We report the second case of infection with Chromobacterium violaceum that occurred in Brazil. A farm worker living in the State of São Paulo presented fever and severe abdominal pain for four days. At hospitalization the patient was in a toxemic state and had a distended and painful abdomen. Chest X-ray and abdominal ultrasound revealed bilateral pneumonia and hypoechoic areas in the liver. The patient developed failure of multiple organs and died a few hours later. Blood culture led to isolation of C. violaceum resistant to ampicillin and cephalosporins and sensitive to chloramphenicol, tetracyclin, aminoglicosydes, and ciprofloxacin. Autopsy revealed pulmonary microabscesses and multiple abscesses in the liver. The major features of this case are generally observed in infections by C. violaceum: rapid clinical course, multiple visceral abscesses, and high mortality. Because of the antimicrobial resistance profile of this Gram-negative bacillus, for appropriate empirical antibiotic therapy it is important to consider chromobacteriosis in the differential diagnosis of severe community infections in Brazil.


Companies need of qualified and educated staff has stressed the importance of life long learning. Distance education can be one method to meet these demands. Distance education offers flexibility for students to choose time and place for their studies and the possibility to combine work and family life with university studies. The purpose of this study is to investigate a learning environment represented by a Learning Centre and a Learning Management System (LMS). The need of communication and social interaction in four different distance courses offered by Malardalen University are explored. Both students and tutors appreciated an introduction meeting face-to-face and the students felt that support and feedback from the tutors were important. The four courses used different LMS:s and students as well as tutors were satisfied with the functionalities regardless of what kind of LMS they used. The Learning Centre was appreciated and utilized by half of the student group. Some of the workgroups felt it was easier to meet face-to-face than to use the LMS for interaction. The conclusion is that social interaction between students as well as students and tutors is important for the students´ learning processes. A LMS, while appreciating the importance of social interaction, can fulfil the demands of communication, collaboration, support and feedback from both students and tutors. Therefore a LMS can be seen as a learning environment on its own and a Learning Centre as a complementary part of the learning environment for students who appreciate face-to-face meetings.


Abstract. A substantial degree of uncertainty surrounds the value of the diffusion coefficient for water vapor diffusing through snow under the influence of a temperature gradient. A collection of theoretical, numerical, and experimental studies suggest the value of the normalized diffusion coefficient of snow with respect to water vapor diffusing through humid air ranges from near zero to as high as 7. The challenges in quantifying the diffusion coefficient are attributed to the fact that snow is a phase changing mixture of ice and humid air. Phase changes involving sublimation and condensation of water molecules significantly alter diffusion paths that water vapor molecules must travel through in the complex ice/humid air microstructure. I identify 4 major diffusion mechanisms caused by the introduction of an ice phase into humid air that should be accounted for in any calculation of the diffusion coefficient. Mathematical and experimentally motivated arguments enable one to estimate the physical significance of each of these diffusion mechanisms. Using this information, three separate models of increasing complexity are developed to provide estimates of the diffusion coefficient for snow. Finally, several prior studies are anchored to a formal definition of the diffusion coefficient and, if necessary, adjusted to account for the 4 diffusion mechanisms presented. The end result is a remarkable consistency in predicted values for vapor diffusion in snow, showing the normalized diffusion coefficient with respect to water vapor in air to be slightly enhanced at all densities, with typical values between 1 and 1.3. These values are consistent with the models developed herein.


The contributors to this volume offer an original approach to debates about indigenous knowledge. Concentrating on the political economy of knowledge construction and dissemination, they look at the variety of ways in which development policies are received and constructed to explain how local knowledges are appropriated and recast, either by local elites or by development agencies. Until now, debates about indigenous knowledge have largely been conducted in terms of agricultural and environmental issues such as bio-piracy and gene patenting. The book opens up the theoretical debate to include areas such as post-war traumatic stress counselling, representations of nuclear capability, architecture, mining, and the politics of eco-tourism


Driverless vehicles have the potential to significantly affect the transport system, society, and environment. However, there are still many unanswered questions regarding what the development will look like, and there are several contradictory forces. This paper addresses the effects of driverless vehicles by combining the results from 26 simulation studies. Each simulation study focuses on a particular case, e.g. a certain mobility concept or geographical region. By combining and analysing the results from the 26 simulation studies, an overall picture of the effects of driverless vehicles is presented. In the paper, the following perspectives are considered: what types of application of driverless vehicles have been studied in literature; what effects these simulation studies predict; and what research gaps still exist related to the effects of driverless vehicles. The analysis shows that it is primarily driverless taxi applications in urban areas that have been studied. Some parameters, such as trip cost and waiting time, show small variations between the simulation studies. Other parameters, such as vehicle kilometres travelled (VKT), show larger variations and depend heavily on the assumptions concerning value of time and level of sharing. To increase the understanding of system level effects of driverless vehicles, simulations of more complex applications and aspects such as land use, congestion and energy consumption are considered.


Objective: The purpose of this study was to explore the ability of senior students within a chiropractic educational setting to apply a scholarly approach to identifying and describing myofascial trigger points and mechanical low back pain. Clinical features: 6 patients with a median age of 21 years consulted the RMIT University chiropractic teaching clinics with uncomplicated subacute mechanical low back pain and were treated with spinal manipulation and trigger point therapy. Intervention and Outcomes: All cases were assessed for change in the prevalence of trigger points by the Specified Myofascial Trigger Point Count (SMTPC). Low back pain and functional disability were evaluated using the Modified Oswestry Questionnaire, Quadruple Visual Analogue Scale (QVAS) and the Modified-Modified Schober?s Technique. Monitoring was completed prior to commencement of therapy and after 6 treatments provided on a weekly basis. Spinal manipulative therapy included high-velocity, low-amplitude chiropractic adjustments to areas of joint dysfunction and myofascial trigger point therapy in the form of static digital compression. For the majority of the cases there was improvement in pain and the level of disability, lumbar spine flexibility and reduction in the number of myofascial trigger points. Conclusion: It would appear from this case series that in the context of a chiropractic educational setting senior students are able to apply a scholarly approach to identifying and describing myofascial trigger points and mechanical low back pain. Supporting this statement are the principle findings of the observed changes in the outcome measures utilised and myofascial trigger points examined.


Objectives: This study aimed to investigate electronic medical record (EMR) implementation in a busy urban academic emergency department (ED) and to determine the frequency, duration, and predictors of EMR downtime episodes. Materials and Methods: This study retrospectively analyzed data collected real time by the EMR and by the operations group at the study ED from May 2016 to December 2017. The study center has used the First Net Millennium EMR (Cerner Corporation, Kansas City, Missouri, USA). The ED operations data have been downloaded weekly from the EMR and transferred to the analytics software Stata (version 15MP, StataCorp, College Station, Texas, USA). Results: During the study period, 12 episodes of EMRD occurred, with a total of 58 hours and a mean of 4.8 ± 2.7 hours. The occurrence of EMRD event has not been associated with on-duty physician coverage levels (p = 0.831), month (p = 0.850), or clinical shift (morning, evening, or night shift) (p = 0.423). However, EMRD occurrence has been statistically significantly associated with weekdays (p = 0.020). Discussion: In a real-world implementation of EMR in a busy ED, EMRD episodes averaging approximately 5 hours occurred at unpredictable intervals, with a frequency that remained unchanged over the first 20 months of the EMR deployment. Conclusion: The study could define downtime characteristics at the study center. The EMRD episodes have been associated with inaccuracies in hourly census reporting, with a rebound phenomenon of over-reporting in the first hour or two after restoration of EMR operations.


In this study, two radar sensors with angular diversity are used to recognise dynamic hand gestures by analysing the sparse micro-Doppler signatures. The radar echoes are firstly mapped into the time–frequency domain through the Gaussian-windowed Fourier dictionary at each radar sensor. Then the sparse time–frequency features are extracted via the orthogonal matching pursuit algorithm. Finally, the sparse time–frequency features at two radar sensors are fused and input into the modified-Hausdorff-distance-based nearest neighbour classifier to achieve the dynamic hand gesture recognition. The experimental results based on the measured data under three different experimental scenes demonstrate that (i) the recognition accuracy can be improved by fusing the features extracted at two radar sensors when each radar sensor works well on its own; (ii) the recognition accuracy produced by feature fusion keeps satisfactory even if one of the radar sensors has poor performance, which means that the feature fusion can improve the robustness of the recognition system; and (iii) it would be more helpful if the line-of-sights of the two radar sensors are set to be orthogonal to each other.


Abstract. Methane emissions inventories for Southern California's South Coast Air Basin (SoCAB) have underestimated emissions from atmospheric measurements. To provide insight into the sources of the discrepancy, we analyze records of atmospheric trace gas total column abundances in the SoCAB starting in the late 1980s to produce annual estimates of the ethane emissions from 1989 to 2015 and methane emissions from 2007 to 2015. The first decade of measurements shows a rapid decline in ethane emissions coincident with decreasing natural gas and crude oil production in the basin. Between 2010 and 2015, however, ethane emissions have grown gradually from about 13 ± 5 to about 23 ± 3 Gg yr−1, despite the steady production of natural gas and oil over that time period. The methane emissions record begins with 1 year of measurements in 2007 and continuous measurements from 2011 to 2016 and shows little trend over time, with an average emission rate of 413 ± 86 Gg yr−1. Since 2012, ethane to methane ratios in the natural gas withdrawn from a storage facility within the SoCAB have been increasing by 0.62 ± 0.05 % yr−1, consistent with the ratios measured in the delivered gas. Our atmospheric measurements also show an increase in these ratios but with a slope of 0.36 ± 0.08 % yr−1, or 58 ± 13 % of the slope calculated from the withdrawn gas. From this, we infer that more than half of the excess methane in the SoCAB between 2012 and 2015 is attributable to losses from the natural gas infrastructure.


The concept of "intrinsic motivation", initially proposed and developed within psychology, is gaining an increasing attention within cognitive sciences for its potential to produce open-ended learning machines and robots. However, a clear definition of the phenomenon is not yet available. This theoretical paper aims to clarify what intrinsic motivations are from a biological perspective. To this purpose, it first shows how intrinsic motivations can be defined contrasting them to extrinsic motivations from an evolutionary perspective: whereas extrinsic motivations guide learning of behaviours that directly increase fitness, intrinsic motivations drive the acquisition of knowledge and skills that contribute to produce behaviours that increase fitness only in a later stage. Given this difference, extrinsic motivations generate learning signals on the basis of events involving body homeostatic regulations, whereas intrinsic motivations generate learning signals based on events taking place within the brain itself. These ideas are supported by presenting some examples of biological mechanisms underlying the two types of motivations. The paper closes by linking the theory to the current major computational views on intrinsic motivations and by listing the main open issues of the field.


This thesis examines the recontextualization and localization of global culinary discourse to Slovenia after its independence from Yugoslavia in 1991 and its transition into a free market economy. Slovenia and its emerging celebrity chefs, Luka and Valentina Novak, are an example of the 'local', whereas the global is represented by the British celebrity chef Jamie Oliver. The study is based on culinary texts from Oliver and the Novaks' cookbooks. However, 'standard' Slovene cookbook texts are also analysed with the aim of showing the difference between the previous educational role of cookbooks and the contemporary, increasingly edutaining role of the new 'celebrity' cookbooks. This study is situated within critical discourse analysis and it generally draws on the methodological framework of the discourse-historical approach ('DHA') (Reisigl and Wodak 2001), but also combines this with theoretical insights from the dialectic-relational approach (Fairclough 2010, 1992, 2001 [1989]). Its underlying theoretical focus has been recontextualization, which is one of the salient concepts within 'CDA' (e. g. Wodak and Fairclough 2010; Chouliaraki 1998). The model of recontextualization that I presented in this thesis (based on the definition of discourse in 'DHA') enables me to show how global culinary discourse has been recontextualised from Britain to Slovenia, via, firstly, a translation of Jamie Oliver's cookbooks, and secondly, via the production of an original local discourse. The main claim of this thesis is that under the influence of global culinary discourse, local representations related to food and taste change, and so do cookbooks as genres. While recontextualization as translation results in appropriation of the text to the local circumstances in terms of genre conventions, branding opportunities, country-related representations (e. g. Italy) and the reconfirmation of the national identity, the second phase of recontextualisation reveals the characteristics of the locally produced discourse based on global characteristics. Compared to the 'standard' Slovene cookbooks, its 'celebrity' variant aims to reconstructs the national culinary identity via legitimation of the tastes of the new middle classes. Influenced by the global model, the Novaks' tend to represent food and foodstuffs relying on characteristics found in advertising while social actors are often synthetically personified (Fairclough 1989). Likewise, various perspectives construct a seemingly democratisized discourse and disperse the top-down authority as found in 'standard' cookbooks.


Abstract Lu et al. found that health aid displaces domestically-raised government health expenditure, which renders health aid at least partially fungible. These findings are questioned in The Fungibility of Health Aid Reconsidered. Van de Sijpe's emphasis on disaggregating on- and off-budget aid is a valid contribution, although his empirical conclusions are overstated. We re-evaluate the data he criticises and find they sufficiently capture on-budget aid. To re-measure health aid fungibility, we update the Lu et al data, adding 23 countries and four years of data. Despite the confidence we have in these data, we employ two estimation specifications, each of which addresses the measurement error discussed by Van de Sijpe. The extended data and alternative methods show that development assistance for health channelled to governments remains significantly fungible.


In this paper, a characterization of Lyapunov graphs associated to smooth flows on surfaces is presented. We first obtain necessary and sufficient conditions for a Lyapunov graph to be associated to Morse-Smale flows and then generalize them to smooth flows. The methods employed in the proofs are of interest in their own right for they introduce the use of the Conley index in this context. Moreover, an algorithmic geometric construction of flows on surfaces is described


A method based on computer vision technologies is presented to achieve the function that the simulated motion in sport simulation system and the motion in sport video are presented on the same screen and at the same view point. The proposed method first applies the camera self-calibration theory to obtaining camera intrinsic parameters in sport video according to the 2D video features correspondence. Next it makes use of the feature 3D reconstruction to get a feasible estimation of extrinsic parameters. The extracted camera parameters information is applied to sport simulation and training system to achieve the function that the simulated normal motion of 3D virtual athlete in sport training system and the athlete motion in sport video are presented on the same screen and at the same view point. So we can quickly and accurately find the difference between the athlete motion in sport video and the simulated motion. It is very helpful to coaches and the training of athletes.


Split Hopkinson Pressure Bar (SHPB) experiments are carried out to study the deformation behavior of acrylonitrile-butadiene-styrene (ABS) resin at elevated temperature and high strain rate. The temperature and strain rate considered are 293K and 343K and 8.0×102s-1, 2.7×103s-1 and 1.0×104s-1, respectively. The curves of engineering stress and strain at different temperatures and different strain rates are experimentally obtained. The effects of temperature, strain rate and the fraction of ABS on the deformation behavior of ABS resin are discussed in detail. Then, a rate and temperature dependent phenomenological constitutive law for ABS resin is developed.


Cd-free fluorescent InP/ZnS quantum dots (QDs) have attracted attention for use as color converters of liquid crystal displays. To protect InP/ZnS QDs from oxygen, which degrades them by photo-oxidation during excitation, we fabricated a transparent monolithic silica composite containing the QDs using an aqueous solution of tetramethylammonium silicate (TMAS) as a silica source. The TMAS solution was basic and readily dispersed the negatively charged QDs obtained by ligand exchange of 1-dodecanethiol for 3-mercaptopropionic acid (MPA). A highly transparent monolithic TMAS-derived silica composite containing the MPA-modified QDs (InP/ZnS-MPA@TMAS) was obtained from the aqueous QD dispersion through a sol–gel process. The photoluminescence (PL) quantum yield of InP/ZnS-MPA@TMAS was 21.7%. Changes in PL intensity under continuous 400-nm excitation were measured to evaluate the photostability of the QDs in InP/ZnS-MPA@TMAS. The PL intensity of InP/ZnS-MPA@TMAS was over 90% of the initial value after 180 min, while that of a reference polymethylmethacrylate film containing hydrophobic QDs decreased to 69%. The higher photostability of InP/ZnS-MPA@TMAS than that of the reference film was explained by the TMAS-derived silica acting as a gas barrier to protect the embedded QDs from photo-oxidation by oxygen in air. © The Author(s) 2017. Published by ECS. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives 4.0 License (CC BY-NC-ND, http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reuse, distribution, and reproduction in any medium, provided the original work is not changed in any way and is properly cited. For permission for commercial reuse, please email: firstname.lastname@example.com. [DOI: 10.1149/2.0091707jss] All rights reserved.


Unrelated families of repetitive DNA were identified in the genome of Atlantic salmon (Salmo salar) and characterized. -- 1) A segment of DNA containing a single Bg/I repeat tandem array was isolated from a genomic library. Bg/I repeats comprise 2.3% of the S, salar genome and were found in the vicinity of rDNA genes. Southern blot hybridization detects a homologue of the Atlantic salmon Bg/I repeat in the brown trout (Salmo truita) genome but not in other salmonids. However, a DNA fragment with sequence homology to part of the Bg/I repeat has been isolated from Arctic charr (Hartley and Davidson 1994). The Bg/I repeat also detects RFLPs in Atlantic salmon. -- 2) Tel transposon-like sequences are present in salmon, trout, and charr species and may belong to several families that do not follow phylogenetic lines. As many as 15,000 copies reside in the Atlantic salmon haploid genome. The complete DNA sequence of one transposon-like element (SALT1) in Atlantic salmon is 1535 base pairs long. It contains terminal inverted repeats and a degenerate open reading frame of 1273 nucleotides whose inferred amino acid sequence shares homology with transposases from Caenorhabditis sp. and Drosophila sp. Zoo blot analysis indicates that Tel transposon-like sequences are present in other lower vertebrates including several fish species and amphibians but the copy number can vary significantly in different lineages. -- 3) Members of the NheI family share a great deal of sequence similarity with one another and with corresponding elements present in brown trout (over 95% identity). These elements, which comprise more than 1.2% of the Atlantic salmon genome, do not exist in long tandem arrays as is typical of satellite DNA. Subfamily structure exists and there is evidence that members of the same subfamilies are found in both Salmo species. Sequences homologous to the NheI repeat are located within a 1424-bp segment inserted immediately downstream of the 5' end of a Tc1 transposon-like sequence isolated from Atlantic salmon (Radice et al. 1994). -- 4) Various minisatellite and other short tandem repeat loci were characterized. Southern blot analysis of the phylogenetic distribution of a subset of the minisatellites indicates one sequence to be pervasive among vertebrates, others present only in Salmoninae or Salmonidae species, and one selectively amplified in Atlantic salmon. Their value as probes for detecting variable number tandem repeat loci is assessed. Evidence exists for coevolution of microsatellite and minisatellite arrays at some loci.


Dithiocarbamates (DTCs) have a wide variety of applications in diverse fields ranging from agriculture to medicine. DTCs are teratogenic to vertebrates but the mechanisms by which they exert these effects are poorly understood. Here we show that low nanomolar exposure to three DTCs, tetraethylthiuram (thiram), tetramethylthiuram (disulfiram) and sodium metam (metam), leads to craniofacial abnormalities in developing zebrafish embryos that are reminiscent of DTC induced abnormalities found in higher vertebrates. In order to better understand the molecular events underlying DTC teratogenesis, we exposed embryonic zebrafish (PAC2) cells to thiram and disulfiram and measured changes in gene expression with microarrays. We found differential expression of 166 genes that were specific for exposure to DTCs and identified a network of genes related to connective tissue development and function. Additionally, we found eight downregulated genes related to transforming growth factor β-1 (TGF-β1) signalling, including an essential transcription factor for zebrafish craniofacial development; SRY-box containing gene 9a (sox9a). Finally, we show that sox9a expression is perturbed in the ceratobranchial arches of DTC exposed zebrafish suggesting that this is an important event in the development of DTC induced craniofacial abnormalities. Together, we provide evidence for a novel teratogenic endpoint and a molecular basis for a better understanding of DTC induced teratogenesis in vertebrates. Toxicol Sci. 2010;117(1):209-17.


Abstract The Kodachrome pipes were developed in a porous-sand host medium which is very unusual. The sub-vertical cylindrical sand pipes have previously been interpreted as injection structures with material derived from source beds near the base of the pipes. However, the large pipe formation (diameter >4 m) was probably caused by the disruption and partial liquefaction of the host sediments which have been broken into blocks by upward fluid streaming, with injection of only small amounts (<20% of pipe volume) of fluidized sand, derived from a source below. The strongest evidence for this mechanism is the sub-horizontal layering of large tabular blocks up to 4 m in length, which occurs in the largest pipes, and the preservation of traces of bedding extending from the host rock across the pipes. There is also a notable absence of rim synclines and upturned bedding around most of the pipes, which would be expected with local removal of highly viscous material containing large blocks derived from a source bed below the pipes.


Objective:Although phytochemical curcumin has been shown to possess anti-inflammatory properties, it remains unknown whether this agent has any beneficial effects in sepsis. The purpose of this study was to demonstrate whether curcumin protects septic animals and, if so, whether activation of peroxisome proliferator-activated receptor (PPAR)-γ, an anti-inflammatory nuclear receptor, plays any role. Design:Prospective, controlled, and randomized animal study. Setting:A research institute laboratory. Subjects:Male Sprague-Dawley rats. Interventions:A bolus injection of 0.2 &mgr;mol of curcumin was given intravenously to male adult rats, followed by continuous infusion of curcumin (0.24 &mgr;mol/day) for 3 days via a primed 2-mL mini-pump. The rats were then subjected to sepsis by cecal ligation and puncture (CLP). Measurements and Main Results:Serum levels of liver enzymes (alanine aminotransferase and aspartate aminotransferase), lactate, albumin, and tumor necrosis factor (TNF)-α were measured at 20 hrs after CLP (i.e., late stage of sepsis). In addition, a 10-day survival curve was conducted following CLP and cecal excision with or without curcumin treatment. Furthermore, macrophages cell line RAW 264.7 cells were treated with curcumin followed by stimulation with endotoxin. TNF-α and PPAR-γ expression were then measured. The results indicate that intravenous administration of curcumin before the onset of sepsis attenuated tissue injury, reduced mortality, and decreased the expression of TNF-α in septic animals. Similar results were also found when curcumin was administered after the onset of sepsis. Moreover, the down-regulated PPAR-γ in the liver at 20 hrs after CLP was significantly improved by curcumin treatment. Concurrent administration of curcumin and GW9662, a specific PPAR-γ antagonist, completely abolished the beneficial effects of curcumin under such conditions. In cultured RAW 264.7 cells, curcumin inhibited endotoxin-induced increases in TNF-α expression and markedly up-regulated PPAR-γ expression without affecting cell viability. Curcumin also prevented morphologic alterations in macrophages induced by endotoxin. Conclusions:The protective effect of curcumin makes it or its analogues strong candidates as a novel therapy for sepsis. The beneficial effect of curcumin appears to be mediated by up-regulation of nuclear receptor PPAR-γ.


The magnetization of single crystal Gd5Ge4, which in a zero magnetic field orders antiferromagnetically at 128 K, indicates a reversible spin-flop transition when the magnetic field is along the c axis and the absence of similar transformations when the magnetic field vector is perpendicular to the c axis. This anisotropic behavior is due to variation of magnetization energy between the c axis and the a or b axes of the orthorhombic crystal caused by a different alignment of the Gd moments with respect to the magnetic field vector. The anisotropy of the antiferromagnetic state diminishes with the increasing magnetic field and temperature. The critical magnetic field for the antiferromagnetic-ferromagnetic transition is the smallest and the ferromagnetic state is most stable when the magnetic field vector is parallel to the b axis, indicating an easy magnetization direction along this axis. The anisotropy of the magnetic field-induced transformation in Gd5Ge4 is discussed in connection with the coupled magnetic and structural transitions. Anisotropic magnetic phase diagrams along the three major crystallographic axes are constructed.


This study examines the causal effect of a change in administration of the New York State milk price gouging law on retail milk prices. Specifically, we focus on the November 2008 shift from a threshold pricing policy that consisted of monthly announced prices to a fixed margin policy. Using a regression discontinuity approach, we find lower prices and thus increased consumer welfare for retail milk purchasers in New York State. Furthermore, the change in application of the law may have eliminated previously hypothesized coordination in pricing by retailers through a more competitive retail milk environment.


In this study, 700 samples of dairy and its products were collected from İstanbul and Trakya region and the samples were analyzed for L. monocytogenes by using the reference methods. 20 samples of 700 were L. monocytogenes positive. The positive samples were confirmed by using PCR. Antibiotic susceptibility tests were applied to the positive samples by using 16 diff erent kinds of antibiotic to expose the sensitivity profiles of the agents. Serotyping procedures were applied to the positive samples and all the agents were determined as L. monocytogenes serovar 4d. PCR confirmed samples were sequenced and specific DNA sequences of the agents were determined. Afterwards, Lineage groups of the positive samples were investigated and all the positive samples were exposed to be in Lineage I. The last step of our study was to compare our samples with the reference samples that are isolated from diff erent origins which were belonged to same and diff erent Lineages and to discuss all procedures that were applied in the study.


Next-generation force fields must incorporate improved electrostatic potentials in order to increase the reliability of their predictions. A crucial decision toward this goal is to abandon point charges in favour of multipole moments centered on nuclear sites. Here we compare the geometries generated by quantum topological multipole moments with those generated by four popular point charge models (TAFF, OPLS-AA, MMFF94x and PFROSST) for a hydrated serine. A main feature of this study is the dual comparison made, both at static level (geometry optimisation via energy minimisation) and at dynamic level (via molecular dynamics and radial/spatial distribution function analysis). At static level, multipolar electrostatics best reproduces the ab initio reference geometry. At dynamic level, multipolar electrostatics produces more structure than point charge electrostatics does, over the whole range. From our previous work on liquid water [Int. J. Quantum. Chem., 2004, 99, 685], where agreement with experiment only occurs when using multipole moments, we deduce that our predictions for hydrated serine will also be closer to experiment when using multipolar electrostatics. The spatial distribution function shows that only multipolar electrostatics shows pronounced structure at long range. Even at short range there are many regions where waters appear in the system governed by multipolar electrostatics but not in that governed by point charges.


A dynamic data correction method embedded in the process of data acquisition improves spectral quality. The method minimizes the impact of random errors in spectroscopic measurements by correcting peak positions in every single-scan spectrum. The method is fast enough to facilitate on-line data correction. Integration of corrected spectra improves resolving power and signal-to-noise ratio. The correction method can apply to most analytical spectra. In mass spectrometry and Raman spectroscopy, observations show that it improved the average resolving power by roughly 40 - 150% and revealed unresolved spectral features.


SU-8 photoresist has received a lot of attention in the MEMS field because of its excellent lithography properties. However, its high internal stress affects the overall pattern quality of the micro structures. The purpose of this work is to reduce the internal stress in SU-8 micro structure by ultrasonic stress relief technology. The stress relief mechanism of SU-8 micro structure was presented. The effect of ultrasonic stress relief on SU-8 micro structure was studied by experiments. The experimental results show that the internal stress in SU-8 micro structures can be reduced by ultrasonic stress relief technology.


OBJECTIVE
Angiosarcomas and hemangioendotheliomas are rare malignant vascular neoplasms (MVTs). Here, we reviewed the clinicomorphological characteristics of 27 MVTs with the implementation of two novel immunohistochemical markers: GLUT1, and FKBP12.

MATERIAL AND METHOD
MVTs, except for Kaposi's sarcoma, were retrieved from the archive and reviewed. Tumor size, the presence of hemorrhage and necrosis, growth pattern, cellularity, cellular characteristics and mitotic activity were recorded as morphological variables. Immunohistochemically, CD34, CD31, GLUT1, FKBP12, Mdm2, p53, c-kit, and CD99 were applied. Clinical information was gathered from hospital records and computer-based patient data systems.

RESULTS
The median age was 53 years (range 16-77). Extremities (37%) were the most common primary site followed by the head and neck. Five of 16 (31%) low grade and 7 of 11 (64%) high grade tumors were metastasized to varying organs, mainly the liver and lungs. The median survival was 49 months. Ninety percent of high grade tumors were larger than 3 cm. Hemorrhage and necrosis were seen in 85% and 41% of cases, respectively. Nuclear pleomorphism, cellularity and mitotic activity were higher in high grade tumors than in low grade ones (p < 0.0001). While 68% of the cases expressed CD34, 81% of them were positive with CD31. All cases except one low grade tumor were strongly and diffusely stained with FKBP12. Significant GLUT1 expression was observed in 23% of cases, especially in areas showing epithelioid morphology. Either Mdm2 or p53 was positive in over one third of the tumors.

CONCLUSION
The studied markers were not able to distinguish between low and high grade MVTs. FKBP12 may take a role in the diagnostic panel of MVTs. GLUT1 expression, previously proposed for the diagnosis of infantile hemangioma, should be assessed carefully since almost one quarter of MVTs were also GLUT1 positive.


A novel circuit technology which introduces a pipeline scheme in a read operation and improves the random-access data rate by roughly 30% is described. This technology has been applied to a 4M DRAM, and the RAM showed a short cycle time of less than 100 ns, i.e. a more than 10-MHz data rate, under the worst operating condition. In addition, a very fast virtual RAD access time of 20 ns has been obtained. Since the pipeline DRAM does not require any new process and/or assembly technologies, it can be added to the standard DRAM family


ABSTRACT Crapoulet, A., Héquette, A., Levoy, F. and Bretel, P., 2016. Using LiDAR topographic data for identifying coastal areas of northern France vulnerable to sea-level rise. In: Vila-Concejo, A.; Bruce, E.; Kennedy, D.M., and McCarroll, R.J. (eds.), Proceedings of the 14th International Coastal Symposium (Sydney, Australia). Journal of Coastal Research, Special Issue, No. 75, pp. 1067 - 1071. Coconut Creek (Florida), ISSN 0749-0208. A major portion of the coast of northern France consists of wide macrotidal beaches and coastal dunes protecting low-lying backshore areas (mostly reclaimed lands) from marine flooding. Although the shoreline was stable or even prograded seaward in places during the last decades, several coastal areas underwent severe erosion during the same period, while flooding sporadically occurred locally during major storms. A study of the potential impacts of sea-level rise on the coast of northern France was conducted based on airborne LiDAR topographic data collected from 2008 to 2014. Mapping of areas at risk of erosion and flooding during storm-induced events associated with high water level with a 100-year return period by 2050 was carried out using high water level statistics derived from tide gauge measurements, offshore wave climate statistics, and a sea-level rise projection based on RCP6.0 scenario (IPCC, 2013). Wave run-up was computed based on the Cariolet and Suanez (2013) equation developed for macrotidal beaches and using beach topographic profiles extracted from the LiDAR data. Results show that marine flooding would still be limited in 2050 even with a higher sea-level, but reveal that coastal dune erosion will most likely be widespread (Fig. 1). However, our study also shows that if coastal retreat proceeds during the next decades at the same or higher rates as today, several coastal dune systems will be entirely eroded in the near future, which would result in extensive storm-induced marine flooding in several coastal areas.


This paper describes the relationship between Rockwell C hardness and elastic-plastic material constants by using finite element analyses. Finite element Rockwell C hardness analyses were carried out to study the effects of friction coefficient and elastic-plastic material constants on the hardness. The friction coefficient and Young's modulus had no influence on the hardness but the inelastic materials constants, yield stress, and strain hardening coefficient and exponent, had a significant influence on the hardness. A new equation for predicting the hardness was proposed as a function of yield stress and strain hardening coefficient and exponent. The equation evaluated the hardness within a ±5% difference for all the finite element and experimental results. The critical thickness of specimen and critical distance from specimen edge in the hardness testing was also discussed in connection with JIS and ISO standards.


Bullying cannot be tolerated as a normal social behavior portraying a child's life. This paper quantifies its negative consequences allowing for the possibility that victims and nonvictims differ in unobservable characteristics. To this end, we introduce a factor analytic model for identifying treatment effects of bullying in which latent cognitive and noncognitive skills determine victimization and multiple outcomes. We use early test scores to identify the distribution of these skills. Individual‐, classroom‐ and district‐level variables are also accounted for. Applying our method to longitudinal data from South Korea, we first show that while noncognitive skills reduce the chances of being bullied during middle school, the probability of being victimized is greater in classrooms with relatively high concentration of boys, previously self‐assessed bullies and students that come from violent families. We report bullying at age 15 has negative effects on physical and mental health outcomes at age 18. We also uncover heterogeneous effects by latent skills, from which we document positive effects on the take‐up of risky behaviors and negative effects on schooling attainment. Our findings suggest that investing in noncognitive development should guide policy efforts intended to deter this problematic behavior.


High-fidelity color image reproduction is one of the key issues in visual telecommunication systems, for electronic commerce, telemedicine, digital museum and so on. All colorimetric standards of display systems are up to the present day trichromatic. But, from the shape of a horseshoe-area of all existing colors in the CIE xy chro- maticity diagram it follows that with three real reproduc- tive lights, the stated area in the CIE xy chromaticity dia- gram cannot be overlaid. The expansion of the color gamut of a display device is possible in a few ways. In this paper, the way of increasing the number of primaries is studied. The fourth cyan primary is added to three conventional ones to enlarge the color gamut of reproduction towards cyans and yellow-oranges. The original method of color management for this new display unit is introduced. In addition, the color gamut of the designed additive-based display is successfully compared with the color gamut of a modern subtractive-based system. A display with more than three primary colors is called a multiprimary color display. The very advantageous property of such display is the possibility to display metameric colors.


Portal hypertension is a milestone in the progression of cirrhosis and heralds the onset of the fatal complications of liver disease. Over the last two decades significant progress has been made in the diagnosis and treatment of portal hypertension and of variceal haemorrhage (VH) in particular. As Bertrand Russell, the British philosopher, said, 'the most savage controversies are those about matters as to which there is no good evidence either way'. This article will focus on developments in screening for oesophageal varices (OVs), for the prophylaxis of VH from OVs and gastric varices (GVs), and the remaining controversies that will shape treatment strategies for portal hypertension in the coming decade.

VH is a catastrophic event for the patient with cirrhosis, with 1-year mortality of up to 40% following an episode of VH.1 2 Since one-third of patients with OVs will develop VH, screening for OVs in the cirrhotic population is mandatory on the basis of the availability of effective diagnostic and prophylactic measures.

Oesophagogastroduodenoscopy (OGD) is considered the primary modality for the detection and surveillance of OVs, and is recommended at the time of diagnosis of cirrhosis.3 4 With this approach, OVs are found to be present in ∼40% of patients with compensated cirrhosis.5 The interval for endoscopic surveillance for OVs following an initial negative examination depends on the rate of progression of OVs. The overall incidence of OVs is 5–10% per year,5 although this is modified by the severity of portal hypertension. Current guidance is for OGD to be repeated at 1–3 yearly intervals depending on the severity of liver disease (box 1).3 4

### Box 1 Recommendations for the diagnosis and management of OV

#### Recommendations for endoscopic screening for OVs (modified from Garcia-Tsao et al 4):

1. Compensated cirrhosis without varices: 2–3 years.

2. Compensated cirrhosis with clinically significant portal hypertension (HVPG >10 mm Hg) without varices: 1–2 years.

3. Compensated cirrhosis and small varices: 1–2 years.*

4. Decompensated cirrhosis: 1 year. …


Getting consumers to disclose their personal information is an essential first step for Internet businesses that choose to pursue a niche marketing strategy. Previous research has examined how the reward preferences and privacy concerns of consumers may affect their disclosure tendency. However, it is not known how key characteristics pertaining to Internet businesses, such as consumer trust, may affect disclosure tendency. Based on the results obtained from a survey, this study found that consumer trust in Internet businesses can facilitate disclosure tendency. Moreover, consumer trust can suppress the reward preferences and privacy concerns of consumers, thereby reducing the costs that Internet businesses need to incur in collecting personal information from consumers.


Rainwater samples were collected from rainwater harvesting (RWH) systems at seven sites located in a 30 km radius around the City of Guelph in Ontario, Canada. From October 2006 to October 2007, a total of 360 samples were collected from two sampling locations—the rainwater cistern and at the point of use—and analysed for pH, turbidity, colour, total and fecal coliforms, total organic carbon, total nitrogen and UV absorbance (254 nm). Additional parameters, including polycyclic aromatic hydrocarbons, total metals, Campylobacter and Legionella were examined in selected samples. Following data collection, statistical analysis was performed to investigate the factors that influenced rainwater quality. The results of the quality assessment programme were largely consistent with those reported by several other researchers, with the exception of improved microbiological quality during periods of cold weather. Total and fecal coliforms were detected in 31% and 13% of the rainwater samples, respectively, while neither Campylobacter nor Legionella were detected above 1 CFU/100 ml detection limits. The results indicate that, while quality can be expected to vary with environmental conditions, the rainwater from a RWH system can be of consistently high quality through the selection of appropriate catchment and storage materials and the application of post-cistern treatment.


Nowadays, there are various electrokinetic phenomena which are utilized in a wide range of applications, ranging from microfluidics and colloid and interface science to electrochemistry. However, even after 200 years of research on electrokinetic phenomena, there are still open questions with respect to fundamental understanding. The focus of this thesis is on three different phenomena, i.e., streaming potential, streaming current and electroosmosis. Hence, the thesis is divided in two parts: The first part focuses on the applicability of the classical Helmholtz-Smoluchowski theory on streaming potential and streaming current measurements of poly(methyl methacrylate) (PMMA) wafers, to infer the zeta potential of this substrate in contact with liquids of defined pH and ionic strength. In detail, we perform electrical impedance spectroscopy measurements to infer the electrical resistance in a PMMA microchannel and derive novel correlations for the electrokinetic characterization of the substrate. We conclude that convection can have a significant impact on the electrical double layer configuration which is reflected by changes in the surfaces conductivity. The second part of the thesis is concerned with electroosmotic flows in porous substrates where we develop a phenomenological correlation which is based on dimensional reasoning. A large set of experiments is carried out using a relatively simple and cost-effective setup including different sintered packed beds of borosilicate microspheres. A centre-of-mass model of the experimental setup allows for the interpretation of various effects. Streaming current measurements result in a correlation for the zeta potential of borosilicate depending on ionic strength and pH of the liquid. Finally, a quantitative expression for electroosmotic flow in packed beds of granular material is derived from the experiments. This correlation can be employed with other materials as well.


ABSTRACT
 Galendromus occidentalis (Nesbitt) is one of several phytoseiid species that are available for purchase to supplement endemic predator populations that are not providing sufficient control of spider mites. We performed a series of releases of commercially reared G. occidentalis in commercial apple (Malus domestica Borkhausen) orchards in Washington from 2010 to 2012. Releases of up to 50,000 mites per acre did not lead to an increase in populations of predatory mites or to a decrease in populations of pest mites. Assessments of mite numbers in shipments and quality (survival and fecundity) of those mites indicated that the commercial insectary was correctly estimating the number of predatory mites in their shipments, and that predator quality was not different than a laboratory colony. Finally, a predator-prey model that used the intrinsic rates of increase of tetranychid prey and the prey consumption rate of the predator indicated that the density of G. occidentalis required to control the prey at the action threshold was not economically feasible. We conclude that G. occidentalis cannot be used to bring about short-term control via inundative releases in crops such as apple with large canopy volumes.


Background Many hospices owe their origins to volunteers. Volunteers' involvement today is still integral and vital to the success of the hospices they support. However the strategic importance of volunteers is often overlooked and the role of volunteers and their contribution to the cost effectiveness and sustainability of hospices is rarely considered. However if volunteers are to be fully recognised as a strategic asset we must be brave enough also to describe volunteers in business terms. Purpose of project The purpose of the project is to: ▶ Determine the economic value of volunteers and return on investment ▶ Demonstrate volunteering as a strategic asset. ▶ Explore the use of the economic value of volunteers to influence funders. Methods Volunteer hours may be collected in many different ways depending on the way volunteering is structured. Hours are calculated on a monthly basis and recorded on a spreadsheet. Staff equivalent roles and hourly rates are then listed for each volunteer role. These are then multiplied by the number of volunteer hours and a percentage added for on costs. Once the total has been calculated the return on investment can be calculated. One hospice's experience Volunteer value in CHAS is calculated and reported on an annual basis. In the year 2009–2010, 900 volunteers donated 83,100 h, with an economic value of £1.25 m. The return on investment was 7:1. The information is disseminated in many ways and is used for many purposes, including as part of the charity's annual report. Conclusions In this time of challenging and uncertain economic circumstances, measuring the value of volunteer time has many benefits to hospices and can be used in many ways. These include monitoring and demonstrating the cost effectiveness of services and influencing funders.


To investigate the relationship between fatigue or Chronic Fatigue Syndrome (CFS)-like symptoms and basic dimensions of personality, a sample of 466 Kuwaiti college students took part in the study ( M age = 19.0 years, SD = 2.1). Participants completed the Arabic Scale of Chronic Fatigue Syndrome (ASCFS; Abdel-Khalek & Al-Theeb, 2006) and the Arabic version of the Eysenck Personality Questionnaire (EPQ; Abdel-Khalek & Eysenck, 1983; Eysenck & Eysenck, 1975). The ASCFS was found to be significantly and positively correlated with neuroticism and psychoticism and negatively correlated with extraversion. Two high- loading factors were extracted from both sexes and labeled "Fatigue and neuroticism versus extraversion", and "Psychoticism versus lie". A multiple stepwise regression was carried out and the predictors of ASCFS were found to be neuroticism and psychoticism (positive) and extraversion (negative) among men, while in women the predictors were neuroticism and psychoticism. It was concluded that high scores on neuroticism, psychoticism, and introversion may predispose people to CFS. Clinicians treating CFS could find this result useful. It is suggested that treating neurotic symptoms may ameliorate CFS symptoms.


Objectives – To determine the number of interlibrary loan (ILL) requests in academic libraries in the United States of America over the period 1997-2008, and how various factors have influenced these rates. These factors included electronic database subscriptions, size of print journal and monograph collections, and the presence of link resolvers. Data were collected from libraries as both lenders and borrowers. The study also looked at whether the number of professional staff in an ILL department had changed during the period studied, and whether ILL departments led by a professional librarian correlated positively with rates of ILL.

Design – Online questionnaire.

Setting – Academic library members of the Online Computer Library Center (OCLC) ILL scheme in the United States of America.

Subjects – A total of 442 academic library members of the OCLC ILL scheme.

Methods – An electronic questionnaire was sent to 1433 academic library member institutions of the OCLC ILL scheme. Data were collected for libraries as both lending and borrowing institutions. Data were analyzed using a statistical software package, specifically to calculate Spearman's rank correlations between the variables and rates of ILL.

Main Results – Responses to the electronic questionnaire were received from 442 (31%) academic libraries. There was an overall increase in the number of ILL requests in the period 1997-2008. The number of ILL requests which were unfulfilled also increased during this period. There was a positive correlation between rates of ILL and all of the variables investigated, with the strongest correlations with size of print monograph collections and size of print journal collections. The numbers of staff in ILL departments remained relatively static during the period covered by the study, although the majority of staff working in ILL was composed of paraprofessionals. There was a weak positive correlation between numbers of ILL requests and whether ILL departments were headed by a professional librarian.

Conclusions – Access to full text electronic databases has not decreased the numbers of ILL requests in academic libraries in the United States of America. In fact, ILL requests have increased, probably due to the fact that students and staff of academic libraries now have access to a larger number of citations through online databases and other information sources. The authors suggest that the increase in unfulfilled ILL requests is also due to this increased access. Libraries with large print collections are more likely to receive ILL requests precisely because they have more material to lend out, and may make more ILL requests due to the research output of their presumably larger institutions. There may be a higher number of ILL requests fulfilled by departments headed by a professional librarian because a librarian has more knowledge of sources to fulfil requests.


Background: The APOE genotype predicts the age at onset of Alzheimer disease (AD) and neuropathologic progression. However, studies relating APOE alleles to the rate of cognitive decline have been inconclusive. This may stem from their use of linear statistical analyses. Objective: To model relations of APOE alleles to the rate of cognitive decline in AD, nonlinearly. Methods: Serial measures of cognitive ability were obtained using the cognitive scale of the Cambridge Examination for Mental Disorders of the Elderly in 218 patients with AD. The relations of these serial scores to APOE alleles were tested using nonlinear and linear mixed-effects models. Results: In the non-linear model, possession of an APOE ε4 allele related to earlier and faster cognitive decline, but possession of an APOE ε2 related to slower decline. Patients homozygous for APOE ε4 showed faster cognitive decline than heterozygotes. The linear model was less sensitive and did not detect differences between APOE ε4 homo- and heterozygotes. Conclusions: APOE genotype strongly predicts the rate of cognitive decline in Alzheimer disease. The decline shows a dose–response relation with the APOE ε4 allele, but the APOE ε2 allele is protective. The nonlinear model yielded larger estimates of the maximal rate of decline than the linear.


On Augus>t 31, 1968 at 10:47:37.4 G.M.T., the Khorassan Province of northeastern Iran was shaken by one of the most destructive earthquakes in Iranian history. The epicenter of the earthquake was about 250 kilometers south-southwest of Mashad, approximately 10 kilometers east of the measured surface fault. Its magnitude (Ms) was 7.3. A field investigation revealed that a number of villages were extensively damaged or destroyed, resulting in about 10,000 fatalities> and 60,000 homeless residents.

Surface fractures were noted in several areas. Maximum horizontal displacement was a left-lateral movement of 4.1 meters east of Dasht-e Bayāz. The measured fault length was 25 kilometers. Inaccessibility to part of the area and a time limitation factor curtailed a more complete analysis of the possible fault extensions both to the west and east.

The extensive property damage is attributed principally to poor construction in the region. However, the location of some of the villages on alluvium with a shallow water table was a contributing factor in some instances.

In particular this paper analyzes the regional intensities, the effects on local structures, and the fresh surface faulting phenomenon resulting from the earthquake. Also presented are the results of the investigations on the temporal, spatial, and magnitude characteristics of all recorded seismic activity, before, after, and including the major event.


Accurate, nonintrusive, and inexpensive techniques are needed to measure energy expenditure (EE) in free-living populations. Our primary aim in this study was to validate cross-sectional time series (CSTS) and multivariate adaptive regression splines (MARS) models based on observable participant characteristics, heart rate (HR), and accelerometer counts (AC) for prediction of minute-by-minute EE, and hence 24-h total EE (TEE), against a 7-d doubly labeled water (DLW) method in children and adolescents. Our secondary aim was to demonstrate the utility of CSTS and MARS to predict awake EE, sleep EE, and activity EE (AEE) from 7-d HR and AC records, because these shorter periods are not verifiable by DLW, which provides an estimate of the individual's mean TEE over a 7-d interval. CSTS and MARS models were validated in 60 normal-weight and overweight participants (ages 5-18 y). The Actiheart monitor was used to simultaneously measure HR and AC. For prediction of TEE, mean absolute errors were 10.7 +/- 307 kcal/d and 18.7 +/- 252 kcal/d for CSTS and MARS models, respectively, relative to DLW. Corresponding root mean square error values were 305 and 251 kcal/d for CSTS and MARS models, respectively. Bland-Altman plots indicated that the predicted values were in good agreement with the DLW-derived TEE values. Validation of CSTS and MARS models based on participant characteristics, HR monitoring, and accelerometry for the prediction of minute-by-minute EE, and hence 24-h TEE, against the DLW method indicated no systematic bias and acceptable limits of agreement for pediatric groups and individuals under free-living conditions.


The thesis aimed to develop a theoretical approach to the study of behavioural aspects of the physical environment through an examination of the special case of attitudes to housing in Glasgow. The theoretical discussion and performance of the research were developed in two main sections, one dealing with attitudes and their measurement, in which a semantic differential questionnaire was tested and adapted, and the other dealing with the organisation of human space and relating the attitude towards the environment as disclosed by the semantic differential study to some of the space units and their characteristics. The first chapter of the thesis set the context for the study in the field of environmental psychology. It outlined the author's interest in a system approach to the study of man-environment interaction and introduced some basic points of importance in such an approach. A model of the man-environment interaction system was outlined and its limitations discussed. The methodology to be employed in creation of a theoretical framework was described. Part I of the thesis (chapters 2-8) was concerned with the theoretical structure of the attitudes and their measurement. It also dealt with some methodological implications of different techniques, and tried to place the chosen technique of semantic differential in its correct position relative to other studies of the attitude towards the physical environment. The research replicated the factor structure of the semantic differential for physical environment stimuli, using the buildings the subjects live in as the physical stimuli. The subjects were school children aged 14-16 who responded to a questionnaire describing the physical environment on the pilot phase and one for both the physical and social environments in the main study. Principal component analysis with oblique rotation resulted in a three factor structure - Friendliness, Activity and Aesthetic, The implications of the deviation of the factor structure from Osgood's EPA model wore discussed, and further analysis employing the G-L. SSA.l method was done to explain this point. Part II of the thesis (chapters 9-14) dealt with the structure of space organization, placing the stimuli used for the research in their position in the organization of space. It also presented the characteristics of the subjects and placed the sample of the current study in its dimensional .position relative to other studies. The research at this stage explored the relationships between the building find social background characteristics of the .respondents, and the attitudes expressed towards the environment. The characteristics of the environment which were examined were the size of the building, the tenure of the residential unit, and the position of the building in the city. The characteristics of the subject background which were looked into were sex, denomination and occupation of head of family. Analysis of variance was employed comparing differences between attitudes of subjects with different characteristics. The results show that both characteristics of residential unit and those of the respondent influence the attitude. It also shows that different aspects of the attitudes are predicted by different variables. The concluding discussion in chapter 15 sought to integrate the different stages of the research. It considered the extent of success for the system approach adopted in the thesis and tried to relate the separate sub-systems into the general model of man-environment interaction discussed in the first chapter. It also suggested possible implications of the .findings of the research for those involved in environmental decision-making, and drew attention to potentially useful areas of further research.


Controlling a manufacturing cell is a complex task to. A manufacturing system could be regarded as a discrete event system from flow and control perspective. However, it's a rather intractable to model it analytically for behavior analysis and control development.It is necessary to generate a control to ensure every part of the manufacturing cell do the right activity at the right time and make sure that various operations are coordinated and with the right sequence. This is the task of cell control to which programmable logic controllers (PLC) play a role.Though much success have been achieved in simplifying the development of work of PLC's by standardization there are still outstanding issues in interoperability of programs from different vendors and long development time particularly for code generation, validation and commissioning.So in this thesis, an attempt has been made to address these issues in a new way to create, verify and validate PLC program using Matlab/Simulink and CoDeSys. The model that generated from Stateflow environment is based on finite state machine theory. With the finite state machine model a manufacturing cell could be described as a graphical group of states and the transitions between each two states. It is clearly to show sequential relation of states and activities in Stateflow model. It also shows where the manufacturing process begins with a default transition. It is easy to alter every part of models when necessary. It is easy to translate PLC code automatically by Matlab after every altering. In this thesis it also discusses how to verify the PLC code by CoDeSys after creating PLC code from Stateflow models.


This paper studied the characteristics of soybean growth under the stress of Cd, UV-B radiation and their combination. The results showed that UV-B radiation gave a more pronounced inhibition on soybean growth than cadmium. Under UV-B radiation, the internode differentiation and elongation were inhibited, the internode and plant height were reduced, and the activities of SOD and POD had an apparent increase. Cd2+ could antagonize the effect of UV-B radiation on POD activity, and inhibit indole-3-acetic acid (IAA) oxidase activity. A significant decrease of POD and IAA oxidase activities in soybean was detected when exposed to combined UV-B and Cd2+, compared with UV-B radiation only. The decrease of POD and IAA oxidase activities was related to the increase of IAA contents and photosynthetic activity, which might account for the increases of biomass and plant height. Moreover, the combined stress enhanced the inhibition of root growth, and significantly decreased root length. The IAA oxidase and POD activities and photosynthesis rate might be the crucial factors determining the pattern of soybean growth under the stress of Cd2+ in combination with UV-B radiation.


For more than 30 years, charge storage based non-volatile memory (NVM) devices such as floating gate (FG) NVM is one of the key enablers in the rapid evolution of modern intelligent consumer electronics. However, incessant technology scaling trend has exposed severe reliability challenges of FG NVM devices. Nitride based charge trap (CT) NVM is one of the most promising candidates to eclipse FG NVM as the mainstream flash memory technology. This is due to the intrinsic immunity to point defects of nitride based CT NVM and its superior device scalability as compared to FG NVM. Due to the aggressive technology scaling trend, nitride based CT NVM devices face reliability challenges in post cycled threshold voltage (Vt) instability. For both FG and nitride based CT NVM devices, post cycled Vt instability induces significant Vt distribution shift and broadening of program cells. Vt distribution shifting and broadening reduce the operating window and premature data retention failures of the charge storage based NVM devices. Vt instability mechanisms of nitride based CTF memory inevitably introduces stochastic fluctuations in Vt of nitride based CTF cells which is detrimental to long term data retention performance. Thus, it is imperative to research and shed new lights in the physical mechanisms of Vt instability in nitride based CT NVM devices. Throughout this work, the charge trap dynamics and Vt instability of nitride based CT NVM were meticulously characterized and studied. Stretched Exponential (SE) is applied to model the decay and steady behaviour of Vt distribution shift exhibited on nitride based CT NVM devices. SE function typically models the decay nature of disordered material. In this work, both SE decay phase and steady phase of Vt distribution shift observed on nitride based CT NVM devices were thoroughly studied to understand the charge loss mechanism that is detrimental to its data retention performance.


NOTATION: The PDF (probability density function) of random variable Xi is denoted as fXi {Xi} means the infinite sequence of random variable X1, X2, X3, . . . {Xi}1≤i≤n means the finite sequence of random variables X1, X2, . . . , Xn {Xi} means the sequence of random variables X1, X2, X3, . . . are iid (independent & identically distributed) {Xi} 1≤i≤n ∈ X is called a random sample from a population X with PDF fX and each Xi has marginal PDF fX . Indicator function I(x ∈ A) = IA(x) := { 1 , x ∈ A 0 , x 6∈ A }


This study aims to analyze the application of SAK ETAP on the presentation of financial statements CV SK. CV SK is a medium-sized businesses engaged in catering services and Wedding Organizer. The method used in this research is descriptive qualitative analysis. The results of the study based on Balance Sheet and Income Statement for 2012-2016, show that the company has not presented cash flow statement, and notes to financial statements (CALK) and inconsistency in the presentation of some post on Balance Sheet not disclosed in CALK. This research suggests that companies develop other components of financial statements and disclose the company's accounting policies in CALK.


The study reports information about the recapture of two tagged adult females of tope shark, Galeorhinus galeus (Linnaeus 1758), in the central Mediterranean Sea (south coasts of Sicily) in 2014 and 2017. The two females were tagged in North-East Atlantic, respectively in Scotland in 2009 and Ireland in 2015. The Scottish specimen was a 175 cm female increasing of about 10 kg in body weight and 37 cm in total length during its 1967 days at liberty (5.39 years). The Irish one, was a pregnant female of an estimated age of 15-17 year which spent 248 days at liberty increasing 14 cm during this period. The growth rate of the two specimens was therefore between 6.8 and 7.8 cm year-1, faster than the annual increments of adults suggested in previous studies. Previous tope recapture records in the Mediterranean Sea were limited to the Alboran Sea, coast of Valencia and the Algerian coasts. The two tope females recaptured in the Strait of Sicily provided the first evidence of long distance entrance of NE Atlantic tope in the Mediterranean Sea. The well known occurrence of mature females and juveniles in this area of the Mediterranean suggest the hypothesis of a migration of adults female from their feeding grounds in north eastern Atlantic to lower latitudes up to the Mediterranean Sea for parturition.


Map showing mineral resources (oil, gas, sand, clay, etc.) in the Key West region of the Florida coastline. Scale 1:100,000.


Limited proteolysis of the arom enzyme complex of Neurospora crassa by trypsin or subtilisin yielded a stable fragment of Mr 68000. This fragment, which was purified by two-dimensional polyacrylamide-gel electrophoresis, was shown by activity staining to contain the shikimate dehydrogenase active site, and by substrate labelling with 3-dehydroquinate and NaB3H4 to contain the 3-dehydroquinase active site. The fragment thus constitutes a bifunctional domain containing the two enzymic activities that are known, from genetic evidence, to be located adjacently at the C-terminal end of the pentafunctional arom polypeptide.


3-O-Acetyl and 3-O-benzoyl derivatives of 1,6-anhydro-N-acetyl-beta-D-glucosamine were synthesized via its selective tritylation followed by the 3-O-acylation and removal of the trityl protective group. Tritylium trifluoromethanesulfonate, which can easily be prepared by mixing solutions of triphenylcarbinol and trimethylsilyl trifluoromethanesulfonate in an equimolar ratio, was suggested as a reagent for the effective tritylation of a secondary hydroxyl group.


OBJECTIVE —To investigate the prevalence of the unique HNF-1α G319S mutation in a population of aboriginal youth with type 2 diabetes and to describe the relationship between clinical and historical characteristics and the presence or absence of the HNF-1α G319S mutation. RESEARCH DESIGN AND METHODS —Participating youth were genotyped for the G319S mutation of the HNF-1α gene. Clinical, laboratory, and historical data were collected via chart review (blinded to genotype results). Comparison data were derived from another study involving young nondiabetic pregnant aboriginal women. RESULTS —A total of 51 youth seen sequentially in a type 2 diabetes clinic participated in this study. Of these, 21 (41.2%) had at least one copy of the mutant allele. The allele frequency in the study population was 0.29 (95% CI 0.20–0.38), which was significantly different from the allele frequency of 0.13 in the comparison population (χ 2 = 6.78, P = 0.009). The frequency of the homozygous mutation (S319/S319) was 0.18. Mean BMI was significantly lower ( P = 0.002), mean HbA 1c was significantly higher ( P = 0.02), and acanthosis nigricans was significantly less frequent ( P = 0.004) in those with the mutation compared with the wild type. Mean insulin levels were lower and insulin sensitivity (assessed by homeostasis model assessment [HOMA]) was greater in the homozygote group compared with the wild-type group ( P = 0.002 and P = 0.0007, respectively). A dose-dependent gradient was observed for these characteristics. CONCLUSIONS —These data support the association between the HNF-1α G319S mutation and early-onset type 2 diabetes in this population. Those with the mutation lacked clinical characteristics of insulin resistance (e.g., obesity and acanthosis nigricans) and had lower insulin levels, suggesting that an insulin-secretory and/or -production defect plays an important role in the development of diabetes in this group. Further investigation of the pathophysiology of the S319 homo- and heterozygote is needed because it may impact treatment and/or prevention of this disease.


Despite typically comprising a small volume fraction, grain boundaries often limit many properties of ceramics for energy technologies. The localized charges present at grain boundaries affect local structure and composition which thus impact the ionic conductivities along with thermal, electrical, optical, magnetic, and mechanical properties. While theory regarding grain boundary effects has progressed, direct knowledge of the local chemistry and corresponding potential around individual boundaries remains elusive. Some model bicrystal systems have been well-characterized experimentally; however, the complexities of random grain boundary structures in bulk-prepared polycrystalline ceramics have prevented quantified analysis of the most commonly occurring types. Here, the three-dimensional quantification of oxygen and cation compositions around arbitrarily selected high-angle grain boundaries in a polycrystalline material as measured by atom probe tomography are used to extract nm-scale, quantitative values of the three-dimensional space-charge potentials around grain boundaries and are related to the observed macro-scale conductivities. We focus specifically on Nd-doped ceria, a well-known ion conducting oxide with significant energy applications. However, the techniques employed here are directly applicable to other technologically-relevant polycrystalline ceramics and create opportunities for correlating nano-scale composition with macro-scale properties for optimizing materials design, expanding progress in ionic chemistry theory, and refining simulations for "real-world" polycrystalline materials.


Background: Angular deformities of the lower limbs are commonly encountered deformities in pediatric orthopedic clinics. The values of the tibiofemoral angle undergoes changes as the child grows and these changes are self-limiting. The aim of the study is to establish the normal variation of knee angles of children between 2 and 12 years of age in Enugu metropolis and to establish any correlation between the knee angles and the intermalleolar distances (IMDs). Subjects and Methods: This study was done on 630 school children in Enugu metropolis between the age groups of 2 and 12 years. Multistage sampling was used in the study. The tibiofemoral angles and intermalleolar/intercondylar distances were measured. Results: The maximum tibiofemoral angle from this study was 7.6° ± 2.4° and the age corresponding to this value was 4 years. Only 23 subjects (3.5%) had varus knee angle. The values of the mean tibiofemoral angle and IMDs plateaued from 8 to 12 years. There was a significant positive correlation between average knee angle and IMD (r = 0.785, P < 0.001). Conclusion: The physiological changes in the knee angle (tibiofemoral) follow a similar pattern as established in the literature and there was positive correlation between IMD and the tibiofemoral angle.


IBM's Technical Support Services division runs remote support centers, where agents provide phone support for client problems related to IBM and non-IBM hardware and software products. Support center personnel use numerous pieces of information—including many searches, log files, and records of historical support tickets, from disparate data sources—to recommend solutions for customer technical problems. We have built an advanced search system to assist support agents who are resolving customer service requests and improving our client experience. The system has been deployed and used globally by thousands of support center personnel. In this paper, we describe the system's architecture, the technical challenges, and the innovative solution we have built. In addition, we discuss the novel ideas to address the unique requirements and challenges of the support services domain. These ideas include using system logs and domain knowledge to automatically expand agent queries, incorporating implicit agent feedback, and selecting features to extract useful information from highly unstructured and noisy ticket data. Results on the effectiveness of the system are presented. We also discuss future work on enhancing the system's capability to automatically diagnose customer hardware and software problems and remediate them.


BACKGROUND AND AIMS
The microbial ecosystem seems to be an important player for therapeutic interception in inflammatory bowel disease (IBD). We assessed longitudinal microbiome changes in IBD patients undergoing therapy with either azathioprine (AZA) or anti-tumor-necrosis-factor (anti-TNF) antibodies. We predicted the metabolic microbial community exchange and linked it to clinical outcome.

METHODS
Fecal and blood samples were collected from 65 IBD patients at baseline and after 12 and 30 weeks on therapy. Clinical remission was defined as i.e. CDAI < 150 in Crohn´s disease (CD), partial Mayo score < 2 in ulcerative colitis (UC) and fecal calprotectin values < 150µg/g and C-reactive protein < 5mg/dl. 16S rRNA amplicon sequencing was performed. To predict microbial community metabolic processes, we constructed multi-species genome-scale metabolic network models.

RESULTS
Paired Bray-Curtis distance between baseline and follow-up timepoints was significantly different for UC patients treated with anti-TNF antibodies. Longitudinal changes in taxa composition at phylum level showed a significant decrease of Proteobacteria and an increase of Bacteroidetes in CD patients responding to both therapies. At family level, Lactobacilli were associated with persistent disease and Bacteroides abundance with remission in CD. In-silico simulations of microbial metabolite exchange predicted a 1.7-fold higher butyrate production capacity of patients in remission compared to patients without remission (p=0.041). In this model, the difference of butyrate production between patients in remission and patients without remission was most pronounced in the CD group treated with AZA (p=0.008).

CONCLUSIONS
In-silico simulation identifies microbial butyrate synthesis predictive of therapeutic efficacy in IBD.


Abstract Several Pd-base alloys display a large tendency for glass formation that renders them especially suitable for investigations concerning (metastable) equilibrium properties of the deeply undercooled liquid including the glass transition, since the detrimental interference of premature crystallization can be avoided rather easily compared to other alloy systems. Here, thermodynamic, dynamic, and transport properties were analysed and compared to an Al-rich marginal glass former in the context of a possible relation between fragility, thermodynamic excess and kinetic stability against crystallization. Additionally, the possibility for liquid-phase separation occurring in the undercooled state of bulk glass-forming alloys is analysed as a function of thermal history, and critically discussed with respect of alternative mechanisms that are often summarized as 'short-range ordering'.


We have investigated the relaxation of single and double layer stepped Si(100) surfaces depending on working cell size and heat treatment by MD simulation based on LJ–AT empirical potential energy function. It is found that smooth relaxation can be satisfied for both types of stepped Si(100) surfaces by continuous MD runs. The dependence of relaxation on the size of working cell is found only for single layer stepped Si(100) surface. The total potential energy calculation by MD shows that double layer Si(100) surface is more stable than the single layer stepped Si(100) surface.


This study is an investigation of the variation between the accusativus cum infinitive (a.c.i.) and quod clauses with verba sentiendi and declarandi in the Revelaciones, Books I-VII, of St. Bridget of Sweden (1303-73). The variation between the quod clauses and the a.c.i. has been emphasized as a characteristic feature of late and mediaeval Latin. The present investigation has uncovered some grammatical patterns which are important or decisive for the choice of construction after governing verbs in the texts of the Revelaciones. These patterns are connected with semantic criteria, such as assertivity, with the category of co-reference and also with stylistic factors (prompted by various kinds of syntactic complexity). These tendencies and preferences are very strong, and we have apparently to do with phenomena that must be regarded as fundamental rules of Bridgettine grammar. The present study also includes an investigation of the use of the moods in quod clauses and the sequence of moods and tenses. Finally a brief survey of the subordinate constructions with verba voluntatis and curandi is included.


Non-disjoined chromosomes 15 from 115 cases of uniparental disomy (ascertained through Prader-Willi syndrome) and 13 cases of trisomy of maternal origin were densely typed for microsatellite loci spanning chromosome 15q. Of these 128 cases a total of 97 meiosis I (MI) errors, 19 meiosis II (MII) errors and 12 mitotic errors were identified. The genetic length of a map created from the MI errors was 101 cM, as compared with a maternal length of 137 cM based on CEPH controls. No significant differences were detected in the distribution of recombination events along the chromosome arm and a reduction was seen for most of the chromosome 15 intervals examined. It was estimated that 21% of tetrads leading to MI non-disjunction were achiasmate, which may account for most or all of the reduction in recombination noted. The mean age of mothers of cases involving MI errors which showed no transitions from heterodisomy to isodisomy was significantly lower (32.7) than cases showing one or more observable transitions (36.3) (P < 0.003, t -test). However, even among chiasmate pairs the highest mean maternal age was seen for multiple exchange tetrads. Chromosome-specific differences in maternal age effects may be related to the normal distribution of exchanges (and their individual susceptibilities) for each chromosome. However, they may also reflect the presence of multiple factors which act to ensure normal segregation, each affected by maternal age in a different way and varying in importance for each chromosome.


Lord Neaves, the Chair of this Anniversary meeting, addressed the members of the Society and emphasised the importance of the study of antiquarians to both historic and prehistoric research. He also stresses that subjects such as comparative philology and legal history can provide key insights for the study of the past. The Secretary then reported on the state of the Society's collections and noted that they could soon be moved into a larger premises, which would allow the Society to expand the national collection.

Meeting notes for 13 December, 1858 are appended.


This study has used biochemistry and real time confocal imaging of green fluorescent protein (GFP)-tagged molecules in live cells to explore the dynamics of protein kinase B (PKB) regulation during B lymphocyte activation. The data show that triggering of the B cell antigen receptor (BCR) induces a transient membrane localization of PKB but a sustained activation of the enzyme; active PKB is found in the cytosol and nuclei of activated B cells. Hence, PKB has three potential sites of action in B lymphocytes; transiently after BCR triggering PKB can phosphorylate plasma membrane localized targets, whereas during the sustained B cell response to antigen, PKB acts in the nucleus and the cytosol. Membrane translocation of PKB and subsequent PKB activation are dependent on BCR activation of phosphatidylinositol 3-kinase (PI3K). Moreover, PI3K signals are both necessary and sufficient for sustained activation of PKB in B lymphocytes. However, under conditions of continuous PI3K activation or BCR triggering there is only transient recruitment of PKB to the plasma membrane, indicating that there must be a molecular mechanism to dissociate PKB from sites of PI3K activity in B cells. The inhibitory Fc receptor, the FcγRIIB, mediates vital homeostatic control of B cell function by recruiting an inositol 5 phosphatase SHIP into the BCR complex. Herein we show that coligation of the BCR with the inhibitory FcγRIIB prevents membrane targeting of PKB. The FcγRIIB can thus antagonize BCR signals for PKB localization and prevent BCR stimulation of PKB activity which demonstrates the mechanism for the inhibitory action of the FcγRIIB on the BCR/PKB response.


Floating point multiplication is a crucial operation in high power computing applications such as image processing, signal processing etc. Multiplication of floating point numbers found extensive use in DSP applications involving huge range. And also multiplication is the most time and power consuming operation. This paper proposes an efficient method for IEEE 754 floating point multiplication which gives a better implementation in terms of delay. The proposed log based Floating point Multiplier is designed using Verilog HDL and targeted on Spartan 6 FPGA.


Asthma is a chronic inflammatory disease that causes hyper-responsiveness of the bronchial tree, with reversible airflow obstruction. The condition places a significant burden on our healthcare system. Chronic asthma can cause remodelling of the airway. Patients suffering from asthma should be aware of the signs and symptoms thereof, as well as the factors that can precipitate an asthmatic attack. Asthma is mostly classified as either acute or chronic; the diagnosis of asthma is based on identifying both a characteristic pattern of respiratory symptoms and variable expiratory airflow limitation. Treatment is based on how the patient presents and includes bronchodilators, inhaled corticosteroids and mast cell stabilisers. This article provides an overview on the diagnosis, characterisation and treatment of asthma.


Gangrene of the scrotum is not a common condition, but it is by no means rare. As far back as 1905, Whiting1collected from the literature 93 cases of scrotal gangrene. In 1911, Coenen and Przedborski2reviewed 203 cases, and in 1930, Gibson3collected 203 cases of idiopathic or spontaneous gangrene of the scrotum—only one variety of this malady. The earliest case reported is credited to Boerhave,4in 1753, occurring in a man, 40 years of age, as the result of urinary retention. The patient recovered with a resulting urinary fistula. The first case of scrotal gangrene in a child was reported in 1764 by Baurienne,5who observed the condition in a 14 year old boy. The earliest case in an infant found in the literature was one reported by Hebler,6in 1848. His patient was a 12 weeks old infant with erysipelas of


During the past two decades, dramatic strides have been made in the treatment of metastatic testicular cancer. In the early 1970s, cisplatin, vinblastine, and bleomycin (PVB) produced durable complete remissions (CR) in approximately 70% of treated patients. In the early 1980s, etoposide emerged as the only drug with single‐agent activity in cisplatin‐refractory patients. Based on preclinical data demonstrating synergy of cisplatin plus etoposide, the two‐drug combination proved to be a useful salvage therapy, curing approximately 25% of such patients. Further evaluation of etoposide as part of initial therapy by the Southeastern Cancer Study Group (SECSG) compared PVB with bleomycin, etoposide, and cisplatin (BEP) in previously untreated patients with metastatic germ cell tumors. Not only did BEP have significantly less toxicity, it proved to be superior to PBV in patients with advanced disease. Varying the dose and schedule of etoposide also may provide patients with potentially useful avenues of treatment. High‐dose etoposide plus carboplatin in drug‐refractory patients has produced durable CR in a cohort of treated patients; it is currently being evaluated as part of initial salvage therapy. The schedule dependency of etoposide in small cell lung cancer led us to evaluate daily oral administration of etoposide in patients refractory to previous etoposide therapy; objective response rates of approximately 15% to 25% were observed. In summary, etoposide remains an integral part of the treatment regimen for testis cancer. However, the incorporation of innovative dose and schedule combinations for etoposide may further improve its therapeutic index for this disease.


A theoretical and experimental study on the growth and properties of a ternary carbon-based material, CSxFy, synthesized from SF6 and C as primary precursors is reported. The synthetic growth concept was applied to model the possible species resulting from the fragmentation of SF6 molecules and the recombination of S–F fragments with atomic C. The possible species were further evaluated for their contribution to the film growth. Corresponding solid CSxFy thin films were deposited by reactive direct current magnetron sputtering from a C target in a mixed Ar/SF6 discharge with different SF6 partial pressures (PSF6). Properties of the films were determined by x-ray photoelectron spectroscopy, x-ray reflectivity, and nanoindentation. A reduced mass density in the CSxFy films is predicted due to incorporation of precursor species with a more pronounced steric effect, which also agrees with the low density values observed for the films. Increased PSF6 leads to decreasing deposition rate and increasing density, as explained by enhanced fluorination and etching on the deposited surface by a larger concentration of F/F2 species during the growth, as supported by an increment of the F relative content in the films. Mechanical properties indicating superelasticity were obtained from the film with lowest F content, implying a fullerene-like structure in CSxFy compounds.


Summary Methotrexate and colchicine administered during a primary response to S. adelaide in mice both preferentially inhibit γG antibody formation. In these experiments, the γM and γG antibody responses seem to be independent of one another. The γM antibody response is not prolonged by the immediate absence of a following γG response. Also, the γG antibody response is able to recover from the effects of both drugs and reach near-normal serum titers whether or not there is a preceding γM response. During a methotrexate inhibited response, normal levels of γM can occur in the serum at a time when no pyroninophilic blast cells or secondary nodules are evident in the spleen. The recovery of γG production is well correlated with the appearance of many hemocytoblasts in the splenic red pulp, although no secondary nodules or mature plasma cells can be found at this time. A study has also been made of γM and γG antibody production in x-irradiated recipients after transfer of spleen cells from primed animals. When spleen cells are taken from immunized donors on day 2 or day 6 after injection of antigen, only γM antibody can be demonstrated in the recipients. Spleen cells taken on day 8 or day 10 after antigen produce mostly γG antibody in the recipients.


Individuals with disabilities living in developing countries often face numerous challenges which make particularly difficult for them to fulfill basic life needs. We present the case study of twelve people unable to walk in a low-income neighborhood of Bogota, Colombia. As health professionals and human rights advocates, we have provided care to these individuals over the past 15 years. Following a subjectivist epistemological approach to qualitative research, we found that these individuals experience four main types of limitations: socio-economic, structural/environmental, emotional, and functional, which restrict their autonomy and life satisfaction. Their limitations make life strenuous and usually produce feelings of sadness, uselessness, and hopelessness. Social support, primarily from family members, alleviates these limitations. By following this group over time, we witnessed a rapid impairment of their health and emotional status, as well as their family members' growing exhaustion. Several policy changes and practical measures to address this situation are proposed.