In the pursuit of achieving the Sustainable Development Goal targets of universal health coverage and reducing maternal mortality, many countries in sub-Saharan Africa have implemented health insurance policies over the last two decades. Given that there is a paucity of empirical literature at the sub-regional level, we examined the prevalence and factors associated with health insurance coverage among women in in sub-Saharan Africa. Materials and methods We analysed cross-sectional data of 307,611 reproductive-aged women from the most recent demographic and health surveys of 24 sub-Saharan African countries. Bivariable and multivariable analyses were performed using chi-square test of independence and multi-level logistic regression respectively. Results are presented as adjusted Odds Ratios (aOR) for the multilevel logistic regression analysis. Statistical significance was set at p<0.05. Results The overall coverage of health insurance was 8.5%, with cross-country variations. The lowest coverage was recorded in Chad (0.9%) and the highest in Ghana (62.4%). Individual-level factors significantly associated with health insurance coverage included age, place of residence, level of formal education, frequency of reading newspaper/magazine and watching television. Wealth status and place of residence were the contextual factors significantly associated with health insurance coverage. Women with no formal education were 78% less likely to be covered by health insurance (aOR = 0.22, 95% CI = 0.21–0.24), compared with those who had higher education. Urban women, however, had higher odds of being covered by health insurance, compared with those in the rural areas [aOR = 1.20, 95%CI = 1.15–1.25]. Conclusion We found an overall relatively low prevalence of health insurance coverage among women of reproductive age in sub-Saharan Africa. As sub-Saharan African countries work toward achieving the Sustainable Development Goal targets of universal health coverage and lowering maternal mortality to less than 70 deaths per 100,000 live births, it is important that countries with low coverage of health insurance among women of reproductive age integrate measures such as free maternal healthcare into their respective development plans. Interventions aimed at expanding health insurance coverage should be directed at younger women of reproductive age, rural women, and women who do not read newspapers/magazines or watch television.


Chloride attacks concrete structures becoming a primary factor that deteriorates the durability of concrete structures. For this reason, research has been conducted on chloride ion penetration and diffusion. This research produced an accurate durability life prediction through reliability assessments and proposes a prediction method for the chloride ion diffusion coefficient of a concrete applied assessment program for reliability. As a result, test materials were fabricated using different admixtures and chloride ion diffusion coefficient was calculated by applying an RCPT test at each equivalent age. Based on these results, reliability prediction formulas were indicated through the reliability analysis for a durability life design using a Montecarlo method. In addition, propriety was verified through comparisons and analysis using the proposed formula with the investigated data for chloride ion diffusion.


1. The relative importance of excretory routes in the removal of recently stored 67Cu following tetrathiomolybdate (TTM) administration was studied. Lambs fed on either 5 mg Cu/kg dry matter (DM) or 35 mg Cu/kg DM, were primed intravenously (iv) with 67Cu and challenged 27 h later with 99Mo-labelled TTM given either iv or intraduodenally (id). The profiles of 67Cu and 99Mo and of Cu and Mo in blood, bile, urine and faeces were measured. 2. Level of dietary Cu and route of administration of 99Mo-TTM affected the amplitude of blood, bile and urine profiles of 67Cu and stable Cu, but not the pattern of the responses observed. 3. The present study describes for the first time increased excretion of endogenous 67Cu through gastrointestinal secretions other than bile due to TTM administration. 4. Administration of TTM resulted in the immediate release of 67Cu from storage compartments in the body into the blood circulation. Changes in stable Cu levels in blood, bile, urine and faeces, and gut and systemic effects were evident. Biliary and urinary Cu excretion due to TTM was rapid and maximal within 24 h of injection. 5. Administration of 67Cu iv resulted in the immediate excretion of 67Cu in bile in a pulsatile, constant pattern. A similar pattern of 67Cu excretion into bile in synchrony with that of 99Mo was observed after 99Mo-labelled TTM administration. 6. The similar pattern of biliary 67Cu excretion observed after injection of 67Cu and after injection of 99Mo-labelled TTM 27 h later is discussed in relation to the times required to process the Cu through different hepatic pathways for excretion in bile.


Based on the research of Life Ring in Shen Fu, the basic criteria for structural design of the unconventional rigid mega-structure linked with the ground are proposed in this paper. Through the structure comparison and selection, the space steel truss is used as the optimal structure form. After static analysis and time-history analysis by FEM, it is found that the control load case is the combination of dead weight and wind load. Because of its long vibration period, the structure is not sensitive during an earthquake. The key design of the structure is the selection of foundation form, a mixed-foundation made of steel trusses with piles is proposed in this paper. The steel truss is used as a bridge which transmits forces between superstructure and foundation. At last, the pile foundation is classified by the loading mechanism, the analysis and design of key joints in the mixed-foundation is proposed.


The engineering education and research sectors are interlinked, and there exists a need within both for readily deployable low-cost systems. Smartphones are affordable and easy to use technology available to almost everyone. Images or video frames taken with smartphone cameras, of structures subjected to loadings, can be analyzed to measure structural deformations. Such applications are very useful for university students and researchers when performing tests in laboratory environments. This paper investigates the feasibility of using smartphone technologies to measure structural deformation in the laboratory environment. Images and videos collected while structures are subjected to static, dynamic, and quasi-static loadings are analyzed with freeware and proprietary software. This study demonstrates capabilities of smartphone technologies, when coupled with suitable image processing software, for providing accurate information about structural deformations. Smartphones and open source software are affordable and available in comparison to professional cameras and proprietary software. The technology can be further developed to be used in real world environments to monitor deformation of engineering structures.


This article analyzes the effect of savings-related policies on labor supply in a model that explicitly incorporates myopic decision-making. Both social security and capital taxation may cause labor supply to rise or fall when individuals are myopic, depending on the curvature of individuals' utility as a function of consumption. Moreover, whatever is the sign of these effects under one assumption about how myopia relates to labor supply decisions, the sign is reversed under the other assumption that is considered. Additionally, some interventions have a first-order effect on labor supply from the outset but others do not, and some labor supply effects rise with the magnitude of the intervention whereas others fall.


This manuscript presents a method of downscaling climate model data, using an algorithm, with objective to create high-resolution global monthly climatology for precipitation and temperature for the period of last 21000 years. The manuscript consists of description of the method, evaluation of obtained results and an example of potential use of created high-resolution climate data set in paleo-ecology to detect refugia of plant species at the end.


The focus of the study has been on students' conceptions of learning in three South African Technikons amidst the changing circumstances of teaching and learning from subject-based to outcomes-based education. First-year students face a particular measure of unpreparedness as they graduate from a conventional high school teaching methodology to an OBE methodology in the Technikon. It is for this reason that this study concentrated more on the advanced students as it has been assumed that they had greater interaction with the OBE format of teaching and learning. This article will describe the results obtained in a survey that used the ASSIST instrument. The Approaches to Study Skills Inventory for Students (ASSIST) has been developed as a simplification but a strengthening of the Approaches to Study Inventory (ASI) as developed by Tait, Entwistle and McCune (1998). The ASSIST was administered to 377 Technikon students (N=377) at three different Technikons in South Africa. The purpose of the study was to determine to which extent students pursue deep, strategic or surface apathetic learning approaches within a changing teaching and learning environment with the aim of establishing best practice. The findings seem to suggest that methods of assessment, direction given by lecturers and relevance of learning material are key factors in enhancing deep approaches to learning.

(South African Journal of Higher Education: 2003 17 (3): 178-183)


Both sulfur and fluorine play important roles in organic synthesis, the life science, and materials science. The direct incorporation of these elements into organic scaffolds with precise control of the oxidation states of sulfur moieties is of great significance. Herein, we report the highly selective electrochemical vicinal fluorosulfenylation and fluorosulfoxidation reactions of alkenes, which were enabled by the unique ability of electrochemistry to dial in the potentials on demand. Preliminary mechanistic investigations revealed that the fluorosulfenylation reaction proceeded through a radical-polar crossover mechanism involving a key episulfonium ion intermediate. Subsequent electrochemical oxidation of fluorosulfides to fluorosulfoxides were readily achieved under a higher applied potential with the adventitious H2O in the reaction mixture.


Introduction
 Almost all neoplasms have their prognosis determined by cytogenetic and molecular factors, which determines a tailored approach for each case. According to the World Health Organization, every case of Acute Lymphoblastic Leukemia (ALL) must be classified not only immunophenotypically but also from a genetic point of view. Over the last few years, it has been recognized the differences in incidence and genetic profile of ALL from Latin America (LA). In Brazil, a large country with a distinctive ethnical background when compared to the rest of LA, few reports on ALL have been published and there is a limited availability of genetic tests for classification, especially in public health service.
 Objective
 To describe cytogenetic (karyotype and fluorescence in situ hybridization, FISH), molecular markers and World Health Organization (WHO) -2016 classification of diagnostic samples sent to two reference centers in Brazil.
 Material and Methods
 This is a cross-sectional study involving patients diagnosed with ALL from January 2014 to May 2018. Diagnostic bone marrow specimens were analyzed by G band conventional karyotyping (Nomenclature according International System for Human Cytogenomic 2016) (n: 157), molecular markers [(genic fusions by RT-PCR - BCR-ABL1 (n: 96), TCF3-PBX1 (n: 77), ETV6-RUNX1 (n: 83), KMT2A-AFF (n:74)] and B-ALL multi-probe FISH (n:54) were employed according to manufacturer's recommendations and following international guidelines. It was attempted to classify all cases by WHO-2016, as well as by age. Samples with no metaphases, non-conclusive or without molecular tests were considered non-classifiable
 Results
 Samples from 157 ALL patients at diagnosis were analyzed. Median age was 8 years old (1 month - 88 years) [6 (3.8%) cases had less than 12 months; 99 (63%) between 1 to 15 years; 22 (14%) between 16 and 39 years and 30 (19.1%) older than 40 years]. The majority were B cell lineage ALL (93%). Thirty cases were excluded due to missing immunophenotyping, karyotype and/or molecular studies. Alterations were detected in 94 (74%) of 127 cases [88 (76%)/116 in B-ALL and 6 (54%)/11 in T-ALL. It was possible to classify by WHO 2016 B-ALL subtypes 116 cases, all of them stratified by age groups (Graphic 1).
 Conclusion
 Our results are consistent with the literature, showing that KMT2A rearrangement predominates in infant ALL, while a pediatric age range from 1 to 15 years old, with a predominance of good prognostic subtypes: hyperdiploidy and ETV6-RUNX1. In adults, there is predominance of the BCR-ABL1 subtype, which seems to be more frequent than non-Latin cohorts. B-ALL NOS was detected in 27.8% of the cases, predominating in the age group of 16 to 39 years, which may correspond to Ph-like ALL, a recently described subtype linked to a worse prognosis and seemingly more common in latinos.
 Figure. Figure.

 No relevant conflicts of interest to declare.


Background Extrapulmonary manifestations including cardiac dysfunction have been demonstrated in children with respiratory syncytial virus (RSV) infection requiring intensive care. The aim of this study was to examine cardiac function in hospitalized children with moderate RSV infection admitted to a regular pediatric ward. Methods We used echocardiography to determine cardiac output, and right and left ventricular function in 26 patients (aged 2 weeks to 24 months) with RSV infection. The echocardiographic results were compared with s-troponin, the need for supplementary oxygen or noninvasive respiratory support, and capillary refill time. Results The number of measured s-troponins (ten [38%] of the included children) was too low to assess differences between children with elevated levels and those with normal levels. There were no differences in cardiac function between patients receiving oxygen treatment or respiratory support and those who did not. Capillary refill time did not correlate with any of the echocardiographic parameters. Both left and right ventricular output (mL/kg/min) was higher than published reference values. All other echocardiographic parameters were within the reference range. Conclusion Children with moderate RSV infection had an increased left and right ventricular output, and cardiac function was well maintained. We conclude that routine cardiac ultrasound is not warranted in children with moderate RSV infection. The role of an elevated s-troponin in these patients remains to be determined.


Peatlands, which account for approximately 15% of land surface across the arctic and boreal regions of the globe, are experiencing a range of ecological impacts as a result of climate change. Factors that include altered hydrology resulting from drought and permafrost thaw, rising temperatures, and elevated levels of atmospheric carbon dioxide have been shown to cause plant community compositional changes. Shifts in plant composition affect the productivity, species diversity, and carbon cycling of peatlands. We used hyperspectral remote sensing to characterize the response of boreal peatland plant composition and species diversity to warming, hydrologic change, and elevated CO2. Hyperspectral remote sensing techniques offer the ability to complete landscape-scale analyses of ecological responses to climate disturbance when paired with plot-level measurements that link ecosystem biophysical properties with spectral reflectance signatures. Working within two large ecosystem manipulation experiments, we examined climate controls on composition and diversity in two types of common boreal peatlands: a nutrient rich fen located at the Alaska Peatland Experiment (APEX) in central Alaska, and an ombrotrophic bog located in northern Minnesota at the Spruce and Peatland Responses Under Changing Environments (SPRUCE) experiment. We found a strong effect of plant functional cover on spectral reflectance characteristics. We also found a positive relationship between species diversity and spectral variation at the APEX field site, which is consistent with other recently published findings. Based on the results of our field study, we performed a supervised land cover classification analysis on an aerial hyperspectral dataset to map peatland plant functional types (PFTs) across an area encompassing a range of different plant communities. Our results underscore recent advances in the application of remote sensing measurements to ecological research, particularly in far northern ecosystems.


or region of the country to provide evervnmember of its community with skilled service in time of illness o; accident, whether that service is in the field of anaesthesia, of medicine, of pathology, of surgery, of radiology, or of obstetrics. Stuch an ideal can only be attained in the case of anaesthesia when three conditions have been satisfied: (a) the specialtv has been recognized as one requiring postgraduate study; (b) there are schools where stuch study can be pLirsued under expert sLupervision : and (c) anaesthetist services have been organized in such a way that every member of the community can have as much confidence in his anaesthetist as he has in his surgeon--and, mav I add, each surgeon has as much confidence in his anaesthetist as in himself! Lord Nuffield estahlished the first Universitv Chair and department of anaesthetics in this country in the hope that this branch of medicine woulld soon receive its legitimate share of public and professional recognition. The department over which Professor Macintosh presides will continue to give admirable postgraduate training to qualified practitioners who desire to specialize in anaesthesia, but other departments of the same kind are necessary to meet the demands of the country as a whole. In Lord Nuffield's Provincial Hospitals TruLst there is the seed of a regional organization under which the public may be assured of competent anaesthetization and the anaesthetist of the recognition as well as of the wAage he deserves.-I am, etc.,


We live in a time of unprecedented social, economic, technological and environmental problems and desperately are in need of change and improvement in many different areas on a global scale. Present education systems are fundamentally based on Verbal/Linguistic and Mathematical/Logical Intelligences, defined as IQ, and as a result focus mainly on the functions of the left brain. These systems aim at acquiring similar skills and passing the courses and as a result provide advantages to those who already have an advanced level of these intelligences in their profiles of intelligences. Since these systems assess individuals via standardized and centrally performed tests, they never help individuals to question, to think, be creative, take risks and think critically. The answer to all these concerns is entrepreneurial teaching and teachers. Entrepreneurial teaching which takes individual differences into account and is based on alternative assessment systems has the power to be the ultimate solution to overcome present obstacles of education systems. Entrepreneurial teaching implemented by entrepreneurial teachers has a potential power to help the world create economic growth, jobs, innovation and raise happy citizens capable of finding solutions for many long-lasting and ever-growing global issues in all sectors. This paper focuses on explaining how individual differences and alternative assessment techniques could be used by entrepreneurial teachers to implement entrepreneurial teaching.


Background Sinus tachycardia during exercise attenuates ST‐segment elevation in patients with Brugada syndrome, whereas ST‐segment augmentation after an exercise test is a high‐risk sign. Some patients have premature ventricular contractions (PVCs) related to exercise, but the significance of exercise‐related PVCs in patients with Brugada syndrome is still unknown. The objective of this study was to determine the significance of exercise‐related PVCs for predicting occurrence of ventricular fibrillation (VF) in patients with Brugada syndrome. Methods and Results The subjects were 307 patients with Brugada syndrome who performed a treadmill exercise test. We evaluated the occurrence of PVCs at rest, during exercise and at the peak of exercise, and during recovery after exercise (0–5 minutes). We followed the patients for 92±68 months and evaluated the occurrence of VF. PVCs occurred in 82 patients (27%) at the time of treadmill exercise test: PVCs appeared at rest in 14 patients (4%), during exercise in 60 patients (20%), immediately after exercise (0–1.5 minutes) in 28 patients (9%), early after exercise (1.5–3 minutes) in 18 patients (6%), and late after exercise (3–5 minutes) in 12 patients (4%). Thirty patients experienced VF during follow‐up. Multivariable analysis including symptoms, spontaneous type 1 ECG, and PVCs in the early recovery phase showed that these factors were independently associated with VF events during follow‐up. Conclusions PVCs early after an exercise test are associated with future occurrence of VF events. Rebound of vagal nerve activity at the early recovery phase would promote ST‐segment augmentation and PVCs in high‐risk patients with Brugada syndrome.


This is an unusual book that comes at a time when emergency medicine is acquiring an identity of its own. Nearly 500 pages in length, it is copiously and well illustrated. Its narrative consists of cogent but not overly brief discussions of the radiologic diagnosis of trauma and acute illness. The illustrations are of high quality and the legends are informative. The book is organized into 14 chapters: "Skull," "Face," "Spine," "Shoulder," "Elbow," "Hand and Wrist," "Chest," "Abdomen," "Kidneys and Ureters," "Pelvis and Hips," "Knee," "Ankle," "Foot and Heel," and the "Diaphyses." Each chapter concludes with a list of well-chosen references. The major portion of the book deals with traumatic injury to the skeletal system. It illustrates not only the common but also the more subtle manifestations of injury and indicates the roentgenographic means of demonstrating them. All of the chapters deal not only with trauma but also delve into


The natural resistance of cattle to infection with Mycobacterium paratuberculsis in relation to their immunological reactions is recorded. In vivo and in vitro manifestations of cell-mediated immunity during infection are reviewed, together with the antibody responses. It is suggested that three distinct immunological states may arise following exposure to infection.


The relationship between perinatal factors and lung function or development of asthma has been studied for decades and we have increasing evidence for the importance of early life factors for respiratory health in adulthood [1]. Pregnancies in adolescent and older women have implications for maternal and child health. The topic is relevant at present, as first-birth rates for women aged >35 years have increased exponentially [2]. A number of studies showed an association between maternal age and respiratory symptoms and asthma in childhood, suggesting that lung development might differ between children born to very young or very old mothers [3]. However, the evidence for longer lasting effects is scarce. Adjusting for residual confounding when studying perinatal factors and offspring health can be difficult but it is very important for designing future studies http://ow.ly/H78y30kPxMZ


Recent studies have been done to achieve biomedical alloys containing non-toxic elements and presenting low elastic moduli. It has been reported that Ti-Nb-Zr alloys rich in beta phase, especially Ti-13Nb-13Zr, have potential characteristics for substituting conventional materials such as Ti-6Al-4V, stainless steel and Co alloys. The aim of this work is to study the internal friction (IF) of Ti-13Nb-13Zr (TNZ) alloy due to the importance of the absorption impacts in orthopedic applications. The internal friction of this alloy produced by arc melting was measured using an inverted torsion pendulum with the free decay method. The measurements were performed from 77 to 700 K with heating rate of 1 K/min, in a vacuum better than 10-5 mBar. The results show a relaxation structure at high temperature strongly dependent on microstructure of the material. Qualitative discussions are presented for the experimental results, and the possibility of using the TNZ as a high damping material is briefly mentioned.


This study of 12 patients with mild-to-moderate hypertriglyceridemia compares the mechanisms of triglyceride (TG) lowering by caloric restriction and by clofibrate. Turnover rates of very low density lipoprotein triglycerides (VLDL-TG) were determined by using 3H-glycerol as a precursor. Radioactivity-time curves of VLDL-TG were analyzed with a multicompartmental model. Hypertriglyceridemia in these patients was due mainly to overproduction of VLDL-TG. Clofibrate therapy for 1 month had a variable effect on VLDL-TG levels. A group of relatively poor responders to the drug had a mild increase in the fractional catabolic rate (FCR) of VLDL-TG, but no change in production rates. The remaining patients were relatively good responders; they had increased FCR and modest reductions in synthetic rates of VLDL-TG. However, clofibrate largely failed to correct the primary defect in this group of patients, namely, the overproduction of VLDL-TG. Almost all patients responded to 1 month of caloric restriction (1000 cal/day) with marked reductions in VLDL-TG levels. The major response to reduced caloric intake was a decrease in production of VLDL-TG, although FCR was also increased to some extent. Despite these differences in mechanisms for VLDL-TG lowering, both regimens tended to raise levels of LDL and HDL.


Abstract This paper introduces the concept of identity dynamics to evolutionary economic analysis. The extant literature on the economics of identity is reviewed and integrated into the micro- meso-macro model of evolutionary economic analysis. This model of identity dynamics serves to both generalise extant concern with the economics of identity as well as to integrate and develop broader psychological, social science and humanities models of identity in the context of open-system evolution as a contribution to cultural science.


After mixing HZSM-5 single crystals and solid t-stilbene, micro Raman mapping and micro fluorescence emission imaging provide evidence of the adsorption, spontaneous ionization and diffusion of the guest into the pores of zeolite. The experiments provide evidence of both radical cation and subsequent charge transfer complexes (CTC). Using a set of excitation wavelengths, Raman spectra of different charge separated states (CSS) were identified by taking advantage of the resonance effect; the correct assignment of the species stabilized in the single crystal is confirmed by analysis of the reference CSS stabilized in powder samples. This assignment is also supported by the correlation of fluorescence emission images obtained for single crystals at different excitation wavelengths and the fluorescence excitation-emission matrix (EEM) plots obtained for the powder reference samples. Thanks to complementary fluorescence and Raman imaging techniques, the spatial distribution of the CSS was found to be mainly located at the tips and in the intergrowth after long times of contact which are correlated with high loading rates. Unusual Al zoning at the crystal extremities and higher polarity in the sinusoidal pores might be put forward to explain these features.


Knowledge of how income varies with age on average, and the extent to which individual trajectories differ from an average profile, is relevant to many aspects of social policymaking. A modelling framework is developed for describing income-age trajectories that is useful for summarizing not only the average profile for a group of individuals with similar characteristics, but also how individual trajectories differ from the group average. Using data from waves 1-17 of the British Household Panel Survey, the model is estimated separately for twelve groups of individuals differentiated in terms of educational qualifications, birth cohort and sex. The results indicate significant differences in the shapes of average trajectories across groups, and substantial variations in trajectories across individuals within groups.


Independence and integrity in research are prerequisites for objective and ethically responsible research. At the same time, image promotion plays a significant role in many contemporary organisations, and this might influence how research is carried out and presented. The article suggests that organisational branding is significant to understand the conditions in which researchers conduct and present critical research on powerful organisations. In this article we explore what prevents researchers from challenging the police's brand and how researchers can act when their results do so. The results are based on several sources of data, such as field notes, public records, media statements, research reports and interviews with researchers who have presented critical research.


Background: Much congenital and intracranial pathology may affect optic nerve (ON) and caused increased or decreased in size, so the measurement is crucial and aiding in diagnosed of some neurogenic and endocrine disorders. The aim of this study was to measure the normal ON length and diameter by magnetic resonance imaging among pediatric at Khartoum state Sudan.Methods: This was descriptive, cross section study,  done in 100 Sudanese pediatrics with age from 1 month to 15 years came to Magnetic resonance imaging (MRI) department for MRI brain at three hospitals in Khartoum state  (Al-Amal national hospital, Al-Zaitona hospital and Modern Medical Center) during the period from December 2019 to March 2020, all of patients had no pathological or medical condition that may affect the orbits and optic nerve (OON), any child with and medical condition or pathology related to orbits excluded from study sampling. The data were collected by data collection sheet designed especially for this study then analyzed.Results: The study found that the mean diameter of ON was 2.06±0.44 mm, the mean length of right ON was 31.54±4.11 mm, there is no significant different in measurement between males and females (p>0.05), there was strong significant correlation between ON length and diameter with children age (r=0.592**, 0.654**, p<0.001 respectively).Conclusions: The study concluded that there was strong correlation between right and left ON diameter and length with age.


Renewable energy sources; which are abundant in nature and climate friendly are the only preferable choice of the world to provide green energy. The limitation of most renewable energy sources specifically wind and solar PV is its intermittent nature which are depend on wind speed and solar irradiance respectively and this leads to power fluctuations. To compensate and protect sensitive loads from being affected by the power distribution side fluctuations and faults, dynamic voltage restorer (DVR) is commonly used. This research work attempts to withstand and secure the effect of voltage fluctuation of grid connected hybrid PV-wind power system. To do so battery and super magnetic energy storage (SMES) based DVR is used as a compensating device in case of voltage sag condition. The compensation method used is a pre-sag compensation which locks the instantaneous real time three phase voltage magnitude and angle in normal condition at the point of common coupling (PCC) and stores independently so that during a disturbance it used for compensation. Symmetrical and asymmetrical voltage sags scenario are considered and compensation is carried out using Power System Computer Aided Design or Electro Magnetic Transient Design and Control (PSCAD/EMTDC) software.


. Dynamical Systems theory is a valuable tool in the profound study of Cosmology, as qualitative methods allow to characterize cosmological solutions on the basis of their relevant physical features (e.g. stability and asymptotic be-haviour). Here we briefly review some well established results for cosmological models in the framework of General Relativity. Then we consider a family of modified cosmological models which are gaining more and more relevance, namely Loop Quantum Cosmologies. In particular we analyze the geometrical structure and dynamical properties of the model presented in earlier.


Market implementation of active and intelligent packaging (AIP) technologies specifically for fiber-based food packaging can be hindered by various factors. This paper highlights those from a social, economic, environmental, and legislative point of view, and elaborates upon the following aspects mainly related to interactions among food packaging value chain stakeholders: (i) market drivers that affect developments, (ii) the gap between science and industry, (iii) the gap between legislation and practice, (iv) cooperation between the producing stakeholders within the value chain, and (v) the gap between the industry and consumers. We perceive these as the most influential aspects in successful market implementation at a socioeconomic level. The findings are supported by results from quantitative studies analyzing consumer buying expectations about active and intelligent packaging (value perception of packaging functions, intentions to purchase AIP, and willingness to pay more) executed in 16 European countries. Finally, in this paper, we discuss approaches that could direct future activities in the field towards industrial implementation.


Introduction
Previous studies showed that over the course of learning many neurons in the medial prefrontal cortex adapt their firing rate towards the options with highest predicted value reward but it was showed that during later learning trials the brain switches to a more automatic processing mode governed by the basal ganglia. Based on this evidence, we hypothesized that during the early learning trials the predicted values of chosen options will be coded by a goal directed system in the medial frontal cortex but during the late trials the predicted values will be coded by the habitual learning system in the dorsal striatum.

Methods
In this study, using a 3 Tesla functional magnetic resonance imaging scanner (fMRI), blood oxygen level dependent signal (BOLD) data was collected whilst participants (N=12) performed a reinforcement learning task. The task consisted of instrumental conditioning trials wherein each trial a participant choose one of the two available options in order to win or avoid losing money. In addition to that, depending on the experimental condition, participants received either monetary reward (gain money), monetary penalty (lose money) or neural outcome.

Results
Using model-based analysis for functional magnetic resonance imaging (fMRI) event related designs; region of interest (ROI) analysis was performed to nucleus accumbens, medial frontal cortex, caudate nucleus, putamen and globus pallidus internal and external segments. In order to compare the difference in brain activity for early (goal directed) versus late learning (habitual, automatic) trials, separate ROI analyses were performed for each anatomical sub-region. For the reward condition, we found significant activity in the medial frontal cortex (p<0.05) only for early learning trials but activity is shifted to bilateral putamen (p<0.05) during later trials. However, for the loss condition no significant activity was found for early trials except globus pallidus internal segment showed a significant activity (p<0.05) for later trials.

Conclusion
We found that during reinforcement learning activation in the brain shifted from the medial frontal regions to dorsal regions of the striatum. These findings suggest that there are two separable (early goal directed and late habitual) learning systems in the brain.


BACKGROUND
The aim of this study is to measure the quality of information about 'flatfoot' and 'pes planus' presented online on the social media site YouTube and to determine the trends of viewers to medical information on YouTube.

METHODS
'flatfoot and pes planus' was typed into the YouTube search module. From the search results, videos with 50000 views or more, longer than 45 seconds, containing information about flatfoot and pes planus disease were selected. DISCERN, JAMA scoring, daily average views, number of likes, number of comments were collected from 53 videos that met the criteria. The profession of the sharer was evaluated in terms of the information quality of the sharing and the orientation of the audience.

RESULTS
The mean number of views per day of the examined videos was 2047. Mean video presentation time was 8 minutes 50 seconds. The mean JAMA score was 2/4 and the mean DISCERN score was 38.16/75. According to the DISCERN score according to the professions, the video quality was moderate in doctors (41.44±12.99), moderate in physiotherapists (41.91±9.04), poor in coaches (32.78±7.87), poor in patients (34.50±5.32) and weak in others (34.89±14.00). According to the Spearman correlation between DISCERN score and mean daily viewing significant relationships were found in the doctors group p:0.0102 and the others group p:0.0033, however, no significant relationships were observed in the physiotherapists group p:0.1073, the flatfoot patients group p:0.5363 and the coaches group p:0.9111. There were significant relationships between like and comment counts in all groups (doctors p:0.0088, coaches p:0.0069, physiotherapists p:0.0007, others p:0.0018, patients p:0.0066).

CONCLUSIONS
Looking at previous studies, it was observed that the quality of online health information was historically inadequate. Likewise, in our study on YouTube, we found that the quality of flatfoot and pes planus information was poor to moderate.


We suggest that moral panics exert spillover effects through stigma by mere association. Individuals are harmed even if their ties to stigmatized affiliates are heterophilous, and high-status individuals can also suffer. This creates a broadcast effect that increases the scale of the moral panic. Analyzing the U.S. film industry from 1945 to 1960, we examine how artists' employment in feature films was influenced by their associations with co-workers who were blacklisted as communists after working with the focal artist. Mere association reduces an artist's chances of working again, and one exposure is enough to impair work prospects. Furthermore, actors' careers are impaired when writers with whom they worked are blacklisted. Moreover, the negative effects of stigma by mere association hold even when the focal artist has received public acclaim. These findings have broad implications. When a few individuals or organizations are engaged in wrongdoing and publicly targeted, stigma by association can lead to false positives and harm many innocents.


This study was conducted in Lanfuro woreda from February, 2017 to June, 2017 in Southern Ethiopia. The major objectives of this study were to assess the small ruminant production and health problems and to identify the constraints of small ruminant production. The study used questionnaire survey in 150 households in three kebeles that were reared sheep and goat. The results of this study showed that most of small ruminant owner were kept mainly for the purpose of income, manure and meat, 67.33%. The main supplementary feeds of the small ruminants were maize and atela (sediment) 29.33%, leaves 26% and maize 20.67%. The prominent problem was the diseases and feed shortage, 51% and it followed by water shortage 20.67%, diseases 20% and feed shortage 8%. The small ruminant production constraints faced in the study area were the existence of less market outlet (availability) 21.33%, absence of improved breed 20%, and low selling price 17.33%. The prevalent diseases encountered in the study area were bloating, pasteurollosis, lameness, nerve diseases, PPR and SGP. The prevalent disease of small ruminant was bloating, 29.33% and followed by pasteurollosis 14%. Abdominal swelling, 28% and nasal discharge, 15.33% were the higher recorded clinical symptoms. The respondents mainly used their main house for their sheep and goat, 77%. The households used the small ruminant milk primarily for their home consumption, 91.33% than for selling, 8.67%. The male sheep and goat slaughter was more common, 77.33% than female one, 2.67% during the festival, 90% and funeral ends/working days, 10%. The main reasons for selling of small ruminants in the study area were for buying fertilizer, education and health care for animal and human care expenditures. In conclusion, this study identified the prominent challenges for small ruminant production as diseases, feed and water shortage, less market availability and selling price, and absence of improved breed so as they influenced the production of small ruminant in the study area. Based on the conclusions, the production constraints and or problems should be planned and implemented properly to enhance the productivity; and it's be better to encourage to constructed the separated house of for the small ruminant so as it could reduce the disease transmission from animal to human and vice versa.


when the number of terms x is a rather arbitrary real or even complex number. The resulting theory includes the known interpolation of the factorial by the Γ function or Euler's little-known formula ∑ −1/2 ν=1 1 ν = −2 ln 2 . Many classical identities like the geometric series and the binomial theorem nicely extend to this more general setting. Sums with a fractional number of terms are closely related to special functions, in particular the Riemann and Hurwitz ζ functions. A number of results about fractional sums can be interpreted as classical infinite sums or products or as limits, including identities like


Multi-core tape composites with various filament configurations have been made by a tape-in-rectangular tube (TIRT) process. This TIRT process is based on the deformation of multifilamentary composites assembled from a rectangular Ag (Ag-alloy) tube filled by pre-deformed single-core BSCCO/Ag tapes. Two-axial rolling induces texture in the filaments in two rolling planes, with the filament planes oriented parallel or perpendicular to the tape width, thus reducing the high Ic anisotropy which can degrade the total current in coils working at high temperatures (77 K). The homogeneity of the filaments was studied by a magneto-optical technique. Roll-sintered samples were measured at 77 K in an external magnetic field up to 1 T and at constant fields (0.1 T and 0.5 T) at various orientations (between parallel and perpendicular) to the tape surface. The results demonstrate the possibility of using these tapes for selected parts of a coil winding to reduce the apparent effect of the radial field component on the reduction of the total coil current.


Internal audit is an important tool in helping senior management of organizations to find the right solutions in meeting the objectives. Through findings and recommendations, auditors provide assurance and advice on the management of internal control systems, risk and governance. The management of public organizations in Albania still has an incomplete conception and a low level of awareness on the role of contemporary internal audit services. This is firstly related to the quality of audit activities, where in significant cases the quality of this service is assessed to be not at the levels required by contemporary standards and practices, and secondly to the lack of recognition and misuse of these services by many administrators of public organizations. The aim of this research is to determine the state of capacity of public administration employees in the field of internal audit, in public organizations in Albania and give the right recommendations for the development of these capacities in order for the internal audit service to become a powerful tool in the hands of managers to achieve their objectives by adding value to the organization. The methodology used for the research has its own dimensions such as: specification of research subjects and sampling, tools used for research, implementation plan, ethical issues, presentation of research findings, etc. The research is based on primary and secondary data collection. The research is based on the testing of the Hypothesis, H0. The practical implications of this paper consist in the fact that: this is an in-depth study of the problems faced by the internal audit activity in public sector organizations in Albania. The conclusions and recommendations given to address these issues will add value to the management of these organizations, by helping managers reconsider their roles and responsibilities in order to strengthen the Internal Control System, and to make it a powerful tool in meeting their objectives. They also serve internal auditors to improve their practical activities. The paper is original, as so far in Albania no other studies with these dimensions have been conducted in this field, and it also has both theoretical and practical value for researchers, internal auditors and managers of the field.