: We have analyzed the 57 ARDS admitted at the Intensive Care Unit (ICU) of the Hospital General Vall d'Hebron of Barcelona in 1996 (the 5.7% of the ICU and the 0.18% of the hospital admission). We have studied the epidemiological characteristics, as well as their ICU complications and mortality. This year was the first to have nitric oxide (NO) as complementary treatment in the ARDS patients at our hospital. They were 42 males and 15 females, with a mean age of 60 years, APACHE II 21 and a lung injury score 3.1. The 87% of the patients need vasoactive drugs. The 47% need Swan-Ganz catheter to optimize the haemodynamic management. The 77% presented a multiple organ disfunction syndrome (MODS) and the 56% acute renal failure. The total mortality was 70%, basically due to MODS (68%), while due to hypoxemia only in the 22%. The group treated with NO (the 35% of the ARDS patients) were younger, without any other differences the patients who did not received this treatment and with the same stage and mortality. Patients who presented MODS, renal failure or hemodynamic unstableness presented a higher mortality (p < 0.05).


As of 2014, the State of Vermont adopted a policy package directing schools to implement a new way of educating and graduating students. Vermont's Act 77 and Education Quality Standards require schools to identify specific skills and knowledge students must be proficient in to graduate and ensure each student has a personalized experience. Vermont's tradition of local control means high school principals are leading change in their schools. How high school principals are understanding, valuing, and acting to lead the implementation of Vermont's policies for personalized, proficiencybased education therefore varies by location. The purpose of this multiple case study was to explore high school principal leadership at a critical juncture of implementing Vermont's personalized proficiency education paradigm. Principals' understanding was analyzed using an accountability vs. flexibility framework influenced by Sturgis (2016) and Labaree (1997). Principals' action steps were considered through the lens of Frontier and Rickabaugh's (2014) five levers for school change. Principals' leadership style was analyzed using transformational leadership practices (Leithwood & Sun, 2012). The findings from five high school principals suggest that Vermont's policies were valued for their potential to improve student outcomes, student engagement, and future career opportunities. Principals' understanding of the policies varied, suggesting a lack of cohesive understanding of policy goals across the state. They leveraged school structures and education standards to enact policy implementation, suggesting a focus on proficiency over personalization at the time of this study. Principals in this study were leading school change by building teacher capacity and enabling teacher collaboration, suggesting they were accessing key transformational leadership practices to enable school change. The principals also identified sticking points to implementation, including: a lack of appropriate computer software for proficiency-based grading, a limited timeframe for implementation, limited leadership resources and supports from the state, and worries about a lack of equity of opportunity for all students. This study has implications for education policy developers, state-level education agencies, and other high school principals. The findings suggest school-based implementation of state-level education policy, even in local control states, can be facilitated by supports for growing leader understanding of policy intentions and facilitating policy implementation with suggested timelines and key steps. The findings also suggest high school principals access transformational leadership practices when engaging their schools in a change process. By increasing the breadth of these practices, they can facilitate the whole-school change in a personalized proficiency paradigm.


To meet the growing online and face-to-face library instruction needs of a large research university, a team of librarians set out to develop asynchronous online instruction of sufficient quality to supplement and replace classroom teaching. This report describes the best practices that were identified from a review of the literature, the instructional design process that was used to implement these practices in a pedagogically effective way, the results of pilot testing of the instruction, and implications for future practice. The result is a template for development that can be used by other librarians seeking to develop robust, effective, and accessible online learning objects, whether to reach out to online learners or improve the scalability of information literacy instruction.


Diarrhea is a non-specific symptom which may be associated with Addison's disease and several causes had been demonstrated in the aetiology. We describe a patient with Addison's disease who was suffering from chronic diarrhea for three months. She was diagnosed as having collagenous colitis and successfully treated with Sulphasalazine, 2 g/day. Collagenous colitis is an uncommon cause of chronic diarrhea and the association of collagenous colitis with Addison's disease has not previously been described. We think that collagenous colitis may play a role in the aetiology of diarrhea in patients with Addison's disease and therefore we suggest a full colonoscopic examination in other patients with Addison's disease and diarrhea to determine the incidence of collagenous colitis in the aetiology of diarrhea.


BACKGROUND
Hookworm-related cutaneous larva migrans (CLM) and tungiasis are commonly diagnosed in travelers returning from endemic areas, but reliable data on disease occurrence do not exist. To describe the occurrence of CLM and tungiasis in international travelers, a cross-sectional study was done.

METHOD
We conducted an airport survey in European travelers exiting northeast Brazil. Questionnaires were distributed at the departure gate of the international airport of Fortaleza (Ceará State) while passengers were waiting to board their plane. The questionnaire included questions on personal characteristics, pretravel health advice, acquired parasitic skin diseases during their stay in Brazil, and clinical characteristics of the infestation. To help identify CLM and tungiasis, photographs of the typical appearances of the infestations were presented.

RESULTS
Data from 372 tourists (aged 16-76 y, median = 40 y) were available for analysis; 45% had obtained pretravel health advice, usually from travel clinics (46.2%) and Internet sites (39.6%). Only 14% of those who obtained advice had been informed about CLM as a travel health risk and 22% about tungiasis. During their stay in Brazil, 12 (3.2%) tourists had experienced tungiasis and 3 (0.8%) CLM. In all cases, lesions were confined to the feet. The three travelers with CLM complained of irritability; itching was present in two cases. Pain (58.3%) and itching (50%) were the most common symptoms in travelers with tungiasis. The length of stay was a clear predictor for tungiasis, with a 20 times higher occurrence in travelers who had stayed for more than 4 weeks in Brazil.

CONCLUSIONS
Tungiasis and CLM are not rare in international tourists departing from Brazil, and pretravel counseling is insufficient. Pretravel health advice should include information on the risk of acquiring tungiasis and CLM and how to prevent an infestation. Airport surveys using questionnaires can be used to obtain incidence data on both parasitic infestations.


We report the MR imaging findings in a 44-year-old man with a low-grade synovial sarcoma. There was a right-sided epidural and paravertebral mass, widening of the ipsilateral neural foramen at the L4-L5 level, and focal erosion of the right superior articular process of the L5 vertebra. The mass was relatively homogeneous, hyperintense to muscle and isointense to fat on T2-weighted images, and isointense to muscle on T1-weighted images, and it demonstrated moderate homogeneous enhancement.


The inter-relationship of the affective and the cognitive is an issue in the spiritual and moral fields of the Christian tradition. Drawing on the analogical use of the 'spiritual senses' together with insights from virtue ethics, this article investigates wisdom as loving knowledge in Dag Hammarskjöld's Markings. The article has five stages: first, the various forms of love present in Hammarskjöld's reflections are outlined; second, after a brief explanation of affective/cognitive aspect of the spiritual senses, it probes a representative text in Marking on the process of knowing and loving God; third, it analyses key passages in the journal concerning wisdom as a virtue; fourth, in the light of the theology of the Gifts of the Holy Spirit and contemporary approaches based on the second-person perspective, the Gift of wisdom is examined in the journal leading to some concluding observations.


This paper describes our method used for the 2017 DAVIS Challenge on Video Object Segmentation [26]. The challenge's task is to segment the pixels belonging to multiple objects in a video using the ground truth pixel masks, which are given for the first frame. We build on our recently proposed Online Adaptive Video Object Segmentation (OnAVOS) [28] method which pretrains a convolutional neural network for objectness, fine-tunes it on the first frame, and further updates the network online while processing the video. OnAVOS selects confidently predicted foreground pixels as positive training examples and pixels, which are far away from the last assumed object position as negative examples. While OnAVOS was designed to work with a single object, we extend it to handle multiple objects by combining the predictions of multiple single-object runs. We introduce further extensions including upsampling layers which increase the output resolution. We achieved the fifth place out of 22 submissions to the competition.


The securities rating industry has been heavily criticized for its subprime mortgage ratings that performed so poorly during the 2007-9 subprime crisis. This chapter traces the history of Moody's bond ratings since their inception in 1909. The stated purpose of the ratings was as an aid in investment analysis with the large number of U.S. securities outstanding at the time. However, evidence is reviewed that the Great Depression was a turning point for ratings, with a switch in focus from investment analysis to default analysis. The ratings during this period were compared with a structural default analysis in terms of their ability to rank order defaults that occurred during the Great Depression. The conclusion is that advances in finance has created technologies that tend to outdate the ratings technology.


In this paper, a performance evaluation of the state-of-the-art H.264/AVC video coding standard is carried out with the aim of determining its feasibility when applied to hyperspectral image compression. Results are obtained based on configuring diverse parameters in the encoder in order to achieve an optimal trade-off between compression ratio, accuracy of unmixing and computation time. In this sense, simulations are developed in order to measure the spectral angles and signal-to-noise ratio (SNR), achieving compression ratios up to 0.13 bits per pixel per band (bpppb) for real hyperspectral images. Moreover, in this work it is detected which blocks in the encoder contribute the most to performance improvements of the compression task for the particular case of this type of images, and which ones are not relevant at all and hence could be removed. This conclusion yields to reduce the future design complexities of potential low-power/real-time hyperspectral encoders based on H.264/AVC for remote sensing applications.


The major dose-limiting adverse effect of ricin A chain-containing immunotoxin (IT) therapy is vascular leak syndrome (VLS). Since plasma fibronectin (Fn) plays a role in maintaining microcirculatory integrity and since the gradient between plasma and tissue Fn can be altered in various pathological situations, we determined whether the administration of IT-ricin A chain to patients resulted in changes in the levels of serum Fn and, if so, whether these changes correlated with the severity of VLS. We also measured the serum levels of tumor necrosis factor alpha (TNFalpha), a proinflammatory cytokine which has been implicated in tissue damage and in interleukin 2-mediated VLS. Our results indicate that the most severe manifestations of VLS were associated with the highest pretreatment levels of Fn, the largest decreases in Fn immediately after starting IT therapy, increases in the levels of serum TNFalpha, higher concentrations of circulating IT, and the lowest numbers of circulating tumor cells. These parameters should, therefore, be useful for predicting which patients will have severe VLS.


reduces cortisol or epinephrine and increases norepinephrine, which acts as an antidepressant associated with a decrease in sympathetic nerve and hypothalamic–pituitary–adrenal activity, according to the Australian Physical Activity and Se-dentary Behaviour Guidelines. [12,13] Therefore, adding physical activity to an elderly person's routine is crucial for enhancing Objectives: The purpose of this study was to conduct a systematic assessment of the available data about the benefits of physical activity and the appropriate forms of exercise for older adults' mental health. Methods: LILACS, PubMed, SciELO, CINAHL, Scopus, Google Scholar, ProQuest, and ScienceDirect were all searched. Based on PRISMA, the reviewing guideline was selected. The Quality Assessment Tool (QAT) for Quantitative Studies was used to evaluate the methodological quality of each included study. We only included studies with moderate to strong quality. Results: Fourteen studies were eligible for inclusion (six randomized controlled trials and eight pretest-posttest studies). A variety of exercises, including aquatic, aerobic, yoga, and muscle-strengthening ones, have been shown to improve elderly people's physical and mental health. According to QAT, five studies with Cohen's Kappa values of at least 0.80 and 11 high-quality studies with p<0.05 had a significant impact on the mental health of the elderly. Conclusion: This comprehensive study demonstrated how an exercise program benefits elderly people who are both usually healthy and have suffered a variety of symptoms.


The efficacy of weekly paclitaxel in androgen-independent prostate cancer and its addictive cytotoxicity with anthracycline derivatives led us to determine the safety and efficacy of a weekly schedule of paclitaxel and epirubicin. Between October 2000 and November 2002, 32 patients were enrolled in this study. Patients characteristics included a median age of 72 years (range 68–77), adequate hepatic, cardiac, renal and bone marrow functions, ECOG performance status of 1–2, and no prior chemotherapy. All patients had received hormonal manipulation and seven patients (22%) had received prior palliative radiation therapy. The regimen consisted of paclitaxel 70 mg/m2 i.v. infusion for 2 h and epirubicin 30 mg/m2 in bolus every week. Treatment was continued for 3 months or until disease progression or unacceptable toxicity were observed. During the study, prostate-specific antigen (PSA) was monitored and response was defined as a 50% reduction in PSA levels, to be confirmed 4 weeks later. Thirty-one patients were evaluable for toxicity and 21 for objective response. Seventeen patients (57%) had a decline above 50% in PSA level that lasted more than 4 weeks with a median time to PSA progression and a median duration of PSA response of approximately 5.5 months. Ten of the 21 patients with measurable disease (47%) had a confirmed objective response (one complete response and 20 partial responses). Thirteen of 25 symptomatic patients (56 %) had improvement in pain. The median time to disease progression was 7.6 months and the median survival was 12.9. The most prominent grade 3 toxicities were reversible myelosuppression and fatigue. Nausea, vomiting, diarrhea and peripheral edema were minimal. No evidence of cardiac toxicity was recorded. Alopecia was frequent, but reversible, in all patients. We conclude that despite the small sample size, this study demonstrates that the combination of weekly paclitaxel and epirubicin is a well-tolerated regimen for androgen-independent prostate cancer. The results imply that a combination of these agents in a weekly schedule may have clinical potential in prostate cancer treatment.


The chemical composition and reactivity of petroleum pitches under non-isothermal thermogravimetric conditions were studied. Thermogravimetry (TG) was used to study pyrolysis of petroleum pitches. Non-isothermal thermogravimetric data were used to evaluate the kinetics of the pyrolysis of this carbonaceous material. The paper reports application of Ozawa–Flynn–Wall model to deal with non-isothermal TG data for the evaluation of the activation energy corresponding to the pyrolysis of two different petroleum pitches. Nonisothermal kinetic studies of pyrolysis of the pitches based on the TGA measurements at different heating rates resulted that the average activation energy of the pyrolysis of pitch B (213.2 kJ/mol) was higher than that of the average activation energy of pitch A (185.7 kJ/mol). The reaction orders of pitch A and pitch B were calculated to be 1.6 and 0.9, respectively. These calculated reaction orders were considered to be as second-order and first-order kinetics.


The purpose of this study was study the attitude, knowledge and experience of coaches of Karate Federation Islamic Republic of Iran toward sport psychology counseling. For this purpose, 150 official coaches (75 women and 75 men) of karate Federation of Islamic Republic of Iran who had grade 1 and 2 of certified coach and had participated in the senior Championships of Iran, championship adolescents of young people and under 21 years, national team qualifiers and teams participating in premier League, had participated in this research as individual. In order to collect the required information the researcher made and the research questionnaire Sports coaches on sports psychology was used. Research results by using a two variable Pearson correlation coefficient showed that there is meaningful relationship between experience and attitude to sport psychology consulting and as well as between knowledge and attitudes toward sport psychology consulting that is (p=0.001,p=0.001 respectively). also results of research using independent t-tests showed that there is not meaningful relationship between male and female attitudes towards sport psychology consulting (p=0.207) while there is meaningful difference between adult and youth educators' attitudes towards sports psychology counseling (p=0.001). It seems that according to common concerns that exist between coaches and athletes perhaps existence sport psychology can be effective to athletes and coaches in reducing stress and achieve the desired result.


Confessions represent one of the most influential types of evidence, and research has shown that mock jurors often fail to dismiss unreliable confession evidence. However, recent studies suggest that jurors might believe in the false confession phenomenon more than they once did. One possible reason for this could be increased publicity regarding false confession cases. To assess this possibility, we administered an extensive online survey to a sample of potential jurors in the United States from 11 universities and Amazon Mechanical Turk. Perceptions of confession behaviors (as related to others and oneself), Miranda waivers, interrogation methods, dispositional risk factors, and confession admissibility and evidentiary weight were assessed, in addition to respondents' self-reported crime-media activity and familiarity with disputed confession cases. Respondents' perceptions were generally consistent with empirical research findings. Respondents believed suspects do not understand their Miranda rights; gauged interrogation tactics usage relatively accurately; viewed psychologically coercive tactics as coercive and more likely to result in false, rather than true, confessions; and recognized that confessions elicited via coercive measures should be inadmissible as evidence in court. However, respondents' perceptions did not align with research on interrogation length, and respondents did not fully appreciate the risk youth poses in interrogations. Moreover, being familiar with disputed confession cases resulted in more negative views of interrogations and confessions. Overall, potential jurors are seemingly more cognizant of false confessions and the tactics that elicit them than in the past, and evidence suggests that media outlets can be used to promote interrogation and confession knowledge.


: A case of a bladder fistula following total hip replacement is attributable to thermal injury by self-curing polymethylmethacrylate projecting into the retropubic space.


In view of continuing economic stagnation and consequent budgetary constraints facing the state, Hawaii public libraries have been concerned with their operational efficiency and library managers have been seeking better methods in allocating limited resources among the libraries. This paper employed data envelopment analysis (DEA) technique to assess the performance and resource utilization efficiency of 47 public libraries in Hawaii. Three output measures—circulation, reader visits, and reference transactions and four input categories—collection, library staff, days open, and nonpersonal expenditures were used in the analysis. For fiscal year 1996/97, the estimated technical efficiency scores for Hawaii State public library branches ranged from 0.45 to 1.00, with an average of 0.84. The results showed that 14 of the 47 libraries are technically efficient. The estimated efficiency scores were related to relevant library-specific factors and community characteristics, such as total floor space, size of collection, population density, and location to identify factors influencing library performance. Only floor space and volume of collection did show moderate positive effects on library performance. The resulting information can be mainly useful in improving the performance of inefficient libraries. With special consideration to factors uncontrollable by the libraries the results may also be useful in allocating limited resources among them.


This article looks at 30 years of editorial perspectives and trends in social work as a profession through the analysis of editorials from the journal Social Work. It identifies the wax and wane of philosophic (intellectual or scholarly) questions in social work thinking in the past three decades. It defines what philosophic thinking means and identifies the types of knowledge generated by the editorial discussions and the directions set by them. It reviews the emergence of scientific thinking in social work and links it to the persistent influence of Flexner's thinking and critique of 1915 in the minds of scholars. The perspectives and themes in the editorials accurately correspond with the paradigms observed in the profession and the different directions taken by social work education. The text analysis of 30 years of editorials shows the characteristic discussions and controversies that have challenged social work through the past three decades.


Abstract This paper reexamines, at a range of investment horizons, the asymmetric dependence between hedge fund returns and market returns. Given the current availability of hedge fund data, the joint distribution of longer-horizon returns is extracted from the dynamics of monthly returns using the filtered historical simulation; we then apply the method based on copula theory to uncover the dependence structure therein. While the direction of asymmetry remains unchanged, the magnitude of asymmetry is attenuated considerably as the investment horizon increases. Similar horizon effects also occur on the tail dependence. Our findings suggest that nonlinearity in hedge fund exposure to market risk is more short term in nature, and that hedge funds provide higher benefits of diversification, the longer the horizon.


The use of injectable local anesthetic solutions to facilitate pain-free surgery is an integral component of many procedures performed by the plastic surgeon. In many instances, a solution that has both rapid onset and prolonged duration of analgesia is optimal. A combination of lidocaine and bupivacaine, plain or with epinephrine, is readily available in most Canadian health care settings where such procedures are performed, and fulfills these criteria. However, commercially available solutions of both medications are acidic and cause a burning sensation on injection. Buffering to neutral pH with sodium bicarbonate is a practical method to mitigate the burning sensation, and has the added benefit of increasing the fraction of nonionized lipid soluble drug available. The authors report on the proportions of the three drugs to yield a neutral pH, and the results of an initial survey regarding the use of the combined solution with epinephrine in hand surgery.


Abstract This paper discusses and presents data obtained through various studies and surveys on the effect of the IUD contraceptive programme in Taiwan. It has been demonstrated that the fertility of IUD acceptors before first acceptance was 58 % higher than that of married women in general and that, after acceptance, it declined by about 76%. The corresponding fertility decline among married women in general was only about %. Acceptors had had more recent births, as indicated by their shorter 'open interval' of 20.7 months, compared with 374 months among the women in the KAP survey sample. If the fertility of IUD acceptors had declined at the same rate as that of married women in general in the absence of IUD, the insertion of about 4 IUDs would probably prevent one live birth in the following year. Observation over a longer period, however, is needed to determine the demographic effect of IUD. Data on fertility control practice after termination, type of termination of pregnancies after first acceptance, life-table rates by various socio-demographic characteristics of acceptors, and the 'life expectancy' of the first segment of IUD are also presented.


De novo assembled alphoidtetO-type human artificial chromosomes (HACs) represent a novel promising generation of high capacity episomal vectors. Their function and persistence, and any adverse effects, in various cell types in live animals, have not, however, been explored. In this study we transferred the alphoidtetO-HAC into mouse ES cells and assessed whether the presence of this extra chromosome affects their pluripotent properties. AlphoidtetO-HAC-bearing ES cells were indistinguishable from their wild-type counterparts: they retained self-renewal potential and full capacity for multilineage differentiation during mouse development, whereas the HAC itself was mitotically and transcriptionally stable during this process. Our data provide the first example of fully synthetic DNA behaving like a normal chromosome in cells of living animals. It also opens a new perspective into functional genetic studies in laboratory animals as well as stem cell-based regenerative medicine.


The accelerated economic development of landlocked Laos, combined with extreme climate variables, points to dramatic transformations in subsistence fisheries on its rivers. In the country's first Fisheries Law, adopted in 2009, co-management of village fisheries is required as a way to promote sustainable development at a local level. The co-management model, however, does not stipulate participation by women fishers, important stakeholders who make up almost one-half of all Lao fishers and whose work contributes directly to family nutrition and well-being. Based on fieldwork conducted in fishing villages on the Sekong River in southern Laos in 2013, this paper takes an ecosystems approach to discuss how the country can build resilience and social cohesion into fisheries by incorporating women and their knowledge into village fishery management. In the process, the health of river ecosystems and food security will improve, while women fishers will acquire new skills to help them avoid 'poverty traps.'


Laser and electron-beam powder bed fusion (PBF) additive manufacturing (AM) technology has transitioned from prototypes and tooling to production components in demanding fields such as medicine and aerospace. Some of these components have geometries that can only be made using AM. Initial applications either take advantage of the relatively high surface roughness of metal PBF parts, or they are in fatigue, corrosion, or flow environments where surface roughness does not impose performance penalties. To move to the next levels of performance, the surfaces of laser and electron-beam PBF components will need to be smoother than the current as-printed surfaces. This will also have to be achieve on increasingly more complex geometries without significantly increasing the cost of the final component. Unsettled Topics on Surface Finishing of Metallic Powder Bed Fusion Parts in the Mobility Industry addresses the challenges and opportunities of this technology, and what remains to be agreed upon by the industry.


Pipeline failures can be severe events that impact both society and industry. The oil spills in North Battleford, Saskatchewan in 2016 and the gas rupture in Beardmore, Ontario in 2011 are examples of recent pipeline failures in Canada. Pipeline failures have led to pipe fabricators developing new precursor steels and manufacturing processes to improve the final product properties. This paper is aimed at summarizing historically the advancements made in manufacturing of steels used for pipelines. High strength low alloy (HSLA) steels are used extensively to manufacture these pipelines. After the introduction of the first generation of HSLA steels, i.e., X42 in 1948, various classes of HSLA steels, such as X52 and X60, were developed to improve the mechanical properties. In 1970, X70 and X80 HSLA steels were developed to further improve the properties and to improve weldability. Even higher strength grades, such as X100 and X120, have been introduced in recent years.


Methods to generate human intestinal tissue from pluripotent stem cells (PSCs) open new inroads into modeling intestine development and disease. However, current protocols require organoid transplantation into an immunocompromised mouse to achieve matured and differentiated epithelial cell states. Inspired by developmental reconstructions from primary tissues, we establish a regimen of inductive cues that enable stem cell maturation and epithelial differentiation entirely in vitro. We show that the niche factor Neuregulin1 (NRG1) promotes morphological change from proliferative epithelial cysts to matured epithelial tissue in three-dimensional cultures. Single-cell transcriptome analyses reveal differentiated epithelial cell populations, including diverse secretory and absorptive lineages. Comparison to multi-organ developmental and adult intestinal cell atlases confirm the specificity and maturation state of cell populations. Altogether, this work opens a new direction to use in vitro matured epithelium from human PSCs to study human intestinal epithelium development, disease, and evolution in controlled culture environments.


The morbidity statistics for the United States alone would suggest that there are 400,000 victims each year who succumb to sudden coronary death, which suggests that there is a need for the development of pharmacological interventions capable of preventing ventricular fibrillation (VF) in patients identified as being at high risk. A major deficiency in this area of experimental investigation is the lack of an animal model that would permit preclinical studies to identify potentially useful therapeutic agents. We have developed an experimental canine model of sudden coronary death in which VF occurs in the chronically injured heart that is subjected to a period of transient ischemia in a coronary region remote from the site of a previous myocardial infarction. The experimental model is subject to the induction of ventricular tachyarrhythmias in response to programmed electrical stimulation, thereby permitting the investigator to correlate the effectiveness of a pharmacological agent in preventing electrically induced arrhythmias with its potential to prevent the development of VF in response to ischemia at a site remote from a previous infarct. Thus, acute myocardial ischemia at a site distant from a previous myocardial infarction enhances the likelihood of primary VF in the conscious dog. This model of sudden coronary death may stimulate more closely the clinical state in humans and might serve as an appropriate model for the study of electrophysiological mechanisms associated with the development of VF and for the evaluation of potential antifibrillatory drugs.


A theology of creation requires clarity about trinitarian doctrine, especially the relation of the one divine essence to the three persons, the distinction between immanent and transitive acts, and the indivisibility of God's outer works. The triune God is one undivided essence in an irreducible threefold personal modification. The persons of the godhead are distinguished from each other by mutual relations and by each person's proper characteristics; these relations constitute God's immanent perfection anterior to creation. The work of creation is a non-necessary, novel and voluntary work of the Trinity. As an outer work it demonstrates God's unity: the work of creation is not divisible into three distinct actions. But distinct and eminent appropriation of specific acts to specific persons is permissible if each person is understood as a mode of the one divine essence. Creation is thus a common work of the undivided three-in-one; there are not three creators, but three who create.


It is usually said that textbooks are at least five years behind the most recent advances in any subject. This book remedies that situation as far as infant feeding is concerned. It is a clear, concise account of the presentday ideas on the subject, and gives precise instructions, advocating the more liberal feeding advised to-day. If amongst doctors and nurses there are still some who fear overfeeding, or worry about slight variations in conposition, this book will help to remove their doubts. It will support mothers who, I suspect, often felt that the rigid schedules of the past were wrong. It contains a wealth of factual information mainly in the form of tables, and reflects the mature opinion of two experienced and widely read clinicians, retaining only those ideas of the past which have stood the test of time, without advocating doctrines not yet fully accepted. It discusses difficulties likely to be met and their management. One or two subjects perhaps might have been more fully discussed, such as 'rooming-in' and 'demand feeding', and a minor criticism of the later chapters on such subjects as prematurity, diarrhoea, vomiting and constipation is that they are perhaps not detailed enough for doctors, yet too detailed for mothers. These, however, form a comparatively minor section of this excellent book which has some valuable diets and suggestions for feeding infants and childrn suffering from conditions requiring special food such as coeliac disease, obesity, etc. The book is well indexed and the numerous references are listed and because of its style is likely to have a wide appeal. It should be read by all who are concerned with infant feeding and it should find a place in the library of every hospital, welfare clinic and doctor, especially at the reasonable price at which it is published.


Characterizing the response of ecosystems to global climate change requires that multiple aspects of environmental change be considered simultaneously, however, it can be difficult to describe the relative importance of environmental metrics given their collinearity. Here, we present a novel framework for disentangling the complex ecological effects of environmental variability by documenting the emergent properties of eelgrass (Zostera marina) ecosystems across ∼225 km of the Atlantic Coast of Nova Scotia, Canada, representing gradients in temperature, light, sediment properties, and water motion, and evaluate the relative importance of different metrics characterizing these environmental conditions (e.g., means, extremes, variability on different time scales) for eelgrass bioindicators using lasso regression and commonality analysis. We found that eelgrass beds in areas that were warmer, shallower, and had low water motion had lower productivity and resilience relative to beds in deeper, cooler areas that were well flushed, and that higher temperatures lowered eelgrass tolerance to low-light conditions. There was significant variation in the importance of various metrics of temperature, light, and water motion across biological responses, demonstrating that different aspects of environmental change uniquely impact the cellular, physiological, and ecological processes underlying eelgrass productivity and resilience, and contribute synergistically to the observed ecosystem response. In particular, we identified the magnitude of temperature variability over daily and tidal cycles as an important determinant of eelgrass productivity. These results indicate that ecosystem responses are not fully resolved by analyses that only consider changes in mean conditions, and that the removal of collinear variables prior to analyses relating environmental metrics to biological change reduces the potential to detect important environmental effects. The framework we present can help to identify the conditions that promote high ecosystem function and resilience, which is necessary to inform nearshore conservation and management practices under global climate change.


Jakarta suffers from land subsidence. The rate at which this happens is alarming. The subsidence causes much direct and indirect damage to buildings and both surface and subsurface infrastructure. Also the flood risk is increased since domestic, industrial and economic buildings have a higher probability of being flooded and damages will only increase with the (economic) growth of Jakarta. Another consequence of the subsidence is the disruption of the water management, since the gradients of surface water flows change. Groundwater abstractions play a major role in the land subsidence and it is important to schematise the Jakarta groundwater system. In this way also possible groundwater strategies, which could influence the subsidence rate, can be evaluated. Already similar models were developed, but for the current model there are now more possibilities due to technological advance and a continually growing database. The goal of this research was to support the modelling study with an analysis of the sensitivities of the model. Although a larger database was available compared to earlier models, still a vast lack of input data is present. Data collection is the solution, but to save resources it is of importance which input data have priority in the collection. Based on the sensitivity analysis in this study suggestions could be made on where what parameters have the largest influence on the model. In this way, with the data collection one can focus on improvement of quantity and/or quality of input data for certain parameters in certain areas. The research question which was answered in this study is to what extent the input parameters influence the model. This research question was elaborated in subquestions concerning which parameters are used in the model, what sensitivity is attributed to these parameters, and what sensitivity these parameters have in the model. The results present the outcomes of a univariate sensitivity analysis done with a selection of parameters. This selection consisted out of the parameters for the horizontal and vertical hydraulic conductivity, the recharge of groundwater, and the groundwater abstractions. This selection was made based on found sensitivities in literature. The results of the sensitivity analysis with these four parameters are shown as differences in groundwater heads compared to the original results from the model. These results are presented in tables and maps per model layer. The selected parameters each had their own influence on the model. Important is to notify that these influences are relative to each other and that thus on the influence of a sole parameter on the model nothing could be concluded. The horizontal hydraulic conductivity parameter had an overall influence on the model. The adjustment of the groundwater abstractions resulted in the largest sensitivities, but these were only present in the deeper layers in the northern part of the study area. Groundwater recharge also had a large overall influence on the model, but it is not certain of this statement could be made based on the found results. Changing the vertical hydraulic conductivity had the least influence when compared with the other parameters If Deltares will continue developing the current model and sampling data for it, then therefore some recommendations are proposed in the study. It is advised to carry out a detailed research for data on abstractions in the northern, industrial districts, as in this region the model reacted most to the variations in the abstractions parameter. Also is recommended for Deltares that for the overall model more research should be into horizontal hydraulic conductivity in the whole study area, with which a more detailed, layer specific map can be made to use as input for the horizontal hydraulic conductivity parameter.


Recruitment limitation of tree population dynamics is poorly understood, because fecundity and dispersal are difficult to characterize in closed stands. We present an approach that estimates seed production and dispersal under closed canopies and four limitations on recruitment: tree density and location, fecundity, seed dispersal, and estab- lishment. Consistent estimates are obtained for 14 canopy species using 5 yr of census data from 100 seed traps and several thousand mapped trees and seedlings from five southern Appalachian forest stands that span gradients in elevation and moisture. Fecundity (seed production per square centimeter of basal area) ranged over four orders of magnitude, from 10° cm2 basal area/yr (Carya, Cornus, Nyssa, Quercus) to >10 3 cmVyr (Betula). Mean dispersal distance ranged from 20 m (Acer, Betula, Liriodendron, Tsuga) and was positively correlated with fecundity. Species also differ in the degree of seed clumping at fine (1 m2) spatial scales. Dispersal patterns can be classed in two groups based on dispersal vector: wind-dispersed taxa with high fecundities, long-distance dis- persal, and low clumping vs. animal-dispersal taxa with low fecundities, short-distance dispersal, and a high degree of clumping. "Colonization" limitations caused by sizes and locations of parent trees, fecundity, and dispersal were quantified as the fraction of sites receiving seed relative to that expected under null models that assume dispersal is nonlocal (i.e., long-distance) and not clumped (i.e., Poisson). Difference among species in coloni- zation levels ranged from those capable of saturating the forest floor with seed in most stands (Acer, Betula, Liriodendron) to ones that leave much of the forest floor without seed, despite presence of adults (Carya, Cornus, Nyssa, Oxydendrum). Seedling establish- ment is one of the strongest filters on recruitment in our study area. Taken together, our results indicate (1) that fecundity and dispersal can be resolved, even under a closed canopy, and (2) that recruitment of many species is limited by the density and location of source, dispersal patterns, or both.


The cloning and complete sequencing of gene 2 from four independently isolated temperature-sensitive mutants in the phage phi 29 DNA polymerase (ts2 mutants) is reported. The results obtained indicate that, in vivo, the mutations only affect the initial steps of the replication process. Interestingly, three of these mutations consist in the single amino acid change Ala to Val at position 492 of the protein. The ts2(24) and ts2(98) mutant phi 29 DNA polymerases were expressed, purified and their thermosensitivity was studied at two different steps of DNA replication: 1) protein-primed initiation and 2) elongation of the DNA chain. Whereas the ts2(24) mutation gave rise to a temperature-sensitive phenotype in both reactions, the ts2(98) mutant protein was rather insensitive to the temperature increase. In addition, the ts2(98) mutant protein showed clear differences in the activation by divalent cations. The relationship of these results with structural and functional domains in the phi 29 DNA polymerase are discussed.


Objectives

The general educational development (GED) diploma is intended to be equivalent to a high school (HS) credential; however, recent evidence finds that GED recipients have worse health than HS graduates. This study aims to explain the health disadvantage, focusing on three domains: noncognitive skills, health behaviors, and economic factors.

Methods

We analyze data on 3,119 HS graduates and GED recipients in the NLSY79 who reported their health status at the age of 40. Logistic and ordinal regression models examine whether the three domains account for the GED health disadvantage.

Results

The GED health disadvantage was jointly explained by lower noncognitive skills, unhealthy behaviors, and adverse economic circumstances, with the latter being particularly important.

Conclusions

A multipronged approach may be necessary to reduce the GED health disadvantage, including improving noncognitive skills during K–12 education, expanding opportunities for employment and living wage for low-skill workers, and continued focus on improving health behaviors.


Thank you very much for downloading political economy power and the body global perspectives. Maybe you have knowledge that, people have look hundreds times for their favorite books like this political economy power and the body global perspectives, but end up in infectious downloads. Rather than reading a good book with a cup of coffee in the afternoon, instead they are facing with some malicious virus inside their desktop computer.


Ptosis of the midfacial tissues with resultant deepening of the melolabial folds, vertical lengthening of the lower eyelid, and depression of the oral commissure are generally only slightly improved with traditional superficial musculoaponeurotic system (SMAS) suspension or rhytidectomy techniques. Subperiosteal, deep plane, and composite rhytidectomies have evolved in an attempt to rejuvenate these areas. This article reviews a series of patients who underwent an endoscopic subperiosteal face-lift either as an isolated procedure or in conjunction with an SMAS rhytidectomy. Although all patients showed good initial improvement, patients with thin faces and well-defined facial bone structure maintained the best long-term result. Complications were minimal, with no permanent facial nerve injuries observed. The endoscopic subperiosteal face-lift is a useful technique as an isolated procedure or in conjunction with facial liposuction or SMAS suspension rhytidectomy. Arch Facial Plast Surg. 2000;2:274-278


For the first time it has been made possible to merge a German and a Swiss firm-level data set that include detailed information about costs and benefits of apprenticeship training. Previous analyzes based only on aggregate data showed that the net costs of training apprentices are substantial in Germany, whereas apprenticeship training is on average profitable during the training period for firms in Switzerland, even though the two training systems are rather similar. This paper analyzes the reasons for these differences with matching methods. We simulate the impact of changes in certain parameters such as wages, apprenticeship systemrelated factors and allocation of tasks to apprentices on the cost-benefit ratio using the counterfactual values of the other country. The results show that most of the difference in the net costs of training between the two countries can be explained by a higher share of productive tasks allocated to apprentices in Switzerland and the differences in relative wages.


This paper reconsiders implementation of social choice functions defined as mapping from states to consequences, where we require the uniqueness of equilibrium outcome at every state. In contrast with the standard models, we construct only mechanisms that are universal, i.e., are free from the detail of the model specification such as the set of states, and allow each agent to have small moral preference. We show that a single mechanism can implement every incentive compatible social choice function. Moral preferences serve not only to eliminate unwanted equilibria but also to make the central planner's information processing simplified as much as possible in ways that each agent will translate her indescribable private signal into the describable characteristic of the socially optimal alternative.


This article presents the first models developed specifically for understanding the infiltration and interdiction of ongoing terror plots by undercover intelligence agents, and does so via novel application of ideas from queueing theory and Markov population processes. The resulting "terror queue" models predict the number of undetected terror threats in an area from agent activity/utilization data, and also estimate the rate with which such threats can be detected and interdicted. The models treat terror plots as customers and intelligence agents as servers. Agents spend all of their time either detecting and infiltrating new terror plots (in which case they are "available"), or interdicting already detected terror plots (in which case they are "busy"). Initially we examine a Markov model assuming that intelligence agents, while unable to detect all plots, never err by falsely detecting fake plots. While this model can be solved numerically, a simpler Ornstein-Uhlenbeck diffusion approximation yields some results in closed form while providing nearly identical numerical performance. The transient behavior of the terror queue model is discussed briefly along with a sample sensitivity analysis to study how model predictions compare to simulated results when using estimated versus known terror plot arrival rates. The diffusion model is then extended to allow for the false detection of fake plots. Such false detection is a real feature of counterterror intelligence given that intelligence agents or informants can make mistakes, as well as the proclivity of terrorists to deliberately broadcast false information. The false detection model is illustrated using suicide bombing data from Israel.


An association between theBstUI (Pro/Pro) genotype of the p53 codon 72 polymorphism and lung cancer has been reported previously (X. Jin et al., Carcinogenesis (Lond.), 16: 2205–2208, 1995). However, the genotype distribution of p53codon 72 polymorphism as well as the association of this polymorphism with lung cancer risk and prognosis remain undefined in the Taiwanese population. Therefore, we investigated the genotype distribution ofp53 codon 72 polymorphism in 194 lung cancer patients and 152 noncancer controls. The genotype frequencies in Taiwanese noncancer controls were 0.56 (Arg) and 0.44 (Pro).x analysis indicated significant differences in genotype distribution ofp53 from other reports in Swedish (P < 0.001), Spanish (P< 0.001), Caucasians in the United States ( P 5 0.002), and African-Americans (P 5 0.027). In addition, our data suggest that the Pro allele of the p53 codon 72 polymorphism increased the risk of lung cancer among female Taiwanese. The female patients with genotypePro/Pro showed a significantly increased odds ratio (3.14; confidence interval, 1.48– 6.64; P 5 0.003) of having lung adenocarcinoma, compared with normal controls with the other genotypes. Patients with the Pro/Pro genotype had an odds ratio of 2.63 (confidence interval, 1.22–5.68; P 5 0.01) higher than those with the other genotypes to be diagnosed with lung cancer at the early ages. We further investigated the association of p53 codon 72 polymorphism with prognosis in 133 lung cancer patients. Patients with thePro/Pro genotype tended to have poorer prognosis than those with theArg/Pro genotype (P5 0.05, by the log-rank test). Our data suggested thatp53 codon 72 polymorphism may play a role in cancer susceptibility and prognosis in specific classes of lung cancer patients in Taiwan.


As a sovereign state, Ethiopia can exercise its jurisdiction on criminal cases based on principles recognized under its Criminal Code and International Law. At times, Ethiopia may not be practically able to exercise its jurisdiction over the offender when, for instance, someone after committing the crime absconds to other state. If there is no possibility of extradition of such suspect Ethiopia may delegate the exercise of its jurisdiction to the country of refuge so that the offender will be tried in the latter's court. In some other cases, when someone absconds and sought refuge in Ethiopia after committing a crime in another country, the latter may delegate the exercise of its jurisdiction to Ethiopia. In both scenarios, the criminal law that the delegated country shall apply to entertain the delegated case is a question that calls for an answer. This question triggers the usually neglected question of choice of applicable law in criminal matters. This Article aims at discussing the choice of applicable criminal law at the time of delegation of criminal jurisdiction between Ethiopia and other countries. By examining the issue in light of the principles of criminal jurisdiction and customizing the principles developed in the choice of law over civil cases, this Article argues that the applicable law by the delegated state (country of refuge) in the case of delegated exercise of jurisdiction is the criminal law of the delegating state.


We compare the quantum mechanical procedures to estimate the total $\ensuremath{\alpha}$-decay width from deformed nuclei in the laboratory and intrinsic systems of coordinates. Our analysis shows that the total half-life estimated in the intrinsic frame by neglecting the rotational motion of the core (adiabatic approach) is one order of magnitude smaller at ${\ensuremath{\beta}}_{2}=0.3$ than the corresponding value in the spherical case. A similar calculation in the laboratory system of coordinates by considering the core motion (giving the correct theoretical estimate) predicts a reduction by only a factor of 2. The widely used ``angular WKB'' (Wentzel-Kramers-Brillouin) semiclassical procedure provides decay widths which are comparable to the adiabatic approach. We propose a new and very simple semiclassical ``angular momentum WKB'' procedure to evaluate the decay width in deformed nuclei. It provides decay widths very close to the ones obtained by the exact laboratory coupling channels procedure.


Educators of the next generation of neurologists will face several challenges, including changes in academic medical centers and hospitals, changes in the scope and practice of neurology itself, and changes in trainees, related to both access to information technology and professional goals. This article, which originated as a lecture given at the A.B. Baker Education Symposium at the 60th annual meeting of the American Academy of Neurology in April 2008, arose out of an attempt to enumerate these challenges and to suggest ways to address them. First, approaches to overcoming challenges will likely require reinvigorating the commitment to teaching in fundamental and concrete ways, including, for example, establishing communities of educators and taking seriously the teaching role provided by clinicians. Second, it is expected that changes in the scope of educational content will be needed. Learning the role of the neurologist in a broader societal context will become an increasingly important part of training. It should be emphasized, as well, that trainees should play an important role in the redesign of neurology training and practice; in fact, their participation in this hidden curriculum constitutes an important part of their education. Third, new information technologies, such as Google, Wikipedias, and podcasting, will likely play an increasingly important role in neurology education. Finally, generational differences in familiarity with these new technologies, and differences in professional and personal goals, may lead to different career opportunities and plans for future neurologists than have been considered the norm in the past.


Growing awareness of the importance of parents and the home environment in shaping children's achievement, coupled with the recognition of the school as a site for engagement in broader aspects of social and personal development, has raised interest in the interactions between these different influences as a way of addressing issues of educational attainment and inequality. This study explores the nature of these links and considers the relative contribution of different aspects of four different 'contexts' or likely spheres of influence on pupil achievement in England at Key Stage 2 (age 10/11), as well as their associations with one another. The results highlight that the quality of each of the different aspects of their lives is important for children's attainment in primary school: pupils with better contexts – i.e. better individual, school and family background and experience – have higher scores in Key Stage 2 assessments in English, maths and science. However, these contexts do not act in isolation, but are closely related to one another, and their influence on children's attainment is affected by these interrelationships. Furthermore, these results indicate that the interaction effects are greater for those with poor quality contexts. This suggests not only that there is scope to narrow the gaps in educational opportunity, but also that, where influence is possible, the greatest likely returns are for those whose background and experience are poor.


Objective. Synovial angiogenesis, a critical determinant of juvenile idiopathic arthritis (JIA) pathogenesis, is sustained by various mediators, including vascular endothelial growth factor (VEGF) and osteopontin (OPN). We characterized the contribution of the local hypoxic environment to VEGF and OPN production by monocytic cells recruited to the synovium in JIA. Methods. Paired synovial fluid (SF) and peripheral blood (PB) samples were collected from 20 patients with JIA. Mononuclear cells (MC) were isolated, and monocytic cells were purified by adherence, maintained in a hypoxic environment, or subjected to reoxygenation. VEGF and OPN protein concentrations were tested in SF, plasma, and culture supernatants by ELISA, and mRNA expression was assessed in freshly purified and cultured cells by reverse transcriptase-polymerase chain reaction. Synovial tissue was obtained at synovectomy from 4 patients with JIA, and analyzed by immunohistochemistry for VEGF, OPN, CD68, and hypoxia-inducible factor-1α (HIF-1α). Results. VEGF mRNA expression was increased in SFMC and SF monocytic cells compared to matched PBMC and PB monocytic cells or SF lymphocytes, correlating with significantly higher protein levels in SF relative to plasma samples. Accordingly, OPN mRNA expression in SF monocytic cells was associated with significant increase of SF protein. Immunohistochemistry revealed the presence of both factors in synovial tissues at the level of the lining and sublining layers, which colocalized with intense CD68 and HIF-1α staining, suggesting production by hypoxic synovial monocytic cells. VEGF and OPN expression was abrogated upon SF monocytic cell reoxygenation and maintained by exposure to prolonged hypoxia. Conclusion. Hypoxic synovial monocytic cells are a likely source of VEGF and OPN in JIA. These data point to a role for hypoxia in the perpetuation of synovitis in JIA.


textabstractPublic health is continually threatened by re- and newly emerging infections, as well as pathogen resistance to available intervention strategies, including vaccines. This persistent threat of the unmet medical need challenges vaccine developers to anticipate future epidemiological outbreaks. Nevertheless, there are insufficient resources available to address all unmet medical needs: developing the average vaccine candidate from the symbolic 'bench to bedside' takes approximately 10 years requiring an investment exceeding €400 million. Furthermore, vaccine development is affected by the so-called innovation paradox. In short; regardless of increasing research and development activities, the predicted output - as measured by successful market entry of the commercialized product - is lacking behind. This situation has intensified over the past few decades and significantly impacts the productivity gap in vaccine valorization. In the view that there is a correlation between health and wealth; it is critical to select the appropriate target disease area for vaccine development.

This dissertation evaluates the innovation paradox in selecting human infectious disease targets for vaccine development. When it comes to selecting the target, there is a distinction between the level at which the infectious disease is manifested (societal-level), and the level at which valorisation takes place (entrepreneurial- and organizational-level). This action-reaction reciprocity between the micro- and macro-level lies at the heart of the innovation paradox. The six research chapters offer an assessment into entrepreneurial- and organizational-level productivity, focusing on strategies that would potentially stimulate and restrict vaccine target selection. Additionally, we propose the valorization process would be more efficient as an all-inclusive cycle, delineating a number of sequential steps from bench-to-bedside and back again. Such a cycle would allow for proper assessment into the available resources, in order to most accurately determine and address the unmet medical need. Nevertheless, it is up to the biopharmaceutical community to demonstrate their innovative capacity within the context of valorization in order to continue to develop safe and effective vaccines for the benefit of public health.


Background: Immunization is one of most cost effective public health intervention. Aims: (1) To assess immunization status among children of 12-23 months age group (2) To find out left out/dropout rate (3) To check association of socio demographic factors with immunization status. Material & Methods: A cross sectional study of sample 240 children aged between 12 to 23 months (using 30 cluster sampling technique) from Jamnagar municipal corporation area. Immunization of child was assessed through immunization card, presence of BCG scar & interview. Results: Out of 240 children, Coverage of BCG-99.58%, OPV0-94.58%, DPT1-98.33%, DPT2-96.67%, DPT395.42%, OPV1-96.67%, OPV2-95.83%, OPV3-4.58%. Coverage of HepB1, HepB2, and HepB3 were 73.33%, 70.42%, 68.75% respectively. Coverage of measles was 87.75%. Fully immunized children were 65%. Vaccine dropout of BCG-Measles was highest 11.34%, followed by DPT1-measles 10.58%. For BCG-DPT3 4.17%, DPT1DPT3 2.96% & for HEP1-HEP3 6.25%. Fully immunized status was higher among male child as compare to female child which was statistically significant. Fully immunized children were more in Hindu religion compared to others which was statistically significant. No association found between educations of mother & immunization status of child. Socioeconomic class had no association with immunization status. Conclusion: Vaccination coverage shows gradual improvement in last decade (Fully immunized 65%) but at the same time reflects incomplete utilization (dropout rate is around 11%). Coverage was higher among male children as compared to female children which indicate the existence of gender difference in utilization of immunization services in our study areas. Utilization of immunization services was higher in Hindu community as compared to other community.


The socioeconomic factors have crucial effects on health inequality. The unequal distribution of socioeconomic factors may lead to the health inequality. This study aimed to determine and give priority to the socioeconomic factors affecting health in Iran in the experts' point of view. This study was a sequential mixed methods research conducted in quantitative and qualitative phases. The study population consisted of 16 policymakers and experts in the field of economic and social determinants of health. The purposive stratified non-random sampling method was employed. The qualitative data were collected in a semistructured interview and giving priority to factors was conducted using multiple criteria decision making with the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method. The qualitative phase showed that the main socioeconomic factors determining health were the economic factors, income, education, sex, social class, and employment. The data analysis in TOPSIS technique showed that priority parameters were income, employment, and economic factors with coefficient of 0.66, 0.60, and 0.55, respectively. Paying attention to the socioeconomic factors may result in the increased equity and eventually the promoted public health. It is essential for policy makers to take this approach into account and improve the socioeconomic factors for attaining the promoted health outcomes.


Humans have a natural desire to keep a certain physical distance from other humans.
This distance is called personal space (or personal distance). Edward T. Hall (1966) describes
it as a distance of 45 to 120cm kept from each other, a which people can touch if they extend
their arms and see each other clearly, but not asa whole. Humans always try to keep this
minimum distance to strangers, but might let familiar people closer, depending on their
relationship. If personal space isinvaded without consent it comes to physical reactions such
as increased heart rate, sweating and increased blood pressure (Middlemist and Knowles,
1976). We simply feel uncomfortable when others come too close.
Personal space is well described for standing and seated test subjects (e.g. Newman
and Pollack, 1973; Thompson et al., 1979;Hayduk and Mainprize, 1980; Hayduk, 1981;
Strube and Werner, 1984; Evans and Wener, 2007; Robson, 2008), but not for walking
people. Gerin-Lajoie and his colleagues (Gerin-Lajoie et al., 2006; Gerin-Lajoie et al., 2008)
described minimum distances that pedestrians keep from stationary and moving obstacles,
which were used as a basis for this study. Using a newly developed system called CCB
Analyser the walking patterns of pedestrians in an Austrian shopping center were recorded.
Data included number and frequency of people,average speed, speed changes and number of
speed changes, direction changes and number of direction changes, and two different
measures for personal space, one being personal space in circles around stationary recording
frames and the other being personal space for pedestrians that plan their paths ahead.
The tested hypothesis was that high density and low interpersonal distance leads to a
change of walking behavior – increasing walking speed because of stress (Konecni et al.,
1975) and making people change their speed and directions whenwalking. The results of the
present study show that all measured variables seem to highly depend on each other. We
could at least partly confirm the hypothesis ofpeople walking faster when personal space is
51
invaded. People changed their walking speed and direction to a higher degree at high
densities, however the percentage of people changing their walking behavior was the same or
even smaller.
These results offer a first insight into the relationship of human walking behavior and
personal space, but much more research needs to be done on this topic.


Minority racial and ethnic groups often view themselves as targets of abusive treatment at the hands of the police. Although racial variation in public assessments of the police in the United States has been amply documented in past research, less research has explored the sources of these differences at the intersection of demographic, interactional, and ecological levels. This article examines the role of each factor in shaping citizens' perceptions of police misconduct, racial differences in these perceptions, and the reasons underlying them. The locus of the study is also important. Most research on police–community relations has been conducted in cities whose populations and police departments are majority White in composition, despite the growing number of minority-White cities. The present study draws on data from residents of a majority-Black city with a majority-Black police department: Washington, DC. The findings contribute to our understanding of policing in such underresearched cities.


National innovativeness is one key driver of economic development. The relation of national innovativeness and national culture has been firmly established by research. Cultural factors, however, influence national innovativeness via different mechanisms on the macro-, meso-, and micro-level of a country. In our article, we build on existing research on the link between cultural dimensions and national innovativeness to develop a new model that classifies different cultural dimensions in groups according to their mechanism: political, social, or individual (PSI-model). Using a newly established data set composed of world data, we test and find support for this model using a variety of regression models. The PSI-model provides a more structured theoretical background of the impact of different cultural dimensions on national innovativeness, especially with regard to social practices and social values. It can be used to generate policy recommendations on national innovativeness and offers further applications in fields related to the various impacts of national culture.


As a new strategy for drug discovery and development, we propose here the establishment of drug re-profiling strategy. In this strategy, the actions of existing medicines, whose safety and pharmacokinetic effects in humans have been confirmed already, are examined comprehensively at the molecular level and the results are used for the development of new medicines. For example, identification of the mechanisms underlying the side effects of medicines enables us to develop safer drugs. The results can also be used for developing existing drugs for use as medicines in treatment of other diseases. Promoting this research strategy could provide breakthroughs in drug discovery and development by pharmaceutical companies.


Previous studies showed that lung and skin mast cells do not contain eosinophil granule major basic protein (MBP). However, MBP has been localized by immunofluorescence to mast cells from a recently established human mast cell line. Analysis of MBP in human mast cell-1 cell lysates by radioimmunoassay showed immunochemical similarity to eosinophil MBP as judged by comparison of dose-response regression lines. Based on these findings and other new information about mast cell heterogeneity, we tested whether mast cells contain MBP. Mast cells were preserved in Carnoy's fixative and were identified by staining with rhodamine-conjugated avidin or for chloroacetate esterase or aminocaproate esterase activity. MBP was localized by immunofluorescence to mast cells in 6 of 7 nasal polyps, 4 of 4 ileal tissue specimens, and 12 of 14 cutaneous mastocytosis specimens. Furthermore, by immunoelectron microscopy MBP was localized to mast cell granules in cutaneous mastocytosis lesions. In contrast, normal skin mast cells preserved in Carnoy's fixative did not contain MBP. After injection of MBP into normal skin and fixation in Carnoy's fluid, mast cells became MBP-positive within 3 minutes, suggesting that endocytosis of MBP by mast cells had occurred. These results suggest that human mast cells in several tissues may sequester toxic eosinophil proteins by endocytosis.


must be given (and this is partly why the service is expensive) to allow the couple to express any fears and anxieties they may have about the methods, and to help them choose the method best suited to them. Also, poorly motivated couples need constant encouragement and reassurance if they are to persevere with contraception as they are less tolerant of side effects. In Haringey special problems exist (found also in Birmingham and Wandsworth) in that there is a large immigrant population, mostly West Indian, Irish, and Greek Cypriot, with differing cultures which have to be taken into account when birth control advice is given. Domiciliary family planning should be regarded as preventive medicine-families where it is successful are better able to care for the well-being of their children. While it is to be hoped that the increasing liberalization of attitudes will continue there will still be a need for "individual and sympathetic family planning advice," to use Dr. Wilson's words, to be brought to the homes of a small but disproportionately problemridden section of the population.-I am, etc.,


A methodology and a macro-modelling approach are presented for analysing low-level current dynamics at the instruction and program level for a complex VLIW DSP processor core. An instruction-level macro-model, whose input parameters can be extracted from the DSP core's assembly level program, is introduced for power modelling. For the first time, dynamic power models of algorithms are introduced and verified with real power measurements of a DSP processor core in a VLSI chip. Results from both cryptographic and bubble sort applications show that dynamic power can be modelled with an average error in energy estimation ranging from 0.3% to 9.7%. The instruction-level macro-model of power also supports different clock frequencies and compressed algorithmic traces, important for security aware compilers. In general, the research is important for analysing and modelling the impact of software on power, the design of embedded cryptographic VLSI systems that are safe from power attacks, and for reliable design by detecting the peak current values generated by the software application.


The purpose of this paper is to document university student perceptions of the status of water resources in the Pacific Northwest. Water resource perceptions of 7,400 students at the University of Idaho (Moscow, ID, USA) were measured between 1993 and 2014. As part of a learning assessment study students in the large freshman environmental science class were asked several questions about the environment in a standardized survey on both the first and last day of class. In this way changes in student perceptions as a result of the course could be quantified. This survey included several questions about water resources, including water quantity, water quality and drinking water. For each statement in the survey students were asked to choose one of the following answers: (1) strongly agree, (2) agree, (3) no opinion, (4) disagree, or (5) strongly disagree. Key findings of this study include: (1) most students initially believed that water pollution had increased in the last 25 years; however, after the class they believed that water pollution had decreased; (2) students did not consider water shortages a serious problem in the region; (3) student views changed from not emphasizing to emphasizing the need for water conservation in homes and yards; (4) over threequarters of students that took this class believe that water from the tap in cities was safe to drink; and (5) students changed their views on bottled water – a majority disagree that bottled water is safer than tap water. Student major, gender, and year surveyed (1994 vs. 2014) also had an impact on student answers.


Background Triple therapy (anticoagulation plus corticosteroids plus plasma exchange and/or intravenous immunoglobulins) is empirically prescribed for the management of catastrophic antiphospholipid syndrome (CAPS). However, previous analyses have been inconsistent regarding the beneficial effect of triple therapy on patients' survival. Objectives The objective of this study was to assess the effect that triple therapy has on the mortality risk of CAPS patients. Methods In a cohort including 525 episodes of CAPS (CAPS Registry), we evaluated the relationship between triple therapy and mortality. Patients were grouped in three based on their treatments: a) triple therapy (anticoagulation plus corticosteroids plus plasma exchange and/or intravenous immunoglobulins); b) drugs included in the triple therapy but in different combinations; c) none of the treatments included in the triple therapy. The primary endpoint was all-cause mortality. Multivariate logistic regression models were used to compare mortality risk between groups taking into account a set of possible confounding variables. Results The "CAPS registry" cohort included 525 episodes of CAPS accounting for 502 patients. After excluding 38 episodes (7.2%), a total of 487 episodes of CAPS accounting for 471 patients (mean age 38 years; 67.9% female; primary APS patients 68.8%) were analyzed. Overall, 177 (36.3%) patients died. Triple therapy was prescribed in 197 episodes (40.5%), other combinations in 278 (57.1%), and none of those treatments in 12 episodes (2.5%). According to these three groups, mortality rate increased up to 27.9%, 40.6%, and 75%, respectively. Triple therapy was positively associated with a higher chance of survival when compared to non-treatment (adjusted odds ratio [OR]: 7.7 95%; confidence interval [95CI] 2.0–29.7) or to treatment with other combinations of drugs included in the triple therapy (adjusted OR 6.8; 95CI 1.7–26.9). Triple therapy accounted for a 64% decrease of the risk of death in patients with CAPS that received this combination of drugs. Conclusions Triple therapy is independently associated to a higher survival rate among CAPS. Acknowledgements To the CAPS Registry Project Group (European Forum on Antiphospholipid Antibodies). Disclosure of Interest None declared


P2X4 and P2X7 receptors are ATP-gated ion channels, which play important roles in neuropathic and inflammatory pain, and as such they are important drug targets in diseases of inflammatory origin. While several compounds targeting P2X4 and P2X7 receptors have been developed using traditional high-throughput screening approaches, relatively few compounds have been developed using structure-based design. We initially set out to develop compounds targeting human P2X4, by performing virtual screening on the orthosteric (ATP-binding) pocket of a molecular model of human P2X4 based on the crystal structure of the Danio rerio receptor. The screening of a library of approximately 300,000 commercially available drug-like compounds led to the initial selection of 17 compounds; however, none of these compounds displayed a significant antagonist effect at P2X4 in a Fluo-4 ATP-induced calcium influx assay. When the same set of compounds was tested against human P2X7 in an ATP-stimulated Yo-Pro1 dye uptake assay, one compound (an indeno(1,2-b)pyridine derivative; GP-25) reduced the response by greater than 50% when applied at a concentration of 30 µM. GP-25 displayed an IC50 value of 8.7 μM at human P2X7 and 24.4 μM at rat P2X7, and was confirmed to be active using whole-cell patch clamp electrophysiology and not cytotoxic. Schild analysis suggested that mode of action of GP-25 was orthosteric. Screening of a further 16 commercially available analogues of GP-25 led to the discovery of five additional compounds with antagonist activity at human P2X7, enabling us to investigate the structure-activity relationship. Finally, docking of the R- and S-enantiomers of GP-25 into the orthosteric pocket of molecular models of human P2X4 and human P2X7 revealed that, while both enantiomers were able to make multiple interactions between their carboxyl moieties and conserved positively charged amino-acids in human P2X7, only the S-enantiomer of GP-25 was able to do this in human P2X4, potentially explaining the lack of activity of GP-25 at this receptor.


Abstract. Positive ionospheric storm effects that occurred during the superstorm on 20 November 2003 are investigated using a combination of ground-based Global Positioning System (GPS) total electron content (TEC), and the meridian chain of ionosondes distributed along the Latin America longitude of ~280° E. Both the ground-based GPS TEC and ionosonde electron density profile data reveal significant enhancements at mid-low latitudes over the 280° E region during the main phase of the November 2003 superstorm. The maximum enhancement of the topside ionospheric electron content is 3.2–7.7 times of the bottomside ionosphere at the locations of the ionosondes distributed around the mid- and low latitudes. Moreover, the height of maximum electron density exceeds 400 km and increases by 100 km compared with the quiet day over the South American area from middle to low latitudes, which might have resulted from a continuous eastward penetration electric field and storm-generated equatorward winds. Our results do not support the conclusions of Yizengaw et al. (2006), who suggested that the observed positive storm over the South American sector was mainly the consequence of the changes of the bottomside ionosphere. The so-called "unusual" responses of the topside ionosphere for the November 2003 storm in Yizengaw et al. (2006) are likely associated with the erroneous usage of magnetometer and incomplete data.


Abstract The taxation system is most certainly one of the main pillars of economic development towards sustainable growth.The aim of this paper is to critically assess the importance of an effective Tax System, its impact on the Albanian economy. Furthermore we shall outline a comparison of the Albanian Tax system to that of the United Kingdom. At this time a number of very important reforms are being undertaken by the government of Albania in light of future integration towards the European Union.The overview on the United Kingdom has the aim to enlighten the path on what should be our focus while building a Tax System that can help economic growth, to that effect Great Britain as a country of a stable and strong economy can be of example.Many differences can be noticed between the United Kingdom tax system and the Albanian one. This fact is simple to be accepted as Britain is one of the world superpowers, while the Albanian economy is a developing one. The tax systems in these two countries, the development history, application of VAT or Income Tax have had very different processions.The United Kingdom has one of the most voluminous Tax Acts in the world. The international company of legal research "LexisNexis" discovered that the Acts of Parliament on Taxation in the United Kingdom have more than doubled since 1997. The annual amendments to taxation are part of the Finance Act which has the power to change norms and principles of taxation as previously defined. Taxation in the United Kingdom usually includes payments for central government agencies called Her Majesty's Revenues and Incomes and local councils. Local Councils collect a tax called business norms from businesses. The Albanian Taxation System consists of a packet of laws, regulations, guidance and tax agreements, on the procedure of application, measure, amendment and removal of taxes.Taxes are the main source of income in the state budget and the local government budget and the foundation of the whole Albanian tax system. In conclusion, we shall analyze the impact of the frequent changes to Taxation Law within the Albanian system and the challenges faced in light of this changes in terms of implementation and application.


Two studies were conducted to further our understanding of the inherited condition in mice known as C57BL/6J-Y(POS) (B6-Y(POS)) sex reversal. One study determined what proportion of B6 XY(POS) mice develop as females or hermaphrodites. We found that 75% develop as females and the remainder develop as hermaphrodites regardless of whether the analysis is conducted at 14.5-16 days of embryonic development (based on gonad phenotype) or at weaning (based on the appearance of external genitalia and presence of mammary-associated yellow pigmented hair). We also found that 75 % of the gonads in B6 XY(POS) mice develop as ovaries and the remainder develop as ovotestes; none develop as a testis. We conclude that if any testicular tissue develops, sufficient testosterone is produced to cause at least some masculinization of the external genitalia. The second study tested the hypothesis that development of testicular tissue in B6 XY(POS) mice is due to the presence of a POS-derived gene, whereas B6 homozygosity of this gene guarantees ovarian development. The results did not support the POS gene theory. Therefore, we conclude it is a matter of chance that 75 % of B6 XY(POS) mice develop as females and 25 % develop as hermaphrodites.


In the Australian Capital Territory during 2008–09, the diet of breeding Wedge-tailed Eagles Aquila audax consisted of 65 per cent mammals, 33 per cent birds and 1 per cent reptiles by number (n = 94 prey items from 10 nests), of which 19 per cent consisted of macropods, 34 per cent rabbits (mostly adults, plus 4% hares), and a range of other large mammals, many probably eaten as carrion. Breeding Little Eagles Hieraaetus morphnoides took 52 per cent mammals, 45 per cent birds and 3 per cent reptiles by number (n = 58 prey items from six nests), of which 2 per cent consisted of macropod (one small joey kangaroo) and 50 per cent rabbits (mostly juveniles). Both eagle species took more rabbits in 2008–2009, compared with two earlier periods in 2002–2003 and 2004–2007. By biomass Wedge-tailed Eagles took 93 per cent mammals (20% rabbits, 45% macropods); Little Eagles took 73 per cent mammals (almost entirely rabbits) and 24 per cent birds. Geometric Mean Prey Weight for Wedge-tailed Eagle prey was 1650 grams, for Little Eagles 337 grams. Standardised food niche breadth was 0.205 for Wedge-tailed Eagles, and narrower (0.143) for Little Eagles. The Shannon Index for Wedge-tailed Eagles was 2.75, for Little Eagles 2.28. Although a Pianka Index suggests 46 per cent overlap in prey used by the two eagles, the great diff erence in GMPW and heavy use of rabbits by Little Eagles suggest that there is little interspecifi c competition for prey. Little Eagles may be declining in the ACT because rabbits, their main prey, are poisoned, and this poisoning may aff ect Little Eagles more than some other raptors.


Dr. A. Parker writes: Dr Hancock claims that in the Brent Sand there is an inverse correlation between authigenic illite and authigenic kaolinite, and considers that the illite is forming by progressive alteration of the kaolinite with increasing depth. He does not believe there to be a significant amount of detrital clay present. Except in the case of the Upper Brent sand, this correlation is far from obvious by simple visual inspection of the data, and some quantification would appear necessary. Furthermore, Dr Hancock has not determined the mineralogy of the shales that are interbedded with the sandstones. In a similar investigation, I have found that the clay mineralogies of adjacent shales and sandstones are often identical, both qualitatively and quantitatively. Although there may be some clay authigenesis in these Jurassic shales, it is reasonable to assume that most of their clay mineral component is detrital in origin, the Scandinavian platform having contributed fair amounts of kaolinite. I have found that it is very easy to overestimate the proportion of authigenic clay in such studies; when using the SEM in particular, it is far easier to identify well-crystallized material than poorly crystalline or amorphous material, and one tends to be influenced by this in making visual estimations of relative proportions. In my experience, partial recrystallization and re-distribution of detrital clay-sized material, particularly in pore throats, are usually more significant in permeability reduction than authigenic kaolinite, which generally forms in actual pores. A Parker, Sedimentology Research Laboratory, The University, Whiteknights, Reading,


For the upcoming Solvency II framework, the Smith-Wilson method constitutes the extrapolation technique for valuing long-term liabilities. Next to the Smith-Wilson method this paper considers three other methods to extrapolate the long end of the Euro yield curve. Two of them belong to the popular Nelson-Siegel family and the other represents the equilibrium class of interest rate term structure models. Evaluated by the models' ability to reduce volatility for long-term yields and by their extrapolation errors, the Smith-Wilson method performs best. Unlike the other methods, it does not require parameter estimations. Only since mid-2011, when yields have shifted to unprecedentedly low levels, the Smith-Wilson method deteriorates and the Nelson-Siegel model exhibits substantially better tted extrapolations.


STUDY OBJECTIVE
To identify brain regions underlying the fastest and slowest reaction times on the Psychomotor Vigilance task (PVT) under well-rested conditions, as well as brain regions related to particularly poor performance after sleep deprivation.

DESIGN
Subjects took the PVT twice while undergoing functional magnetic resonance imaging: once 12 hours after waking from a normal night of sleep and once after 36 hours of total sleep deprivation (TSD). Session order was counterbalanced.

SETTING
UCSD J. Christian Gillin Laboratory for Sleep and Chronobiology (the sleep core of the General Clinical Research Center) and UCSD Magnetic Resonance Institute.

PATIENTS OR PARTICIPANTS
Twenty right-handed healthy adults (8 women; age = 27.4 +/- 6.7 years; education = 15.6 +/- 1.5 years).

MEASUREMENTS AND RESULTS
After a normal night of sleep, optimal performance was related to greater cerebral responses within a cortical sustained attention network and the cortical and subcortical motor systems. Slow reaction times, particularly after TSD, were associated with greater activity in the "default mode network" consisting of frontal and posterior midline regions.

CONCLUSIONS
Optimal performance on the PVT appears to rely on activation both within the sustained attention system and within the motor system. Poor performance following TSD may result from a disengagement from the task and related inattention, and brain regions responsible for this localize within midline structures shown to be involved in the brain's "default mode." Finally, particularly poor performance after TSD may elicit a subsequent attentional recovery that manifests as greater activation within the same regions normally responsible for fast reaction times.


This paper makes an empirical contribution to recent debates about the causes and consequences of rising market concentration, in which two polar views have surfaced: the ''winner-takesall'' approach and the ''market power'' approach. The former sees rising market concentration as an inherent part of the innovative and productive drive of market economies, with no substantive change in market power whatsoever, whereas the latter views rising market concentration and market power as two simultaneous phenomena feeding off each other, and adversely affecting innovation and overall economic performance. To contribute to differentiate empirically between these two approaches, this paper proposes a new methodology to measure the magnitude of surplus profits, as in both Classical and Marxian traditions, and the persistence of these over time. It then presents global estimations based on firm-level accounting data for 56 developed and developing countries. The paper finds that the share of surplus profits in total profits has increased from an average of 7% in 1995-2000 to 25 % in 2009-2015, and from 24% to 42 % for the 1% most profitable companies. It also reports increasing market concentration and strong profit persistence among top corporations over time.


The article deals with the analysis of failure probability of the effect of random factors in uencing fatigue crack propagation in a steel element under bending moment. The theoretical model of fatigue crack progression is based on linear fracture mechanics. When determining the required degree of failure probability, it is possible to specify the time of the first inspection of the construction, which will focus on the fatigue damage. Using a conditional probability, subsequent inspection times are specified. The failure probability is examined using a fairly new sensitivity analysis subordinated to a contrast. The importance ranking of the input random variables to the failure probability is investigated. Fatigue properties of steel are taken from recent experimental research. Numerical results are obtained using the Monte Carlo simulation.


In the present study, we evaluate the N2+/OH emission intensity ratio as a diagnostic tool for identifying the best instrumental operating conditions in microwave-induced plasma optical emission spectrometry (MIP OES). This molecular species signal ratio is compared with the traditional Mg II/Mg I ratio. Aluminum, Ba, Mn, Sr and Zn (analytes), and high concentrations of C, Na, Ca, HNO3 and HCl (sample matrices) are used as models to investigate the effects of complex matrices on analyte recoveries. The N2+/OH signal ratio is more sensitive to changes in plasma conditions than the Mg II/Mg I ratio. Some other advantages include real-time monitoring capabilities, and the possibility of independently tracking variations in both plasma and sample introduction. For less complex matrices, the N2+/OH signal ratio may be used for instrument optimization, which ensures plasma conditions are as similar as possible when analyzing standard solutions and samples. For analyses involving severe matrix effects, molecular species such as CN, N2, N2+ and OH are used for signal correction. Significant improvements in accuracy are achieved by employing the analyte-to-molecular species signal ratio, or their product, for calibration. Both the use of the N2+/OH signal ratio as a diagnostic tool, and of molecular species for signal correction to minimize matrix effects are simple strategies that may significantly contribute to expanding the analytical capabilities of MIP OES and facilitating its application in routine analysis.


Since 1986, two West African countries have been delivering immunizations within the framework of reorganized peripheral health systems. This revitalization is based on strategies which are implemented by an increasing number of African countries under the name «Bamako Initiative». It aims at providing universal access to a minimum package of maternal and child health priority interventions starting with immunizations, pre and perinatal care, oral rehydratation for diarrhoea, treatment of malaria and acute lower respiratory infections. Within this package, immunization has been given high priority. Several strategies aimed at improving immunization coverage have been implemented: services have been reorganized so that any child or woman making contact with the health system receives immunization if needed. Health information systems have been revised so as to allow for active individual follow up and better management of health centre resources. Health staff have been given training in management and a biannual monitoring/microplanning process at health centre level has been introduced. The goal of monitoring is to enable health personnel to identify the obstacles to attaining optimum coverages with the priority interventions and to select locally appropriate corrective strategies. Health centres have also been provided with a motorcycle allowing for regular outreach activities. To cover the running costs of the services (mainly restocking of drugs, running and maintenance of the cold chain and the motorbike, and staff incentives), financial contribution from local communities have been sought through a fee-for-treatment system. Prices have been set at an affordable level by limiting the number of drugs to a minimal list purchased under generic names by international tendering procedures. Standardized flow charts for diagnosis and treatment have helped to decrease further the cost of treatment. A major element in the sustainability of the system is active community participation, through management committees, in the decision-making process for choice of strategies and management of financial and other resources. Around 60% of health centres in Benin and 80% in Guinea are currently operating these strategies. Immunization coverages have been steadily increasing in both countries reaching, for DTP3 in 1993, 75% in Benin and 63% in Guinea. There are among the best performances in Africa. Although some issues remain to be addressed such as quality of the services, continuing underutilization of services, depreciation of local currencies, these two countries seem to have succeeded in creating solid foundations for a revitalized and viable peripheral health system. Using this approach, the attainment of the EPI mid-decade goals and end-of-the century world summit goals seem feasible.


Abstract:The reception of Joe Brainard's work, recently canonized in a comprehensive Library of America collected edition, has long been organized around a surprising rubric: the author's niceness. Although it might seem that sidestepping the hagiographic attention to Brainard as a friend might be necessary to achieve a more accurate sense of his significance as an artist and author, this essay argues on the contrary that Brainard's friendliness is in fact central to his aesthetics. The problem is not the attention to Brainard's niceness but rather the assumption that this quality is a feature of his character rather than a particular sort of affective and poetic labor. Brainard's work thematizes the relationship between generosity and creativity in ways that run parallel to Eve Sedgwick's account of reparative reading, and his experiments raise similar questions about what it means to interpret the relation between sexuality and the aesthetic. "Friending Joe Brainard" considers these parallels through a close reading of Brainard's most important literary work, the queer memoir I Remember, suggesting that Brainard mobilizes a queer form of tact to present a model of sexuality organized not around stigma and shame but rather around milder forms of embarrassment.