BACKGROUND
The Distress Thermometer (DT) is a well-validated tool that is frequently used in patients with cancer to screen for general distress and to generate referrals. However, a majority of the DT problem list items relate to physical concerns; this may lead to psychosocial issues being overshadowed.

OBJECTIVES
The purpose of the current study is to examine the endorsement rates for nonphysical items, as well as the relationship between these items and overall DT scores.

METHODS
A multiple logistic regression analysis of the first-time distress rating scale of 1,209 patients from 2005-2009 was conducted to determine whether nonphysical items on the DT significantly contributed to a patient falling into one of two categories.

FINDINGS
This study provides evidence that emotional variables are particularly significant for patients who are at risk for distress and, consequently, should be prioritized for intervention when endorsed on the DT problem list.


Improving drug permeability in skin is considered as one of
the most important issues for designing new methods of
transdermal drug delivery. Consequently, many techniques
have been proposed to more effectively deliver drugs across
the stratum corneum, including chemical enhancers or
physical enhancer techniques, e.g., iontophoresis and
ultrasound. Standard hypodermic injection is an effective
method for drug delivery, but it causes difficulties in using it,
either due to needle phobia or possibility of having skin
infections. Patches is an alternative way for drug delivery
across skin. However, this approach generally delivers drugs
with low molecular weight and show difficulties in
permeability of high molecular solutes in skin. Microneedle is
a new technology to enhance transdermal delivery of high
molecular weight. This combines the concepts of transdermal
drug delivery across the skin using patches and the
hypodermic injections. The microneedles have been shown
experimentally to increase the skin permeability by order of
magnitude in vitro for a range of drugs varying in molecular
size and weight. Different microneedle designs have been
manufactured for transdermal drug delivery during the last 10
years. Recently, other questions appeared while using these
microneedles, e.g., how to reduce needle diameters by which
the hole produced to be as small as possible to exclude
bacteria and other foreign particles. Another issue that has
come up in this regard is how to correlate the skin thickness
and microneedle length with the skin permeability. In this
work, we have developed a framework which considers
different classifications of skin thickness, arising from different races, sex groups, age and anatomical regions. This is
done because of their implications in enhancing the process of
transdermal drug delivery using microneedles. It is also
obvious that in order to know the optimum design of these
microneedles, the effect of the microneedle geometry on skin
should be determined. However, this necessitates development
of an optimization framework for skin permeability from these
systems which includes many parameters (e.g., number of
microneedles, microneedle radius, surface area of the patch,
etc.). In the presented work an optimization algorithm for
improving skin permeability to drugs using microneedle arrays
is presented. The outcome of this work will be used to suggest
optimum microneedle designs based on the parameters of
interest.


Cytokines are peptides used by immune and inflammatory cells to communicate with each other and to control the milieu interieur in which they operate. Recent evidence suggests that they are of immense importance in controlling the local and systemic events of the immune response, inflammation, hemopoiesis, healing, and the systemic response to injury. Many of them can now be measured by immunoassay, and the role of such measurements in the diagnosis and management of disease is actively under investigation. Similarly, the availability of recombinant DNA techniques to produce cytokines in almost unlimited quantities is leading to new and exciting therapeutic applications.


Most teachers incorporate some form of information and communication technologies (ICT) into their teaching and learning practice. This study reviews teachers' overall perceptions of ICT, including their views on professional development, barriers they encounter and successes they have achieved. The study was undertaken at an Australian private school, with 39 online questionnaire participants and 4 interviewees. The data suggested that teachers have a positive perception towards the benefits of ICT integration in their school administration and into their classrooms, however, there is a negative perception regarding the ongoing obstacles teachers encounter in gaining appropriate or relevant professional development and on ICT integration.


INTRODUCTION
The relationship between donor age and adolescent heart transplant outcomes remains incompletely understood. We aimed to explore the effect of donor-recipient age difference on survival after adolescent heart transplantation.

METHODS
The United Network for Organ Sharing database was used to identify 2,855 adolescents aged 10-17 years undergoing isolated primary heart transplantation from 1/1/2000 to 12/31/2022. The primary outcome was 10-year post-transplant survival. Multivariable Cox regression identified predictors of mortality after adjusting for donor and recipient characteristics. A restricted cubic spline assessed the non-linear association between donor-recipient age-difference and the adjusted relative mortality hazard.

RESULTS
The median donor-recipient age-difference was +3 (range -13 to +47) years, and 17.7% (n = 504) of recipients had an age- difference > 10 years. Recipients with an age-difference > 10 years had a less favorable pre-transplant profile, including a higher incidence of priority status 1A (81.6%, n = 411 vs. 73.6%, n = 1730; p = .01). The 10-year survival rate was 54.6% (95% confidence interval (CI) 48.8- 60.4) among recipients with a donor-recipient age-difference > 10 years and 66.9% (95% CI: 64.4-69.4) among those with an age-difference ≤10 years. An age-difference > 10 years was an independent predictor of mortality (hazard ratio 1.43, 95% CI: 1.18-1.72, p < .001). Spline analysis demonstrated that the adjusted mortality hazard increased with increasingly positive donor-recipient age-difference and became significantly higher at an age-difference of 11 years.

CONCLUSION
A donor-recipient age-difference > 11 years is independently associated with higher long-term mortality after adolescent heart transplantation. This finding may help inform acceptable donor selection practice for adolescent heart transplant candidates.


Prior studies indicate that tissue factor (TF), the primary cellular initiator of hemostasis, is persistently up-regulated in human endometrial stromal cells (HESCs) undergoing progestin-induced decidualization in vivo and in vitro. The mechanism underlying progestin enhancement of TF mRNA and protein levels in these cells involves transcriptional activation of the TF gene. Transient transfections of HESCs with the truncated TF promoters driving the luciferase reporter gene have demonstrated that the region spanning -111 to +14 bp retained differential progestin-enhancing effects. We now demonstrate that RU486 displays inhibitory effects on the progestin-induced TF promoter activity, confirming the involvement of the progesterone receptor. Since the TF minimal promoter (pTF 111 spanning -111 to +14 bp) contains three overlapping Sp1 and three Egr-1 sites, the present study determined whether Sp1 and/or Egr-1 were required for progestin-regulated TF expression. The results indicate that the three Sp1 sites are primarily responsible for both the constitutive and progestational activity of the pTF 111 promoter, whereas the Egr-1 sites have only a minor involvement in both activities. Overexpression of the Sp1 protein resulted in greater than a 6-fold induction in TF promoter activity. In contrast, no enhancement was observed when the Sp3 protein was overexpressed. The concomitant overexpression of Sp1 and Sp3 demonstrated that Sp3 completely blocked the induction of TF promoter activity by Sp1. Moreover, the addition of 10 nM mithramycin, a concentration that inhibits Sp1 binding to target DNA, blocked the progestational induction of TF mRNA expression. Immunohistochemical studies demonstrated increased Sp1 levels in perivascular stromal cells in secretory phase compared with proliferative phase endometria. In contrast, Sp3 expression was greatly decreased in stromal cells of secretory, compared with proliferative phase tissues. The levels of Egr-1 were low in both proliferative and secretory endometria. Immunocytochemistry of E2 vs. E2 + medroxyprogesterone acetate-treated HESCs demonstrated a dramatic reduction in Sp3 expression after progestin treatment, and Northern blots demonstrated progestational increases in Sp1 and reduction in Sp3 mRNA expression compared with controls. Taken together, our results demonstrate that progestin enhancement of TF gene expression in HESCs is mediated principally by Sp1. We propose that progestins regulate HESC TF gene expression in vivo by altering the ratio of Sp1 to Sp3 nuclear factors.


The herb of Allium victorialis var. platyphyllum (Liliaceae) has been used as an edible wild herb and to treat heart failure and gastritis. We have already reported antihyperlipidemic anti-tumor effects of this plant. To enlarge the commercial availability of this food, it was investigated whether the extracts of A. victorialis var. platyphyllum reduce hyperlipidemia and obesity or not. The plants tested in this experiment were collected from two eco-types of Is. Ullung and Mt. Odae cultivated at Pyongchang. Extracts were prepared by extracting the fresh leaves and those dried at 36℃ and 90℃, respectively. Pretreatment with the ethanolic extracts for two weeks (p.o.) reduced serum triglyceride-, total cholesterol- and LDL-cholesterol contents in rats induced by Triton WR-1339, respectively. Furthermore, oral administration of the extracts also inhibited the hyperlipidemia induced with oral diet of 30% corn oil. In the other attempt to find to alleviate the obesity, the model rats with obesity were induced by the high fat-diet for six weeks. Post-treatment with the extracts for two weeks significantly reduced the hyperlipidemia. Retroperitoneal-, epidymal- and total abdominal fat pad weights were considerably reduced at 100 ㎎/㎏ oral administration of the extracts. Increased feces lipid contents were also found in the rat treated with the extracts. The extract of Mt. Odae eco-type showed more potent activity than that of Is. Ullung one. These results suggest that use of the fresh leaves may lead to the higher activity in treatment of hyperlipidemia and obesity than of the dried one.


The emerging research and application domains of the Internet-of-Things and Big Data, together with socio-technical phenomena such as social networking, as well as mobile phones (equipped with sensors, GPS, etc.) make us – companies, research centres, people in general – all (sometimes unwittingly, possibly unwillingly) producers and consumers of data. A sensitive issue for data providers concerns control over access, sharing, dissemination and use of data. By control, we mean placing limitations on who can access the data, when data can be accessed, how data can be accessed, and so on. We propose means to capture the expression of controls over data and to associate that indivisibly with the data via what we call "policy-carrying data" (PCD). The PCD establishes permissions for what the consumer may do to the data, but also – in a novel addition for such policies – establish what the consumer can/must do subsequently with the data. We formalise PCD and illustrate how it can meet potential stakeholder requirements.


The response of blood flow to choroid plexus (CPBF) during hypercapnia is controversial. The goal of this study was to determine the effect of hypercapnia on CPBF in unanesthetized rats. Rats breathed air or a mixture of 5-8% CO2 in air, and CPBF was measured with [14C]isopropyliodoamphetamine and quantitative autoradiography. In hypercapnic rats [arterial PCO2 61.6 +/- 1.6 (SE) mmHg; n = 7] CPBF was similar to that of normocapnic control rats (525 +/- 39 ml.min-1.100 g-1; arterial PCO2 42.7 +/- 0.6 mmHg; n = 5). In contrast, blood flow to cerebral cortex increased 67% during hypercapnia. CPBF in normocapnic rats that were treated with phentolamine was similar to untreated normocapnic and hypercapnic rat CPBF. However, during hypercapnia, CPBF in phentolamine-treated rats increased 29%. Responses were similar in blood flow to choroid plexus of lateral, third, and fourth ventricles. Our findings indicate that hypercapnia has no effect on CPBF when alpha-adrenergic receptors are intact. In contrast, after blockade of alpha-adrenergic receptors, hypercapnia increases CPBF. These findings suggest that, during hypercapnia, levels of sympathetic activity or blood-borne catecholamines are increased that prevent increases in CPBF.


Four experiments investigate the hypothesis that cues to the direction of another's social attention produce a reflexive orienting of an observer's visual attention. Participants were asked to make a simple detection response to a target letter which could appear at one of four locations on a visual display. Before the presentation of the target, one of these possible locations was cued by the orientation of a digitized head stimulus, which appeared at fixation in the centre of the display. Uninformative and to-be-ignored cueing stimuli produced faster target detection latencies at cued relative to uncued locations, but only when the cues appeared 100 msec before the onset of the target (Experiments 1 and 2). The effect was uninfluenced by the introduction of a to-be-attended and relatively informative cue (Experiment 3), but was disrupted by the inversion of the head cues (Experiment 4). It is argued that these findings are consistent with the operation of a reflexive, stimulus-driven or exogenous orient...


This paper presents a method to generate new melodies, based on conserving the semiotic structure of a template piece. A pattern discovery algorithm is applied to a template piece to extract significant segments: those that are repeated and those that are transposed in the piece. Two strategies are combined to describe the semiotic coherence structure of the template piece: inter-segment coherence and intra-segment coherence. Once the structure is described it is used as a template for new musical content that is generated using a statistical model created from a corpus of bertso melodies and iteratively improved using a stochastic optimization method. Results show that the method presented here effectively describes a coherence structure of a piece by discovering repetition and transposition relations between segments, and also by representing the relations among notes within the segments. For bertso generation the method correctly conserves all intra and inter-segment coherence of the template, and the optimization method produces coherent generated melodies.


Although public debate ensues over whether parents or nonparents have higher levels of emotional well-being, scholars suggest that being a parent is associated with a mixed bag of emotions. Drawing on the American Time Use Survey for the years 2010, 2012, and 2013 and unique measures of subjective well-being that capture positive and negative emotions linked to daily activities, we "unpack" this mixed bag. We do so by examining contextual variation in the parenting emotions gap based on activity type, whether parents' children were present, parenting stage, and respondent's gender. We found that parenting was associated with more positive emotions than nonparenting, but also more negative emotions. This pattern existed only during housework and leisure, not during paid work. Moreover, patterns in positive emotions existed only when parents' children were present; patterns in negative emotions were primarily observed during earlier stages of parenting. Results were similar for men and women.


The Hypothesis that low‐frequency variation of ENSO predictability may be caused by stochastic processes is tested using an Intermediate Coupled Model (ICM). Three "perfect model scenario" prediction experiments were carried out, each of which consists of large ensemble predictions. In the first case (reference case), the model is solely forced by stochastic forcing without any explicit decadal‐varying background. In the other two experiments, decadal‐varying backgrounds with different amplitudes were introduced into the ICM in addition to the stochastic forcing. By comparing the low‐frequency variations of ENSO predictability in these experiments, it is found that only when the amplitude of the decadal‐varying background is unrealistically strong, the effect of decadal‐varying background on ENSO predictability is comparable to or larger than the stochastically induced low‐frequency ENSO variation. Therefore, to the extent that the simple coupled system can represent reality, it seems that one can not simply reject the null hypothesis that the decadal variation of ENSO predictability may be stochastically induced.


This study examines the engineering characteristics and properties of peat soils in coastal environments in Ireland, Italy, Malaysia, Netherlands, Turkey and USA. The engineering properties to be examined are consolidation characteristics, Atterberg limits, density, organic content, shear strength, and moisture content. Moisture content and organic content are good indication of the occurrence of peat soils because these parameters are inherently high in this soil type. In addition, peat soil is highly compressible and is known to be problematic for geotechnical construction. The peat layer has an adverse effect on the long-term settlement of road embankments. A case study of peat soil deposits in Surfers Paradise in Australia will be presented in the paper. Peat soil in the study area is embedded at depth ranging between R.L. -10 to R.L. - 19.6 m below the ground surface and it has a thickness ranging from 0.1 to 7.0 m in some locations. It possesses low shear strength of between 30-40 kPa and the moisture content can be up to 247 %. Four empirical equations have been established for the peat soils and they are compared with those published in the literatures.


Abstract
Background
Representatives of helping professions who are working with socially maladjusted youths and children with developmental disorders are particularly exposed to occupational stress. The aim of the study was to evaluate mental and physical well-being, as well as their correlates and predictors in a group of employees working at youth educational centres and sociotherapy centres.
Materials and Methods
A total of 96 employees working at youth educational centres and sociotherapy centres took part in the study. The following psychometric tools were used: the Psychosocial Working Conditions Questionnaire, the Mini-COPE, the LOT-R, and the GSES.
Results
The results obtained indicate that people working in helping professions experience mental and physical health problems. Only 3% of the subjects declared they sleep all night. Over 40% and over 35% of the subjects estimate they suffer from low mood and irritation episodes, respectively, rather frequently or continually. Subjects with poorer mental health are more likely to use Helplessness, Avoidance behaviours, or Turning to religion to cope with stress. The strongest predictor of mental well-being is the sense of self-efficacy. Whereas, the strongest predictor of physical well-being is the ability to cope with stress by giving into the feeling of Helplessness.

Conclusions
The study demonstrated poor mental and physical well-being of the subjects. A statistically significant correlation was found between sex and the level of mental and physical health. Employees working at youth educational centres and sociotherapy centres with better mental and physical well-being had a stronger sense of self-efficacy and a higher level of life optimism.


We consider an ensemble of $N$ discrete nonintersecting paths starting from equidistant points and ending at consecutive integers. Our first result is an explicit formula for the correlation kernel that allows us to analyze the process as $N\to \infty$.   In that limit we obtain a new general class of kernels describing the local correlations close to the equidistant starting points. As the distance between the starting points goes to infinity, the correlation kernel converges to that of a single random walker. As the distance to the starting line increases, however, the local correlations converge to the sine kernel. Thus, this class interpolates between the sine kernel and an ensemble of independent particles. We also compute the scaled simultaneous limit, with both the distance between particles and the distance to the starting line going to infinity, and obtain a process with number variance saturation, previously studied by Johansson.


A UK trial launched on 1 November will seek to establish whether cognitive behavioural therapy (CBT) delivered online is effective in treating chronic fatigue syndrome (CFS) in children.

Esther Crawley, professor of child health at the University of Bristol, hopes to recruit 734 children and adolescents over the next three years to be randomly assigned either to a programme of online CBT already shown to be effective in the Netherlands or to advice on managing activities and sleep.

The consultations will be conducted using Skype and will involve children and their parents. The children will answer questions and keep diaries and will have regular consultations with therapists, usually weekly. A full course will comprise 19 consultations, and Crawley hopes that, after allowing for loss to follow-up, she will have 330 children in each group to …


Vegetation indices derived from optical remote sensing data are a valuable source of information for agricultural monitoring. However, cloud cover over some areas reduces the number of valid observations, which can difficult the detection of changes in crop condition. In this context, synthetic aperture radar (SAR) systems are an interesting alternative due to their low sensitivity to clouds. In this work, we analyze the relationship between SAR backscatter from Sentinel-1 and vegetation indices derived from the Harmonized Landsat-8 Sentinel-2 (HLS) product with data from the year 2017 over 6 land cover classes in Ukraine: Winter crops, summer crops, bare land, grasslands, forest, and water. Results show that SAR data from Sentinel-1 could be used to complement optical indices for certain land covers. In the case of winter crops (rapeseed and wheat), the ratio between Sigma-0 VV and VH polarization showed the highest relationship with the Normalized Difference Vegetation Index (NDVI) while for summer crops (maize, sugar beet, sunflower, and soybean) the highest relationship was shown by the Sigma-0 VH polarization and NDVI. Further work is being developed to exploit more complex SAR models which account for other variables that affect the backscatter signal such as soil moisture.


bladder cancer A PHASE II PROTOCOL FOR PATIENTS WITH STAGE T1 BLADDER CANCER TO EVALUATE SELECTIVE BLADDER PRESERVING TREATMENT BY RADIATION THERAPY CONCURRENT WITH CISPLATIN CHEMOTHERAPY FOLLOWING A THOROUGH TRANSURETHRAL SURGICAL RE-STAGING Trial ID: RTOG 0926 Coordination: Radiation Therapy Oncology Group (RTOG) Trial design: A randomized phase II study assessing a bladder preservation strategy for T1G2G3 bladder cancer. Patient population: Operable patients with stage T1 disease (T1G2 or T1G3) for whom radical cystectomy is being considered as the next conventional step in therapy by standard urologic guidelines. Sample size & primary endpoint: n = 37, rate of freedom from radical cystectomy at 3 years


The purpose of this study was to determine the differences in blood pressure, cardiovascular disease bio-chemical risk markers, physical activity and nutrition, between an Urban (US) and Pastoral (PS) sample, in the context of the global epidemiological transition taking place globally causing a shift in mortality and morbidity from communicable diseases to non-communicable diseases. A total of 133 adults from both samples meeting the inclusion criteria, were randomly recruited from clusters in sub-locations, villages and homesteads from available demographic data available from Central Bureau of Statistics (CBS) on Kirisia and Kibera divisions in Samburu and Nairobi, in Kenya. Data was collected using questionnaires, venipuncture, blood pressure measurement and anthropometric measurements. Resulting data was stratified and analyzed by locality, gender and age-category using SPSS V 11.5 and computed in terms of percentages and frequencies. Chi-square test was used to test for differences in proportions. Student t-test and ANOVA were used to compare means where applicable and in cases where there were more than two means being compared. The level of significance at 0.05 was used for the statistical tests. In case of significant F-ratio, post-hoc analysis was done using DMRT. Stepwise multiple regression analysis was used to identify predictors of cardiovascular disease, p-values <0.05 were considered significant. There was no difference in proportions between the two groups. Means for SBP, apoB, apoA, apoB/A ratio, Co-Q10, were significantly different at p<.019, p<.001, p<.001, p<.001 and p<.001 respectively, between these two samples. Means for lifestyle factors: MET mins/week (physical activity), Lymphocytes, BMI and MUAC (nutrition status markers) were significantly different at p<.001, p<.027, p<.001 and p<.001 respectively. Mean nutrient intake was significantly different at p<.030, p<.039, p<.001, p<.009, p<.025, p<.049 and p<.001, for protein, carbohydrates, dietary cholesterol, SAFA, MUFA, DHA and Folic acid between the two samples. Mean %B. Fat and WC were significantly different at p<.001 and p<.001 in the two samples respectively. MUAC in both samples could be used to predict Systolic BP. Lymphocytes count could be used to predict Co-Q10 in the US while derived % B. Fat could be used to predict ApoB/A ratio in the PS. The Urban sample had a higher CVD risk than the Pastoral sample therefore perhaps at a more advanced stage of the epidemiological transition.


An apiary trial was conducted in 2016 August to October in Szabolcs-Szatmár-Bereg County, Nyírmada to evaluate the influence of queen's age on the Varroa destructor-burden in the treatment colonies. Sixty colonies of bees belonging to the subspecies Apis mellifera carnica pannonica in Hunor loading hives (with 10 frames in the brood chamber/deep super) were used. The colonies were treated with amitraz and the organophosphate pesticide coumaphos active ingredients. The amitraz treatment includes 6 weeks. The coumaphos treatment with Destructor 3.2% can be used for both diagnosis and treatment of Varroasis. For diagnosis, one treatment is sufficient. For control, two treatments at an interval of seven days are required. The colonies were grouped by the age of the queen: 20 colonies with one-year-old, 20 colonies with two-year-old and 20 colonies with three-year-old queen. The mite mortality of different groups was compared. The number of fallen mites was counted at the white bottom boards. The examination of spring growth of honey bee colonies has become necessary due to the judgement of efficiency of closing treatment. The data was recorded seven times between 16th March 2017 and 19th May 2017.
Data on fallen mites were subjected to one-way analysis of variance (ANOVA) and Post-Hoc Tukey-test. Statistical analysis was performed using the software of IBM SPSS (version 21.). During the first two weeks after treatments, the number of fallen mites was significantly higher in the older queen's colonies (Year 2014). The total mite mortality after amitraz treatment in the younger queen's colonies was lower (P<0.05) compared to the three-year-old queen's colonies. According to Takács and Oláh (2016) although the mitemortality tendency, after the coumaphos (closing) treatment in colonies which have Year 2014 queen showed the highest rate, considering the mite-burden the colonies belongs to the average infected category. The colonial maintenance ability of three-year-old queen cannot be judged based on the influencing effect on the mite-burden. The importance of the replacement of the queen was judged by the combined effect of several factors.
During the spring-growth study (16th March–19th May) was experienced in the three-year-old queen's colonies the number of brood frames significantly lower compared to the one- and two-year-old queen's colonies. In the study of 17th April and 19th May each of the three queen-year-groups were varied. Therefore in the beekeeping season at different times were determined the colonial maintenance ability of queens by more factors: efficiency of closing treatment in early spring, the spring-growth of bee colonies, the time of population shift (in current study, this time was identical in each queen-year), honey production (from black locust).


The aim of the study is to determine the effect on death anxiety of loneliness in the elderly during the COVID-19 pandemic. The population of this study that is descriptive and cross-sectional type consist of 354 elderly who meet the inclusion criteria from three different associations operating for charitable purposes in a city center located in north-west Turkey. The average score of Loneliness Scale of Elderly (LSE) of the elderly was determined as 11.39 ± 5.31, and the average score of Death Anxiety Scale (DAS) of the elderly was determined as 8.54 ± 4.82. According to these results, it was found that the elderly experienced acceptable levels of loneliness and moderate death anxiety. A statistically significant difference was found in the LSE and DAS scores of the elderly according to their age, marital status, education status, chronic illness status and living at home with relatives. In addition, during the COVID-19 epidemic, the scale scores of the elderly who have increased worries, who have a hobby at home, and who communicate with their relatives via social media/mobile phones were found to be statistically significant (p < 0.05).


A high speed pneumatic drill was used to perform 190 percutaneous transthoracic biopsies in 161 patients. The resultant cores of tissue provided a definite diagnosis in 146 patients, giving a success rate of 90.7%. Complications occurred in 58 patients, subcutaneous emphysema being the most common, though only seven patients required active treatment, giving a rate of 3.7% for important complications. One patient died within 24 hours of the biopsy procedure owing to asphyxia resulting from aspiration of the contents of an acutely dilated stomach. Our experience clearly establishes that the drill biopsy as used by us is simple and safe and can be carried out in an outpatient department, yielding better overall results than any other procedure for closed biopsy of the lung currently practised.


In the present study I look first at findings of earlier surveys on women's birth control behavior since 1958 in Hungary. I then turn to the detailed analysis of the birth control practices of Hungarian women based on data from the Generations and Gender Survey (2008–2009). First I examine the influences on whether partnered women of reproductive age employ any birth control methods or not, and then I explore the methods that are chosen. What emerges from this examination is that modern contraception has spread widely in Hungary since the 1960s, but in 2009 a quarter of Hungarian women were still not using any method of birth control, or else they were merely using a traditional low-efficiency types. The profile of such abstainers is clear: they are reaching the end of their reproductive period, have a low level of education, are married, have financial difficulties, are generally childless, and do not plan to have a child in the short-term. The results of a multinomial logistic model show that there are also several demographic and social factors behind choosing a method of contraception. In 2009 the most common of these was the condom, followed by birth control pills ("the Pill") and intra-uterine devices (IUDs, "the coil"). Finally, the study compares birth control in five European countries and its changes since the 1990s. The use of the Pill declined in all the countries in the 1990s, and only in Bulgaria and Hungary have condom users outnumbered pill-takers.


My research is an enquiry into the nature of divine grace in the making and contemplation of art. It is, therefore, practice led and operates through phenomenological processes that explore three encounters: firstly, experiential - my art practice, secondly, historical - the theoretical context of my reflection and sources and thirdly, lyrical - the mode of my writing and the assimilation of my research. The study of Sandro Botticelli's painting, Mystic Nativity, 1500, juxtaposed with aspects of Arte Povera and my own contemporary practice, steers my theoretical study. This strategy has revealed various fields of thought; philosophical, esoteric and psychoanalytically informed feminist scholarship. The shift in perception that juxtaposition affords contributes to my understanding of an unseen dynamic integral to metaphysical thought. With this in mind I focus upon the way in which Botticelli has depicted the hay that circulates around the form of the Christ child in this Nativity painting. My investigation into the nature of this overlooked dimension detected in Mystic Nativity has enabled me to find a way to articulate the divine in art.

The research operates through a number of practices art, writing, conversing and contemplation. My artwork explores spatial and haptic elements in the form of installation. Here an experiential encounter extends the reflection of my sources in further unforeseen sites of contemplation and practice. In my writing I seek to articulate a lyrical encounter of my own artwork and the art that I contemplate.

This research responds to the themes: hay as membrane; hay as calligraphy; and the palimpsest. In my first chapter, Painting the Picture , I consider the intellectual and historiographic context in which Mystic Nativity was painted. The Florentine scholar, Marsilio Ficino was Botticelli s mentor. Ficino was the founder of the Platonic Academy influential in the intellectual life of Renaissance Florence. The theme of the palimpsest is evident as I investigate the diffusion of knowledge through the humanist scholarship and their translation of ancient texts. In my second chapter, Hay as Membrane , I explore contemporary thought that considers the Other: variously described in the theory of Emmanuel Levinas - as feminine; by Simone Weil as divine; by Bracha Lichtenberg-Ettinger as a matrixial dimension; and by Julia Kristeva as lyrical. These theorists contribute to my interpretation of a pre-articulated and circulatory, transient and overlooked, dimension. I have come to understand this as a feminine dynamic that contributes to our subjective development and operates beside the formation of meaning. My last chapter, Hay as Calligraphy , looks at the language of the Other and the ever-evolving language of art. I review my installation, Hay in Salem Chapel, in these terms. Walter Benjamin presents a phenomenological approach to language through his concept of the archaic and these thoughts return me to the theme of the palimpsest. The semiotic thought of Julia Kristeva and Mieke Bal helps to reveal new discursive approaches with which to engage with Mystic Nativity. Their research supports my exploration of the quality of interchange that may take place.

In my conclusion I refer to the significance of the practice of art as the site where the immanence of a feminine dynamic interacts with the metaphysical. Luce Irigaray s thought concerning the innate quality of the divine within our subjective makeup informs me as I reflect upon the current practice of Marie Cool and Fabio Balducci in their artwork called Prayers.

This research aims to open up new sites for thought and ways of appreciating the divine. I have placed the experience of that encounter in the frame of making and contemplating art, initiated from my personal experience.


Purpose: Integrate dynamic delivery techniques with TomoTherapy® treatment system and make preliminary dose verification with film and ion chamber measurements. Method and Materials: Dynamic delivery techniques utilize variable jaw width and variable couch speed to reduce beam‐on time and to improve longitudinal dose conformity. Several dynamic delivery techniques have been implemented in TomoTherapy® TPS, including Running Start and Stop (RSS), Dynamic Jaw with Dynamic Couch Speed (DJDC), with/without symmetric jaw constraint. With RSS, the back jaw follows the target's superior border as it enters the radiation field and the front follows the target's inferior border as it moves out of the field. With DJDC, jaws can move at any time during the treatment and the couch moves as fast as possible to speed up the treatment as long as the intended fluence is delivered. New hardware for jaws and couch subsystems is integrated into the delivery system. New casting, encoders and actuators for the jaws have higher accuracy and reliability. A simple cylindrical target and avoidance structure were used for planning and measurements. Radiation beams were delivered with RSS and preliminary film and ion chamber measurements were taken in a cheese phantom. Results: Film measurement taken with RSS 5.0 cm is compared to that with regular 5.0 cm and the penumbra is significantly reduced. The cheese phantom measurement shows good agreement between the calculated and measured dose. With the 2% −2 mm criterion, 83% of the area where dose is higher than 20% of Dmax has a λ index <1. The point doseion chamber measurement shows a discrepancy as little as 0.14% between the calculation and measurement. Conclusion: The preliminary results demonstrate that integration of the dynamic TomoTherapy® delivery system is successful and the dynamic jaw model of TomoTherapySM beam model can generate satisfactory results for treatment planning.


Platelet-derived growth factor (PDGF), a potent mitogen for mesenchymal cells, elicits its effects by binding to cell surface tyrosine kinase receptors, denoted α- and β-receptors. This thesis describes the mechanism of interaction between stimulated PDGF receptors and various intracellular molecules.PDGF-B is homologous to the transforming protein v-sis encoded by the simian sarcoma virus (SSV). Transformation of cells by the v-sis oncogene occurs through an autocrine mechanism, whereby the v-Sis protein produced by a cell activates the cells own PDGF receptors. We investigated the subcellular location of the autocrine signal and found that in c-Sis/B-chain transformed cells, autophosphorylated intracellular receptors initiated activation of phosphatidylinositol 3' kinase, and tyrosine phosphorylation of phospholipase C-γ (PLC-γ) and Ras GTPase-activating protein (RasGAP). These signals were, however, not sufficient for transformation of the cells.Receptor-association with Grb2 and SHP-2, phosphorylation of Shc and SHP-2 and activation of Raf and Src kinases, on the other hand, correlated with the transformed phenotype. Intermediate filaments (IFs) are one of three major components of the cytoskeleton. We observed a marked reorganization of vimentin containing IFs within 30 minutes of stimulation with PDGF, in which the fine fibrillar vimentin network aggregated into a dense coil around the nucleus. Concomitantly, the amount of soluble vimentin in the cytoplasm was decreased The reorganization of vimentin was dependent on intact organization of actin-containing microfilaments. PDGF stimulation also resulted in increased tyrosine phosphorylation of vimentin, a reaction which appears to involve Src kinase activity.Activation of Stat and Jak proteins in response to PDGF was also investigated. Stat1, Stat3 and Stat5 were tyrosine phosphorylated and activated in response to PDGF. Ligand-stimulated PDGF β-receptor associated with Jak1, Jak2 and Tyk2, and Jak1 was tyrosine phosphorylated in response to PDGF. Activation of both Stats and Jaks was more efficiently mediated by the PDGF β-receptor than the α-receptor. The interaction between β-receptor and Stat5 was investigated further and tyrosine residues 579, 581 and 775 in the β-receptor were found to be important for PDGF-induced phosphorylation and activation of Stat5. In addition, the MAP kinase cascade was found to negatively modulate Stat5 activity in PDGF-stimulated cells, as revealed by use of a MEK specific inhibitor (PD98059). This negative effect by MEK appears not to be exerted through a direct phosphorylation mechanism, since serine phosphorylation of Stat5 was not affected by the presence of the MEK inhibitor.


Globalization, at its core, is about a new operating theory of the world based on connectedness between, across, above, below and through preexisting political, social, economic, thematic, geographic and security boundaries. The connections and interactions can be so intense and transformative, says the author, that we can no longer distinguish between actors and their environments. Advances in telecommunication have linked the information and economic domains of customer, competitor and collaborator as never before. And, because all players have access to virtually the same information and information technologies, and can therefore equally target a demographic with precision, there is no compelling competitive advantage in any digital marketing capability. At the end of the day, marketers confront the same dilemma they turned to the Internet and information technology to solve: consumers opting out in ever greater numbers. To grow a business today, says the author, companies must take a marketing ecosystems view, which shifts away from the logic of ?brand? as the primary unit for business strategy. Citing Microsoft, Google, AT&T and McKinsey, among others, the author suggests that the only sensible way for a company to compete is not by offering new products with similar functional attributes, but by being better than its rivals at molding the ecosystem in which the competition takes place.


Two methods of surgical treatment optimization can be used in patients with persistent stenosis of cervical trachea: 1) reconstruction of tracheal cartilaginous frame by means of insertion of the rings made of the rib autocartilage in the tissues adjacent to trachea, 2) hydromassage (pulsating change in the latex balloon serving as a stent which is placed in the trachea after its surgical recanalization). Hydromassage shortens duration of tracheal epithelization to 2-3 months. Positive results achieved with the above methods allow the authors to recommend them into wide clinical practice.


. During the work of lifting machinery there are considerable dynamic loads in the elements of the drive and the metal structure, which lead to the rapid failure of the elements of the structure and mechanisms and emergencies. The issue of elimination of dynamic loads has not been solved yet, so in this work, the dynamic loads in the elastic elements (ropes) of load lifting cranes have been optimized within various methods of cargo lifting: "pick - up", "using weight", "from the ground". As a criterion for optimization (minimization of the specified loads) in the transient modes of operation of the crane (start, brake, reversal), the functional, which takes the minimum value and is the root mean square of the dynamic coefficient at the interval of time, corresponding to the duration of the transition, is proposed. Classical variational calculus methods were used to solve the problem of optimizing the mode of motion of the lifting mechanism. With these methods, the appropriate (optimal) modes (laws) of cargo movement and the electromechanical system of the drive mechanism of lifting are established. The results obtained in this study can be further used to refine and improve existing engineering methods for calculating lifting mechanisms of the crane with flexible suspension both at the design / construction stages and under actual operating conditions.


Experimental studies presented in this paper indicate that stationary and sliding contacts of practical applications may exhibit nonlinear behaviour. This can be attributed to the microstructures formed on the apparent contact surface. The physical phenomena which appear in this case seem to be dependent on the degradation of the contacts and the increase in thickness of the overlayers. The conductivity through thin interfacial layers (<50 /spl Aring/) is attributed to quantum mechanical tunnelling and through thicker interfacial layers to field emission and impact ionisation. The well-established metal-insulator-metal theory provides the required theoretical basis for the interpretation of the measurements. Based on the above, an equivalent circuit is proposed, which is valid for both stationary and sliding contacts.


INTRODUCTION
We report our experience with a new technique for transperitoneal laparoscopic partial nephrectomy with the kidney turned upside down intraoperatively.

MATERIALS AND METHODS
Laparoscopic partial nephrectomy was performed in 10 patients with upper pole lesions through a transperitoneal approach. Once complete mobilization of the kidney was achieved, it was rotated 180 degrees around the horizontal axis, so that the upper pole was positioned inferiorly. After performing partial nephrectomy, the resection bed was sutured by 2-0 polyglactin sutures and application of Hem-o-Lok clips. Then, the kidney was returned into its normal position and fixed to the abdominal wall.

RESULTS
We performed laparoscopic partial nephrectomy on 9 patients with a contrast-enhancing upper pole kidney mass and 1 patient with a nonfunctioning upper pole. The median tumor size was 58 mm (range, 41 mm to 92 mm). The median operative time was 206 minutes (range, 114 to 262 minutes) and the mean warm ischemia time was 30 minutes (range, 22 to 35 minutes). One patient underwent surgical exploration due to bleeding 6 hours after the operation. Prolonged urine leakage (more than 7 days) was observed in 1 patient, which responded to ureteral stent insertion. Surgical margins were negative in all of the patients. Renal cell carcinoma was histologically diagnosed in patients with a kidney tumor.

CONCLUSION
Laparoscopic upper pole partial nephrectomy had acceptable results while the kidney was turned upside down intraoperatively, in terms of operative time and complications. This approach facilitates the procedure by achieving a better field of vision.


The economic adjustment programmes for Ireland, Portugal, Greece and Cyprus were based on a range of legal measures and economic policy documents. In each programme, the concept of 'monitoring the impact of the programme measures on the vulnerable' was expressed, though in different formats. Based on research undertaken on the quarterly reviews compiled by the Troika missions to each of the four bail-out states, this article demonstrates that an inconsistent approach was taken to the monitoring of the impact of the programme measures on vulnerable groups and that statistical information was used in a haphazard manner. The legal consequences of this failure to adequately undertake statistical monitoring is examined in the context of challenges mounted to aspects of some of the bailout programmes before the European Court of Human Rights and the Committee of Social Rights. The article highlights how information concerning the impact on the vulnerable was accessible through the Union's longstanding commitment to provide statistical data through Eurostat and the specific availability of figures on social deprivation through the EU Statistics on Income and Living Conditions (EU-SILC).


Idiopathic basal ganglia calcification, or Fahr Syndrome, often presents in middle-aged patients presenting with parkinsonian symptoms. Unique presentation of young patient presenting with a seizure, and without the presence of parkinsonian symptoms. Imaging revealed near complete calcification of bilateral basal ganglia. Most common etiology of basal ganglia calcification is idiopathic or familial, but may also be secondary to metabolic derangements.


A network-level abstraction called phi -channel that supports the requirements of real-time applications is proposed. A phi -channel represents a simplex, end-to-end communication channel between a source and a destination. The channel is characterized by a set of specific performance parameters associated with its traffic, namely packet maximum end-to-end delay and the maximum number of packets that can be sent over that delay. The primary attribute supported by the phi -channel is on-time reliability. The basic scheme used to verify the feasibility of accepting a phi -channel, and the run-time support to guarantee its performance are described. The results of a simulation experiment implementing the basic functionalities of the proposed scheme are presented.<<ETX>>


Objective Cross-cultural adaptation of the questionnaire: Nurses Work Functioning Questionnaire into Portuguese in the Brazilian context. This questionnaire was developed by Gartner et al. (2011) in order to detect early what are the nursing staff affected at work because they have TMC and identify the specific aspects of work that are harmed. Method The adaptation process was conducted in accordance with internationally recommended methodologies, following the translation stages, synthesis, back translation, review by a committee of judges and pretest. Results and discussion The questionnaire was initially translated into Portuguese resulting in two versions which were analysed and resulted in the synthesis of the translations. All produced versions were submitted to back translation and then carried to judges. This committee was composed of five experts who reviewed and compared all translations, developing a final version for application in the pre-test. At this stage it verified the content validity of all the items of the questionnaire by applying the concordance rate of 80% among participants. The pre-test was conducted with 35 nursing workers, including technicians and nurses from the Cardiac Surgery Unit of Hospital São Paulo. To check the reliability of the instrument was used Cronbach's alpha, which averaged 0.88 indicating high internal consistency index. Conclusions The results indicated that the adaptation process was conducted successfully and the adapted version of the questionnaire has demonstrated adequate psychometric properties, making it reliable to be used with the Brazilian culture.


The apparel industry contributes significantly to the economic development of many developing countries. Between 1974 and 2004, the Multifiber Arrangement (MFA) heavily regulated this industry. Since the total abolition of the MFA in 2005, competition in apparel trade has increased many folds and some developing countries, such as Bangladesh and Vietnam, have been successful while some others, such as Mexico and the Philippines, are struggling to meet this challenge. This study presents a historical evolution of the apparel industry before and after the introduction of MFA and analyzes the factors that enhance apparel export performance during the post‐MFA period. The analysis reveals that cheap labor, firm size, product quality, foreign ownership, availability of local input materials, new product development, preferential market access and working conditions are the major factors that help gaining competitiveness in apparel exports during the post‐MFA period. These observations provide new insights to the policy makers and business managers to formulate and implement appropriate policies in order to become competitive in apparel exports.


Hurricane Irma affected the Florida peninsula from September 9-11, 2017, with high winds, rainfall, and storm surge. Although the storm made landfall on the west coast of Florida, impacts of the rainfall and storm surge affected central and northeast Florida. A GEER team mobilized on September 23, 2017, spent three days documenting sinkhole damage in central Florida, coastal scour and erosion along the northeast coast of Florida, and infrastructure damage in northeast Florida. Numerous sites with geotechnical damage were documented but this case history focuses specifically on sinkhole damage in The Villages, erosion and scour at Vilano Beach, failure of a concrete cover earth dam at Hampton Lake, and bridge embankment damage on US-17 over the Trout River. The most notable challenges to reconnaissance were the widespread and varied nature of the damages from Hurricane Irma and the rapid repair of damaged infrastructure that required the team to work closely with local, state, and federal officials to obtain documentation of the damage prior to repair.


Cochlear endolymph has a highly positive potential of approximately +80 mV known as the endocochlear potential (EP). The EP is essential for hearing and is maintained by K(+) circulation from perilymph to endolymph through the cochlear lateral wall. Various K(+) transport apparatuses such as the Na(+),K(+)-ATPase, the Na(+)-K(+)-2Cl(-) cotransporter, and the K(+) channels Kir4.1 and KCNQ1/KCNE1 are expressed in the lateral wall and are known to play indispensable roles in cochlear K(+) circulation. The gastric type of the H(+),K(+)-ATPase was also shown to be expressed in the cochlear lateral wall (Lecain E, Robert JC, Thomas A, and Tran Ba Huy P. Hear Res 149: 147-154, 2000), but its functional role has not been well studied. In this study we examined the precise localization of H(+),K(+)-ATPase in the cochlea and its involvement in formation of EP. RT-PCR analysis showed that the cochlea expressed mRNAs of gastric alpha(1)-, but not colonic alpha(2)-, and beta-subunits of H(+),K(+)-ATPase. Immunolabeling of an antibody specific to the alpha(1) subunit was detected in type II, IV, and V fibrocytes distributed in the spiral ligament of the lateral wall and in the spiral limbus. Strong immunoreactivity was also found in the stria vascularis. Immunoelectron microscopic examination exhibited that the H(+),K(+)-ATPase was localized exclusively at the basolateral site of strial marginal cells. Application of Sch-28080, a specific inhibitor of gastric H(+),K(+)-ATPase, to the spiral ligament as well as to the stria vascularis caused prominent reduction of EP. These results may imply that the H(+),K(+)-ATPase in the cochlear lateral wall is crucial for K(+) circulation and thus plays a critical role in generation of EP.


Due to data overload and time-critical nature of information need, automatic summarization of documents plays a significant role in information retrieval and text data mining. This paper discusses the design of a multi-document summarizer that uses Katz's K-mixture model for term distribution. The model helps in ranking the sentences by a modified term weight assignment. The system has been evaluated against the frequently occurring sentences in the summaries generated by a set of human subjects. Our system outperforms other auto-summarizers at different extraction levels of summarization with respect to the ideal summary, and is close to the ideal summary at 40% extraction level.


The use of a laser to weld tissue in combination with a topical photosensitizing dye permits selective delivery of energy to the target tissue. A combination of indocyanine green (IG), absorption peak 780 nm, and the near‐infrared (IR) alexandrite laser was studied with albino guinea pig skin. IG was shown to bind to the outer 25 μm of guinea pig dermis and appeared to be bound to collagen. The optical transmittance of full‐thickness guinea pig skin in the near IR was 40% indicating that the alexandrite laser should provide adequate tissue penetration. Laser "welding" of skin in vivo was achieved at various concentrations of IG from 0.03 to 3 mg/cc using the alexandrite at 780 nm, 250‐μsec pulse duration, 8 Hz, and a 4‐mm spot size. A spectrum of welds was obtained from 1‐ to 20‐W/cm average irradiance. Weak welds occurred with no thermal damage obtained at lower irradiances: stronger welds with thermal damage confined to the weld site occurred at higher irradiances. At still higher irradiances, local vaporization occurred with failure to "weld." Thus, there was an optimal range of irradiances for "welding," which varied inversely with dye concentration. Histology confirmed the thermal damage results that were evident clinically. IG dye‐enhanced laser welding is possible in skin and with further optimization may have practical application.


Objectives: This study aimed to compare the durability of four adhesive systems by assessing their microtensile bond strength (MTBS) and microleakage during six months of water storage. Materials and Methods: A total of 128 human third molars were used. The adhesives tested were Scotch Bond Multipurpose (SBMP), Single Bond (SB), Clearfil-SE bond (CSEB), and All-Bond SE (ABSE). After sample preparation for MTBS testing, the microspecimens were subjected to microtensile tester after one day and six months of water storage. For microleakage evaluation, facial and lingual class V cavities were prepared and restored with composite. After thermocycling, microleakage was evaluated. Bond strength values were subjected to one-way ANOVA and Tamhane's test, and the microleakage data were analyzed by the Kruskal-Wallis, Dunn, Mann Whitney and Wilcoxon tests (P<0.05). Results: Single Bond yielded the highest and ABSE yielded the lowest bond strength at one day and six months. Short-term bond strength of SBMP and CSEB was similar. After six months, a significant decrease in bond strength was observed in ABSE and SBMP groups. At one day, ABSE showed the highest microleakage at the occlusal margin; however, at the gingival margin, there was no significant difference among groups. Long-term microleakage of all groups at the occlusal margins was similar, whilst gingival margins of SBMP and SB showed significantly higher microleakage. Conclusion: The highest MTBS and favorable sealability were obtained by Clearfil SE bond. Water storage had no effect on microleakage of self-etch adhesives at the gingival margin or MTBS of CSEB and SB.


This report studies the effect in Sweden of the funding of research in the HE sector. In particular, it will analyze how so-called project funding will influence the performance and quality of research. In Sweden project funding makes up 56 percent of the total funding for research. The analysis shows that the performance in terms of citations measured at a university level almost entirely depends on the total amount of research funding available. For the period studied, 98 percent of the differences between HE institutions are explained by the total amount of funding alone. This means that only two percent cannot be attributed to the amount of funding. The differences in performance between institutions corresponding to the two percent are then studied and it is shown that the relative amount of project funding has no positive effect on the performance. In fact, the data indicates a negative effect of project funding on performance. This implies that project funding will not promote quality. Finally, the effect of decreasing the project funding on performance is analyzed. A decrease in the amount of funding that is project based will lead to a quite substantial increase in performance, since it will give researchers more time to do research as opposed to applying for project funding. Our estimates show that in Sweden between ten and twenty percent loss of performance is due to time spent on applications. Consequently, by reducing the amount of project funding one can gain the same amount in performance. In money, this will represent a quality gain corresponding to four to eight billion SEK annually, a substantial amount compared to the roughly forty billion SEK that the HE institutions receive in total for research. We believe that the findings are of importance not only in Sweden, but in general for countries with project funding.


The majority of neuroimaging studies focus on brain activity during performance of cognitive tasks; however, some studies focus on brain areas that activate in the absence of a task. Despite the surge of research comparing these contrasted areas of brain function, their interrelation is not well understood. We systematically manipulated cognitive load in a working memory task to examine concurrently the relation between activity elicited by the task versus activity during control conditions. We presented adults with six levels of task demand, and compared those with three conditions without a task. Using whole‐brain analysis, we found positive linear relations between cortical activity and task difficulty in areas including middle frontal gyrus and dorsal cingulate; negative linear relations were found in medial frontal gyrus and posterior cingulate. These findings demonstrated balancing of activation patterns between two mental processes, which were both modulated by task difficulty. Frontal areas followed a graded pattern more closely than other regions. These data also showed that working memory has limited capacity in adults: an upper bound of seven items and a lower bound of four items. Overall, working memory and default‐mode processes, when studied concurrently, reveal mutually competing activation patterns.


This thesis examines the volatility in the equity and short-term interest-rate markets, and the spillover from the short term interest rate market to the equity market. It consists of three papers and focuses on adapting and proposing models for the estimation and forecasting of financial market volatility. Chapter 1 gives a brief introduction to the parametric and nonparametric volatility models, as well as the estimation methods used in this thesis. Chapter 2 applies a nonparametric smoothing technique to examine the volatility of the Chinese stock markets due to the unique characteristics of the Chinese markets. The results suggest that the leverage effect exists in the Chinese stock markets: Bad news does affect the return volatility more than good news. Further, compared with the superior performance of the nonparametric model in the in-sample and out-of-sample forecast, the parametric models tend to overestimate the volatility process in turbulent periods and yield larger estimation errors. The results also suggest that the nonparametric model is a more appropriate tool to use in estimating the Chinese stock-return volatility than the parametric GARCH models. Chapter 3 proposes a semi-parametric procedure to estimate the volatility of the weekly three-month U.S. Treasury bills. The new approach accommodates asymmetry, levels effect and serial dependence in the conditional variance and the volatility is estimated by a nonparametric smoothing technique. Results from our Monte Carlo simulation illustrate the robustness of the semiparametric approach when estimating short-rate volatility with misspecification in the short-rate drift function and the underlying innovation distribution. The empirical application to three-month U.S. Treasury bill yields suggests that the semiparametric estimation procedure provides superior in-sample and out-of-sample volatility forecasts compared to the widely used diffusion volatility models. Finally, we demonstrate that the semiparametric approach has pertinent implications for pricing long-dated and path-dependent interest-rate derivatives. Chapter 4 examines the equity-return volatility and the spillover effects from short-term interest rates in the EMU area. The empirical study is carried out by estimating an extended Markov switching GJR-in-mean model with a Bayesian-based Markov chain Monte Carlo methodology. Our results suggest that two regimes exist in the EURO area stock markets; a high-mean low-variance (bull) market and a low-mean high-volatility (bear) market. Most of the EURO countries have the same regime-switching status between the bull and bear markets. Our results also suggest that bad news from unexpected stock returns (negative residuals from returns) has an asymmetrically larger effect on the returns and the volatility than good news has. Such an impact is larger in the bear market than in the bull market. As implied in the news-impact surface, we find that changes in short-term interest rates only significantly affect stock market volatility in the bear period in most of the EMU countries. (Less)


The procyclic form of Trypanosoma brucei exists in the midgut of the tsetse fly. The current model of its surface glycocalyx is an array of rod-like procyclin glycoproteins with glycosylphosphatidylinositol (GPI) anchors carrying sialylated poly-N-acetyllactosamine side chains interspersed with smaller sialylated poly-N-acetyllactosamine-containing free GPI glycolipids. Mutants for TbGPI12, deficient in the second step of GPI biosynthesis, were devoid of cell surface procyclins and poly-N-acetyllactosamine-containing free GPI glycolipids. This major disruption to their surface architecture severely impaired their ability to colonize tsetse fly midguts but, surprisingly, had no effect on their morphology and growth characteristics in vitro. Transmission electron microscopy showed that the mutants retained a cell surface glycocalyx. This structure, and the viability of the mutants in vitro, prompted us to look for non-GPI-anchored parasite molecules and/or the adsorption of serum components. Neither were apparent from cell surface biotinylation experiments but [3H]glucosamine biosynthetic labeling revealed a group of previously unidentified high apparent molecular weight glycoconjugates that might contribute to the surface coat. While characterizing GlcNAc-PI that accumulates in the TbGPI12 mutant, we observed inositolphosphoceramides for the first time in this organism.


As a result of the increased level of uncertainty and variability of the socio-economic environment, the influence of various social pathologies (for example, the COVID-19 pandemic, etc.) has grown, that have significant negative consequences for the functioning of society. Modeling the most important factors and trends in social development will help to resist the impact of modern negative changes.
From the analysis of the socio-economic development of the Republic of Uzbekistan, it is obvious that there exists the effect of all those factors and trends in social development that are positive and are primarily associated with STP (including the digitalization of society), as well as the effect of negative factors associated with various social pathologies. The strategy of development of the Uzbek economy is aimed at strengthening the former and limiting the latter.


This paper reports on an important yet unexplored area of indoor comfort studies, the relationship between historical attributes of buildings, personal values, and indoor environmental quality (IEQ) of office spaces. For this study we employed a comparative case study design to assess environmental conditions and occupants' behavioral responses of a year-long IEQ assessment of office settings inside ten adaptively reused historical palaces in Cairo Egypt. These palaces were selected based on their historical value, indoor decor, and their common mixed- mode ventilation system. In addition to subjective IEQ evaluations by occupants, physical measurements of the settings' layout, temperature, relative humidity, lighting intensities, air flow rates, and noise levels of the indoor office spaces were recorded during both the winter and summer seasons respectively. Focused interviews, questionnaires, field notes and occupants' comfort diaries were used systematically to evaluate the occupants' response towards their office environmental quality. The results of this investigation support the proposition that latent and symbolic qualities of the environment such as pride, status, historical value, and indoor decor attributes affect the overall perceived physical qualities of the environment in offices and workspaces. The findings provide both substantive and context specific knowledge to aid engineers, architects, and planners interested in the study topic.


Learning visual models of object categories notoriously requires thousands of training examples; this is due to the diversity and richness of object appearance which requires models containing hundreds of parameters. We present a method for learning object categories from just a few images (1 /spl sim/ 5). It is based on incorporating "generic" knowledge which may be obtained from previously learnt models of unrelated categories. We operate in a variational Bayesian framework: object categories are represented by probabilistic models, and "prior" knowledge is represented as a probability density function on the parameters of these models. The "posterior" model for an object category is obtained by updating the prior in the light of one or more observations. Our ideas are demonstrated on four diverse categories (human faces, airplanes, motorcycles, spotted cats). Initially three categories are learnt from hundreds of training examples, and a "prior" is estimated from these. Then the model of the fourth category is learnt from 1 to 5 training examples, and is used for detecting new exemplars a set of test images.


The present account outlines a scenario of chronically-unfolding disaster that has arisen from the propensity for 'ongoing-acceptance-of-war-states' despite the costs paid by all those touched by its epidemic proportions. From the perspective of trauma and traumatization of combatants, civilians and survivors, the consequences, generally life-long, may be measured in various terms that include posttraumatic stress disorder, epigenetic and telomeric manifestation, the destruction of relationships, child welfare and individual profiles with a high probability of irreversibility. The ravages of war describe a confluence of syndromes and disorders, pathophysiological and neurogenetic predispositions, and requirement for prevention and intervention that entice dire considerations of cataclysm if left to fester.


HCI research has increasingly examined how sensing technologies can help people capture and visualize data about their health-related behaviors. Yet, few systems help people reflect more fundamentally on the factors that influence behaviors such as physical activity (PA). To address this research gap, we take a novel approach, examining how such reflections can be stimulated through a medium that generations of families have used for reflection and teaching: storytelling. Through observations and interviews, we studied how 13 families interacted with a low-fidelity prototype, and their attitudes towards this tool. Our prototype used storytelling and interactive prompts to scaffold reflection on factors that impact children's PA. We contribute to HCI research by characterizing how families interacted with a story-driven reflection tool, and how such a tool can encourage critical processes for behavior change. Informed by the Transtheoretical Model, we present design implications for reflective informatics systems.


[1] As rivers cut a path through bedrock, what influences the relationship between channel width, slope, and erosion rate? Data from naturally incising bedrock rivers show differing relationships among these parameters. For instance, while some studies show a strong inverse relationship between erosion rate and channel width, others show no such correlation. To explain the field data, Yanites and Tucker created a model of optimized channel geometry that accounts for water discharge, sediment supply, and base-level fall. They found that including the erosion-inhibiting effects of immobile sediment is necessary to explain the observed disparate relationships. Essentially, as more sediment is added to a river, the channel geometry must widen and steepen to transport the supplied sediment and continue eroding bedrock at the rate of base-level fall. For channels carrying significant bed load, they found that channel width can be the primary morphological control on the erosive potential of the river, a prediction matched by field data. Further, trade-offs between increasing sediment supply (which widens the channel) and erosion rate (which narrows the channel) can generate rivers with no relationship between channel width and erosion rate. The model helps explain the conflicting field observations of controls of channel geometry and could contribute to improved understanding of landscape evolution. (Journal of Geophysical Research-Earth Surface, doi:10.1029/2009JF001601, 2010)


The number of people over age 65 will almost double by 2030 and as they age, they generally prefer to remain in their home or go to a nursing home. There are a variety of reasons for their decision, such as convenience or a need for security or privacy. So, it is time to break through the physical boundaries of hospitals, and bring the hospital information to the homes of the elderly rather than bringing elderly folks to the hospital. Despite growing requests by people to be able to take a more active part in managing their own health, wireless or internet-based healthcare devices have not been accepted for use in this area. This is probably due to the reluctance of this age group to make use of new technology, as well as the lack of reliable, individualized, or user friendly interfaces. In this paper, we discuss the challenges of developing Wellness Assistant (WA), software which is looking to solve some of these problems. The Assistant will use pervasive computing technologies because of the availability of inexpensive handheld devices such as PDAs, cell phones, and wrist watches with short range wireless capabilities. The WA can also be used by people with obesity, diabetes, or high blood pressure, conditions which need constant monitoring.


Roll forming (profiling) is known as a versatile process to create long, often complex metallic shapes from strips and that in a continuous way. Due to its formability and work hardening behaviour, stainless steel exhibits an interesting potential to create such profiles. Moreover, its corrosion resistance makes it a durable and economical solution too. This paper discusses a case study about a profiled ("section rolled") design that replaces a 1.4571 (316Ti) welded solution for a long structural parts in a railway car body shell. Starting from the desired shape, a grade selection has been performed, prototypes have been characterised and the industrial product has been produced accordingly. An alternative stainless steel grade has been selected for this complex part because of its roll forming capability, high mechanical properties, fatigue and corrosion resistance. After all the tests done, corrosion and fatigue properties were adequate.


A74-year-oldwhitewomanpresentedwithanapproximately 1-year history of median longitudinal ridging of the right thumb that had evolved in a deep fissure along with distal onycholysis. She had previously been diagnosed as having onychomycosis and had been treated with topical and systemic antimycotic drugs, with no improvement. The medial part of the nail plate had progressively become thin and brittle, causing median longitudinal fissuring of the whole nail and isolating 2 lateral parts of normal nail plate (Figure 1). The nail bed, which was exposed by onychodystrophy, was yellowish red and had a few scales. The nail fold was not involved, and the hyponychium was not ulcerated and looked only slightly hyperkeratotic. The digital pulp was normal and painless. A punch biopsy specimen of the lesion was obtained, and a total excision of the nail apparatus was subsequently performed. The specimens were stained with hematoxylin-eosin (Figure 2) and HMB-45 (Figure 3). What is your diagnosis?


Lipid infiltration of the corneal stroma, sclera, and uvea occurred in a 2-year-old cottontail rabbit that had been fed an all-milk diet for 20 months. Superficial keratectomy was performed on the left eye but the rabbit died. Histologically, lipid deposits were most extensive in the anterior corneal stroma and posterior iridal epithelium.


In this article, we consider the infinite dimensional linear control system describing the Population Models Structured by Age, Size, and Spatial Position. The control is localized in the space variable as well as with respect to the age and size. For each control support, we give an estimate of the time needed to control the system to zero. We prove the null controllability of the model, using a technique avoids the explicit use of parabolic Carleman estimates. Indeed, this method combines final-state observability estimates with the use of characteristics and with L∞ estimates of the associated semigroup.


In recent years, there has been an apparent increase in the incidence of pulmonary embolus after joint arthroplasty at our institution. We hypothesized the use of sophisticated imaging modalities such as the multidetector computed tomography scan, with better sensitivity, resulted in an apparent increase in the incidence of pulmonary embolus. We studied all patients with pulmonary embolus after joint arthroplasty between 2000 and 2005. The incidence of pulmonary embolus increased from 0.21% (six of 2859) when VQ scan was the modality of choice to 0.98% (50 of 5095) during the time spiral computed tomography was used to 1.72% (89 of 5179) in recent years when multidetector computed tomography was used. Despite the apparent increase in pulmonary embolus, we observed no change in mortality during the study period. Surgeons should be aware of the challenges sophisticated imaging modalities in general and modern imaging introduce for pulmonary embolus in particular. Extremely sensitive imaging tests with unknown specificity have resulted in an increase in diagnosed pulmonary embolus. However, diagnosing pulmonary embolus generates implications for further treatment such as prolonged anticoagulation and/or inferior vena cava filter insertion with potential for catastrophic complications. The challenge is to distinguish which require treatment and which do not.Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.


As the Canadian population ages, healthcare systems have become increasingly interested in exploring new ways to deliver services to frail older adults, and in particular older adults with dementia. The Specialized Seniors Clinics (SSCs) are an innovative integrated network of six outpatient clinics in BC's Fraser Health Authority that utilize interprofessional teams to provide comprehensive geriatric assessments and care planning for frail older adults. The SSCs provided approximately 19,000 appointments in the past fiscal year, and clients and primary care physicians are highly satisfied with the model. This article describes the SSC model and provides reflection on the model development, implementation and standardization processes.


Range‐expanding species are expected to gain an increasing importance in the context of global change. They provide a great opportunity to study contemporary evolutionary changes and to unravel the mechanisms of evolution. Cryphonectria parasitica, the causal agent of chestnut blight, originating from Asia, has been spread since the beginning of the 20th century into different continents. We took advantage of the C. parasitica recent emergence in northern France to study the changes in population genetic structure and in phenotypic traits along this colonization and climatic gradient. Four hundred twenty‐seven C. parasitica isolates were sampled in 47 chestnut sites in northern France. The C. parasitica outbreak in the north was found to be due to the expansion of five dominant clonal groups from southern France and to the emergence of a few rare recombined genotypes. The evolutionary changes during C. parasitica range expansion were studied by analysing phenotypic changes in isolates from the same clonal lineage, with or without a geographic shift. Growth rates were assessed in vitro, at four temperatures. The northern isolates grew faster at 12 and 15 °C and more slowly at 28 and 32 °C than the southern isolates. These results strongly suggest local adaptation to low temperatures in C. parasitica, with a trade‐off of slower growth at high temperatures. They also reflect the high evolutionary potential of C. parasitica along a colonization gradient and show that clonal evolution is not a limitation for the rapid thermal adaptation of this invasive fungal species.


Reflecting on the role of the nursing staff in civil construction has paramount importance, because it enables improving knowledge and making discoveries. Such reflection is further useful for managers and workers to jointly develop disease prevention and health promotion strategies. The aim of the present study is to describe a nurse's contributions to a civil construction company. It consists of an experience report according to Callista Roy's adaptation theory. The analyzed experience took place from August 2017 through March 2018. We describe the activities carried out by the nurse jointly with other healthcare workers. We believe that the present study evidences the significance of occupational health nursing actions, particularly within civil construction, as well as the relevance of providing theoretical scientific grounds to such actions to contribute to make working environments healthier for all the involved actors without neglecting the aspect of productivity.


Designing and conducting standardized microbiological method interlaboratory validation studies is challenging because most methods are manual, rather than instrument-based, and results from the methods are typically subjective. Determinations of method recovery, in particular, are problematic, due to difficulties in assessing the true spike amount. The standardization and validation process used for the seven most recent USEPA 1600-series pathogen monitoring methods has begun to address these challenges. A staged development process was used to ensure that methods were adequately tested and standardized before resources were dedicated to interlaboratory validation. The interlaboratory validation studies for USEPA Method 1622, for Cryptosporidium , USEPA Method 1601 for coliphage, and USEPA Method 1605 for Aeromonas assessed method performance using different approaches, due the differences in the nature of the target analytes and the data quality needs of each study. However, the use of enumerated spikes in all of the studies allowed method recovery and precision to be assessed, and also provided the data needed to establish quantitative quality control criteria for the methods.


In responding to the demand for vaccine outreach solutions in remote off-grid areas in developing countries, Intellectual Ventures Global Good developed a highly-efficient vaccine storage and PCM (Phase Change Material) freezing device prototype, called Arktek SDD (Solar Direct Drive). A final design and product, which may differ in certain details from the prototype, will be developed by Global Good's commercial partner Aucma, a leading manufacturer of refrigeration and cold chain equipment. The prototype device consists of two parts: a SDD cooling system as an add-on to an Arktek PSD (Passive vaccine Storage Device). The active-cooling system employs thermoelectric cooling technology, which maintains inside temperature of a 10L vaccine compartment from 2 to 8°C. Two removable PCM packs can be fully frozen inside the device, and then put into WHO standard vaccine carriers for outreach. Five prototype devices were built and tested inside an environmental chamber. The test results showed that the performance met or exceeded WHO verification protocol for combined SDD refrigerator and freezer. For example, the devices achieved 8 days holdover time vs 20 hours as WHO requires. Four devices were then taken to 4 remote health posts in west Senegal for field tests. The test results demonstrated that the devices met all the relevant requirements under real world conditions and use cases. The devices maintained the vaccine temperature within 3–5°C all the time; and a 100W solar panel is sufficient to power the system with ample margin. Routine vaccine-retrievals and PCM pack's insertion / freezing did not adversely impact vaccine temperature range.


Nanoparticles are known to self-assemble into large aggregates through interparticle and external forces. Understanding how interparticle interaction forces affect the construction and organization of nanomaterials is of growing importance to the development of the self-assembly technique. Current studies tend to focus on the individual factors and lack the collective effects from multiple forces as virus, lipid, or peptide does. The dual control on the self-assembly process of citrate-capped Au nanoparticles (AuNPs) mediated by the interparticle forces is reported. This self-assembly process is governed by the collective effects of both thiol-containing biomolecules and the ionic strength of dielectric medium. Thiol-containing biomolecules can effectively replace surface citrate molecules on AuNPs forming stable AuS bonds, leading to the lowering of surface potential or charge. Ionic strength of the solution can decrease the ion binding and the screening length of the double-layer repulsion. When these two factors are in play simultaneously, they collectively affect the AuNPs self-assembly process through the interparticle interactions by contributions from both factors, which have been interrogated based on the classical Derjaguin–Landau–Verwey–Overbeek theory. It is interesting to observe the existence of a quasi-stable state existed between two aggregated states, where two factors cancel each other and the AuNPs remain well dispersed, indicating that their concurrent effects are not simply additive. The results provide new insight to the assembly process of metal nanoparticles, and may open up new avenues to manipulate process.


Mental health is the most neglected and stigmatized branch of medical science in Bangladesh. Attitudes towards psychiatry are an important determination for selection of the subject as career by the undergraduate medical students. The objective of this study was to determine the attitudes of undergraduate medical students towards psychiatry and related factors. It was across sectional study conducted from May 2013 to September 2013 among 1 st and 5 th year medical students of Rajshahi Medical College, Rajshashi and Shaheed Shahrawardi Medical College, Dhaka. Results showed that only 2.6% of 5 th year medical students wanted to be specialized in psychiatry and none of 1 st year medical students wanted to be specialized in psychiatry. All of them (100% and 98.7%) agreed with the statement that psychiatric research has made good strides in advancing care of major mental disorder and majority students of both groups were (96% and 86.6% respectively) with the statement that psychiatry was a rapidly expanding frontier of medicine. Around two-third of the students (79.3% and 82.7% respectively) perceived psychiatric treatment as being helpful. Fifty nine (76.6%) of 5 th year students and forty one (55.7%) of 1 st year students did not agree that psychiatrists frequently abuse their legal power to hospitalize patients against their will. Positive opinions on attitudes of undergraduate medical students towards psychiatry became strengthen further following exposure to psychiatry lectures and clerkship in psychiatry ward. Bang J Psychiatry Dec 2014; 28(2): 45-49


There are many ways to express similar things in text, which makes evaluating natural language generation (NLG) systems difficult. Compounding this difficulty is the need to assess varying quality criteria depending on the deployment setting. While the landscape of NLG evaluation has been well-mapped, practitioners' goals, assumptions, and constraints -- which inform decisions about what, when, and how to evaluate -- are often partially or implicitly stated, or not stated at all. Combining a formative semi-structured interview study of NLG practitioners (N=18) with a survey study of a broader sample of practitioners (N=61), we surface goals, community practices, assumptions, and constraints that shape NLG evaluations, examining their implications and how they embody ethical considerations.


Background: There are estimated in the National Czech Cancer
Registry since 1976 to 2010 among 203, 858 cancers a total of
16 622 lung cancers (LCs) in males associated with other
neoplasms, presented 10 % of 166 239 (81,5%) newly registered
LCs in males. They were 4,395 (2.6 %) primary and 12,227 (7.4
%) subsequent LCs; A total of 5,322 LCs in females, presented
14.1 % of 37,619 (18,5%) newly registered LCs in females, of
which were 1,022 (2.7 %) primary and 4,300 (11.4 %) subsequent
LCs. Their representation at the early clinical stages
decreased gradually from 53% to 22 %, at the advanced stages
increased from 20 % to 64 %; One third of subsequent neoplasms
in early stage and one fifth in advanced stage evaluated
replenish 51,2% of unknown stage in men and 47,4% in women.
High proportion of LCs at unknown stages limited detailed
analysis. Dichotomous question of early diagnosis is inquired.
Methods: Miscellaneous group of 548 individuals (260 females
and 288 males) with high risk of lung cancer was formed
predominantly from South Moravia region of the Czech Republic,
EU. They were enrolled since 2001 to 2010. Approximately one
third (n=185) from the group had undergone surgery due to
cancer of head and neck, gastrointestinal, gynecological
including breast, urological and skin location (n=86) and due
to pulmonary malignancy (n=99) . The follow up scheme for this
subgroup represents four time yearly careful clinical
investigation with monitoring of appropriate TM levels during
first three years, then three time in the year during fourth
and fifth years, and two time yearly follow up investigation
during sixth to tenth year in connection with yearly
paraclinical set of CT of thorax and USG of abdominal spaces on
even-numbered, and X-rays of thorax and CT of abdomen on
odd-numbered years, two-year period bone scan, endoscopy, and
yearly laboratory screening tests – serology, hematology, and
basic urine investigation. Another parts of the risk group are
represented by persons (n=203) with high risk of lung cancer
(uranium miners with long term professional exposure to Rn222,
heavy smokers minimally 20 yrs with 1 to 2 packs cigarettes per
day (n=60), pts with hemoptysis (n=15) and persons with other
kind of risk (n=85). These were screened one time yearly by
clinical, laboratory, and bronchoscopy examination and imaging
alternately yearly X rays / thoracic CT scan and abdominal USG.
Classification of malignant tumours TNM-7 and Program Microsoft
Excel® were used to data analysis. Results: Among 548 persons
from the risk group followed during ten years period they were
found in 29 individuals (5,3%) counting 11 females and 18 males
a total of 40 lung cancers. They were 14 primaries and 26
subsequent LC with two cases of triplicity. The early diagnosis
in the stage (I, II) was established 32-times (i.e. 4/5) versus
8-times diagnosed advanced stage (III, IV) of disease (i.e.
1/5). Appropriate treatment was organized and follow up
continues to evaluate survival. Conclusion: Early diagnosis in
patients with lung cancer multiplicity seems attainable despite
of certain limitation.


Background Estimates of statin discontinuation rates are generally high but show large variations. Discontinuation rates are possibly influenced by unrecognized supplies from previous prescriptions and the operational definitions of statin discontinuation. Objective: To investigate whether the outcome (discontinuation) was affected by (1) the operational definition used to calculate statin exposure and (2) the operational definition and different cutoff values used to calculate discontinuation. Methods: Data for this study were obtained from the PHARMO medical record linkage system in the Netherlands. Participants were patients with a new statin and no statin prescription in the preceding year. The outcome, discontinuation, was defined based on a variable number of days without medication after exposure (gaps) or based on the availability of supplies 12 months after the inclusion date (at 1 year). Exposure to statins was assessed by 2 methods. The method termed No Overlap accounted for only the supplies of the last prescription to calculate exposure, and the method termed Overlap accounted for all supplies from previous prescriptions. We investigated the effect of 4 exposure outcome combinations on statin discontinuation estimates. Results: The exposure outcome combinations, including overlap, resulted in a 7% unit lower discontinuation rate. At gap lengths of 90 days and longer, no significant differences between No Overlap and Overlap were observed. Shorter minimum gap lengths gave higher discontinuation rates compared to longer minimum gap lengths and ranged from as high as 86% to 21%. Conclusions: If previous supplies are accounted for in the calculation of exposure to statins, lower discontinuation rates are observed, The influence of previous supplies on discontinuation rates is less pronounced than the influence of gap lengths. The calculation of exposure does not influence discontinuation if gaps longer than 90 days are used to assess discontinuation.


Fan-Out Wafer-Level Interposer Package-on-Package (PoP) design has many advantages for mobile applications such as low power consumption, short signal path, small form factor and heterogeneous integration for multi-functions. In addition, it can be applied in various package platforms, including PoP, System-in-Package (SiP) and Chip Scale Package (CSP). These advantages come from advanced interconnection technology called a redistribution layer (RDL).However, a PoP-type RDL-base platform requires dual-side RDLs on both top and bottom sides to stack another package on top. In a monolithic process flow, that means the second RDL only can be fabricated after finishing all the first RDL and the assembly processes such as flip-chip bonding, molding and grinding. Therefore, this process flow is not quite as advantageous as a non-PoP type platform because chips can be lost during the second RDL process.In this paper, to address this RDL-base Interposer PoP challenge, a real chip-last process flow with a chip-to-wafer (C2W) bonding technology is introduced. And the results are presented of building and testing an RDL-base wafer-level Interposer PoP with a size of 12.5 x 12.5 mm2 and thickness of 0.357 mm including solder ball. The bottom side has a 3-layer RDL structure and the top RDL for the package stacking has a 1-layer structure. These RDLs are implemented with copper (Cu) lines with 5 μm/10 μm of line & space (L/S) and copper (Cu) cored solder balls (CCSBs) are used as the vertical interconnect components. The silicon die and CCSBs' joint quality is confirmed by reliability testing. The test vehicle package passed all the reliability tests of moisture resistance test (MRT) L3, Temperature Cycle, Condition B (TCB) 1,000 cycles and high temperature storage (HTS) 1,000 hrs.