This chapter addresses the various institutional arrangements for the delivery of local public services in France, Germany and Italy. It has a comparative focus but provides an analysis of how the different institutional variants of service provision have developed over time. In particular, it examines what new arrangements have been adopted and what effects may be expected for municipal governance. The chapter is intended to offer a critical analysis of the overall structures and trends rather than an analysis based on sectoral developments (e.g. water or social care). These may be found in other chapters of the book. With regard to the broad portfolio of local services, our intention is to concentrate on services usually provided by local utilities and which are mostly traded on (regulated) markets (in EU terminology: services of general economic interest), for example infrastructure services and basic services such as water, energy and transport. The chapter is organized as follows. It begins with an overview of institutional patterns in the three countries under study. We make a comparative analysis focusing on corporatization, that is, on the ongoing process of transforming local government units into (semi-)autonomous corporations, most with independent legal status and enjoying considerable managerial freedom. We also identify similarities and differences in patterns of service delivery.


This article is about the experience of a group of women in the commercialization of gathered wild fruits through the governmental Food Purchase Program (PAA) in the Brazilian State of Sergipe. The analytical framework is associated to the debate on poverty and specific public policies for traditional communities in rural areas. The women hold a collective identity as the mangaba gatherers, based on their use of common pool resources with low environmental impact. They mobilize themselves through the MCM – Movimento das Catadoras de Mangaba, Mangaba Gatherer Women s Movement. Although they have recently been recognized as having specific legal rights, they are experiencing the dwindling of the resources they gather, as well as difficulties in commercialization of the fruits due to their seasonality and the unpredictability of access. The research was carried out between 2008 and 2011 and involved direct and participant observations and open-ended interviews. The main results show that the PAA has contributed to increased income, consumption and self-esteem. There was a re-arrangement in their way of participating in the program, meanwhile some of their traditional practices were relegated. The program rules were re-signified and adapted locally. While growing solidarity has been observed among the gatherers, competition for the fruits has also increased.


In this article, the observation and control of a general class of nonlinear systems within the full linearization framework is constructed. Under step-by-step linearization procedures, the nonlinear control is determined by solving the implicit, nonlinear ordinary-differential-equation (ODE) while the observability matrix has full rank. Using the finite difference approach, the discrete-time output feedback control architecture is developed. Closed-loop simulations show that an unstable chemical reactor in the presence of input delay and unknown disturbances is successfully demonstrated.


Information about complex technical products such as Radio base Stations (RBS) needsto be presented in ways that make them easy to understand. The aim of this project was toinvestigate Ericsson´s Customer Product Information for complex technical productsfrom the users' point of view and propose improvements to the user interface. Userrequirements were gathered from interviews and from literature on digital libraries,search and navigation. Several usability problems were identified and analyzed. Aprototype was made that demonstrate proposed design solutions to the found problems.General recommendations for digital libraries of customer information about technicalproducts are given.


A Monte Carlo computational model of CT has been developed and used to investigate the effect of various physical factors on the surface air kerma length product, the peak surface air kerma, the air kerma length product within a phantom and the energy imparted. The factors investigated were the bow-tie filter and the size, shape and position of a phantom which simulates the patient. The calculations show that the surface air kerma length product and the maximum surface air kerma are mainly dependent on phantom position and decrease along the vertical axis of the CT plane as the phantom surface moves away from the isocentre along this axis. As a result, measurements using standard body dosimetry phantoms may underestimate the skin dose for real patients. This result is specially important for CT fluoroscopic procedures: for an adult patient the peak skin dose can be 37% higher than that estimated with a standard measurement on the body AAPM (American Association of Physicists in Medicine) phantom. The results also show that the energy imparted to a phantom is mainly influenced by phantom size and is nearly independent of phantom position (within 3%) and shape (up to 5% variation). However, variations of up to 30% were found for the air kerma to regions within the AAPM body phantom when it is moved vertically. This highlights the importance of calculating doses to organs taking into account their size and position within the gantry.


While there are numerous empirical studies on business cycles for developed economies, there are very few analyses regarding developing countries. The purpose of this paper is to document the comovement among sectoral outputs in Turkey, a developing country, and provide evidence about the importance of real factors to explain fluctuations. Specifically, we ask whether business activity in Turkey is generated by a few forces and whether there are differences in the shape, duration, and amplitude of cycles of individual sectors. Furthermore, we examine the relative importance of permanent and transitory innovations. Using sectoral data for fifty years, and employing cointegration and cofeature analysis, we find evidence in favor of strong comovement of sectors in the Turkish economy. Nonetheless, the evidence that almost all variation in total innovations in all sectors could be attributable to permanent innovations implies that the sources of the fluctuations could be real factors. The findings about the procyclicality and amplitudes of transitory components, as well as about the relative importance of permanent innovations, is unlike the evidence reported for advanced economies in earlier research.


In this letter, Vanter discusses with Moore he planned visit to Fort Worth. Vanter apologizes for not being able to visit Moore as last summer and urges Moore to write to her to let her know when school is out. During the trip to Fort Worth, Vanter plans on paying Moore and Visit. She details that an illness prevented her from visiting last summer. Vanter ask about Moore family and states that she hopes they are all well. She also asks about friends and Moore's kin and states that she may not know anybody there as it has been a while since she has visited. She inquires about Mr. Drury and closes the letter. She notes that she hopes to hear from Linnet soon. The envelope is included with the letter.


Adults of the wandering spider Cupiennius salei (Ctenidae) have 936 ( $\pm$ 31 s.d.) trichobothria or filiform hairs on their legs and pedipalps. This is the largest number of these air movement detectors recorded for a spider. The trichobothria are 100-1400 $\mu$ m long and 5-15 $\mu$ m wide (diameter at base). Many of them are bent distally pointing towards the spider body. Their feathery surface increases drag forces and thus mechanical sensitivity by enlarging the effective hair diameter. Typically, trichobothria are arranged in clusters of 2-30 hairs which increase in length towards the leg tip. The trichobothria's mechanical directionality is either isotropic or it exhibits a preference for air flow parallel or perpendicular (from lateral) to the long leg axis. These differences are neither due to the distal bend of the hair nor to the bilateral symmetry of the cuticular cup at the hair base but to the spring supporting the hair. Different directional properties may be combined in the same cluster of hairs. Trichobothria are tuned to best frequency ranges between 40 and 600 Hz depending on hair length. Because, with increasing hair length, absolute mechanical sensitivity changes as well, the arrangement of hairs in a cluster provides for a fractionation of both the intensity and frequency range of a stimulus, in addition, in some cases, to that of stimulus direction. Boundary layer thickness above the spider leg in oscillating airflow varies between about 2600 $\mu$ m at 10 Hz and 600 $\mu$ m at 950 Hz. It is well within the range of hair lengths. In airflow perpendicular to the long leg axis particle velocity above the leg increases considerably as compared to the free field. The curved surface of the cuticular substrate has therefore to be taken into account when calculating hair motion. The experimentally measured properties of hair and air motion were also determined numerically using the theory developed in the companion paper (Humphrey et al. Phil. Trans. R. Soc. Lond. B 340, 423-444 (1993)). There is good agreement between the two. Short hairs are as good or better velocity sensors as long hairs but more sensitive acceleration sensors. In agreement with most of our measurements optimal hair length is not larger than boundary layer thickness at a hair's best frequency. Best frequencies of hair deflection and of ratio a (maximum hair tip displacement:air particle displacement) differ from each other. The highest measured value for ratio a was 1.6. In only 22 $\%$ of the cases hair tip displacement exceeded air particle displacement. Hair motion is insensitive to changes in hair mass as shown by the numerical comparison of a solid and a hollow hair.


The global importance of human rights issues has sparked an ongoing need to develop a universal language for human rights and the procedures for remedying violations, where remedies are, in fact, available. Giving the broadest scope to the terms human rights and freedoms, this reference encompasses constitutional rights and freedoms as well as those addressed in international and regional agreements. Through entries that define and describe concepts and terms, to text excerpts of documents, charts depicting global comparisons, essays on organizations, and biographies of activists and theorists, this reference will serve the research and information needs of students, scholars, activists, and interested citizens. As the title suggests, "International Encyclopedia of Human Rights: Freedoms, Abuses, and Remedies" goes beyond the abstract to include practical information on remedies for violations of a person's rights and freedoms by a national government, and on the private and government rights organizations that assist in reporting on or enforcing human rights. All around the world, there is a growing interest in developing a universal language for human rights and the procedures for remedying violations. "International Encyclopedia of Human Rights: Freedoms, Abuses, and Remedies" is written for both students of the subject and those who are actively working in the field. This reference work points readers in the right direction for enforcing their rights rather than merely setting them forth in the abstract.


ABSTRACT Phytophthora nicotianae and P. palmivora infect and cause rot of fibrous roots of susceptible and tolerant citrus rootstocks in Florida orchards. The infection and colonization by the two Phytophthora spp. of a susceptible citrus host, sour orange (Citrus aurantium), and a tolerant host, trifoliate orange (Poncirus trifoliata), were compared using light and electron microscopy. Penetration by both Phytophthora spp. occurred within 1 h after inoculation, regardless of the host species. No differences were observed in mode of penetration of the hypodermis or the hosts' response to infection. After 24 h, P. palmivora had a significantly higher colonization of cortical cells in susceptible sour orange than in tolerant trifoliate orange. Intracellular hyphae of both Phytophthora spp. were observed in the cortex of sour orange, and cortical cells adjacent to intercellular hyphae of P. palmivora were disrupted. In contrast, the cortical cells of sour orange and trifoliate orange adjacent to P. nicotianae hyphae and the cortical cells of trifoliate orange adjacent to P. palmivora were still intact. After 48 h, the cortical cells of both hosts adjacent to either Phytophthora spp. were disrupted. After 48 and 72 h, P. palmivora hyphae colonized the cortex of sour orange more extensively than the cortex of trifoliate orange; P. palmivora also colonized both hosts more extensively than P. nicotianae. A higher rate of electrolyte leakage among host-pathogen combinations reflected the combined effects of greater cell disruption by P. palmivora than by P. nicotianae, and the higher concentration of electrolytes in healthy roots of trifoliate orange than of sour orange. Although cellular responses unique to the tolerant host were not observed, reduced hyphal colonization by both pathogens in the cortex of trifoliate orange compared with sour orange is evidence for a putative resistance factor(s) in the trifoliate orange roots that inhibits the growth of Phytophthora spp.


Summary The nucleotide sequences of the genes encoding the F 1 F 0 -ATPase β -subunit from Oenococcus oeni , Leuconostoc mesenteroides subsp. mesenteroides , Pediococcus damnosus , Pediococcus parvulus , Lactobacillus brevis and Lactobacillus hilgardii were determined. Their deduced amino acid sequences showed homology values of 79–98%. Data from the alignment and ATPase tree indicated that O. oeni and L. mesenteroides subsp. mesenteroides formed a group well-separated from P. damnosus and P. parvulus and from the group comprises L. brevis and L. hilgardii . The N-terminus of the F 1 F 0 -ATPase β -subunit of O. oeni contains a stretch of additional 38 amino acid residues. The catalytic site of the ATPase β -subunit of the investigated strains is characterized by the two conserved motifs GGAGVGKT and GERTRE. The amplified atpD coding sequences were inserted into the pCRT7/CT-TOPO vector using TA-cloning strategy and transformed in Escherichia coli . SDS-PAGE and Western blot analyses confirmed that O. oeni has an ATPase β -subunit protein which is larger in size than the corresponding molecules from the investigated strains.


The rise of the contingent and gig economies and of outsourced and subcontracted work has left many workers with insufficient bargaining power to successfully negotiate collective bargaining agreements with their direct employers. This problem is exacerbated by a statutory ban on worker picketing and boycotts of non-employers, or "secondaries," even where those employers: collude with direct employers on wage-fixing or the suppression of union activity; have monopsony power over direct employers; or have substantial indirect control over worker wages through contractual arrangements.

This Article is a crucial intervention in modernizing the labor law on worker picketing in the New Economy. It first outlines the current distinction between direct and "secondary" employers under the National Labor Relation Act's secondary picketing ban. It then provides an overview of New Economy work arrangements and developments in economic theory necessary for updating the law on this distinction and for developing the economic expertise of judicial and administrative labor regulation. The Article then proposes unified principles for measuring labor law's success under New Economy work structures. These principles align expressive and associational values with achieving economically efficient and distributional outcomes for labor and capital.

On this foundation, the Article assesses current law on the primary-secondary distinction and finds it deficient under these principles. It puts forward instead an economic effects-based standard that would make a defense to secondary picketing available where employees can demonstrate, through economic evidence, that a secondary target – whether through contractual agreements with a direct employer, monopsony power, or oligopolistic collusion – has sufficient market power to determine the wages or working conditions of picketing workers. The rule would dramatically benefit employees in the "fissured" workplace by providing a tool to correct for unequal bargaining power between workers and their employers. Remedying this imbalance can enhance protections for the expressive activity and self-determination critical for democratic and civil society values and reverse the adverse microeconomic wage effects and distributive consequences of the current law.


This paper seeks to highlight the numerous obstacles to, and opportunities for, the consolidation of PMSCs into a security provision role on the African continent. Obstacles include the lack of definition as to what PMSCs actually are. The inability to fully define the activities of PMSCs allows opportunities for evading accountability, and this is exacerbated by the fact that there is no international legal framework to address PMSCs and any possible abuses that may form part of the industry. This paper argues that there is a need to encourage more robust dialogue concerning the privatisation of security in order to achieve a comprehensive understanding of PMSCs' activities, and enable international legislation that can address these activities.


Sixteen tree-rings of Polar (P. Euramericana) were collected in the different function districts of Kaifeng City, China. Concentrations of Cu and Zn in the xylem of tree-rings from 1990 to 2009 were measured using F-AAS, and that of Co using ICP-MS. The results show that concentrations of Cu and Zn in tree-rings in the control area do not vary significantly in the period from 1990 to 2009 and much lower than that in urban areas. The accumulation sequences of Zn in tree-rings in different urban districts appear increasing trends in the period, and that of Cu present waved rising trends. The sequences of Co in tree-rings both in urban and control area had no significant change in the period. Copper and Zinc are the typical anthropogenic metals, and Co is a natural source metal. We can understand the heavy metal pollution changes in urban area from their accumulation sequences in tree-rings.


The paper investigates stock return dynamics in an environment where executives have an incentive to maximize their compensation by artificially inflating earnings. A principal-agent model with financial reporting and managerial effort is embedded in a Lucas asset-pricing model with periodic revelations of the firm's underlying profitability. The return process generated from the model is consistent with a range of financial anomalies observed in the return data: volatility clustering, asymmetric volatility, and increased idiosyncratic volatility. The calibration results further indicate that earnings management by individual firms does not only deliver the observed features in their own stocks, but can also be strong enough to generate market-wide patterns.


Climate variability and changes in sea ice dynamics have caused several iceobligate or krill-dependent populations of marine predators to decline, eliciting concern about their demographic persistence and the indirect ecological consequences that predator depletions may have on marine ecosystems. Pack-ice seals are dominant ice-obligate predators in the Antarctic marine ecosystem, but there is considerable uncertainty about their abundance and population trends. We modelled the density and distribution of pack-ice seals as a function of environmental covariates in the southern Weddell Sea, Antarctica. Our density surface modelling approach used data from aerial surveys of pack-ice seals collected in the 2013/14 austral summer. Crabeater seals Lobodon carcinophaga, the most numerous pack-ice seal we observed, occurred at the highest densities in areas with extensive sea ice near the continental shelf break, but were almost absent in areas of similar sea ice concentration in the southern extent of the Weddell Sea. The highest densities of Weddell seals Leptonychotes weddelli, which were less abundant than crabeater seals within the pack ice habitat, were predicted to occur over the continental shelf, near the shelf break. The distribution of both seal species broadly corresponded with the distribution and relative abundance of their main prey (Antarctic krill Euphausia superba and Antarctic silverfish Pleuragramma antarctica) obtained from concurrent ecosystem surveys. Ross seals Ommatophoca rossii and leopard seals Hydrurga leptonyx were not detected at all and are apparently rare within the southern Weddell Sea. These results can contribute to biodiversity assessments in the context of marine protected area planning in this region of the Southern Ocean.


ABSTRACT The sesame crop has great economic potential due to the various possibilities of exploitation, however, there is a lack of information about the chemical control of weeds in the crop, mainly about the application of herbicides in pre-emergence. Therefore, the objective of this study was to evaluate the economic viability and efficacy of herbicides applied in pre-emergence for the control of weeds in the sesame crop. The experimental design was in randomized blocks, with four replications. The treatments consisted of seven herbicides (diuron, flumioxazin, oxadiazon, oxyfluorfen, metribuzin, linuron, and S-metolachlor) and a mixture (metribuzin + oxyfluorfen) applied in pre-emergence. The two control treatments were weeded and nonweeded plots. The variables evaluated were percentage of control of the weed community, grain yield, gross and net income, rate of return, and profitability index. The highest productivity value was for weeding, followed by the herbicides diuron and flumioxazin, with 2,000.44 kg ha-1, 1,957.35 kg ha-1;, and 1,933.13 kg ha-1, respectively. The herbicides diuron and flumioxazin obtained the highest net income, in the amounts of R$ 7,831.26 and R$ 7,762.85, respectively. The diuron and flumioxazin applied in pre-emergence showed more than 80% in the control of weeds in the sesame crop, showing efficiency in the control. The use of herbicides applied in pre-emergence to control weeds, mainly diuron and flumioxazin, is as efficient as mechanical control, demonstrating the potential for use and economic viability in relation to mechanical control, which presents a high cost/benefit ratio.


Recently, a major trend is going to redesign a production system by controlling or making variable the production rate within some fixed interval to maintain the optimal level. This strategy is more effective when the holding cost is time-dependent as it is interrelated with holding duration of products and rate of production. An effort is made to make a supply chain model (SCM) to show the joint effect of variable production rate and time-varying holding cost for specific type of complementary products, where those products are made by two different manufacturers and a common retailer makes them bundle and sells bundles to end customers. Demand of each product is specified by stochastic reservation prices with a known potential market size. Those players of the SCM are considered with unequal power. Stackelberg game approach is employed to obtain global optimum solution of the model. An illustrative numerical example, graphical representation, and managerial insights are given to illustrate the model. Results prove that variable production rate and time-dependent holding cost save more than existing literature.


PM2.5 has recently been adopted as the national ambient air quality standard (NAAQS) as of 2015 in Korea, so official measurement began in 2015. The annual average concentration of PM2.5 in Busan was 26 μg/m3 in 2015, 27 in 2016, and showed an increasing trend of exceeding NAAQS (below 25 μg/m3). Korea is located below China, so pollutants emitted from the eastern region of China have also been identified as having a significant impact. In this study, a three-dimensional, numerical air quality model, the Comprehensive Air Quality Model with Extensions (CAMx), was coupled with Particulate Matter Source Apportionment Technology (PSAT) to analyze region and source category contributions to PM2.5 content and related chemical components. This research took place in Busan, Korea, during May 2017. Emission-based models require both meteorological information and emission data. Four nested modeling domains were constructed for both the meteorological model and the chemical transport model (CTM) in this study. Grid resolutions were 27 km, 9 km, 3 km and 1km, respectively, and the corresponding nesting grids are denoted as domain1, domain2, domain3 and domain4. Meteorological input data was determined with a WRF meteorological model using National Centers for Environmental Prediction (NCEP) Final (FNL) global analysis data. The Clean Air Policy Support System (CAPSS) developed by the Ministry of Environment was used to gather air pollutant emission data within South Korea. For other areas, the Model Inter-Comparison Study for Asia (MEIC) and Regional Emission Inventory in Asia (REAS) were used to input air pollutant emission data. According to the CAMx results, the soil-derived component represented the highest proportion. The second highest was sulfate (23.6%), followed by nitrate (12.7%) and ammonium (12.4%). The regional contribution caused by emission sources in Busan represented 36.9% of


This paper introduces three hierarchical mobile IP schemes, i.e. hierarchical mobile IP (HMIP), dynamic HMIP, and distributed and dynamic HMIP to improve the handoff performance, and develops a model for cost analysis based on one-dimensional random walk of mobile host. Then the paper compares signaling transmission cost, packet delivery cost and total cost of the three schemes respectively, and discusses the effects of different home handoff thresholds and directional walk probabilities on these costs. Numerical results show that the DHMIP scheme has best performance among the three under small home handoff threshold.


There is a multitude of agent-oriented software engineering frameworks available, most of them produced by the academic multi-agent systems community. However, these frameworks often impose programming paradigms on their users that are hard to learn for engineers who are used to modern highlevel programming languages such as JavaScript and Python. To show how the adoption of agent-oriented programming by the software engineering mainstream can be facilitated, we provide an early, simplistic JavaScript library prototype for implementing belief-desire-intention (BDI) agents. The library focuses on the core BDI concepts and refrains from imposing further restrictions on the programming approach. To illustrate its usefulness, we demonstrate how the library can be used for multi-agent systems simulations on the web, as well as embedded in Python-based data science tools.


The potential of 90 nm CMOS technology for low-power RF front-ends is demonstrated with fully integrated low-voltage Low-Noise Amplifiers (LNA) and Voltage-Controlled Oscillators (VCO). The 5.5 GHz LNA draws 3.5 mA from a 0.6 V supply with a measured power gain of 11.2 dB, and a 3.2 dB noise figure. The 6.3 GHz VCO has a phase noise of -118 dBc/Hz at 1 MHz offset, drawing 4.9 mA from a 1.2 V supply.


Objective: In the recent years, the ratio of pregnancy has increased at advanced maternal age (AMA) in comparison to the previous times where giving birth was common around age 18. The purpose of this review paper is to develop a comparative study of demographic and obstetric properties of primiparous females at young and advanced maternal age.

Methods: A cross sectional study was carried out of the participants based upon the inclusion strategy. Two groups with 150 participants in each was made; one group had participants aged above 35 years and other group had participants with age between 20 to 29 years. Variables including weight, BMI, age, pre-pregnancy condition, health state, financial status and other factors were also included.

Results: It was found that females with advanced age were more financially stable, literate, and professionals who pursued their carriers even after bearing a child. These advanced age women also reflected more developed background knowledge about pregnancy, child care, labor and parental attitude. However, medically speaking, these females faced more infertility issues, miscarriages and Caesarean sections in comparison to young primiparous females. Conclusion: Pregnant ladies of advanced maternal age were different from young ladies in knowledge, demographic, financial, and parental attitudes and characteristics.


Whilst most research into music therapy with offenders focuses on music interventions in forensic mental health settings, less research exists into affordances of supporting musicking as an everyday practice in prisons. This article explores the prison as a music scene supported by a music therapist, showing how musicking forms an important part of the prison's emotional geography. Through the presentation of findings from an ethnographic study of musical life in a low secure prison in Norway, the article shows how prisoners engage in music as a technology of self, affording the performance of caring and autonomous identities. We argue that supporting everyday musicking in the prison through music therapy fosters a therapeutic music scene, and that drawing on music as data in criminological research can contribute to more nuanced understandings of prisons.


The Social Security Administration (SSA) provides Social Security Disability Insurance (SSDI) benefits to disabled persons of less than full retirement age and to their dependents. SSA also provides Supplemental Security Income (SSI) payments to disabled persons who are under age 65. For both programs, disability is defined as a "medically determinable physical or mental impairment" that prevents an individual from engaging in any substantial gainful activity and is expected to last at least 12 months or result in death. Assuming that an applicant meets the nonmedical requirements for eligibility (e.g., quarters of covered employment for SSDI; income and asset limits for SSI), the file is sent to the Disability Determination Services (DDS) agency operated by the state in which he or she lives for a determination of medical eligibility. SSA reimburses the states for the full costs of the DDSs. The DDSs apply a sequential decision process specified by SSA to make an initial decision whether a claim should be allowed or denied. If the claim is denied, the decision can be appealed through several levels of administrative and judicial review. On average, the DDSs allow 37 percent of the claims they adjudicate through the five-step process. A third of those denied decide to appeal, and three-quarters of the appeals result in allowances. Nearly 30 percent of the allowances made each year are made during the appeals process after an initial denial. In 2003, the Commissioner of Social Security announced her intent to develop a "new approach" to disability determination. In late 2004, SSA asked the Institute of Medicine (IOM) to help in two areas related to its initiatives to improve the disability decision process: 1) Improvements in the criteria for determining the severity of impairments, and 2) Improvements in the use of medical expertise in the disability decision process. This interim report provides preliminary recommendations addressing the three tasks that relate to medical expertise issues, with a special focus on the appropriate qualifications of medical and psychological experts involved in disability decision making. After further information gathering and analyses of the effectiveness of the disability decision process in identifying those who qualify for benefits and those who do not, the committee may refine its recommendations concerning medical and psychological expertise in the final report. The final report will address a number of issues with potential implications for the qualifications of the medical experts involved in the disability decision process.


Summary This study examined the molecular basis of a missense mutation of the platelet glycoprotein (GP) Ibβ gene in two families. In the propositus with a novel form of Bernard-Soulier syndrome (BSS) from Family I, only GPIbα was detectable in reduced amounts on platelet surfaces by flow cytometry. There were no GPIX or GPIbβ found by immunoblotting. DNA sequencing analysis showed a homozygous mutation in the GPIbβ gene which changed Tyr (TAC) to Cys (TGC) at residue 88. Her parents were heterozygous for Tyr88Cys in the GPIbβ gene. In transient transfection studies on 293T cells, both Tyr88Cys and Tyr88Ala mutations suppressed the expression of GPIb/IX complexes. In addition, Tyr88Cys GPIbβ mutation was found to exert a dominant negative effect on the GPIb expression. Five individuals from Family II, four of whom reported elsewhere as having giant platelet disorders with normal aggregation (BLOOD, 1997; 89: 2404) and one newly analyzed in this study, were heterozygous for Tyr88Cys in the GPIb gene. Microsatellite analysis of chromosome 22 showed a common haplotype in 8 of the individuals with Tyr88Cys mutations in Families I and II. Tyr88 in the GPIbβ gene plays a significant role in the GPIb/IX expression; the defect causes BSS in a homozygous form and possibly giant platelets in a heterozygous form.


In order to measure the similarity between two partitions coming from the same data set, we study extensions of the RV-coefficient, the kappa coefficient proposed by Cohen (in case of partitions with same number of classes), and the D2 coefficient proposed by Popping. We find that the RV coefficient is identical to the Janson and Vegelius index. We compare the result coming from kappa's coefficient to the ordination given by correspondence analysis. We study the empirical distribution of these indices under the hypotheses of a common partition. For this purpose, we use data coming from a latent profile model to formulate the null hypothesis.


With continuing emphasis on maximizing capacity of existing equipment and improving product quality specifications, strict mechanical design and specification of mass transfer equipment for hydrocarbon processing has become an area of critical concern. This concern includes both new plant construction and existing plant modification. Basic mass-transfer operations include absorption, fractionation and stripping. Together, these processes are the most common unit operations in hydrocarbon processing. Other allied application areas include gas treating and separation and chemical production. Recommendations for mechanical design criteria and specification of vessel internals for these services are made. Considerations covered include equipment selection criteria, mechanical strength, upset protection, materials selection, leakage, start-up and shut-down considerations, and off-design operating condition requirements. Special emphasis will be placed on specification of modern, high-efficiency, and high-capacity equipment often used in modification of existing units. Practical examples illustrate the key points and concepts developed. These examples show the need for careful and skilled preparation of engineering specifications; especially those going out for competitive bidding. If your own organization cannot specify this type of equipment correctly, arranging access to an experienced engineer that can is critical to complete procurement success. 33 refs., 10 figs., 7 tabs.


The tourism industry in Zimbabwe has experienced fluctuating trends in its growth since the dawn of the new millennium. The Ministry of Tourism and Hospitality Industry undertook a visitor exit survey in 2015/2016 period. The purpose of the study was to gather visitors' views on Zimbabwe as a tourist destination in order to guide policy formulation on the sector. One of the objectives of the survey was to assess the visitor perceptions of Zimbabwe as a competitive tourist destination. Questionnaires were administered to departing visitors at the country's three international airports and seven border posts during the period July 2015 until June 2016. The results of the survey indicated that 77% of visitors use road transport to enter into the country. The survey also showed that 18% of visitors to the country travelled by air. It is recommended that that the government accelerates the implementation of the open skies policy so as to attract more direct international airlines to fly into the country. It is also recommended that the government undertakes massive improvement of the road infrastructure in the country so as to encourage the geographical distribution of tourists within the country. It is finally recommended that the private sector and the national tourist organization, Zimbabwe Tourist Authority (ZTA) engage international tour operators and persuade them to develop and promote fly-drive tour packages to the country.


The Big Data Era creates a lot of exciting opportunities for new developments in economics and econometrics. At the same time, however, the analysis of large datasets poses difficult methodological problems that should be addressed appropriately and are the subject of the present chapter


This study aims to examine the influence of Capital Adequacy Ratio (CAR), earning assets, and liquidity against Return on Asset (ROA) in the conventional bank which has the biggest asset listed in Indonesian Stock Exchange (IDX) during the period of 2006 to 2010. This research used time series data from Bank Indonesia's report and financial reports annually published by banking firms listed in IDX. After passing the purposive sampling, there were 27 conventional banks listed in IDX as sample in this study. By using multiple regression analysis (F-test), results showed that CAR, Non Performing Loan (NPL), and Non Performing Loan (NPL) collectively have significant influence on ROA. However, by using individual analysis (t-test), NPL has a negative and significant influence on ROA, while CAR and LDR have no significant influence on ROA.


This paper considers whether it is possible to devise a nonexperimental procedure for evaluating a prototypical job training programme. Using rich nonexperimental data, we examine the performance of a two-stage evaluation methodology that (a) estimates the probability that a person participates in a programme and (b) uses the estimated probability in extensions of the classical method of matching. We decompose the conventional measure of programme evaluation bias into several components and find that bias due to selection on unobservables, commonly called selection bias in econometrics, is empirically less important than other components, although it is still a sizeable fraction of the estimated programme impact. Matching methods applied to comparison groups located in the same labour markets as participants and administered the same questionnaire eliminate much of the bias as conventionally measured, but the remaining bias is a considerable fraction of experimentally-determined programme impact estimates. We test and reject the identifying assumptions that justify the classical method of matching. We present a nonparametric conditional difference-in-differences extension of the method of matching that is consistent with the classical index-sufficient sample selection model and is not rejected by our tests of identifying assumptions. This estimator is effective in eliminating bias, especially when it is due to temporally-invariant omitted variables.


The seven Bellevalia species and subspecies known from Italy, representing about 10% of the genus and three out of six sections, were studied. An integrated morphological, karyological and molecular approach was used to infer phylogenetic and systematic relationships among them. B. romana (the generitype) is the most distinctive species on karyotype asymmetry grounds. B. boissieri and B.dubia, usually considered as subspecies of one species (the latter endemic to Sicily), deserve specific status based on biparental nrDNA markers (internal transcribed spacer, ITS), since they do not form a single clade. The allotetraploid endemic B. pelagica, morphologically similar to B. romana, is sister to the latter under parsimony, both in morphological and ITS trees; it is also related with B. dubia, based on karyotype asymmetry and a uniparental cpDNA marker (trnL(UAA)–trnF(GAA) IGS (intergenic spacer)). A second allotetraploid endemic, B. webbiana, is closely related, on morphological, karyological and molecular grounds, with B. boissieri and B. ciliata, and also with B. trifoliata, three species that might all involved in its origin. B. sect. Conicae Feinbr. and sect. Nutantes Feinbr. are here typified, the former (type: B. ciliata) is most likely a synonym of the latter (type: B. trifoliata).


The work on this publication has been sponsored by the LTfLL STREP that is funded by the European Commission's 7th Framework Programme. Contract 212578 [http://www.ltfll-project.org]


All cities are forced to deal with homelessness and poverty; often they rely on temporary shelters and welfare programs as the only solutions. These do not assist the impoverished in establishing themselves in the community, and ignore the fact that many lack the necessary education, job skills, and life skills to establish independence. This thesis examines a way to provide vocational education to break the poverty cycle by providing disadvantaged citizens access to education, training, and work. The abandoned Hostess factory on 7 th and S Street NW in Washington DC, and its adjacent vacant land presents an appropriate site for study. Adaptively re-using this factory as a vocational school can rejuvenate the local neighborhood while helping to change the lives of the impoverished. The vocational school is designed as a community school that offers services for poor and homeless adults as well as the continuing education programs for the local community.


In this study, the effect of business firms carrying on business in Central Black Sea Region of Turkey on the performance of these firms. Especially how it affected SMEs (Small and Medium Sized Enterprises) was analyzed. When particularly considering the effects of business that have SME quality on economy of Turkey, such kind of researches are noticed to have a basis in recent years. The research depended upon the data obtained from enterprises through original qualified questionnaire. The questionnaire question forms were scaled benefiting from the studies in the literature based upon international activities and business performance measurement. For all variables, the scales in the literature were taken and included into research questionnaire. The questionnaires were performed to SMEs and large-scale enterprises. In the research factor analysis, correlation and regression analysis were included as analysis methods. According to the obtained results, it was determined that international activities had a positive effect on the performance of enterprises. The results were interpreted, and various suggestions were offered to academicians, and administrators.


A volume is being prepared, under the over-all guidance and editorship of Gottfried O. Lang and Peter F. M. McLoughlin, on progress among the Sukuma, Tanzania's largest tribal group. The book is both historical and interdisciplinary, covering aspects of geography, economics, agricultural economics, anthropology, political science, sociology, and history. Occupying some 20,000 square miles east and south of Lake Victoria, the Sukuma own approximately one-fifth of Tanzania's livestock and produce most of the country's cotton, the second largest export by value. Chapters will pay particular attention to the factors which have been responsible for Sukumaland's positive economic, social, and political changes, as well as to those elements which have precluded or delayed change. The orientation is practical; development experience will be analysed so that current and future policies and procedures may profit from a more precise definition of trends, problems, and prospects. An appendix will synthesise contributors, research methodologies, techniques, and problems.


The morphological fidelity of the olive plants propagated through axillary buds, microplants and somatic embryogenesis, somatic plants was evaluated. Thirty-two morphological traits were used to characterize the tissue culture propagated olive plants. The microplants showed very high phenotypic similarity compared to plants produced by conventional cutting propagation method. The somatic plants exhibited variant morphological stable phenotypes, among somaclonal population two variant phenotypes were studied: BOS (bush-olive somaclone) and COS (columnar-olive somaclone). A wide range of plant traits were differently involved in somaclonal variation as plant height, canopy dimensions, leaf, inflorescence and fruit dimensions in respect to the putative control plants. The present study has established that the morphological stability of tissue culture-derived olive plants is strictly related with the in vitro propagation method used.

 Key words: Tissue culture, phenotypic stability, somaclonal variation, Olea europaea.


Background: A new syndrome has been recognised following thorough analysis of patients with a terminal submicroscopic subtelomeric deletion of chromosome 9q. These have in common severe mental retardation, hypotonia, brachycephaly, flat face with hypertelorism, synophrys, anteverted nares, thickened lower lip, carp mouth with macroglossia, and conotruncal heart defects. The minimum critical region responsible for this 9q subtelomeric deletion syndrome (9q−) is approximately 1.2 Mb and encompasses at least 14 genes. Objective: To characterise the breakpoints of a de novo balanced translocation t(X;9)(p11.23;q34.3) in a mentally retarded female patient with clinical features similar to the 9q− syndrome. Results: Sequence analysis of the break points showed that the translocation was fully balanced and only one gene on chromosome 9 was disrupted—Euchromatin Histone Methyl Transferase1 (Eu-HMTase1)—encoding a histone H3 lysine 9 methyltransferase (H3-K9 HMTase). This indicates that haploinsufficiency of Eu-HMTase1 is responsible for the 9q submicroscopic subtelomeric deletion syndrome. This observation was further supported by the spatio-temporal expression of the gene. Using tissue in situ hybridisation studies in mouse embryos and adult brain, Eu-HMTase1 was shown to be expressed in the developing nervous system and in specific peripheral tissues. While expression is selectively downregulated in adult brain, substantial expression is retained in the olfactory bulb, anterior/ventral lateral ventricular wall, and hippocampus and weakly in the piriform cortex. Conclusions: The expression pattern of this gene suggests a role in the CNS development and function, which is in line with the severe mental retardation and behaviour problems in patients who lack one copy of the gene.


Innovative approaches to field-based biology classes are needed to overcome logistic and financial constraints to running them. Quick Response (QR) technology, which links users to online content by scanning barcodes with their smartphones, provides an inexpensive, customisable way to support field-based learning. This paper reports on the trial of mobile learning, using hand-held devices and online material, in an undergraduate biology class. Students conducted a wildlife survey with reference to an online identification guide, accessed by scanning QR codes on site. Students expressed mixed opinions about the use of QR technology in field-based classes. Technical problems with scanning QR codes, weak wifi coverage and apprehension towards new technologies appeared to influence their attitudes towards mobile learning. However, they felt that they benefited from online resources and endorsed QR codes for learning. To improve student engagement with QR technology, staff should provide students with adequate training, test QR scanning software before use, and emphasise cellular coverage.


Purpose: The purpose of this study is to examine what employee agency entails for psychological contract theory. We explore 1) how employee agency manifests itself, 2) how it is reflected in employees' perceptions of their psychological contract obligations, and 3) what it implies for psychological contract theory. Methodology: The study draws on a qualitative interview study of employees from the mobile phone content production industry in Finland. Our analysis is based on 15 semi-structured employee interviews, which were supported by a discussion of the interviewees' weekly agendas. Findings: This study reveals that employee agency manifests itself as self-actualization, action, influence and creativity, all of which have implications for employees' psychological contracts. Employees emerge as active parties to the psychological contract, consciously modifying and constructing it instead of simply reacting to employer behaviour, as is assumed in current research. Originality/value of paper: This study contributes to psychological contract theory by providing one of the few empirical attempts to demonstrate how employees actively manage the exchange relationship captured by the psychological contract. It highlights the importance of acknowledging employee agency in future psychological contract research. Classification: Research paper


A method for imaging the interventricular septum of the heart by digital subtraction ventriculography in the left oblique projection is proposed: 20 ml of contrast agent is injected in the right atrium, and the right ventricle is imaged, then the left ventricle is seen on the left phase. In order to discern the interventricular septum, the right ventricle image is taken as a "mask", then the left ventricle is fixed, and the interventricular septum is seen between two contrast cavities on the final image. The dual subtraction method by choosing the later "mask"-frame at the maximally contrast right ventricle for imaging the septum was used for the first time.


This study determines the effects of cool roofs on a home's energy use, specifically on heating and cooling energy end-uses. Representative cities were chosen for several ASHRAE US climate zones. A series of parametric simulations in EnergyPlus was carried out to assess the performance of cool roofs for selected prototypical residential building models using detailed simulation analysis. The simulation results are then correlated for each climate zone type to give an approximation of the best roof color per climate. The results are given based on total energy used as well as energy cost based on national average electricity and natural gas residential rates. This method allows builders and homeowners the choice between the most cost effective roofing type, and the most energy efficient in the case that they are not the same.Overall, it was found that in hot climates, it is more efficient to have a white roof, while a black roof benefits cooler climates. In mild and mixed climates, the effect of roof color was found rather are different for energy use and energy cost. Therefore the choice is determined by the owner's requirements. In the cooler and milder climate zones, the analysis shows that the cost excess or savings is fairly small; usually under $10 difference per year. Hotter climates also have a relatively small effect, but more so than the cooler climates, with Phoenix especially showing a savings of $48.60 per year when a white roof is used over a black roof. Energy changes as low as only 4% in the as-built construction style, or as high as nearly 100% change in upgraded envelope cases were found. The study further finds that both the lack of an attic, and high efficiency envelopes increases the magnitude of the percent change in energy requirements.© 2014 ASME


INTRODUCTION
Approximately 60-70 pregnancies are affected by neural tube defects (NTD) in Denmark annually. Folic acid (FA) deficiency can cause NTD. Periconceptional FA supplementation reduces the risk of NTD by up to 70-80%. Danish women planning pregnancy are recommended 0.4 mg of FA daily from at least one month before planned conception and continuing throughout the first 12 weeks of pregnancy. The aim of the present study was to examine the knowledge about and use of FA supplementation among Danish pregnant women.

METHODS
From 11 October 2012 to 15 November 2012, all women attending for a routine nuchal translucency scan were given a questionnaire regarding their knowledge and use of FA supplementation during their current pregnancy.

RESULTS
A total of 462 women answered the questionnaire. 95% had taken FA supplements at some point during their pregnancy, but only 10.4% as recommended. More than 80% stated knowledge about recommendations before the current pregnancy. Positive predictors of knowledge were: age > 30 years, multiparity, Danish origin and education > 3 years.

CONCLUSION
Despite national recommendations on periconceptional FA supplementation, our study showed that women do not follow these recommendations. Especially women with a low socio-economic status were likely to lack knowledge about FA supplementation in relation to pregnancy. There is a need for revision of the existing national recommendations and for other initiatives aiming to improve women's intake of FA, including FA fortification of flour and/or other food products.

FUNDING
not relevant.

TRIAL REGISTRATION
The study was approved by the Danish Data Protection Agency (No.: 01855 HVH-2012-044).


In the context of an ERDF-funded project portfolio, we have carried out a survey to assess the state-of-the-practice in software quality in Belgian companies. With this survey, we wish to find out what are the most common industry practices (processes, techniques and tools) with respect to software quality, and how these practices vary across companies. Companies could use the results of this study to improve upon their current software quality practices compared to other companies. Researchers could use it to develop better techniques and tools for aspects that have not found sufficient take-up by industry. Teachers may use it to adapt their courses to become more directly relevant to industry practices.


A method for the production of a tissue-mimicking phantom material for MR imaging is described. The material consists of a nickel-doped agarose gel. The T1 and T2 values of the gel can be varied independently by changing the relative amounts of nickel and agarose. Practically any T1 and T2 combination of clinical interest can be obtained. The long-term stability was studied and found to be good. The relaxation times were estimated using an MR analyzer. The accuracy and the reproducibility of these measurements were evaluated and found to be reassuring. Gel phantoms were also scanned in an MR unit. The signal strength of an inversion recovery sequence was evaluated using the gel phantoms in order to verify their usefulness. These measurements were compared to theory with good agreement. Furthermore, tissue-equivalent phantoms were made. Gels resembling gray matter, white matter, and CSF were scanned. Comparisons with clinical in vivo scans, as well as calculated levels were made. It is anticipated that the gel phantoms described here will be useful in quality assurance as well as in pulse sequence optimization.


The phytohormone gibberellin (GA) controls floral initiation and development. An important GA-controlled signaling pathway involves GAMYB, a transcriptional regulator that binds to a GA-response element (GARE) in the regulatory regions of GA-activated genes. Target genes include those that encode enzymes that release nutrients from the endosperm during seed germination. In Arabidopsis, GAMYB proteins activate the expression of LEAFY, a floral meristem identity gene. Achard et al. report that in Arabidopsis, a single-stranded microRNA (21 nucleotides) called miR159, with sequence complementarity to GAMYB-encoding transcripts, targets the transcriptional regulators for cleavage. Overexpression of miR159 in transgenic plants reduced expression of GAMBY transcript and protein. Transgenic plants also had reduced LEAFY expression and delayed flowering time. This suggests that miR159 modulates GA-mediated development through GAMYB activity. Paradoxically, miR159 appears to be positively regulated by GA, revealing a complex relationship between GA, miR159, and GAMYB expression that requires further clarification. MiR159 expression also appears to be negatively regulated by DELLA proteins, transcriptional repressors of the GA response. Thus, as observed in Drosophila, plant microRNAs appear to be controlled by hormones as well. P. Achard, A. Herr, D. C. Baulcombe, N. P. Harberd, Modulation of floral development by gibberellin-regulated microRNA. Development 131, 3357-3365 (2004). [Abstract] [Full Text]


Abstract. Measurements of the large-dimensional chemical state of the atmosphere provide only sparse snapshots of the state of the system due to their typically insufficient temporal and spatial density. In order to optimize the measurement configurations despite those limitations, the present work describes the identification of sensitive states of the chemical system as optimal target areas for adaptive observations. For this purpose, the technique of singular vector analysis (SVA), which has proven effective for targeted observations in numerical weather prediction, is implemented in the EURAD-IM (EURopean Air pollution and Dispersion – Inverse Model) chemical transport model, yielding the EURAD-IM-SVA v1.0. Besides initial values, emissions are investigated as critical simulation controlling targeting variables. For both variants, singular vectors are applied to determine the optimal placement for observations and moreover to quantify which chemical compounds have to be observed with preference. Based on measurements of the airship based ZEPTER-2 campaign, the EURAD-IM-SVA v1.0 has been evaluated by conducting a comprehensive set of model runs involving different initial states and simulation lengths. For the sake of brevity, we concentrate our attention on the following chemical compounds, O3, NO, NO2, HCHO, CO, HONO, and OH, and focus on their influence on selected O3 profiles. Our analysis shows that the optimal placement for observations of chemical species is not entirely determined by mere transport and mixing processes. Rather, a combination of initial chemical concentrations, chemical conversions, and meteorological processes determines the influence of chemical compounds and regions. We furthermore demonstrate that the optimal placement of observations of emission strengths is highly dependent on the location of emission sources and that the benefit of including emissions as target variables outperforms the value of initial value optimization with growing simulation length. The obtained results confirm the benefit of considering both initial values and emission strengths as target variables and of applying the EURAD-IM-SVA v1.0 for measurement decision guidance with respect to chemical compounds.


A time-dependent, two-dimensional, axisymmetric magnetohydrodynamics code is employed to model, validate and extend the experimentally-limited performance characteristics of a Gigawatt-level plasma source that utilized magnetoplasma-dynamic acceleration for gas energy deposition. Accurate modeling required an upgrade of the code's circuit routines to properly capture the Pulse-Forming-Network current waveform which also serves as the primary variable for validation. Comparisons to experimentally deduced current waveforms were in good agreement for all power levels. The simulations also produced values for the plasma voltage which were compared to the measured voltage across the electrodes. Trend agreement was encouraging while the magnitude of the discrepancy is approximately constant and interpreted as a representation of electrode fall voltage. Force computations captured the expected electromagnetic acceleration trends and serve as further verification. They also allow examination of the device as a very-high power magnetoplasma-dynamic thruster operating at power levels in the excess of 180 MW. The computations offer insights into the plasma's characteristics at different power levels through two-dimensional distributions of pertinent parameters and identify design guidelines for effective stagnation temperature values as a function of mass-flow rate. (authors)


The use of a three-point bending beam (3PB) test was investigated to characterise hot mix asphalt (HMA) cracking behaviour. Fundamental HMA fracture properties, identified as tensile strength and fracture energy density at first fracture, were determined for six different asphalt mixtures (two natural and four SBS polymer modified) applying the HMA Fracture Mechanics framework. Full-field strain maps obtained from an in-house developed digital image correlation-based method were observed to better understand the crack initiation and propagation mechanisms in the 3PB specimen. The resulting fracture behaviour was predicted using a displacement discontinuity boundary element method to model the microstructure of the six asphalt mixtures and to predict their fracture properties. Both numerical and experimental results indicate that the fracture mechanism of asphalt mixtures can be properly described from 3PB test results when appropriate interpretation models are used.


We analyze Warm Spitzer/Infrared Array Camera observations of the secondary eclipses of three planets, XO-4b, HAT-P-6b, and HAT-P-8b. We measure secondary eclipse amplitudes at 3.6 μm and 4.5 μm for each target. XO-4b exhibits a stronger eclipse depth at 4.5 μm than at 3.6 μm, which is consistent with the presence of a temperature inversion. HAT-P-8b shows a stronger eclipse amplitude at 3.6 μm and is best described by models without a temperature inversion. The eclipse depths of HAT-P-6b can be fitted with models with a small or no temperature inversion. We consider our results in the context of a postulated relationship between stellar activity and temperature inversion and a relationship between irradiation level and planet dayside temperature, as discussed by Knutson et al. and Cowan & Agol, respectively. Our results are consistent with these hypotheses, but do not significantly strengthen them. To measure accurate secondary eclipse central phases, we require accurate ephemerides. We obtain primary transit observations and supplement them with publicly available observations to update the orbital ephemerides of the three planets. Based on the secondary eclipse timing, we set upper boundaries for ecos (ω) for HAT-P-6b, HAT-P-8b, and XO-4b and find that the values are consistent with circular orbits.


At Lightmart, we offer 10 foot, square straight aluminum light poles that are 4 inches wide with a 0.125 inch wall thickness. Choose the options you need for your project.


Purpose
This paper aims to introduce how sociological traditions can provide a complementary, conceptual lens needed to better understand a country's orientation in its digital transformation policies. While historically sociology has been used to study technological effects, introducing a sociological lens that considers broader macro digital policies can better complement a country's national innovation system framework by highlighting where forms of acceleration and inertia in digital diffusion may or may not occur.

Design/methodology/approach
To formulate this lens, iterative literature reviews were conducted and four major sociological traditions (i.e. Durkheim, Functional-Utilitarian, Marxist and Micro-interactionist) were identified and integrated into one structure. The integrated structure was then applied to the French case of Minitel as a sample application. The French Minitel was selected because it is well-known and due to one of the author's familiarity with the French culture. The description was based upon secondary data.

Findings
Through the use and application of this lens, the findings reveal that understanding a country's specific orientation within a sociological tradition can help academics and practitioners determine what accelerates or provides inertia in the diffusion of new digital technologies within a country's sociological frame. For the French Minitel, two dominant views seem to exist in France, the Durkheim and the Functional-Utilitarian view, which both affected the country's path dependency in continued investments in Minitel.

Research limitations/implications
While policymakers are tasked with the development and implementation of digital transformation policies, a key consideration for both scholars and practitioners on digital policy and governance is to understand the broader macro ramifications of sociological frameworks on the evolving effects of digital transformation. While the authors provide a sample illustration, future research is needed to operationalize this lens and to apply it across various regions and countries in the development of new digital transformation policies.

Practical implications
As countries face considerable pressure to digitize their economies, policymakers require a better framework to advance the sociological aspects of digitization and its effects upon local institutions and actors in society. The paper provides a complementary lens that can better help them in this regard.

Originality/value
To date, policymakers and governments lack an integrated framework to understand the sociological effects of digital technologies and their diffusions along with their implications on societies such as on the framework of national innovation. The authors provide a sample integrated structure and sample application.


Background Little agreement exits between different drug interaction databases. Purpose To compare the frequency and severity of potential drug-drug interactions (DDIs) occurring in a haematological unit and detected by two drug interactions databases. Materials and methods A prospective, observational and descriptive study was carried out from November 2012 to February 2013. Twice a week, every patient's treatment sheet was collected and screened through two drug interactions databases: Thomson Micromedex and Drug Interaction Facts. All potential DDIs identified were recorded and graded by their level of severity. Results Among 317 analysed treatment sheets, a total of 2373 potential DDIs were detected by the two databases. According to Micromedex, 1348 potential DDIs were found, counting 176 different pairs of drugs; of these DDIs, 64 were classified as contraindicated, 538 as major, 718 as moderate and 28 as minor. Regarding Drug Interaction Facts, 1025 potential DDIs were found, counting 124 different pairs of drugs; of these DDIs, 203 were classified as major, 537 as moderate and 285 as minor. There was a pool of 225 different pairs of drugs detected by both databases, irrespective of how many times these interactions appeared. Upon assessing the total number of pairs of drugs identified by the two databases, Micromedex identified 78.2% (176/225) and Drug Interaction Facts, 55.1% (124/225) of the potential interactions. Upon evaluation of the congruence of severity ratings between both databases, there was an agreement in 16.4% of the 225 pairs of drugs identified (37/225). Conclusions The lack of agreement between different databases shows how complicated it is to detect potentially significant drug interactions in clinical practice. No conflict of interest.


Nitrogen dioxide (NO2) is a free radical-producing oxidant gas. Inhalation of NO2 could cause airway inflammation, and decrease immune function. This experiment tested the hypothesis that exposure to NO2 would: 1) increase leukocytes in bronchoalveolar lavage (BAL); and 2) change the distribution of lymphocyte subsets and activation in BAL and peripheral blood (PB). Using a counter-balanced, repeated-measures design, 15 healthy volunteers were exposed to filtered air (FA) or 2.0 parts per million NO2 for 4 h x day(-1) (4 x 30 min of exercise), for three consecutive days. Bronchoscopy was performed 18 h following each exposure set, and PB was drawn pre-exposure and pre-bronchoscopy. Flow cytometry was used to enumerate lymphocyte subsets and activation makers in BAL and PB. In the bronchial fraction, there was an increase in the percentage of neutrophils following NO2 exposure compared to FA (median (interquartile range): 10.6 (4.8-17.2)% versus 5.3 (2.5-8.3)%; p=0.005). In the BAL, there was a decrease in the percentage of T-helper cells following NO2 exposure compared to FA (55.9 (40.8-62.7)% versus 61.6 (52.6-65.2)%; p=0.022). For PB, there were no between-condition differences in any leukocyte or lymphocyte subsets, or activation. In conclusion exposure to nitrogen dioxide results in bronchial inflammation and a minimal change in bronchoalveolar lavage T-helper cells, and no changes in peripheral blood cells.


Background: Kigelia africana is an African tree with a wide distribution across southern, central and western Africa. It has a history of therapeutic usage by multiple African ethnic groupings which inhabit the areas in which it grows. Amongst these groups there is a myriad of medicinal uses in the treatment of a wide variety of bacterial, fungal and protozoal infections, as well as in the treatment of inflammation and cancers. This study was undertaken to further examine K. africana fruit extracts for the ability to inhibit cancer cell growth, and to use an unbiased metabolomic profiling approach to detect and putatively identify as many individual components as possible, with the aim of developing a database of identified compounds. Materials and Methods: K. africana fruit powder was extracted and tested for inhibitory activity against the Jeg-3 choriocarcinoma cell line using a colorimetric cell proliferation assay. Toxicity was evaluated using an Artemia franciscana nauplii bioassay. Non-targeted HPLC separation of crude extracts coupled to high resolution time-of-flight (TOF) mass spectroscopy with screening against 3 compound databases was used for the identification and characterisation of individual components in crude plant extracts. Results: The methanol, water and ethyl acetate K. africana fruit extracts displayed significant anti- proliferative activity against Jeg-3 choriocarcinoma cells. The methanol and water extracts displayed the strongest anti-proliferative activity, inhibiting Jeg-3 growth to 42% and 46% of the untreated cell growth respectively. The ethyl acetate extract also significantly inhibited Jeg-3 cell proliferation, with decreases to 62% of the untreated control value. Neither the chloroform or hexane extracts had any effect on Jeg-3 cell proliferation. With the exception of the water extract (which displayed moderate toxicity), all extracts were non-toxic or of low toxicity. HPLC-MS/MS TOF analysis identified 356 unique mass signals in the extracts. The putative identities of 227 of these compounds are reported here. Conclusion: This report extends previous studies into the anti-cancer affects of K. africana fruit extracts. The generation of a database of the detected compounds will allow for rapid differentiation of compound profiles between active and less active extracts in future studies. This is expected to assist in the identification of the most important compounds for further separation and bioactivity studies.


Transfusion and plasma fractionation in France are closely linked to the historical reliance on voluntary unpaid blood donation that constitutes the foundation in the national system for the supply of labile blood components and stable fractionated plasma products. From 1993, three successive laws on safety of blood and medicines have been implemented to separate the missions of the stakeholders leading to clearly distinguish the mission of producers and regulatory bodies: operator for the blood sector, Etablissement Francais du Sang (EFS), operator for the fractionation into medicines, Laboratoire francais du Fractionnement et des Biotechnologies (LFB), and the regulator, the French National Agency for the Safety of Medicines and Health Products (ANSM). LFB has received the mandate of manufacturing fractionated plasma products from the plasma collected by EFS and to serve as a priority the needs of French patients. Since 1989, the European Union has built the regulatory framework for stable products, which are considered as medicinal products derived from human blood or human plasma. Many European legal and regulatory organisations supervise quality, biological safety, clinical safety, and efficacy of both blood components and medicinal products derived from human plasma. Guidelines, monographs, good practices (GXP or blood good practices) and others regulatory documents prompt operators to comply with these requirements, whereas operators, by improving their manufacturing practices, lead the regulation to adapt to innovation. France addresses these requirements in many legal and regulatory texts, most transposed from European legislation. While the two sectors are regulated in France by one unique national competent authority, the European Medicines Agency (EMA) does not include blood and blood components regulation under its responsibility. The safety and protection of donors is still carried out by the collegial cooperation of European and international operators. The European Commission has started to reflect on substances for human origin regulations as a whole, and a revision of the blood directive might lead to adapted definitions of voluntary, non-remunerated blood donations [including for plasma for fractionation (PfF)] in order to further protect the human body and its parts and to promote appropriate supply of European plasma.


The application of new commercial and industrial technologies in the fields of dosimetry and medical physics is of great interest to the scientific community, both to validate existing protocols and to develop new methodologies. The popularization of 3D printing techniques has been analyzed as a great advantage in quality control in complex treatment techniques, such as radiotherapy and the development of patient simulators. Portable dosimetry systems such as Landauer MicroStar OSL system are versatile and their use in quality control is of great importance. The aim of this paper is to compare two of the most used dose calculation algorithms used in Varian Eclipse TPS – AAA and Acuros XB – for treatment planning of multiple brain metastases using a 3D printed anthropomorphic phantom and the OSL InLight system for experimental dosimetry validation. A 3D printed anthropomorphic skull phantom was submitted to a CT scan and planed five target volumes. In order of comparison, two dose calculations were performed in the Varian Eclipse 13.6 TPS with "Alabama technique", using the Varian's AAA and AXB algorithms, and treatment delivered with 6 MV photon beam of a Varian TrueBeam linear accelerator. Landauer nanoDot dosimeters were positioned inside each of the five target volumes planned and the experimental dosimetric results were compared with the algorithms' calculated doses. The findings of this work indicate that ACUROS XB calculates more accurate doses compared with AAA, with all the experimental agreements better than 96.0 %, probably because of the heterogeneity corrections. The uncertainty analysis of the InLight system device is enough to sustain the dosimetric uncertainties below 3.0 %, validating the results.


In their previous works , leading their history since 1988, the authors of this article have repeatedly conceptually shown and experimentally verified the results of research on the teleportation of information between macro objects. Early author's works were performed during the existence of the Russian Federation – as a country called the Union of Soviet Socialist Republics (USSR). Some of which were marked "Top Secret" - links further down the text. Since they were performed under the supervision of the relevant special services and further "Department of external relations of the Russian Academy of Sciences". The authors used numerous examples to demonstrate the possibility of teleportation of information in macro-systems, including ecosystem, biogeocenotic levels, and then tissue and organism levels. Successful experimental verifications occurred only in cases when all the principles and rules laid down in the theory of quantum information, applied to biological objects, were correctly combined. Namely, the preparation of cascades of entangled States was performed both on the mental and somatic levels. In full accordance with the principle of complementarity and taking into account the fact that the observer and the observed are actively connected by the sum of similarities. In addition, the role of the classical communication channel in this process was performed by carrier electromagnetic fields modulated by a useful signal. This signal represented a cast of the simulated experimental process. An example of a real COVID-19 pandemic is the verification of author's works in nature on a biogeocenotic scale. And certainly with anthropogenic – so to speak-participation.


Cancer research gains immensely in value as the various aspects of the problem are studied in detail for particular communities and races, and the several organs or parts of the body affected. In fact I have long felt that the most promising outlook for practically useful results lies in this direction and especially in research of a statistical nature. Hence in my own field I have studied cancer among North American Indians, cancer in Mexico, Russia and Scandinavia, in Haiti and in Hawaii. On the present occasion, I propose to submit briefly a study of cancer by organs and parts in Egypt covering the two years 1927 and 1928. The data considered were generously furnished by the Department of Public Health, Ministry of the Interior, and represent cases admitted to Egyptian General Hospitals. I make use of this opportunity to express my sincere gratitude to the Government of Egypt for the valuable services rendered.

The only extended previous study of its kind, with which I am familiar, is a paper on "The Incidence of Cancer in Egypt" by Drs. Dolbey and Mooro, read before the Royal School of Medicine of Egypt, and reported in the London Lancet, March 1st, 8th, 15th and 22nd, 1924. But numerous brief references to the exceptional cancer situation in Egypt occur in the literature, while Williams many years ago discussed certain phases to good purpose. Most of these writers have drawn attention to the extraordinary frequency, at least proportionate to the total cancer mortality, of cancer of the bladder among the Egyptian population, and its possible or probable relation to bilharzia.


We sought to assess the feasibility of recording the myocardial velocity gradients (MVGs) and mean myocardial velocities (MMVs) measured by color M-mode tissue Doppler imaging (TDI) in the free wall of unsedated normal cats (n = 18) with a 7.4-MHz probe equipped to record TDI images. The peak MVG and MMV values during the different phases of the cardiac cycle corresponded to certain color velocity patterns occurring in the left ventricular free wall (LVFW). Biphasic shifts were recorded in the tracings of both the MVG and MMV during early diastole (E1 and E2) as well as during the isovolumic relaxation (IVR) and isovolumic contraction (IVC) phases. Stepwise regression analysis showed that age was the only significant predictor for the peak MVG values during the 2nd phase of early diastole (E2) (r = -0.79, r2 = 0.63, and P < .001). The peak late diastolic MVG values were associated positively with age (r = 0.50, r2 = 0.25, and P < .05). The peak MMV values showed a negative association with age during E2 (r = -0.71, r2 = 0.50, and P < .001) as well as during early systole (Se) (r = -0.55, r2 = 0.30, and P < .05) and late systole (SI) (r = -0.62, r2 = 0.39, and P < .01). A positive association was found between age and the peak MMV values during late diastole (r = 0.54, r2 =- 0.29, and P < .05). The MVG values showed cyclic variations consistent with wall thickness changes. The accuracy of velocity determination and the spatial resolution of the system used were validated with a phantom. To our knowledge, this study is the 1st report of the application of this technique to the myocardium of cats,providing insights into the physiology of myocardial motion. It provides reference ranges of the peak MVG and MMV values for future studies of feline myocardial diseases.


Although allophonic speech processing has been hypothesized to be a contributing factor in developmental dyslexia, experimental evidence is limited and inconsistent. The current study compared the categorization of native similar sounding vowels of typically developing (TD) children and children at familial risk (FR) of dyslexia. EEG response was collected in a non-attentive passive oddball paradigm from 35 TD and 35 FR Dutch 20-month-old infants who were matched on vocabulary. The children were presented with two nonwords "giep" [ɣip] and "gip" [ɣIp] that contrasted solely with respect to the vowel. In the multiple-speaker condition, both nonwords were produced by twelve different speakers while in the single-speaker condition, single tokens of each word were used as stimuli. For both conditions and for both groups, infant positive mismatch response (p-MMR) was elicited, and the p-MMR amplitude was comparable between the two groups, although the FR children had a later p-MMR peak than the TD children in the multiple-speaker condition. These findings indicate that FR children are able to categorize speech sounds, but that they may do so in a more effortful way than TDs.


Background: Spinal anesthesia is a preferred technique of choice in infraumbilical surgeries. The spinal anesthesia effect can be improved by adding various adjuvant like Fentanyl, clonidine, dexmedetomidine. Dexmedetomidine is a highly selective alpha 2 adrenergic agonists. The aim of study to compare efficacy and safety between Dexmedetomidine and Fentanyl with Bupivacaine.Subjects and Methods:A prospective randomized, double-blind study was conducted on 100 patient by dividing them into two groups. Group D: 2.5ml (12.5mg) of 0.5% hyperbaric bupivacaine with 5mcg (0.5ml) dexmedetomidine and Group F : 2.5ml(12.5mg) of 0.5% hyperbaric bupivacaine with 2 5mcg(0.5ml)  fentanyl. The total volume injected intrathecally was 3.0ml in ASA I and II grade patient undergoing lower limb surgery.Results:Patients in dexmedetomidine groupD had a significantly longer sensory and motor block time than patients in fentanyl group F.The mean time of sensory regression to level S1 was 306.00 ± 13 .32 in group D and 206.14± 16.69 in group F(P<0.001). The regression time of motor block to reach modified Bromage 0 was 257.70±14.61 in group D and 178.54±14.23 in group F(P<0.001).Conclusion:Intrathecal Dexmedetomidine is associated with prolonging motor and sensory block as compare to Fentanyl.


With the objective of evaluating increasing levels of calcium in diets supplemented with the enzyme phytase for chickens from 1 to 21 days of age, an experiment was conducted using 600 1-d old Hubbard-MPK strain chicks. The broilers were allotted to a completely randomized design, factorial arrangement five x two (levels of calcium x sexes), three replicates and 20 birds per plot. The basal ration with 0.54% total phosphorus and 600 units of phytase/kg, was formulated to meet the nutritional requirements of the broilers, according to NRC (1994), except for calcium, whose levels were 0.46; 0.67; 0.88; 1.09 and 1.30%. At 14 days, two chicks of each treatment were transferred to metabolism cages for total collection of the excreta during four consecutive days. At 21 days of age, two broilers from each treatment were slaughtered for removal of the left tibia for subsequent analyses. The males presented higher fed intake and weight gain, and shown a linear reduction as the level of calcium was increased. The levels of 0.67 and 0.71% presented better digestibility of dry matter and higher nitrogen retention, respectively. The females presented content of ashes and calcium in the tibia higher than those of males (1.68 and 2.34% respectively). The level of 0.55% of calcium in the diets provided the maximum deposition of ashes (51.5%) while the level of 0.59% was enabled to reach the maximum calcification (17.8%). Phosphorus deposition showed quadratic effect in relation to increasing levels of calcium in the diets, and 0.75% of calcium provided to reach the largest deposition (10.8%), while deposition of manganese was reduced linearly with the increasing levels of calcium in the diets. It was concluded that high levels of calcium in the diets supplemented with phytase decreased weight gain and shown negative effect on the phosphorus and manganese deposition in the broilers tibia from one to 21 days of age. Low levels of calcium impaired the digestibility of dry matter and nitrogen retention of diets of broilers one to 21 day old broilers.


This paper introduces ordinary kriging as a new tool to predict network coverage in wireless local area networks. The proposed approach aims to reduce the cost of active site surveys by estimating path loss at points where no measurement data is available using samples taken at other points. To take the effect of obstacles on the covariance among points into account, a distance measure is proposed based on an empirical path loss model. The performance of the proposed approach is tested in a simulated wireless local area network. The results show that ordinary kriging is able to estimate path loss with acceptable error levels.


Orientation: Women's work engagement is affected by how well they balance their work and personal life, and their level of confidence in their capability at work.Research purpose: Determine whether women's daily psychological availability mediates daily positive work-home interaction and daily positive home-work interaction on daily work engagement.Motivation for the study: Research into negative work–home and home–work interaction is in abundance. Limited studies focus on the positive effects on women's experiences at work (i.e. work engagement). Little is known about women's psychological availability and how it affects their work. Furthermore, little research provides us insights into the day-level experiences of women at work.Research approach/design and method: A quantitative, shortitudinal design was used. Data analyses accounted for multilevel structure in the data (within-person vs. between-person differences). Female employees (n = 60) from various industries in Gauteng, completed electronic diaries in the form of a survey for 10 consecutive working days.Main findings: Daily psychological availability mediates between daily positive work-home interaction and daily work engagement. Daily positive home-work interaction did not predict daily work engagement, but had a significant effect on daily psychological availability.Practical/managerial implications: Examining systems and structures that promote opportunities for women to become more psychologically available at work impacts their sustainable retention.Contribution/value-add: This study found significant relationships between day-level uses of personal resources and spillover effects of home-work and work-home on day-level work engagement. The study further contributes to the literature on positive work–home and home–work interaction.


Evaluation of: Pelkonen T, Roine I, Cruzeiro ML, Pitkaranta A, Kataja M, Peltola H. Slow initial β-lactam infusion and oral paracetamol to treat childhood bacterial meningitis: a randomised, controlled trial. Lancet Infect. Dis. 11(8), 613-621 (2011). Acute bacterial meningitis is a medical emergency that requires prompt management. Despite effective antibiotic and adjunctive therapies, mortality is still unacceptably high in acute bacterial meningitis in children as this mortality did not substantially improve since the first use of antimicrobial therapies in the mid-20th century. β-lactams and particularly third-generation cephalosporins (ceftriaxone or cefotaxime) penetrate most body tissues and fluids, such as the cerebrospinal fluid, well. They are effective against the three most frequent bacterial causative agents of acute bacterial meningitis (Neisseria meningitidis, Streptococcus pneumoniae and Hemophilus influenzae). They are currently the consensual choices for the presumptive treatment of acute bacterial meningitis and usually used as a bolus every 4-6 h. Pelkonen et al. published a prospective, double-blind, single-center study with a two-by-two factorial design that aimed to explore the benefits in children of infused compared with bolus cefotaxime administration. Each group (bolus and infusion) was divided into two subgroups (with oral paracetamol or with placebo). No significant difference was observed for the final outcomes (mortality or severe neurological sequela and deafness) in the four subgroups. However, a post-hoc analysis of the results suggested that cefotaxime infusion plus paracetamol recipients had significant lower mortality during the first 72 h, irrespective of causative agents. However, the relevance of this study in sub-Saharan Africa is still difficult to evaluate as more than half of the initially assessed patients did not meet the inclusion criteria. The extension of the conclusions to developed countries may require further evaluations in terms of pharmacokinetic/pharmacodynamic properties as well as a thorough characterization of the causative agents under the view of the heterogeneous genetic structure of circulating bacterial strains in developed countries.


The misfolding of the mammalian prion protein from its α-helix rich cellular isoform to its β-sheet rich infectious isoform is associated with several neurodegenerative diseases. The determination of the structural mechanism by which misfolding commences, still remains an unsolved problem. In the current study, native-state hydrogen exchange coupled with mass spectrometry has revealed that the N state of the mouse prion protein (moPrP) at pH 4 is in dynamic equilibrium with multiple partially unfolded forms (PUFs) capable of initiating misfolding. Mutation of three evolutionarily conserved aromatic residues, Tyr168, Phe174, and Tyr217 present at the interface of the β2-α2 loop and the C-terminal end of α3 in the structured C-terminal domain of moPrP significantly destabilize the native state (N) of the protein. They also reduce the free energy differences between the N state and two PUFs identified as PUF1 and PUF2**. It is shown that PUF2** in which the β2-α2 loop and the C-terminal end of α3 are disordered, has the same stability as the previously identified PUF2*, but to have a very different structure. Misfolding can commence from both PUF1 and PUF2**, as it can from PUF2*. Hence, misfolding can commence and proceed in multiple ways from structurally distinct precursor conformations. The increased extents to which PUF1 and PUF2** are populated at equilibrium in the case of the mutant variants, greatly accelerate their misfolding. The results suggest that the three aromatic residues may have been evolutionarily selected to impede the misfolding of moPrP.


Elderly people, particularly those with major depression, are at the highest risk for suicide than any other age group. Religious involvement is associated with a range of health outcomes including lower odds of death by suicide. However, not much is known about the effects of religious involvement on suicidal ideation in the elderly or which aspects of religiosity are beneficial. This study examined the relative influence of various conceptualizations of religious involvement, above and beyond the protective effects of social support, on current and past suicidality among depressed older adults. Participants were 248 depressed patients, 59 years and older, enrolled in the Neurocognitive Outcomes of Depression in the Elderly study. A psychiatrist assessed current suicidal ideation using the suicidal thoughts item from the Montgomery–Asberg Depression Rating Scale. Past history of suicide attempts, four religious involvement indicators, social support indicators, and control variables were assessed via self-report. Church attendance, above and beyond importance of religion, private religious practices, and social support, was associated with less suicidal ideation; perceived social support partially mediated this relationship. Current religious practices were not predictive of retrospective reports of past suicide attempts. Church attendance, rather than other religious involvement indicators, has the strongest relationship to current suicidal ideation. Clinicians should consider public religious activity patterns and perceived social support when assessing for other known risk and protective factors for suicide and in developing treatment plans.


Introduction: The vascular form of Ehlers-Danlos' syndrome (type IV) is a potentially lethal genetic condition because of rupture of major arteries, often in the peri-partum period. Case Report: We report a 31-year-old primipara who died from a rupture of the right subclavian artery. The patient had several symptoms and signs typical of the disease. The rupture occurred during the expulsion-phase of delivery but was recognized only on day 9. Conclusion: Early recognition is crucial to avoid maternal mortality due to this genetic disorder. Once the condition is suspected, the clinical diagnosis is straightforward.


Introduction Enhanced Recovery Programmes (ERP) have gained wide acceptance in many surgical specialities but there is limited evidence in Liver surgery. A number of pilot studies have shown it to be safe but only used historical controls. The primary aim of this thesis is to investigate whether an ERP is effective in reducing post-operative length of hospital stay. The secondary aims are to investigate the differences in time to medical fitness for discharge, morbidity, mortality, pain scores, quality of life, patient satisfaction and cost effectiveness when comparing an ERP to standard perioperative care for open liver resection surgery. Methods This was a single blinded randomised controlled trial (ISRCTN03274575) conducted at The Royal Surrey County Hospital NHS Foundation Trust from March 2010 till April 2011. A total of 104 consecutive patients were randomised in to two groups: the Intervention group (ERP group) or Control group (standard therapy group). Group allocation was un-blinded to patients and researchers, but to reduce bias both groups were treated by strict protocols, including a standard anaesthetic protocol for both groups. The intervention group was treated within a full ERP, which included amongst others pre-admission counselling / education, pre-operative nutritional supplements, pre-operative carbohydrate loading, goal directed fluid therapy for six hours post-operatively, early feeding and mobilisation. Primary end point was length of hospital stay. Secondary end points included time until medically fit for discharge (using strict criteria and a blinded assessor), morbidity, mortality, readmissions, pain control, quality of life (QoL) scores using the EQ-5D questionnaire and patient satisfaction. Calculation of resources used and direct healthcare costs were calculated over a four week period, prospectively from information on operative resources, including theatre overhead costs and hospital costs per level of care. Community costs were calculated from questionnaires, completed by patients on postoperative days 14 and 28. The cost and QoL elements were used to perform a cost effectiveness analysis. Results Ninety-one patients completed the study with the main exclusions being inoperability. There were no differences in patient demographics except that there were a higher number of patients with the diagnosis of colorectal metastases; and a correspondingly higher number of patients who had undergone preoperative chemotherapy in the ERP group. There was also a significantly higher P-POSSUM operative severity score in the ERP group. Despite undergoing more extensive operations the ERP group reached medical fitness for discharge sooner [3.0 versus 6.0 days, p<0.001] and hospital length of stay [4.0 versus 7.0 days, p<0.001]. Medical complications were significantly reduced [6.5% versus 26.7%, p=0.02], there was no difference in mortality (2.2% versus 2.2% (p=0.987), readmissions (4.4% versus 0%, p=0.495) or pain scores. There was an improved quality of life [p=0. 02] but no difference in satisfaction rates, and a cost saving of £837. 25 over the 28 day period. Discussion This study demonstrates the efficacy of a specifically designed ERP for significantly reducing both the time until being medically fit for discharge and hospital length of stay in patients undergoing open liver resection. The two previous ER in open liver resection studies both showed reduced length of hospital stays in the ER group. Lin and colleagues (2011) demonstrated a reduction from a median of 11 to 7 days, and the second study by van Dam and colleagues (2008) reduced their length of stay from a median of 8 to 6 days. However neither of these studies demonstrated any reduction in morbidity. A recent pilot study trialling an ERP for laparoscopic liver resection showed a median length of stay of 5 days (Stoot 2009) - one day longer than the median length of stay for patients having open surgery in this trial. Moreover we found a post-operative stay of only three days was readily achievable with 33% of patients in the treatment group leaving hospital on postoperative day three. In summary this study demonstrated that an ERP is a safe and effective intervention for patients undergoing open liver resection surgery. A comprehensive enhanced recovery programme with a high compliance to the different elements can result in a significant reduction in length of hospital stay and fewer postoperative medical complications.