Localized bonding schemes for the assembly and packaging of polymer-based microelectromechanical systems (MEMS) devices have been successfully demonstrated. These include three bonding systems of plastics-to-silicon, plastics-to-glass, and plastics-to-plastics combinations based on two bonding processes of localized resistive heating: 1) built-in resistive heaters and 2) reusable resistive heaters. In the prototype demonstrations, aluminum thin films are deposited and patterned as resistive heaters and plastic materials are locally melted and solidified for bonding. A typical contact pressure of 0.4 MPa is applied to assure intimate contact of the two bonding substrates and the localized bonding process is completed within less than 0.25 s of heating. It is estimated that the local temperature at the bonding interface can reach above 150/spl deg/C while the substrate temperature away from the heaters can be controlled to be under 40/spl deg/C during the bonding process. The approach of localized heating for bonding of plastic materials while maintaining low temperature globally enables direct sealing of polymer-based MEMS without dispensing additional adhesives or damaging preexisting, temperature-sensitive substances. Furthermore, water encapsulation by plastics-to-plastics bonding is successfully performed to demonstrate the capability of low temperature processing. As such, this technique can be applied broadly in plastic assembly, packaging, and liquid encapsulation for microsystems, including microfluidic devices.


Leptospira interrogans serovars hardjo and szwajizak were isolated from the milk of experimentally infected cows only when using bovine albumin polysorbate-80 solid medium. Semisolid media, with and without the addition of 5-fluorouracil, and hamster inoculations were also used in the isolation attempts. These cultural isolation methods were also compared using cows' urine. Semisolid medium with 5-fluorouracil proved to be the most successful. However, the other methods were satisfactory, with solid medium having the lowest percentage of cultural isolations.


The carabid beetle taxocenes in two treatment types, CRP and rangeland, were investigated to determine what species of carabids inhabit those areas. In the summer of 2005, 34 pitfall-arrays were set-up in a paired design through Trego County, Kansas. A significant difference was found in species richness between the two treatments; however, no difference was found in either abundance or evenness values between the treatments. A canonical correspondence analysis (CCA) showed that sites could be differentiated by treatment by using vegetation composition form each site. Carabid beetles have the potential to be bioindicators of grasslands in North America despite previous research, which states that using arthropods for environmental studies is often considered too difficult. Using on species. Pasimachus elongates LeConte, a logistic regression was able to predict the correct treatment type 91.2% of the time. This justifies the need for further research into the applicability of this species as a bioindicator. My study adds to the limited amount of literature on carabid beetle ecology in the United Sates.


In the San Francisco Bay Area during the 1990's, cohorts that were exiled from forms of feminism during the sex wars gathered in the name of a new kinship, which they called "queer." Women who practiced transgressive sexualities—power play, role play, or sex for money—had been critiqued by radical and cultural feminist claims that the male domination invested in these or all forms of sexuality made their practices oppressive to women. Bisexuals, gay men and others who joined or were inspired by institutions for transgressive sex among men (including bathhouses, sex in public, and sex for money) had been read as reveling in male privileges while performing misogynist sex. Transsexuals and transgenderists who questioned the borders of binary sex found themselves cast as patriarchal agents—invading women's spaces in the case of transwomen, seduced from feminism in the case of transmen—and their actions read as violences against women. Exile from forms of feminism during the 1980's enabled those targeted to form common cause across otherwise great differences. Their varied yet mutual destabilizations of binary sex and sexuality then informed emergent queer politics, and over time, they sufficiently altered the terms of belonging in women's communities to enable queer/feminist reconciliations.


The early embryonic vertebrate heart is a tubular organ that changes shape rapidly. It acquires a pronounced bulge, and bends and rotates to the right side in a process called looping. There has been to date no satisfactory explanation of the mechanisms regulating this morphogenetic sequence. Evidence is presented suggesting that this is a physical deformation rather than the result of differential growth. The control of heat deformation is discussed and possible regulatory mechanisms are explored. It is not yet possible to identify all the factors responsible but it appears that a number of independently regulated variables such as cytodifferentiation and matrix production interact to regulate expression of complex shapes.


The study was attempted to measure the economic performance of cooperative sugar factories in terms of total costs and returns, capacity utilization, physical and financial indicators and ratio analysis of the factories. In this study the three cooperative sugar factories are taken into consideration and the Compound Annual Growth Rate (CAGR) for all the physical and financial indicators are worked out wherein the results suggested that a significant variation in the total cost and returns, capacity utilization and both physical and financial indicators over years within the three sugar factories was found. Further, the study revealed enough evidence about the financial ratios, which in turn showed the economic potentiality of the respective sugar factories. For the better performance of the factories an efficient planning and automation well before the start of the season is necessary and the government should come forward to help the farmers in making the cane bill payment at an early stage by the factories, by extending the financial assistance.


Being strategic at facilitating change in the quality of accommodations employed on behalf of students with learning disabilities means focusing on aspects that can be changed (teacher-specific variables) rather than those that cannot or are more difficult to change (social reality variables). This article provides a critical analysis of these variables and focuses on principles, theory, and supporting research for a triadic, synergistic model focusing on strategic approaches for making professional knowledge accessible, development of quality accommodations, benchmarks and related assessment systems, and strategies for implementing incremental change, and how these serve as the basis for the development of Makes Sense Accommodations software, the Quality Accommodations Inventory software, and the Step-Wise Incremental Change Strategy.


A quantitative model to genetically interpret the histology in whole microscopy slide images is desirable to guide downstream immuno-histochemistry, genomics, and precision medicine. We constructed a statistical model that predicts whether or not SPOP is mutated in prostate cancer, given only the digital whole slide after standard hematoxylin and eosin [H&E] staining. Using a TCGA cohort of 177 prostate cancer patients where 20 had mutant SPOP, we trained multiple ensembles of residual networks, accurately distinguishing SPOP mutant from SPOP non-mutant patients (test AUROC=0.74, p=0.0007 Fisher's Exact Test). We further validated our full metaensemble classifier on an independent test cohort from MSK-IMPACT of 152 patients where 19 had mutant SPOP. Mutants and non-mutants were accurately distinguished despite TCGA slides being frozen sections and MSK-IMPACT slides being formalin-fixed paraffin-embedded sections (AUROC=0.86, p=0.0038). Moreover, we scanned an additional 36 MSK-IMPACT patients having mutant SPOP, trained on this expanded MSK-IMPACT cohort (test AUROC=0.75, p=0.0002), tested on the TCGA cohort (AUROC=0.64, p=0.0306), and again accurately distinguished mutants from non-mutants using the same pipeline. Importantly, our method demonstrates tractable deep learning in this "small data" setting of 20-55 positive examples and quantifies each prediction's uncertainty with confidence intervals. To our knowledge, this is the first statistical model to predict a genetic mutation in cancer directly from the patient's digitized H&E-stained whole microscopy slide. Moreover, this is the first time quantitative features learned from patient genetics and histology have been used for content-based image retrieval, finding similar patients for a given patient where the histology appears to share the same genetic driver of disease i.e. SPOP mutation (p=0.0241 Kost's Method), and finding similar patients for a given patient that does not have have that driver mutation (p=0.0170 Kost's Method). Significance Statement This is the first pipeline predicting gene mutation probability in cancer from digitized H&E-stained microscopy slides. To predict whether or not the speckle-type POZ protein [SPOP] gene is mutated in prostate cancer, the pipeline (i) identifies diagnostically salient slide regions, (ii) identifies the salient region having the dominant tumor, and (iii) trains ensembles of binary classifiers that together predict a confidence interval of mutation probability. Through deep learning on small datasets, this enables automated histologic diagnoses based on probabilities of underlying molecular aberrations and finds histologically similar patients by learned genetic-histologic relationships. Conception, Writing: AJS, TJF. Algorithms, Learning, CBIR: AJS. Analysis: AJS, MAR, TJF. Supervision: MAR, TJF.


Air conditioning is a dual heat and mass transfer process, and the human nasal cavity achieves this through the mucosal wall surface, which is supplied with an energy source through the sub‐epithelial network of capillaries. Computational studies of air conditioning in the nasal cavity have included temperature and humidity, but most studies solved these flow parameters separately, and in some cases, a constant mucosal surface temperature was used. Recent developments demonstrated that both heat and mass transfer need to be modeled. This work expands on existing modeling efforts in accounting for the nasal cavity's dual heat and mass transfer process by introducing a new subwall model, given in the Supplementary Materials. The model was applied to a pipe geometry, and a human nasal cavity was recreated from CT‐scans, and six inhalation conditions were studied. The results showed that when the energy transfer from the latent heat of evaporation is included, there is a cooling effect on the mucosal surface temperature.


This paper presents the results of an empirical study of purchasing skills and how they vary by type of purchase. Building on the purchasing portfolio approach, purchase type was defined using 10 internally oriented, product- related dimensions, and 8 externally oriented, supply-related dimensions. Based on these dimensions, experienced purchasing personnel described a specific purchase and profiled the skills required for effective performance in purchasing that item. Cluster analysis of the 72 valid responses provided three distinct groups of purchasing situations, which were labelled strategic, tactical and routine purchase types. Of the 33 skills identified from prior literature, 24 were found to differ significantly (p>0.05) across purchase type clusters. For each cluster, the purchase situation and skills profile are described. Results show that, as product and market complexity and risk increase, both more purchasing skills are needed, and their importance for successful performance increases. Further analysis through pairwise comparisons of the clusters reveals more detailed insights. Suggestions for refining this survey tool and for its potential application in companies are discussed.


Curriculum learning in reinforcement learning is a training methodology that seeks to speed up learning of a difficult target task, by first training on a series of simpler tasks and transferring the knowledge acquired to the target task. Automatically choosing a sequence of such tasks (i.e., a curriculum) is an open problem that has been the subject of much recent work in this area. In this paper, we build upon a recent method for curriculum design, which formulates the curriculum sequencing problem as a Markov Decision Process. We extend this model to handle multiple transfer learning algorithms, and show for the first time that a curriculum policy over this MDP can be learned from experience. We explore various representations that make this possible, and evaluate our approach by learning curriculum policies for multiple agents in two different domains. The results show that our method produces curricula that can train agents to perform on a target task as fast or faster than existing methods.


A combined geophysical survey was carried out in a oil refinery to study the complex hydrocarbon contamination of the soil and the near surf ace aquifer, resulting from several years of leakage of hydrocarbon products. A near surf ace level characterized by a strong reflector was weIl detected using Ground Penetrating Radar; lateral changes of the strength of the reflection and the subsequent drilling confirmed the existence of a free phase of hydrocarbon in the vadose zone above the water tabIe. Because of the limited thickness of the layer embedded with the residual oil, the geoelectrical resistivity measurements were not effective for detecting this level. The resistivity measurements pointed out very low values in the upper zone of the aquifer; this effect can be associated to complex chemical reactions between the dissolved hydrocarbon phase and the aquifer system. These effects were investigated using high resolution geoelectrical tomography. Soil data resulting from several boreholes confirmed the reliability of the geophysical response. Geochemical and physical analysis of the soil and groundwater samples, combined with the geophysical investigation, allowed the definition of a reliable model ofthe polluted area.


Forest mapping from satellite sensor imagery provides important information for the timely monitoring of forest growth and deforestation, bioenergy potential assessment, and modeling of carbon flux, among others. Due to the daily global revisit rate and wide swath width, MODerate-resolution Imaging Spectroradiometer (MODIS) images are used commonly for satellite-derived forest mapping at both regional and global scales. However, the spatial resolution of MODIS images is too coarse to observe fine spatial variation in forest cover. The last few decades have seen the production of several fine-spatial-resolution satellite-derived global forest cover maps, such as Hansen's global tree canopy cover map of 2000, which includes abundant spectral, temporal, and spatial prior information about forest cover at a fine spatial resolution. In this paper, a novel learning-based spatial-temporal superresolution mapping approach is proposed to integrate both current MODIS images and prior maps of Hansen's tree canopy cover, to map present forest cover with a fine spatial resolution. The novel approach is composed of three main stages: 1) automatic generation of 240-m forest proportion images from both 240- and 480-m MODIS images using a nonlinear learning-based spectral unmixing method; 2) downscaling the 240-m forest proportion images to 30 m to predict the class possibilities at the subpixel scale using a temporal-example learning-based downscaling method; and 3) final production of the fine-spatial-resolution forest map by solving a regularization-based optimization problem. The novel approach produced more accurate fine-spatial-resolution forest cover maps in terms of both visual and quantitative evaluation than traditional pixel-based classification and the latest subpixel based superresolution mapping methods. The results show the great efficiency and potential of the novel approach for producing fine-spatial-resolution forest maps from MODIS images.


Transurethral Microwave Thermotherapy (TUMT) is a unique and promising method of treating benign prostatic hyperplasia. Clinical outcomes after high energy protocol TUMT 2.5 are comparable to transurethral resection of the prostate. Previously this increased efficacy has had greater morbidity than lower energy protocol TUMT 2.0 with catheterization required in all patients. A technique of careful preoperative patient teaching, intravenous ketorolac and remifentanyl; patient discomfort is minimized, bladder spasms avoided, and requirement for catheterization infrequent. In 16 consecutive patients, only four required catheters despite an average energy of 155 KJ and a maximum energy of 208 KJ.


Corrosion performances of several metallic materials (Al6061 and Al319 alloys, 304 stainless steel and grey cast iron) in the ethanol-gasoline alternative fuels were investigated. Cyclic potentiodynamic polarization tests were used to study their corrosion behavior. Anodizing and plasma electrolytic oxidation (PEO) techniques were used to produce oxide coatings on the Al6061 and Al319 alloys, and the corrosion properties of these coatings in the alternative fuel environments were also evaluated. The results showed that, the 304 stainless steel, Al6061 and the coating materials are compatible with the alternative fuels. The oxide coatings on both Al alloys provided effective corrosion protection in the alternative fuel environments.


Quantum states are very delicate, so it is likely some sort of quantum error correction will be necessary to build reliable quantum computers. The theory of quantum error-correcting codes has some close ties to and some striking differences from the theory of classical error-correcting codes. Many quantum codes can be described in terms of the stabilizer of the codewords. The stabilizer is a finite Abelian group, and allows a straightforward characterization of the error-correcting properties of the code. The stabilizer formalism for quantum codes also illustrates the relationships to classical coding theory, particularly classical codes over GF(4), the finite field with four elements.


The purpose of this study was to investigate the feasibility of a shear wave-based elastography prototype on Philips' iU22 ultrasound system for measuring liver tissue stiffness before and after RFA (Radio Frequency Ablation) therapy. A special pulse sequence that generates and tracks shear waves was implemented on a curvilinear transducer C5-1, with RF data acquisition and off-line processing. The system was regulated as safe for use in human. Two RFA lesions were generated in ex vivo porcine liver by a commercial RF ablation electrode (Rita Medical Systems, CA). Lesions were created around depth 40 mm beneath the liver surface. The target temperature was set to 90°C and 95°C, and ablation lasted about 5 and 6 minutes for two lesions, respectively. Elasticity measurements were made pre-RFA at two sites where lesions were centered. Post RFA, the needle tines were retrieved to prevent interference with the shear wave propagation. To avoid residual bubbles, post-RFA elasticity measurement was performed at an image plane about 1 mm away in elevation from the ablation center plane containing the needle shaft. After each elasticity experiment, the liver was cut open approximately at the imaging plane to confirm the pathological changes caused by RFA. For statistical analysis, shear mechanical properties were estimated and averaged in a region with area about 10 mm × 4 mm at the center of the lesions. In this ex vivo study, the shear wave peak displacement at the push focus was about 10 μm pre-RFA. It was significantly reduced to 2 μm post-RFA, signaling the underlying elevated tissue stiffness. Quantitative reconstruction further confirmed the necrosis-induced stiffness increase. Pre-RFA, the shear modulus was 1.56 ± 0.19 kPa and 1.15 ± 0.25 kPa for lesion #1 and #2 respectively; post-RFA, the shear modulus was 29.48 ± 7.28 kPa and 26.80 ± 9.11 kPa. An increase of one order of magnitude in shear modulus was observed for both lesions. Similar stiffness contrast also existed between the ablated and neighboring non-treated region post-RFA for both lesions. These early results demonstrate the feasibility of the prototype for quantifying elasticity of thermal lesions in liver. Further technical development such as imaging capability and automated analysis tools is required to enable the visualization of the ablation zone and assessment of the therapy procedure.


BACKGROUND
The choice of heterologous materials for cranioplasty after decompressive craniectomy is still difficult. The aim of this study is to examine the association between material of choice and related complications to suggest the best treatment option.

METHODS
A systematic review was performed for articles reporting cranioplasty comparing the following heterologous implants: Titanium, poli-methyl-methacrylate (PMMA), Polyetheretherketone (PEEK) and Hydroxyapatite (HA). Extracted data included implant materials and incidence of the most frequent complications.

RESULTS
The final selection resulted in 106 papers but according to our rules only 27 studies were included in the final analysis. Among a total of 1688 custom-made prosthesis implanted, 649 were Titanium (38.49%), 298 PMMA (17.56%), 233 PEEK (13.82%), and 508 were HA (30.13%). A total of 348 complications were recorded out of 1688 reported patients (20.64%). In the Titanium group,139 complications were recorded (21.42%); in the PMMA group 57 (19.26%), in the PEEK group 49 (21.03%) and in the HA group 103 (20.3%). If we examine a summary of the reported complications clearly related to cranioplasty (postoperative infections, fractures and prosthesis displacement) versus type of material in multicentric and prospective studies we can see how HA group patients have less reported infections and cranioplasty explantation after infections than PMMA, PEEK and Titanium. On the contrary HA patients seem to have a higher number of prosthesis displacement again if compared with the other materials. Since these data are not derived from a statistically correct analysis they should be used only to help to differentiate the properties of the various heterologous cranioplasties.

CONCLUSIONS
The ideal material for all heterologous cranioplasty has not yet been identified. The choice of material should be based on the clinical data of patients, such as the craniectomy size, presence of seizures, possibility of recovery, good long-term outcome associated with a cost analysis.


Mitogen-induced lymphocyte blastogenesis was measured following X-irradiation (0-4 Gy) in the presence or absence of superoxide dismutase (SOD), under aerobic and anaerobic conditions. There were no significant differences between radiation survival curves under these different conditions, nor did SOD have any radioprotective effect. This demonstrates the lack of oxygen dependence of radiation-induced inhibition of lymphocyte blastogenesis. Following X-irradiation at 2 Gy, neither SOD nor catalase, alone or together, added before or after irradiation, were radioprotective. In comparison to controls, both enzymes depressed lymphocyte proliferation when added at levels as low as 25 microgram catalase or 100 microgram SOD/ml media. When SOD and catalase were added together, the greatest depression of blastogenesis was obtained with increasing levels of SOD relative to increasing levels of catalase, indicating that SOD was largely responsible for this depression. The suppressive effect of administration of SOD (p less than 0.05), catalase (p less than 0.001) and SOD + catalase (p less than 0.001) on lymphocyte division was significantly greater when given prior to X-irradiation. The lack of an oxygen effect and the inability of SOD and catalase to protect human lymphocytes from X-irradiation suggest that 2- and /or H2O2 are not involved in radiation-induced inhibition of lymphocyte blastogenesis.


Despite unprecedented medical advancements and the near eradication of many serious diseases, there are growing epidemics of preventable illness brought about in part by the overemphasis on individual autonomy and the neglect of obligations to others. Insofar as these diseases develop because of individual choice, this permissiveness hampers the moral analysis of growing epidemics like childhood obesity. While society has contributed to its rapid progression, childhood obesity finds its origins in lifestyle choices implemented at home. Consequently, parents have an unparalleled duty to prevent and correct obesity and unhealthy lifestyles in their children. Failure to do so undoubtedly violates a parent's duty and suggests medical neglect. However, our current understanding of medical neglect is too narrow to be applicable to chronic, preventable illnesses. Relevant principles of tort law may broaden our understanding of neglect to better reflect the nature of parental and societal liability in preventable illnesses.


Within the UK rickets is emerging as a national public health issue, particularly among at-risk groups. There is concern that health professionals are overlooking recommendations for vitamin supplementation and opportunities for prevention. This paper reports on a study that aimed to identify current knowledge and practice regarding vitamin D deficiency and supplementation among community midwifery and health visiting teams employed in one NHS trust. A questionnaire was distributed to all health visiting and community midwifery team members (n=96), with a 76% response rate (n=73). Results suggest varying levels of awareness about vitamin D deficiency and groups at increased risk. Only 52% reported that they were aware of health department recommendations for vitamin supplementation. Health visiting teams recommended supplements more frequently than community midwives, but overall the recommendations were implemented inconsistently. Participants identified families eligible for the government Healthy Start scheme, but fewer were recommending Healthy Start vitamins. A deeper understanding of vitamin D deficiency and health department recommendations for vitamin supplementation is required by health professionals to ensure families are advised about appropriate prevention messages and to implement recommendations effectively.


We demonstrated the effect of hypoalbuminemia on theophylline disposition in rats. The pharmacokinetic parameters in Sprague-Dawley rats (SDRs) were compared with those in spontaneously hyperlipidemic rats (HLRs), which had approximately one half the serum albumin concentration of the SDRs, after a single 10 mg/kg injection (iv) of theophylline. Theophylline clearance (CL) in the HLRs was increased 1.6-fold, and the AUC was decreased by 36%. Although the elimination t1/2 was not significantly different between the two types of rats, the distribution volume (Vd) was increased significantly in the HLRs, compared with the SDRs. The free theophylline concentration in the SDRs was one half of the total concentration. In contrast, the free theophylline concentration in the HLRs was approximately equal to the total concentration. The enzymatic activities and apoprotein expression levels of CYP1A were decreased significantly in the HLRs, compared with the SDRs. The total theophylline CL was increased in HLRs with hypoalbuminemia, even though they exhibited lower enzymatic activity and CYP1A expression than did the SDRs. Because the unbound fraction and Vd of theophylline in HLRs were much larger than those in SDRs, we conclude that hypoalbuminemia may contribute to an increase in the Vd and a decrease in the CL for theophylline.


Abstract In this study, the water balance-based Precipitation-Evapotranspiration-Runoff (PER) method combined with the land surface model Variable Infiltration Capacity (VIC) was used to estimate the spatiotemporal variations of terrestrial water storage (TWS) for two periods, 1982–2005 (baseline) and 2071–2100, under future climate scenarios A2 and B2 in the Yangtze River basin. The results show that the estimated TWS during the base-line period and under the two future climate scenarios have similar seasonal amplitudes of 60–70 mm. The higher values of TWS appear in June during the baseline period and under the B2 scenario, whereas the TWS under A2 shows two peaks in response to the related precipitation pattern. It also shows that the TWS is recharged from February to June during the baseline period, but it is replenished from March to June under the A2 and B2 scenarios. An analysis of the standard derivation of seasonal and interannual TWS time series under the three scenarios demonstrates that the seasonal TWS of the southeastern part of the Yangtze River basin varies remarkably and that the southeastern and central parts of the basin have higher variations in interannual TWS. With respect to the first mode of the Empirical Orthogonal Function (EOF), the inverse-phase change in seasonal TWS mainly appears across the Guizhou-Sichuan-Shaanxi belt, and the entire basin generally represents a synchronous change in inter-annual TWS. As a whole, the TWS under A2 presents a larger seasonal variation whereas that under B2 displays a greater interannual variation. These results imply that climate change could trigger severe disasters in the southeastern and central parts of the basin.


New forms of networked action and informal collaboration are challenging traditional notions of civil society. Based on the proliferation of new technologies, and spurred by the spread of trans-border delocalized communities and the increasing disillusionment with traditional forms of political organization, civic action is becoming increasingly flexible, temporary, and elusive. This type of nontraditionally organized collective action often stays below the radar of public discourse, unless it is propelled to the spotlight because of international political developments such as the WikiLeaks case (and the related actions by the cyberactivist network Anonymous) and the mass protests in Northern Africa and the Middle East (and the role of social networking tools in these uprisings). In this article, we investigate the interactions and (in)compatibilities of Internet-based networked collective action with institutionalized spaces of policy debate. We begin by characterizing online networked action as an emerging form of organized civil society, focusing on the realm of cyberactivists who are building and using cyber-infrastructure ("grassroots tech groups"). In particular, we examine their values, identity features, and organizational forms. Based on this analysis, we explore two dimensions in which cyberactivism challenges established forms of institutionalized policy debate: the structural dimension and the realm of action repertoires. We ask whether these new forms of civil society are structurally compatible with current multistakeholder governance, and we discuss their repertoires of action with regard to policy advocacy and policy interventions, and thus the level and type of their engagement with governance processes and institutions.


The patient was a 58-year-old male with symptomatic alcoholic chronic pancreatitis. Since a 10 mm calculus was observed in the pancreatic body and abdominal pain occurred due to congestion of pancreatic juice, endoscopic retrograde cholangiopancreatography was conducted for assessment of the pancreatic duct and treatment of pancreatic calculus. Pancreatogram was slightly and insufficiently obtained by injecting the contrast media via the common channel of the duodenal main papilla. We tried to cannulate selectively into the pancreatic duct for a clear image. However, the selective cannulation of the pancreatic duct was difficult because of instability of the papilla. On the other hand, selective cannulation of the bile duct was relatively easily achieved. Therefore, after the imaging of the bile duct, a guidewire was retained in the bile duct to immobilize the duodenal papilla and cannulation of the pancreatic duct was attempted. As a result, selective pancreatic duct cannulation became possible. It is considered that the bile duct guidewire-indwelling method may serve as one of the useful techniques for cases whose selective pancreatic duct cannulation is difficult ("selective pancreatic duct difficult cannulation case").


Proximal pyroclastic deposits of the 46 ka caldera-forming eruption of Shikotsu volcano are investigated at new outcrops along the Opoppu river, south of the volcano. The deposits can be divided into 6 units, from A to F in ascending order, according to lithofacies, components, and time intervals. Based on the stratigraphy of the deposits, the sequence of the 46 ka Shikotsu eruption is revealed. Activity started with phreatomagmatic and phreatoplinian eruptions (Phase 1: Unit A). The eruption style changed to magmatic without a time interval before the plinian eruption (Phase 2: Unit B). The eruption column was intermittently unstable, producing pyroclastic surge and flow deposits during the latter period of Phase 2. The lithic breccia content also increased in the latter period. After a possible erosional interval, explosive eruptions occurred, producing voluminous pyroclastic flows and ended with the effusion of lag breccia (Phase 3: Unit C). After a dormant period, pyroclastic flows effused intermittently (Phase 4: Units D and E). At the final stage, small plinian eruption occurred, associated with a pyroclastic surge (Phase 5: Unit F). Juvenile materials of the 46 ka Shikotsu eruption are mainly crystal-poor (CP type) rhyolite pumice from Phases 1 to 3. Small amounts of crystal-rich (CR type) dacite and andesite pumice occurred from the final stage of the Phase 3. Two types of silicic material coexisted during Phases 4 and 5. According to temporal changes of lithic contents, the caldera collapse was almost completed at the end of Phase 3 with the formation of lag breccia. Therefore, it could be considered that activity in Phases 4 and 5 was either the terminal phase of calderaforming activity or the initial activity of post-Shikotsu caldera volcanoes.


The assessment of tissue perfusion by dynamic contrast-enhanced (DCE) imaging involves a deconvolution process. For analysis of DCE imaging data, we implemented a regression approach to select appropriate regularization parameters for deconvolution using the standard and generalized singular value decomposition methods. Monte Carlo simulation experiments were carried out to study the performance and to compare with other existing methods used for deconvolution analysis of DCE imaging data. The present approach is found to be robust and reliable at the levels of noise commonly encountered in DCE imaging, and for different models of the underlying tissue vasculature. The advantages of the present method, as compared with previous methods, include its efficiency of computation, ability to achieve adequate regularization to reproduce less noisy solutions, and that it does not require prior knowledge of the noise condition. The proposed method is applied on actual patient study cases with brain tumors and ischemic stroke, to illustrate its applicability as a clinical tool for diagnosis and assessment of treatment response.


Red meat is considered to be important part of our diet, as it helps in making of blood specially red blood cell which circulates oxygen in our body and it also important part of our body building block as amino acid is use for making of DNA. The objective of this research is not to discuss its biological importance but to clear the objection of other religion towards the way of slaughtering in Islam. And also clear the awareness of slaughtering between each individual Muslim, Non-Muslim and special children.


A novel approach called 'VQ-agglomeration' capable of performing fast and autonomous clustering is presented. The approach involves a vector quantisation (VQ) process followed by an agglomeration algorithm that treats codewords as initial prototypes. Each codeword is associated with a gravisphere that has a well defined attraction radius. The agglomeration algorithm requires that each codeword be moved directly to the centroid of its neighbouring codewords. The movements of codewords in the feature space are synchronous, and will converge quickly to certain sets of concentric circles for which the centroids identify the resulting clusters. Unlike other techniques, such as the k-means and the fuzzy C-means, the proposed approach is free of the initial prototype problem and it does not need pre-specification of the number of clusters. Properties of the agglomeration algorithm are characterised and its convergence is proved.


Abstract we are considering the problem of controlling wind turbine synchronous generators driven through AC/DC rectifiers and DC/AC inverters. The control objectives are threefold: (i) forcing the turbine speed to track a reference signal, (ii) regulating the DC Link voltage, (iii) enforcing power factor correction (PFC) with respect to the power network. First, a nonlinear model of the whole controlled system is developed in the Park-coordinates. Then, a nonlinear multi-loop controller is synthesized using the backstepping design technique. A formal analysis based on Lyapunov stability and average theory is developed to describe the control system performances. In addition to closed-loop global asymptotic stability, it is proved that all control objectives (turbine speed tracking, DC link voltage regulation, and unitary power factor) are asymptotically achieved up to small harmonic errors (ripples). The amplitudes of these harmonic errors depend on the power network frequency: the larger the power net frequency the smaller the error amplitudes. The above results are confirmed by simulations which, besides, show that the proposed regulator is quite robust with respect to uncertain changes of wind speed.


Progression of cutaneous T-cell lymphoma (CTCL) is associated with profound defects in cell-mediated immunity and depressed production of cytokines, which support cell-mediated immunity. Because we have observed marked defects in interleukin-12 (IL-12) production in CTCL and because IL-12 is critical for antitumor cytotoxic T-cell responses, we initiated a phase I dose escalation trial with recombinant human IL-12 (rhIL-12) where patients received either 50, 100, or 300 ng/kg rhIL-12 twice weekly subcutaneously or intralesionally for up to 24 weeks. Ten patients were entered: 5 with extensive plaque, 3 with Sezary syndrome, and 2 with extensive tumors with large cell transformation. One patient with Sezary syndrome dropped out after 1 week for personal reasons. Subcutaneous dosing resulted in complete responses (CR) in 2 of 5 plaque and partial responses (PR) in 2 of 5 plaque, and 1 of 2 Sezary syndrome (overall response rate CR+PR 5 of 9, 56%). A minor response also occurred in 1 of 5 plaque patients. Intralesional dosing resulted in individual tumor regression in 2 of 2 patients. Biopsy of regressing lesions showed a significant decrease in the density of the infiltrate in all cases and complete resolution of the infiltrate among those with clinical lesion resolution. An increase in numbers of CD8-positive and/or TIA-1-positive T cells were observed on immunohistochemical analysis of skin biopsy specimens obtained from regressing skin lesions. Adverse effects of rhIL-12 on this regimen were minor and limited and included low-grade fever and headache. One patient discontinued rhIL-12 at week 6 because of depression. These results suggest that rhIL-12 may augment antitumor cytotoxic T-cell responses and may represent a potent and well-tolerated therapeutic agent for CTCL.


This work has been supported by the DISCSIM project, grant agreement 341137 funded by the European Research Council under ERC-2013-ADG.


In plants, potassium serves an essential role as an osmoticum and charge carrier. Its uptake by roots occurs by poorly defined mechanisms. To determine the role of potassium channels in planta, we performed a reverse genetic screen and identified an Arabidopsis thaliana mutant in which the AKT1 channel gene was disrupted. Roots of this mutant lacked inward-rectifying potassium channels and displayed reduced potassium (rubidium-86) uptake. Compared with wild type, mutant plants grew poorly on media with a potassium concentration of 100 micromolar or less. These results and membrane potential measurements suggest that the AKT1 channel mediates potassium uptake from solutions that contain as little as 10 micromolar potassium.


9 The Julia programming language supports multiple dispatch and provides a rich type annotation 10 language to specify method applicability. When multiple methods are applicable for a given call, 11 Julia relies on subtyping between method signatures to pick the correct method to invoke. Julia's 12 subtyping algorithm is surprisingly complex, and determining whether it is correct remains an open 13 question. In this paper, we focus on one piece of this problem: the interaction between union 14 types and covariant tuples. Previous work normalized unions inside tuples to disjunctive normal 15 form. However, this strategy has two drawbacks: complex type signatures induce space explosion, 16 and interference between normalization and other features of Julia's type system. In this paper, 17 we describe the algorithm that Julia uses to compute subtyping between tuples and unions—an 18 algorithm that is immune to space explosion and plays well with other features of the language. We 19 prove this algorithm correct and complete against a semantic-subtyping denotational model in Coq. 2


Ederington and Guan's article calls into question the informational efficiency of option pricing in the real world, by showing that easily constructed positions earn higher returns than they should. Whaley's article adds evidence of a somewhat different kind to this conclusion. The Chicago Board Options Exchange has recently created an index to measure the returns to a basic covered call strategy that is long the S&P 500 index portfolio (SPX) and short an (approximately) at-the-money one-month SPX call option. In this article, Whaley describes the new index and then uses it to examine the returns to a basic covered call strategy from 1988 to 2001. Measuring the risk of a covered call presents some issues, because it is highly non-normal. Dealing with these, Whaley shows that under several standard measures of investment performance, the covered call strategy has been unusually successful, earning almost as much as the S&P index, with substantially lower risk.


In this article, I examine the specifics of a workspace in one of the Christian Orthodox organizations in Russia. The sisterhood which I analyze represents the interlacement of religious and economic discourses in the workplace. I discuss the "commodification" of piety which is seen as a professional competency in the labour relations among Orthodox Christians. It is true about the sisterhood, where being"inchurched" is one of the main filters for potential employees.I examine the "politics of labour" in the sisterhood through the analysis of its heterogeneous spatial composition and point at the differences between its spaces in their work tempo, prestige, and working conditions. Alongside economic goals, the sisterhood is aimed at missionary and educational work; however, commercial relations are often described using religious terminology. I discussthe conflict between religious and economic aims of work. Particular attention is given to the analysis of techniques that help to maintain discipline in the sisterhood. It is achieved through rational organization of labour, observability of the workplace, hierarchy in employer-employee relationships, and the disciplining of body and emotions. The analysis is based on the materials of participant observation and field materials collected during my four months as a staff member of the sisterhood.


This study intends to assess the removal efficiency of the chemical oxygen demand (COD), biochemical oxygen demand (BOD), and total suspended solids (TSS) from raw tannery wastewater using electrocoagulation by aluminum electrodes as well as to determine the effects of its main operating factors. Therefore, the response surface methodology was applied through an experimental Box-Behnken design by considering the current intensity (I), treatment time (T), and pH levels as the factors. In addition, the BOD, COD, and TSS removal percentages were considered to be the response variables. The results indicate that the treatment time, current intensity, and pH level were significant for COD and TSS, whereas only the treatment time was significant at a confidence level of p-value < 0.05 for BOD. For COD, the optimal operating conditions were I = 3 A, T = 24 min, and pH = 8.4; for BOD, the optimal operating conditions were I = 3 A, T = 24 min, and pH = 5.5; and for TSS, the optimal operating conditions were I = 2.7 A, T = 19 min, and pH = 7.4. Under these conditions, removal efficiencies of 56.8%, 69.2%, 99.9% were observed for COD, BOD, and TSS, respectively. The results suggest that electrocoagulation is an effective method for removing the parameters under study; therefore, it is a viable alternative for reducing the pollution issues caused by the tannery industry.


Premature ejaculation is a common sexual disturbance among men. Both open-label and double-blind studies have demonstrated the effectiveness of serotonergic medications for this disorder. These studies support the hypothesis that the serotonergic system has an important role in the modulation of sexual response, especially attainment of orgasm. Serotonergic dysfunction also has been linked to the pathogenesis of panic disorder. Several studies have demonstrated the efficacy of serotonergic drugs in this disorder. The purpose of the present study was to examine the efficacy of fluoxetine, a serotonin selective reuptake inhibitor for the treatment of comorbid premature ejaculation and panic disorder, in 10 men in an open-label design. The patients were given 20 mg of fluoxetine for 8 weeks of the study. Parameters pertaining to sexual function and measures of anxiety were examined. Improvement of premature ejaculation was noted as of week 2 of the study, whereas measures of panic and sexual satisfaction became statistically significant only as of week 4. Further studies with larger samples and longer periods of follow-up are needed in order to determine the usefulness of fluoxetine for the treatment of comorbid premature ejaculation and panic disorder.


In this contribution we focus on the globalisation of commercial theme parks with Walt Disney Company as the best known case study. After definitions and historical background of theme parks, we analyse the visitors key factors. For the Walt Disney Cie we start with some historical facts, we set up a SWOT-analysis and focus then on Euro Disneyland Paris, the biggest theme park of Europe.


When we speak of the English Renaissance, what is it that we are naming, what are we recognizing reborn? As the essays in this latest collection from the English Institute demonstrate, our basic notions of the period have themselves been reconceived. In Cannibals, Witches, and Divorce, seven critics defamiliarize the images of the Renaissance "to permit the repressed to return, to acknowledge the presence of the unassimilable ghost the mark of difference of an age that is at once self and 'other'." John Hollander discovers a "hidden undersong" in the Spenserian lyric, while Patricia Parker examines the question of feminine dominance and male resistance in the Bower of Bliss. Stephen Orgel and Steven Mullaney document the Renaissance encounter with the alien "other" in essays on The Tempest and The Merchant of Venice. Macbeth, in Janet Adelman's reading, encodes the fantasy of an absolute and destructive maternal figure. Marjorie Garber addresses the Shakespearean authorship controversy in the context of the subversive uncanniness of the texts themselves; Mary Nyquist discusses Milton's Eve, his divorce tracts, and the exegetical tradition as recently examined by feminist biblical scholars. Together, these essays explore Renaissance discourses of estrangement as strategies for the construction of the self and the world.


This article explores the possibility of examining a storytelling platform, which has largely been ignored by scholars of visual politics about Southeast Asia: comics. It particularly describes how comics can serve as a discursive mechanism for visual representation within the purview of the Rohingya refugee crisis in the region. Drawing from post-structuralism and visual discourse analysis as the theoretical and methodological basis of the research, the article considers a case of a long-form online comic's engagement withthe refugee crisis,with particular attention to the criticisms about Aung San Suu Kyi and the bloody military campaign against the Rohingya minorities in Myanmar. By specifically looking into the text-image discourses and inter-textual components of the comics, this article attempts to demonstrate that the ability of comics to "speak" politics is still dependent on international news sources and wider debates, which shape the ways in which the comic artists are able to frame their work. In this case, the use of comics as a story-telling platform, however, also suggests the agency of refugees to be portrayed as political-security actors. Although the article generally focuses on the case of the Rohingya refugee crisis, it also draws attention to the contention that scholars of Southeast Asian visual politics can most profitably engage with other regional issues by turning their attention to the dynamic role of comics as an alternative medium and source of data towards the analysis of threat construction and political-security discourse about Southeast Asia.


A new Linear Predictive Echo Canceller (LPEC) is presented which modifies the classical echo canceller structure to pre-whiten the input signal and hence have better convergence properties in the presence of highly correlated input signals such as speech. This structure is integrated with a 16 KBPS Residual Excited Linear Predictive (RELP) Vocoder [1] to allow significant execution speed savings by sharing common processing modules. The integrated LPEC has been implemented in the Vocoder Demonstration System (VDS-20) using a single TMS32020 processor and will be available at the conference for demonstrations.


Abstract. Recent years have seen a rapid reduction in the summer Arctic sea ice extent. To both understand this trend and project the future evolution of the summer Arctic sea ice, a better understanding of the physical processes that drive the seasonal loss of sea ice is required. The marginal ice zone, here defined as regions with between 15 and 80 % sea ice cover, is the region separating pack ice from open ocean. Accurate modelling of this region is important to understand the dominant mechanisms involved in seasonal sea ice loss. Evolution of the marginal ice zone is determined by complex interactions between the atmosphere, sea ice, ocean, and ocean surface waves. Therefore, this region presents a significant modelling challenge. Sea ice floes span a range of sizes but climate sea ice models assume they adopt a constant size. Floe size influences the lateral melt rate of sea ice and momentum transfer between atmosphere, sea ice, and ocean, all important processes within the marginal ice zone. In this study, the floe size distribution is represented as a truncated power law defined by three key parameters: minimum floe size, maximum floe size, and power law exponent. This distribution is implemented within a sea ice model coupled to a prognostic ocean mixed layer model. We present results to show that the use of a power law derived floe size distribution has a spatially and temporally dependent impact on the sea ice, in particular increasing the role of the marginal ice zone in seasonal sea ice loss. This feature is important in correcting existing biases within sea ice models. In addition, we show a much stronger model sensitivity to floe size distribution parameters than other parameters used to calculate lateral melt, justifying the focus on floe size distribution in model development. It is finally concluded that the model approach presented here is a flexible tool for assessing the importance of a floe size distribution in the evolution of sea ice and is suitable for applications where a simple but realistic floe size distribution model is required.


When performing the Cholesky factorization of a sparse matrix on a distributed-memory multiprocessor, the methods used for mapping the elements of the matrix and the operations constituting the factorization to the processors can have a significant impact on the communication overhead incurred. This paper explores how two techniques, one used when mapping dense Cholesky factorization and the other used when mapping sparse Cholesky factorization, can be integrated to achieve a communication-efficient parallel sparse Cholesky factorization. Two localizing techniques to further reduce the communication overhead are also described. The mapping strategies proposed here, as well as other previously proposed strategies fit into the unifying framework developed in this paper. Communication statistics for sample sparse matrices are included.<<ETX>>


Despite the visual importance of hair and the attention paid to hair modeling in the graphics research, modeling realistic hair still remains a very challenging task that can be performed by very few artists. In this paper we present hair meshes, a new method for modeling hair that aims to bring hair modeling as close as possible to modeling polygonal surfaces. This new approach provides artists with direct control of the overall shape of the hair, giving them the ability to model the exact hair shape they desire. We use the hair mesh structure for modeling the hair volume with topological constraints that allow us to automatically and uniquely trace the path of individual hair strands through this volume. We also define a set of topological operations for creating hair meshes that maintain these constraints. Furthermore, we provide a method for hiding the volumetric structure of the hair mesh from the end user, thus allowing artists to concentrate on manipulating the outer surface of the hair as a polygonal surface. We explain and show examples of how hair meshes can be used to generate individual hair strands for a wide variety of realistic hair styles.


This work is designed to teach natural resources professionals how to be more effective in solving conservation and environmental policy problems. Its presentation of basic concepts, case studies and "real world concerns" offers a deeper understanding of the policy process and should be useful to students and practitioners in such fields as wildlife biology, conservation biology, forestry, range management, ecosystem management and sustainable development. Tim Clark begins by describing the challenges faced by natural resources professionals. He then explains how the substance and process of policy analysis and decision making can be improved by using a policy sciences framework that takes into account biological, social, political and institutional considerations. Finally he reflects on how issues of human rights and morality should affect natural resources management and policy analysis.


Factor analysis is a broad term that refers to a set of statistical methods used to detect underlying patterns in the relationships among a number of observed variables. Its origins were in the large scale studies defining the dimensions of intelligence pioneered by Thurstone.1 ,2 Factor analysis can appear complicated to the general reader but the main principle is relatively straightforward: what it aims to do is identify whether the correlations between a set of multiple observed variables are explicable or can be summarised in terms of a smaller number of underlying, latent, unobserved variables, also called factors. It is useful to have a basic understanding of the specific techniques when reading articles about factor analysis. There are two main approaches: exploratory factor analysis and confirmatory factor analysis.

Exploratory factor analysis is used for the preliminary investigation of a set of observed variables, especially where there are multiple variables, such as each question on the Hopkins Symptom Checklist.3 In a population or sample where a diverse range of symptoms is under study, as is often the case in mental health research, the advantage of this method is that it makes no a priori assumption about the composition of underlying latent variables or factors. The applications of exploratory factor analysis are wide ranging:

1. Data reduction when multiple (over 25) variables have been measured, providing a parsimonious description of the data.

2. Classification of symptoms into clinically meaningful concepts especially when symptoms are many and diverse such as medically unexplained symptoms, symptoms to describe stress, multiple health beliefs and behaviours.

3. Definition of subscales of new measures of psychological functioning—a par exemplar is the validation of the well known General Health Questionnaire4 which was shortened to 12 items after identifying which symptoms in the 60-item version were …


Suppose that we have a basic random experiment with an observable, real-valued random variable \(X\). The distribution of \(X\) has \(k\) unknown real-valued parameters, or equivalently, a parameter vector \(\bs{\theta} = (\theta_1, \theta_2, \ldots, \theta_k)\) taking values in a parameter space, a subset of \( \R^k \). As usual, we repeat the experiment \(n\) times to generate a random sample of size \(n\) from the distribution of \(X\). \[ \bs{X} = (X_1, X_2, \ldots, X_n) \] Thus, \(\bs{X}\) is a sequence of independent random variables, each with the distribution of \(X\). The method of moments is a technique for constructing estimators of the parameters that is based on matching the sample moments with the corresponding distribution moments. First, let \[ \mu^{(j)}(\bs{\theta}) = \E\left(X^j\right), \quad j \in \N_+ \] so that \(\mu^{(j)}(\bs{\theta})\) is the \(j\)th moment of \(X\) about 0. Note that we are emphasizing the dependence of these moments on the vector of parameters \(\bs{\theta}\). Note also that \(\mu^{(1)}(\bs{\theta})\) is just the mean of \(X\), which we usually denote simply by \(\mu\). Next, let \[ M^{(j)}(\bs{X}) = \frac{1}{n} \sum_{i=1}^n X_i^j, \quad j \in \N_+ \] so that \(M^{(j)}(\bs{X})\) is the \(j\)th sample moment about 0. Equivalently, \(M^{(j)}(\bs{X})\) is the sample mean for the random sample \(\left(X_1^j, X_2^j, \ldots, X_n^j\right)\) from the distribution of \(X^j\). Note that we are emphasizing the dependence of the sample moments on the sample \(\bs{X}\). Note also that \(M^{(1)}(\bs{X})\) is just the ordinary sample mean, which we usually just denote by \(M\) (or by \( M_n \) if we wish to emphasize the dependence on the sample size). From our previous work, we know that \(M^{(j)}(\bs{X})\) is an unbiased and consistent


in the very large majority of cases. If it does occur it is of extremely short duration (30 seconds or so). Although apnoea holds no dread for the well-trained anaesthetist, we must not lose sight of the fact that it is essentially an unphysiological state of affairs, as is the positive-pressure artificial respiration which must be instituted to maintain ventilation. Under certain circumstances, such as " bucking," straining, and irregular patterns of respiration, manual respiration may be the lesser of two evils, but, on the whole, apnoeic states should be avoided unless specific indications exist. My second point is one of semantics. "Controlled respiration" by our definition is that state wherein spontaneous respiration has been abolished by means of hyperventilation with oxygen, maximum elimination of carbon dioxide, overdistension of the lungs (inhibition of the Hering-Breuer reflex), and a varying degree of central respiratory depression, but in which spontaneous respiration will resume soon after manual ventilation has been discontinued. Paralysis with muscle-relaxants clearly does not come within this definition, as spontaneous respirations w~ill not resume as long as the drug maintains its paralysing effects on the muscles of respiration and in particular the diaphragm. This type of respiration should be called what it has always been called-namely, " artificial respiration." The borderline between controlled and artificial respiration is not always too clear, and one may blend into the other; this occurs not infrequently after controlled respiration has been maintained for prolonged periods. Artificial respiration may not be as well-sounding a term as controlled respiration, but it is scientifically more correct in the case of apnoea from muscle-relaxants.-I am, etc.,


The article outlines the trends of 2019 – the first half of 2020 in the field of investment behavior of enterprises. The following aspects are examined: the level of investment activity both in terms of equipment purchases and total capital investment; the rating of factors limiting capital investment; the main sources of funds for investment and principal motives to invest; the features of borrowings from banks to finance investment.


BACKGROUND
 With the advent of electronic health record (EHR) systems, there is increasing attention on the EHR system with regard to its use in facilitating patients to play active roles in their care via secure patient portals. However, there is no systematic review to comprehensively address patient portal interventions and patient outcomes.

 OBJECTIVE
 This study aimed to synthesize evidence with regard to the characteristics and psychobehavioral and clinical outcomes of patient portal interventions.

 METHODS
 In November 2018, we conducted searches in 3 electronic databases, including PubMed, EMBASE, and Cumulative Index to Nursing and Allied Health Literature, and a total of 24 articles met the eligibility criteria.

 RESULTS
 All but 3 studies were conducted in the United States. The types of study designs varied, and samples predominantly involved non-Hispanic white and highly educated patients with sizes ranging from 50 to 22,703. Most of the portal interventions used tailored alerts or educational resources tailored to the patient's condition. Patient portal interventions lead to improvements in a wide range of psychobehavioral outcomes, such as health knowledge, self-efficacy, decision making, medication adherence, and preventive service use. Effects of patient portal interventions on clinical outcomes including blood pressure, glucose, cholesterol, and weight loss were mixed.

 CONCLUSIONS
 Patient portal interventions were overall effective in improving a few psychological outcomes, medication adherence, and preventive service use. There was insufficient evidence to support the use of patient portals to improve clinical outcomes. Understanding the role of patient portals as an effective intervention strategy is an essential step to encourage patients to be actively engaged in their health care.


Beatriz Rodríguez-Sánchez 1 Suela Sulo 2 José Antonio Carnicero 3 Ricardo Rueda 4 Leocadio Rodríguez-Mañas 1Faculty of Law and Social Sciences, Universidad de Castilla-La Mancha, Toledo, Spain; 2Abbott Nutrition, Chicago, IL, USA; 3Fundación de Investigación Biomédica, Hospital Universitario de Getafe, Getafe, Spain; 4Abbott Nutrition, Granada, Spain; 5Geriatric Department, Hospital Universitario de Getafe, Getafe, Spain Purpose: Little is known about the economic burden that malnutrition or its risk imposes on community-dwelling older adults. Using cross-sectional and longitudinal analyses, we assessed the impact of malnutrition risk on healthcare utilization and costs in a cohort of older adults living in Spanish community. Patients and Methods: Data from 1660 older (range 66–98 years), community-living adults participating in the Toledo Study on Healthy Ageing, waves 2 (year 2011–2013) and 3 (year 2015), were analyzed. Nutritional status categories were defined according to the Global Leadership Initiative on Malnutrition (GLIM) criteria, using a two-step approach. First, screening for malnutrition risk. Once positive, individuals were classified as malnourished according to some phenotypic (body mass index, grip strength, and unintentional weight loss) and etiologic (disease burden/inflammation and reduced food intake or assimilation) criteria. Outcomes assessed included healthcare resources (hospital admissions, number of hospitalizations, length of hospital stay per hospitalization, and number of medications). Results: Fifteen percent of the population was found to be at risk of malnutrition, while 12.6% was malnourished. Overall, patients from both groups were older, had lower functional status, and had more comorbidities compared to well-nourished counterparts (p<0.05). Results of our cross-sectional analysis showed that being at-risk/malnourished was associated with greater medication utilization, higher rates of hospital admission and longer stays, and higher hospitalization costs. However, when adjusting for covariates, malnutrition/risk was associated only with higher hospitalization costs (range: 11–13%). Longitudinal analysis results indicated that malnutrition/risk was significantly associated with more frequent hospitalizations, longer lengths of stay, higher hospitalization costs, and polypharmacy at follow-up. Conclusion: Malnutrition or its risk, found in over one of four older adults in the Toledo community, was associated with higher healthcare resource use and increased costs. Such findings suggest that malnutrition risk-screening for older adults, and provision of nutrition counseling and care when needed, hold potential to improve their health and to lower costs of care in the Spanish healthcare system.


Perhaps the cornerstone of Daniel Dennett's case for his \multiple drafts" view of consciousness in his Consciousness Explained is a set of inferences he draws from the phi phenomenon. We explain why these inferences are incorrect, in part by explaining phi (as replicated in our own lab) in such a way that it is consistent with the standard conceptions of consciousness Dennett seeks to supplant. (You are directed to |'s web site (URL above) for this paper, for the Turing Machine M discussed herein, and for a Java-based version of the color phi phenomenon which you can experience and react to.)


The aim of this research was to investigate the photo-Friedel-Crafts acylation of napthoquinone with a variety of aldehydes using a Rayonet reactor. The long-term aim of this project was to apply this research to the synthesis of biologically active natural products such as alkannin and shikonin.
As a 100% atom efficient, solar reaction, the photo-Friedel-Crafts acylation of naphthoquinone is understood to be a very environmentally friendly reaction. With this in mind, it was undertaken to improve the "green" nature of this reaction by replacing harmful traditional solvents such as benzene with more benign alternatives. Ionic liquids were chosen for this purpose, due to their low vapour pressure, recyclability, low flammability and customisable solubilising and catalytic properties, as well as the fact that they have been shown to stabilise reactions with radical intermediates. The reaction was also performed in microemulsions.
As an extension of previous work done in DCU by Pratt et al. it was undertaken photochemically generate a series of biaryl trifluorophthalonitriles, and optimise the reaction conditions necessary for their synthesis. Once these novel phthalonitriles had been generated a method for condensing them to phthalocyanines was developed. The novel phthalocyanines generated using this method were then assessed as catalysts for photooxygenation reactions. It was hoped that the introduction of peripheral aryl groups would increase the solubility of the phthalocyanines as well as reducing aggregation.


The paper covered a study aimed at developing a risk-based conceptual ship design method for bulk carriers, while taking into account the life cycle assessment and energy efficiency of the ship propulsion system. The study included conceptual ship design as a part of the risk-based ship design approach. In such conceptual design, using the long-time experience and statistics, the main dimensions and hull form, resistance and propulsion, weights, initial stability, freeboard, seakeeping and manoeuvrability were initially derived and the capital expenditure, operational expenditure, and decommissioning expenditure obtained. An optimal design solution was obtained, based on the energy efficiency design index, shipbuilding, operation, and resale costs at the end of the service life, which were used as input variables in a riskbased analysis.


A microroughness meter (MRM) was used to measure the high-frequency roughness of a number of geomorphic surfaces in the forefield of Glacier de Tsanfleuron, Switzerland. Resulting spectral power densities are added to low-frequency spectra, measured by electro-optical distance meter (EDM), to generate composite roughness spectra that include almost 5 orders of magnitude of roughness in the frequency domain. These are used to define two roughness indices: a general index of bed roughness is defined as the integral of the raw, spectral power densities, and a sliding-related index of bed roughness is defined as the integral of the spectral power densities weighted to account for the optimum dependence of glacier sliding speed on hummock wavelength. Results indicate that MRM-measured geomorphic components vary in roughness by 3 orders of magnitude, principally depending on the surface microenvironment measured and profile orientation relative to the direction of former ice flow. Both MRM- and EDM-measured roughnesses are lower parallel to the direction of former ice flow than perpendicular to it. Composite roughness spectra consequently indicate that the glacier bed is smoothed in the direction of former ice flow at all horizontal scales from 1 mm to 40 m, typically resulting in an order of magnitude decrease in sliding-related roughness relative to that measured perpendicular to ice flow. Comparison of data from two survey sites located adjacent to, and ∼1.2 km from, the current glacier margin indicates that postglacial subaerial weathering homogenizes bedrock roughness, in particular reducing high-frequency, flow-orthogonal roughness. Accounting for the effect of 28% ice-bedrock separation over one of the profiles reduces net, sliding-dependent roughness by between 27% and 43%, depending on the transition wave number used.


In this study, the mechanical behavior of Austenitic stainless steel 304L under low cycle fatigue was investigated under different uniaxial strain-controlled loadings of 0.5%, 0.8%, 1.0%, 1,2% and 1.5%. The analysis of the experimentally determined strain vs stress hysteresis curves were carried out to achieve stress quantities such as amplitude stress, peak effective stress, and peak back stress. It was observed that in the early stage of cyclic loading, material underwent initial hardening, followed by softening phenomena which were more considerable in the lower strain range. Before the failure, the secondary hardening was observed at the final stage. In addition to accumulated plastic strain, it was shown that the peak back stress and peak effective stress which is associated with isotropic hardening and kinematic hardening behavior, respectively, are influenced by the strain range effect. Therefore, the coefficient of recall term that appeared in the Armstrong_Frederick nonlinear kinematic hardening model was considered to be dependent on the radius of the memory surface. Furthermore, to increase the ability of the plasticity constitutive model to show a smooth transition between various hardening stages, the radius of the yield surface which is associated with the isotropic hardening rule was equipped with the fading effect. Finally, by the comparison of numerical and experimental results, the capability of the rate-dependent constitutive model over classical rate-independent plasticity in the prediction of mechanical behavior of steel 304L under strain-controlled cyclic loading was revealed.


The influence of preorganised 7,7-diphenylnorbornane in the stability (Ka) of host-guest complexes as well as in the determination of the energy of edge-to-face aromatic interactions has been investigated. The guest molecules studied bind more strongly with hosts that contain the cofacial 7.7-diphenylnorbornane subunit than with similar hosts that have a 1,1-diphenylcyclohexane subunit. On the other hand, the value of the edge-to-face aromatic interactions calculated for our complexes (-0.2 +/- 0.6 kJmol(-1)) is significantly lower (by a factor of seven) than the one previously reported in the literature. This result highlights the importance of entropic factors in the determination of weak noncovalent interactions.


During the AKP era,Turkish-Iranian relations benefit from the new dynamism in regional affairs, especially in the Middle East,based on the pro-active foreign policy approach.In the decades before the AKP government, Iran was perceived by Turkish elites as the ideological other and rival. The decade after the new millennium witnessed a perception change led by Foreign Minister Davuto'luwho replaced the old mindset based on mistrust with a coursecenteredon cooperation in several significant fields. Nevertheless, Iran's disputed nuclear program is an important barrier for closerrelations. Although the Iranian nuclear program is perceived as a serious threat by the international community, Turkey has, in line with the new mindset of cooperation, vigorously advocated the right of Iran to develop peaceful civilian nuclear technology. Thus, Turkey has not suspected Tehran of secret uranium enrichment activities. The Arab Spring was the breaking point in Ankara's miscalculated Iran perception. After a concretization of differences of interests, mainly on Syrian issue, the position of Ankara toward Tehran has noticeably changed. Ankara has realized that the differences with Iran remain despite Turkey's constrictive new Iran approach. A cooperation-oriented relationship has been replaced with a latent conflictual one due to diametrical interests of both countries during and after the Arab Spring, in particular because ofdifferent positions onSyria. After this perception change, Turkey had to respond and take measures, especially in defense policy, which has driven Turkey into more intensive cooperation with the USA and NATO at the expense of her independent proactive regional policy. This article explores the reasons for the persisting and changing perceptions of Turkey on Iran and seeks to analyze the motivations of Turkey's Iran policy as it relates to Ankara's changing security perceptions, in particular with respect to Iranian nuclear and ballistic technology programs.


The authors have written this manual as a sequel to Mr. MacDonnell's work on the physical interpretation of bloodstain evidence, Flight Characteristics and Stain Patterns of Human Blood. The manual allows the nonscientist the opportunity to evaluate bloodstain patterns produced under known conditions and to draw his own conclusions. The results can be preserved as reference standards. There are twelve experiments as follows: (1) volume of a drop of blood, (2) spot size as a function of distance fallen, (3) effect of target surface on spatter, (4) spot shape versus impact angle, (5) effect of horizontal motion, (6) splashed blood versus distance fallen, (7) projected blood versus distance fallen, (8) "cast off" bloodstains, (9) medium velocity blood spatter, (10) high velocity blood spatter, (11) spot size versus horizontal projection, and (12) drying time of blood.


This article explores the different ways in which gay men in Serbia perceive PrEP as a novel method of HIV prevention. In the article, I draw on data from my research on PrEP use among thirty gay men in Belgrade. The use of PrEP is still very low amongst gay communities in Serbia due to their rejection of PrEP and due to the stigma around PrEP use. In Serbia, the social significance of PrEP relates to HIV status disclosure on gay social/dating media. Paradoxically, on gay dating sites, the signifier "PrEP" blurs the line between HIV positive gay men – who have achieved undetectable HIV status through a potent ARV therapy – and those HIV negative gay men who use PrEP as a preventative tool against HIV transmission. In the article, I will argue that a new form of gay identity has emerged on gay dating apps in Serbia – "undetectable, on PrEP." This new identity emerges from confusion in HIV risk assessment. The use of PrEP has been seen as a marker to denote someone's HIV negative status and to protect them from HIV transmission. However, some gay men with an undetectable HIV status would like to be regarded as HIV negative even though they are not, and thus they use the signifier "on PrEP" to highlight their desire to claim an HIV negative status. PrEP has many symbolic valences: from HIV status disclosure to assumed promiscuity. As I will argue, while the health paradigm is of utmost importance for Serbian gay men, internalized stigma additionally drives the low uptake of PrEP amongst gay communities in Serbia, thus contributing to the confusion regarding PrEP use and the overall approach to HIV prevention. This article finds that those respondents who accept PrEP without stigma or confusion regarding their HIV status are also more willing and ready to recommend using PrEP to other gay men.


Prototype pollution is a dangerous vulnerability affecting prototype-based languages like JavaScript and the Node.js platform. It refers to the ability of an attacker to inject properties into an object's root prototype at runtime and subsequently trigger the execution of legitimate code gadgets that access these properties on the object's prototype, leading to attacks such as Denial of Service (DoS), privilege escalation, and Remote Code Execution (RCE). While there is anecdotal evidence that prototype pollution leads to RCE, current research does not tackle the challenge of gadget detection, thus only showing feasibility of DoS attacks, mainly against Node.js libraries. In this paper, we set out to study the problem in a holistic way, from the detection of prototype pollution to detection of gadgets, with the ambitious goal of finding end-to-end exploits beyond DoS, in full-fledged Node.js applications. We build the first multi-staged framework that uses multi-label static taint analysis to identify prototype pollution in Node.js libraries and applications, as well as a hybrid approach to detect universal gadgets, notably, by analyzing the Node.js source code. We implement our framework on top of GitHub's static analysis framework CodeQL to find 11 universal gadgets in core Node.js APIs, leading to code execution. Furthermore, we use our methodology in a study of 15 popular Node.js applications to identify prototype pollutions and gadgets. We manually exploit eight RCE vulnerabilities in three high-profile applications such as NPM CLI, Parse Server, and Rocket.Chat. Our results provide alarming evidence that prototype pollution in combination with powerful universal gadgets lead to RCE in Node.js.


In view of the spare parts supply route problem with hard time windows in transportation, an optimal model that aims to minimize the total delivery time is put forward. In this paper, the supply route optimization problem with the shortest transportation distance as the decision target is discussed in detail. Taking the shortest total transportation distance of all vehicles as the optimization goal, a mathematical analytical model that considers the hard time window requirements of each customer is established. Based on the improved ant colony algorithm, the algorithm flow of solving the vehicle routing problem with hard time windows is designed to solve the difficulty of the model. In addition, the feasibility of the improved algorithm is verified by a case considering the actual terrain. The results show that the improved algorithm can quickly find the solution of VRPTW and provide an effective delivery plan for decision makers.


Mathematics has formed part of all our daily lives since the most remote origins of our civilization, although on too many occasions schools have done little for this functional view of mathematics reclaiming the formal role of this discipline in detriment of its more practical and applied element. From this perspective the curriculum organized by competence arises due to the need to fill this vacuum and allow our students to function better in the constant elements of real situations which they are going to have to resolve throughout their lives. The specifying of this general view of mathematic competence in the numeric competence should allow all our students to progressively acquire numeric sense, that is, that they have the capacity to apply good quantitative ideas in real situations


Background Excess levels of serum acylcarnitines, which are intermediate products in metabolism, have been observed in metabolic diseases such as type 2 diabetes mellitus. However, it is not known whether acylcarnitines may prospectively predict risk of cardiovascular death or acute myocardial infarction in patients with stable angina pectoris. Methods and Results This study included 4164 patients (median age, 62 years; 72% men). Baseline serum acetyl‐, octanoyl‐, palmitoyl‐, propionyl‐, and (iso)valerylcarnitine were measured using liquid chromatography/tandem mass spectrometry. Hazard ratios (HRs) and 95% CIs for quartile 4 versus quartile 1 are reported. The multivariable model included age, sex, body mass index, fasting status, current smoking, diabetes mellitus, apolipoprotein A1, apolipoprotein B, creatinine, left ventricular ejection fraction, extent of coronary artery disease, study center, and intervention with folic acid or vitamin B6. During median 10.2 years of follow‐up, 10.0% of the patients died of cardiovascular disease and 12.8% suffered a fatal or nonfatal acute myocardial infarction. Higher levels of the even‐chained acetyl‐, octanoyl‐, and palmitoyl‐carnitines were significantly associated with elevated risk of cardiovascular death, also after multivariable adjustments (HR [95% CI]: 1.52 [1.12, 2.06]; P=0.007; 1.73 [1.23, 2.44]; P=0.002; and 1.61 [1.18, 2.21]; P=0.003, respectively), whereas their associations with acute myocardial infarction were less consistent. Conclusions Among patients with suspected stable angina pectoris, elevated serum even‐chained acylcarnitines were associated with increased risk of cardiovascular death and, to a lesser degree with acute myocardial infarction, independent of traditional risk factors. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00354081.


Engineering the immune system against cancer ideally provides surgical precision against the antigen bearing target cell while avoiding the systemic, off-target toxicity of chemotherapy. Successful treatment of patients in the clinic has been achieved by the expression of anti-cancer T-cell receptors (TCR) and chimeric antigen receptors (CAR) in T cells followed by infusion of these cells into cancer patients. Unfortunately, while many patients initially respond showing anti-tumor efficacy, the effects are by and large transient with the majority of patients succumbing to disease. This observation speaks to the power of the engineered antigen receptor, but also indicates a need for a persistent source of cells to mount a continuous response.This thesis work sought to investigate the feasibility of engineering immunity using hematopoietic stem cells (HSC). HSC are at the top of the hematopoietic hierarchy, and would theoretically provide a continuous supply of antigen receptor bearing T cells capable of eliminating disease in a patient. Important considerations for using HSCs in gene therapy include: efficient gene delivery to HSCs which are refractory to gene modification by nature, robust expression of the transgene within gene modified cells to provide efficacy, evaluation of successful gene modification and engraftment following transplant, the ability of gene modified T cells to mount an immune response against their intended targets, and the ability to eliminate the gene modified cells in the event of undesired outcomes.Current systems to study human HSC biology and gene therapy are limited, and the best available are human / mouse chimeric transplant systems. Using these models, we evaluated the utility of positron emission tomography (PET) in the humanized mouse following transplant of gene modified cells, and found it superior to peripheral blood flow cytometry in being able to temporally establish successful engraftment. Using a lentiviral vector expressing both a TCR against a common cancer / testes antigen, NY-ESO-1, as well as a PET imaging / suicide gene, we demonstrated the ability to monitor engraftment, successful generation of effector cells capable of killing patient derived cancer cell lines, and the complete elimination of gene modified cells. This final work provides support for a clinical trial soon to enroll patients at UCLA.The use of HSCs for engineered cancer immunotherapy could overcome current limitations associated with the lack of persistence of engineered terminally differentiated immune cells. Further, the rich clinical history of gene therapy using HSCs provides a broad platform for future studies aimed at the broad spectrum of cancer disease.


This paper investigates the classification of multi-class motor imagery for electroencephalogram (EEG)-based Brain-Computer Interface (BCI) using the Filter Bank Common Spatial Pattern (FBCSP) algorithm. The FBCSP algorithm classifies EEG measurements from features constructed using subject-specific temporal-spatial filters. However, the FBCSP algorithm is limited to binary-class motor imagery. Hence, this paper proposes 3 approaches of multi-class extension to the FBCSP algorithm: One-versus-Rest, Pair-Wise and Divide-and-Conquer. These approaches decompose the multi-class problem into several binary-class problems. The study is conducted on the BCI Competition IV dataset IIa, which comprises single-trial EEG data from 9 subjects performing 4-class motor imagery of left-hand, right-hand, foot and tongue actions. The results showed that the multi-class FBCSP algorithm could extract features that matched neurophysiological knowledge, and yielded the best performance on the evaluation data compared to other international submissions.


A Textbook of Human Embryology. By R. G. Harrison, M.A., D.M. (Pp. xi+244; 144 illustrations. 45s.) Oxford: Blackwell Scientific Publications. 1959. There are many well-tried textbooks of human embryology, scholarly and pedagogically excellent, but all inflated with detail to a size which makes them a trial to most medical students. A book is needed of about the scope of Professor Harrison's, based on consideration of what an ordinary medical student in an ordinary medical course can gain from embryology. The primary function is no doubt to be an aid in grasping anatomy, normal and malformed. For this the book is good: it is clear and balanced and well based on modern descriptive work, though, since the vigilance of no writer is perfect, some refining of careless statements will naturally be needed in later editions. A flavour of experimental work is necessary to prepare the student for future advances that may impinge on medicine: in this admittedly less important aspect, the book is a little disappointing. It is no doubt the incoherence of the subject that makes it so notoriously difficult to give a clear or even reasonably accurate exposition of the experimental analysis of early development. Professor Harrison has tended to pick out one or two papers about each system, and when his choice is unrepresentative the consequence can be an unbalanced picture of the state of knowledge, as in the important topic of sex differentiation. The book is very welr produced.


Early historic and ethnographic accounts report the presence of two types of dogs (Canis familiaris) kept by the Makah and Coast Salish peoples of the south central Northwest Coast of Sorth America (southeastern Vancouver Island, northern Olympic Peninsula, the Gulf Islands, Puget Sound and the Fraser River Delta). These accounts describe a medium-sized, short-haired dog and a smaller, long-haired one. The small type or "wool" dog was reportedly kept almost exclusively for its thick soft fur, which was woven into blankets. The ethnohistoric evidence suggests that the two types of dogs were deliberately maintained as separate populations, with explicit economic reasons for doing so, and thus may constitute true breeds. This pattern of dog use has not been recorded anywhere else in North America. However, the cultural implications of this unique situation cannot be appreciated fully until the issue of whether the wool dog really existed as a separate type during prehistoric times is resolved. The purpose of this study was to determine whether two distinct physical types could be distinguished within a sample of 1163 dog skeletal remains collected from 20 archaeological sites spanning 5000 years of prehistory. The sample consists of crania, mandibles, major front and hind limb elements, selected tarsals, metapodials and vertebrae. A statistical method cribbed from paleontological studies was used to interpret the variation in size demonstrated by the sample. This method allowed specimens to be classified, on an element by element basis, as either large or small according to its total length dimension. Multivariate discriminant function analysis was used to investigate the relationship between breadth and length dimensions. This analysis constitutes the first comprehensive work on prehistoric dog remains from this area. It is a long overdue database that will allow almost all dog skeletal elements, previously excavated material and future remains alike, to be compared and assessed.


Citrus paradisi Macfad. 'Duncan' was transformed with constructs coding for the wild-type and mutant RNA-dependent RNA polymerase (RdRp) of Citrus tristeza virus (CTV) for exploring replicase-mediated pathogen-derived resistance (RM-PDR). The RdRp gene was amplified from a CTV genome and used to generate the wild-type and 2 mutant RdRp constructs for plant transformation. One mutant had the key amino acids GDD changed to AAA (RdRp-mGDD), and the second mutant had a deletion encompassing the GDD domain (RdRp-DGDD). Etiolated epicotyl segments of Duncan grapefruit (Citrus paradisi Macfad. 'Duncan') were transformed with each of these constructs using the Agrobacterium-mediated transformation method. From 4540 transformed epicotyl segments, 1402 kanamycin-resistant shoots were regenerated. After testing for expression of green fluorescent protein (GFP) and \Beta-glucuronidase (GUS) reporter genes by fluorescence microscopy and histochemical staining, respectively, 146 GUS-positive plants were rooted and 97 surviving plants were established in soil in pots. A total of 70 plants were tested for the presence of the GUS gene and CTV RdRp transgenes by polymerase chain reaction (PCR). A total of 51 GUS and CTV transgene-positive transgenic plants (15 with RdRp, 21 with RdRp-mGDD, and 15 with RdRp-DGDD) were identified.


As an art form that has existed since nearly a century ago, animation has birthed many different techniques of presenting visual motion to the audience, either in a more familiar, realistic representation or a stylistic visual choice that goes beyond imagination. Various elements such as characters, objects, environments and abstract constructs are combined into one cohesive shot and subsequently, several of these shots are compiled to create one scene in an animation production. Among these aspects of animation that have to be taken into consideration heavily by animators, is frame rates, or more commonly known and abbreviated as FPS (frames per seconds). The definition of frame rate is basically the amount of frames or images that are playing within one second exactly in a time-based work. There are several variations of frame rates that are used by different styles of animation, whether it is traditional hand-drawn 2D animation, fully computer-generated 3D animation, stop motion and even hybrids of these different methods. One such example of an animated work in recent years that has pioneered the usage of different frame rates in their production is the animated feature film by Sony Animation, Spiderman: Into the Spider-Verse, and its sequel which was newly released in theatres, Across the Spider-Verse, among other examples as well, but for this film in particular, the usage of different frame rates was intentional. In this article, how different frame rates are utilized in different forms of animation are studied by analyzing different existing examples that have been published for the general audience in movie theatres, online streaming and television, as well as exploring the function of different frame rates and the effect that they have towards the audience's psychology as well as in the context of storytelling when it comes to presenting their characters' personality and background.


While generative modeling on multimodal image-text data has been actively developed with large-scale paired datasets, there have been limited attempts to generate both image and text data by a single model rather than a generation of one fixed modality conditioned on the other modality. In this paper, we explore a unified generative vision-and-language (VL) model that can produce both images and text sequences. Especially, we propose a generative VL transformer based on the non-autoregressive mask prediction, named MAGVLT, and compare it with an autoregressive generative VL transformer (ARGVLT). In comparison to ARGVLT, the proposed MAGVLT enables bidirectional context encoding, fast decoding by parallel token predictions in an iterative refinement, and extended editing capabilities such as image and text infilling. For rigorous training of our MAGVLT with image-text pairs from scratch, we combine the image-to-text, text-to-image, and joint image-and-text mask prediction tasks. Moreover, we devise two additional tasks based on the step-unrolled mask prediction and the selective prediction on the mixture of two image-text pairs. Experimental results on various downstream generation tasks of VL benchmarks show that our MAGVLT outperforms ARGVLT by a large margin even with significant inference speedup. Particularly, MAGVLT achieves competitive results on both zero-shot image-to-text and text-to-image generation tasks from MS-COCO by one moderate-sized model (fewer than 500M parameters) even without the use of monomodal data and networks.


There are various studies demonstrating the influence of cultural differences on IS adoption decisions, whereby variation among corresponding findings is substantial. In contrast to previous quantitative studies which focus mainly on uncovering the kinds of differences that exist in the adoption process across cultures, we scrutinize the motives for these differences in adoption decisions with a qualitative case study across China, the United States and Switzerland. By applying the extended technology acceptance model and the GLOBE study, we analyze the adoption decisions of a subset of an ERP system – quality management systems. By means of a case study containing document analysis, evaluations of observations and interviews, five system-related and four project-management-related influencing variables are identified, leading to the basis for a future research agenda. Finally, the practical and theoretical contribution of this study consists of an enriched understanding of culturally determined variables for the implementation of IS.


Case report: We encountered a 28-day-old infant with progressive respiratory failure diagnosed with pertussis after discharge from the hospital. Here, we describe the disease course, diagnostic difϐiculties and treatment procedure. After 20 days of treatment based on the doctors' experience (without an established diagnosis), the child was deemed healthy and discharged. At the 6-month follow-up, the child was healthy and showed normal development. No other Bordetella pertussis infections among newborns or hospital staff who were in contact with the patient and his family were reported. Conclusion: Pertussis morbidity is high in infants younger than 6 months, and the disease should be suspected in any case of respiratory failure. The serological diagnosis of pertussis depends mostly on the organization and effectiveness of the healthcare system; therefore, medical history and physical examination are vital factors in the diagnostic process. The treatment of pertussis in infants should take place in centres with an intensive care unit.


Transparent displays can serve as an important collaborative medium supporting face-to-face interactions over a shared visual work surface. Such displays enhance workspace awareness: when a person is working on one side of a transparent display, the person on the other side can see the other's body, hand gestures, gaze and what he or she is actually manipulating on the shared screen. Even so, we argue that designing such transparent displays must go beyond current offerings if it is to support collaboration. First, both sides of the display must accept interactive input, preferably by at least touch and / or pen, as that affords the ability for either person to directly interact with the workspace items. Second, and more controversially, both sides of the display must be able to present different content, albeit selectively. Third (and related to the second point), because screen contents and lighting can partially obscure what can be seen through the surface, the display should visually enhance the actions of the person on the other side to better support workspace awareness. We describe our prototype FACINGBOARD-2 system, where we concentrate on how its design supports these three collaborative requirements.